by grammarnazzzi on 1/24/22, 2:40 PM with 90 comments
by maxverse on 1/24/22, 3:33 PM
The patients in these stories seem well-intentioned and well-prepared. They double check that their doctors are in-network. They triple-check what charges they should expect. But there's always a gotcha. There's always some hidden, between-the-lines reason hospitals come up with to charge you, and insurance won't cover. In one story, the surgeon invited an out-of-network surgical assistant into the surgery, without notice. In another [2], the labor and delivery department was classified as an ER, for a completely routine delivery.
When these charges are dismissed, it's always because NPR reached out for comment, and the hospital backs down, presumably because of the bad PR.
The unpredictably and seemingly arbitrary nature of medical charges makes me feel... queasy. And scared to seek medical help, which I know is what insurance companies want. Even with great insurance, which I'm lucky to have, it feels like there's nothing I can do to prevent medium-to-insane charges. The only way I can think of to try and combat medical billing is to retain a lawyer.
[1] https://www.npr.org/series/651784144/bill-of-the-month
[2] https://www.npr.org/sections/health-shots/2020/07/22/8919096...
[3] https://www.npr.org/sections/health-shots/2021/10/27/1049138...
by syki on 1/24/22, 3:27 PM
EDIT: I know the U.S. healthcare system isn’t a totally free market. We’ve designed a system that isn’t government run but has mandates like ERs having to see patients. Half the country labels anything that isn’t government run as free market and anything that is government run as communism. These are proxy words.
If you want a healthcare system that isn’t government run but that has a semblance of “free market” in it but that also “treats” most people this is what you get. Well, it’s what our system has morphed into.
by awinter-py on 1/24/22, 4:09 PM
(per this https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bill...)
The hospital in the article has a price transparency page here https://www.ssmhealth.com/resources/patients-visitors/pay-my... (behind multiple TOS of course). It seems to use epic / mychart. I used it to search for 'facility' and 'emergency' and got nothing. the embedded pdf bill calls this 'emergency services'.
My guess is that ER facility fee isn't a 'shoppable service' under CMS definitions because it can't be scheduled in advance, but the fact that it doesn't say 'abandon $800 ye who enter here' on the front door IMO should be a crime.
by dfxm12 on 1/24/22, 3:25 PM
2. Never use it because even though you have no idea what you're going to be charged, you know it is going to be outrageous, even though you have insurance to cover medical bills
What a racket...
by duped on 1/24/22, 3:41 PM
by grammarnazzzi on 1/24/22, 2:48 PM
What nonsense.
This argument is effectively charging a rent without the consent or agreement of the renter (the community).
If the service were reasonable, the community would agree to them. They are not, so the hostipital instead games the insurance system and preys on individuals without the resourses/ability to defend against their predation
by mfer on 1/24/22, 3:24 PM
For example, many procedures at a hospital lose the hospital money. They don't cover the cost. Other things cost more and make up the difference.
Another element is that most US hospitals are very inefficient in what they do. In the book The innovator's prescription you can read the technical details on how those inefficiencies happen.
by irrational on 1/24/22, 3:35 PM
by gedy on 1/24/22, 4:01 PM
by ProAm on 1/24/22, 3:37 PM
by whiddershins on 1/24/22, 3:24 PM
So where does the money go? Is it going to treat people who end up not paying? Is it going to buy expensive diagnostic equipment?
Where does it go? No one seems to know.
by theandrewbailey on 1/24/22, 4:08 PM
by jimbob45 on 1/24/22, 3:40 PM
I'm getting a bit tired of these anti-US healthcare posts day after day. Sure, there are some issues, but this is starting to feel like reformist propaganda. I, for one, am very happy with the current system and don't understand why anti-government activists want to hand the government the keys to run the healthcare system.
by bazzert on 1/24/22, 3:37 PM
by ahelwer on 1/24/22, 3:38 PM
1. Social programs can start regionally. There's a refrain you hear continually that if, say, California were to institute a socialized health insurance system it would immediately collapse because all the "takers" would move there (absent border control) to drain its resources. Yet that's how socialized health insurance developed in Canada - it was driven by the province of Saskatchewan, which had hospitalization insurance a full decade before any involvement by the federal government. To say that regional social programs are doomed to fail is simply against historical fact. This is how federalism is supposed to work! Experimentation is done at smaller scale and success bubbles up.
2. Doctors are the enemy. This was surprising to me, because I'm friends with a good number of (residency) doctors and all are very passionate about health equality. Maybe their opinions will change once that private practice money starts rolling in, I don't know. But basically organized medicine has opposed socialized health programs in every country they have been tried - an interesting counterexample to the idea that labor organization will per se lead to better social outcomes.
3. Liberals won't get it done (and might make things worse). This makes sense if you view it as a negotiation: socialists need to be pushing hard for radical change in order for the final product to land somewhere in the middle. If you're talking about the need for moderation at the beginning of negotiations, you've already lost. A good litmus test to tell whether someone is serious about healthcare reform or just making impotent gestures in its direction.
4. Socialized healthcare means more than free access to care. In retrospect this one is obvious, but I somehow had missed it. Just having access to healthcare doesn't actually make you healthy. The social determinants of health are much more powerful than going to the doctor once years of poverty have already taken their toll. The scope very quickly expands and you start talking about housing access, food access, and just economic equality generally.