Congress is set to ban most surprise medical bills • Hacker News Board

Re: Congress is set to ban most surprise medical bills

#91

Post by Dirlewanger » Mon, Dec 21, 2020, 4:56 PM UTC

curiousgal wrote: post #21

lordnacho wrote: post #11

> Surprise bills happen when an out-of-network provider is unexpectedly involved in a patient’s care. Patients go to a hospital that accepts their insurance, for example, but get treated there by an emergency room physician who doesn’t. Such doctors often bill those patients for large fees, far higher than what health plans typically pay. How do courts uphold this? You go to a restaurant, they say you can buy the tas…

It's just appalling to see a nation as smart, rich and well accomplished as the U.S. being straight up retarded when it comes to healthcare.

Americans are taught that they can do anything they want, which includes fucking over others if they can get away with it. We're educated to only be leery of the government, but are clueless on how corporations run the country. Many don't care. They'll defend it as their right to do so or through some other contrived coping gymnastics.

Re: Congress is set to ban most surprise medical bills

#92

Post by [deleted] » Mon, Dec 21, 2020, 4:57 PM UTC

lotsofpulp wrote: post #88

yboris wrote: post #85

Earlier quoted context omitted.

> Try getting a price for a procedure or visit beforehand "I tried to find out how much my son’s birth would cost. No one would tell me." [0] [0] https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bi...

The answer is always “your out of pocket maximum” if it’s all done with in network providers, and infinity if any out of network providers are involved.

[deleted]

Re: Congress is set to ban most surprise medical bills

#93

Post by AlexandrB » Mon, Dec 21, 2020, 4:57 PM UTC

lacker wrote: post #76

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

We don't have a free market in health care at all. In a free market you would be able to buy a coronavirus vaccine right now, instead of waiting months to get it for free. We haven't had a "free market" in health care in my lifetime.

Are you suggesting that it's better to distribute the vaccine in a way that keeps those most likely to get it vulnerable for longer (i.e. inefficiently)? What's exactly is the benefit of a free market in a situation where it's less efficient at allocating resources than central planning?

Re: Congress is set to ban most surprise medical bills

#94

Post by jrumbut » Mon, Dec 21, 2020, 4:58 PM UTC

leetcrew wrote: post #31

kayodelycaon wrote: post #9

> Some private-equity firms have turned this kind of billing into a robust business model, buying emergency room doctor groups and moving the providers out of network so they could bill larger fees. If this doesn’t describe evil, I don’t know what else would.

I wouldn't reject this out of hand, but I do find that the complexities around healthcare and the obvious political implications lead to a lot of exaggeration and outright falsehoods being propagated. it's my understanding that the affordable care act requires insurers to treat any emergency services (if covered at all) as in-network. can anyone explain either a.) how I am wrong, or b.) how this can be circumvented?

Regarding how it can be circumvented, insurance companies, in my experience, try to say that this or that service was not actually part of the emergency.

For instance, they may want to begin some of the long term maintenance of your new condition while you're still in the hospital. Whether the insurance company is successful or not, they may at least try to say this isn't covered.

Eventually, you and your loved one are dealing with one of the worst moments of your life, how much time do you have to fight all their attempts at not paying your benefits? Keep in mind the fights happen during business hours, and you just missed four weeks of work and need the job to keep the insurance you now need more than ever.

Laws that reduce the number of ways insurance companies can avoid paying will be helpful.

Re: Congress is set to ban most surprise medical bills

#95

Post by [deleted] » Mon, Dec 21, 2020, 4:58 PM UTC

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

[deleted]

Re: Congress is set to ban most surprise medical bills

#96

Post by vasco » Mon, Dec 21, 2020, 5:00 PM UTC

JacobSuperslav wrote: post #42

bearjaws wrote: post #25

Having gone through cancer treatment here in the USA, I have received over a dozen 'after the fact bills' over the past 5 years, sometimes over 9months after the procedure, mainly involving blood work and CT scans. I missed one bill that came months after chemotherapy for $87 in 2015, it only had a 60 day notice before sending to collections. Mind you I was on disability from my employer that paid well. -80pts on my…

how come in Europe credit score isn't really a thing and everything works fine? that's another thing that needs to go

There are credit scores in some places in Europe, mostly in the form of lists of people that may have failed to pay something in the past. It's a pain in the ass to correct if you get there by mistake and it's very opaque. Overall credit scores seem like a great idea with a terrible implementation. In general you as a mindful consumer that pays your bills on time wouldn't want to be paying the same prices for loans (spread, interest) as other consumers that have a history of not paying. A well functioning credit score system makes for a more efficient lending market, allowing consumers to save money if they have a good track record. How it actually works in practice is a joke, though.

Re: Congress is set to ban most surprise medical bills

#97

Post by lotsofpulp » Mon, Dec 21, 2020, 5:02 PM UTC

amelius wrote: post #67

lordnacho wrote: post #11

> Surprise bills happen when an out-of-network provider is unexpectedly involved in a patient’s care. Patients go to a hospital that accepts their insurance, for example, but get treated there by an emergency room physician who doesn’t. Such doctors often bill those patients for large fees, far higher than what health plans typically pay. How do courts uphold this? You go to a restaurant, they say you can buy the tas…

Some people wear a tag with their blood group on it. Perhaps we should be wearing tags with the amount of money we're willing to spend on a hospital visit.

I have joked before that I should wear an undershirt that says “Healthcare accepted only by in network providers . If out of network, stay away and let me die”.

Re: Congress is set to ban most surprise medical bills

#98

Post by colejohnson66 » Mon, Dec 21, 2020, 5:02 PM UTC

lacker wrote: post #78

jrumbut wrote: post #52

Earlier quoted context omitted.

It's worse than that, my wife got one of these bills from a provider who was never in her hospital room. The bill ended up getting waived but it was for more than the rest of the stay.

Yeah, we got a bill from the hospital once with a footnote saying, some of these procedures may have actually been for another patient, not for you, we don't have complete records. But your insurance agreed to pay it, so we recommend you don't worry about it.

How is that not straight up fraud? If you don’t know if a procedure was for me or someone else, you’re lying by billing me!

Re: Congress is set to ban most surprise medical bills

#99

Post by dpayonk » Mon, Dec 21, 2020, 5:04 PM UTC

WrtCdEvrydy wrote: post #81

tehjoker wrote: post #47

Earlier quoted context omitted.

Price discovery doesn't help you. If you get knocked out, heart attack, your arm cut off, whatever (i.e. a lot of the expensive stuff) you just go to the nearest hospital, no consumer market finagling is even possible other than trying to live near a good hospital. Other times with chronic conditions where theoretically price discovery could help, the problem is that you need care badly so all the chronic care provid…

The biggest fuck you is that Medicare can't negotiate.. it's actually written into the law.

I believe that’s specific to drug prices. Services are interesting in that they just dictate it.

Re: Congress is set to ban most surprise medical bills

#100

Post by iaw » Mon, Dec 21, 2020, 5:04 PM UTC

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

> has turned me from a pure free market thinking into a believer in single payer healthcare

The current trend in 'free-market economics' is to call captured markets free and then argue for the relatively lax regulation.

Most markets are not free markets and the healthcare definitely isn't. There's very little true choice, participants are typically under duress when seeking expensive services, and prices are hidden.

If there was ala-carte transparent pricing and no insurer lockouts things may be a bit better.

My suspicion is that Private Equity has been funneled in healthcare for two decades intentionally distorting the market behaviors for increased profitability which is why the US has such excessive healthcare costs without any apparent justification.