Thanks Obama!
The entire problem seems so utterly bizarre. Iâm spoiled, living in one of the gentler countries in Europe. A system that allows a person to go bankrupt because she survived a heart attack seems like such an inhuman thing to do.
Further to what @Gorgonaut wrote: the idea that a major insurer would only deal with certain hospitals, and that this matters as you are having a heart attack, is bizarre.
But if we just paid for medical care for folks, EVERYBODY would have heart attacks.
We may be looking at the end of that here, too. Because between the âfree tradeâ secret stuff and our own stupid politicians, most of our countries are seeing how much of the healthcare system they can destroy and how fast.
I just want to print this and hand it over to the next cretin that tells me that âprivate healthcare is more efficientâ while our goverment guts another public hospital.
What is also bizarre is that the Hospital she was at had to know they did not have a relationship with Blue Cross and made no attempts to transfer her once she was stabilized, just kept racking up the charges.
Only dealing with some subset of providers is the main way that insurers reduce costs - itâs called ânarrow networksâ and is on the rise. If the insurers couldnât eliminate some providers from their networks, they would reduce their ability to control costs because they wouldnât really have any negotiating levers to use against providers who wanted to raise prices.
The only way to avoid this sort of situation is having the government set prices (which it does in large part for Medicare patients, though there are a million and one complications) or to have a single payer, because with a single payer then providers would have no choice but to negotiate.
A potential middle ground could be to have the government set prices for emergency situations while still allowing the system to work the way it does now for elective procedures. This would be a logical extension of the federal law that requires all hospitals to treat and stabilize any patient who arrives at their emergency department with an acute problem. This law avoids the awful situation of having hospitals turning away people to die in the streets, but in so doing creates the situation this woman found herself in.
When they donât even disclose the cost (of services)
This is what always drives me nuts about health insurance - most of the time, youâre not going to be able to get any solid information about how much you will owe until the insurance company has decided how itâs going to treat the bill. Even with routine procedures, they make sure to disclaim any numbers you get as only estimates until much further down the road. It makes it so difficult to make informed choices even in the best of times.
In many states you can go to an emergency room at a hospital where your insurance has a âpartnershipâ and still end up with major bills because the emergency room docs are sometimes independent contractors and thus have separate billing/etc. NPR had a story about a woman in TX that I heard on the way home last nightâŚ
Edit: NPR Story
Surprise Medical Bills: ER Is In Network, But Doctor Isnât : Shots - Health News : NPR
After working in a hospital business office for a few years and then running a hospital IT department, my take has been that the real problem is not the cost of healthcare, but rather the charges. The cost is actually fairly low. What happens is that these hospitals jack up their rates to squeeze as much as possible from the insurance companies. They enter in to agreements whereby the insurer is given an automatic percentage reduction on the bill. This gives hospitals a financial incentive to jack up the charges to ludicrous amounts.
Most hospitals raise their rates on their chargemaster twice a year by around 3% with the minimum increase being $1. After doing that for 10 years, a $0.25 aspirin costs the customer over $20.
This problem can be remedied with a single payer system but before we can get the public on board, we need to force hospitals to publicly disclose their rates. I think that once the public is aware of the rates and how they increase, we will see some change for the better.
Welcome to America.
Just donât get sick.
We should be so proud.
Thatâs tricky: transfer someone too early, when they are still unstable, and thatâs called âpatient dumpingâ.
Funnily enough, this is the kind of system that that nice Mr Farage down the pub would like to go to. I wonder how many ukippers really know this.
Americaâs âhealthcareâ system is fucking nuts.
It gives both hospitals and insurers a reason to want higher bills. Shockingly, when both the person selling the service and the person buying it want the price to be higher, the price goes up pretty fast. This outrageous prices also help make insurance a dire necessity so that they can keep charging higher prices. It ends when the health care system is extracting as much money as the economy can possibly pay for it.
What would happen to bread prices if supermarkets had unconscious people delivered to their door and were allowed to sell them bread without their consent? Apparently this is the free market at work, but I donât quite see it.
Itâs not the hospitalâs job to save the patient money. Nurses and doctors donât care about this, theyâve got their own jobs to do. This is just another facet of our fucked up healthcare system and its amazing ability to drive people into bankruptcy.
Can we sue the hospitals for price-gouging?
When some gas stations raised the cost of a gallon of gas to $5 shortly after 9/11, there was talk of attorney general investigations. But charge someone $100 for a Tylenol, and itâs business as usual. Then add Obamacare to the mix. Iâm not sure what it does exactly, other than politicize everything. I guess technically I might see some sort of tax credit at the end of the year, which maybe will bring back a few dollars of our $500/month catastrophic healthcare plan. But it will bring those dollars back from the taxpayer, not the insurance companies who received the money and paid none of it out. So basically, Obamacare allows the health insurance companies to keep increasing rates past our ability to pay by siphoning tax dollars back into our pockets. Can that be right? And in the meantime, because itâs a catastrophic healthcare plan, weâve paid all our medical expenses out of pocket, including $2500 for 10 minutes of outpatient oral surgery when my daughter smashed her teeth out on the edge of a table.
I better chill out. The longer I think about this, the higher my heart rate gets. And we all know what that gets you.
Next up: surge prices at ERs to manage the busy periods during holidays when people finally get around to that DIY job.
Itâs honestly pretty amazing that anyone who describes healthcare as a âmarketâ isnât immediately laughed out of the place and/or beaten down by an angry mob.
Even if you are a hardcore believer in Homo Economicus and the Rational Market (benevolently tended by the invisible hand), the assertion that healthcare even remotely resembles such a thing is absolutely absurd.
Getting prices out of providers is like pulling teeth(and the numbers you do get are frequently more or less pure fiction, readily changing under ânegotiationâ, larded with opaque generic categories, if itemized at all, and otherwise calculated to defy understanding). Getting numbers out of insurers is typically even worse (unless you count the vague sense that what you get will end up being less than what you paid in premiums), never mind cutting through the thicket of what, how much of it, and where, a given service is or isnât included this time.
Then, of course, you run into the fact that you make your biggest âpurchasesâ while in the worst position to comparison shop(even if you managed to gather enough data to do so). You do so when at your sickest, often impaired or severely time constrained, and you have close to zero control over consults, assistants, and so on being called in without comment and then billing entirely separately.
This Just Isnât What A Market Looks Like. Not at all.
The Freedom Of The Open Road is a constitutional right, one that we will engage in rather a lot of messy foreign policy to defend. Healthcare? Not so much, sickie.
