Ambulance takes comatose, insured woman to "wrong" hospital, drives her to bankruptcy, too

Perhaps Maker Spaces need to add a Fixer Space wing for self-repair of injuries… I picture lots of superglue and perhaps some 3D printed casts…

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“Fourteen teeth have had to be removed by myself with pliers,” said one respondent to the survey.Another temporarily fixed a broken crown with superglue.

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I’m starting to think that the US, like Russia, China and India, is simply too large to be governed effectively. Smaller countries are more nimble, and often more inclined to listen to the public. At least, in the West.
When one has such an enormous population, spread over such a vast area, the inertia becomes almost infinite, the corruption easier to hide, and the further one is from the seat of power, the more distant and unreal it seems.

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Coming from a small country that over the last 30 years has spend billions on weapons and lots of millions in under the table deals to choose one company over an other, which only recently surfaced, I can tell you that corruption hides everywhere.

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And sometimes, it even hides in plain sight… We all deserve better than this, don’t we, no matter where we live?

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perhaps we do, but why do we get this? Is it the system thats flawed, or the indifference that fuels it? And how can that change?

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Historically, at least in the modern era, periods of change emerged from mass action - in the US the civil rights movement was eventually successful in changing laws. at the end of the Cold War, mass movements helped to change the communist states, and changes have been brought about during the Arab Spring (though there was also some horrible backlashes there - Bahrain, Syria, Kuwait, eventually Egypt).

As for the system vs. indifference, it’s likely both, at least here in the US. Polls consistently show one thing and politicians do another, because they know they’ll not face consequences, because they reside in “safe districts” or states.

Major change really does need a mass movement, and at least here in the US, things just aren’t bad enough in terms of impacting people’s daily lives. But the worse things get, the more people will get pissed off, and maybe demand actions.

The thing is that stories like this are not uncommon. Almost everyone I know has problems with insurance, doctors, hospitals, etc. But no one really agrees on the common problem. A republican partisan would see this and say “Thanks Obama” sarcastically, and blame it on Obamacare, while a democrat would blame it on the health care system. Its almost lke we don’t have a shared reality any more.

So, TL;DR, I don’t know, and I wish I did… :frowning:

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And most of us Americans agree with you, but too many are unwilling to make or understand the (perceived) tradeoffs needed to fix it.

Also, I know courts have really diluted the “meeting of the minds” idea in contract law, but really, what would happen if she said, “I refuse to pay, prove that I owe the debt, show where I agreed to it since I was unconscious at the time of admission. If I had been conscious I would have insisted on an in-network ER”?

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I’m curious, is this situation somehow a result of Obamacare? I wouldn’t have thought so, but the local news report vaguely implied that.
Stories like this about US healthcare make me feel kind of queasy. Not just the situation itself, but the way so many people can see this and still argue that it’s preferable to the flat-out socialist healthcare we have in the UK (or even some intermediate form like other countries have).
Swivel-eyed free-market horseshit is almost as dominant in British politics as it is in America, so it’s kind of amazing that we have the system we do. It took a very specific historical situation to make it possible, and that will never happen again, and it’s horrible to think of the Conservative Party (or UKIP) working to dismantle such a monumental political achievement.

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I was wondering about this. Are there special laws covering healthcare, so that a doctor can agree to a contract (to their own advantage) on your behalf?
I understand that medical ethics are a factor, and might also explain why they didn’t transfer her to the covered hospital. But doing something because you think it’s right doesn’t create a contractual obligation.

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The way to avoid this is to nationalise the whole shebang. At fucking gunpoint if necessary.

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The contract between a doctor, hospital, etc and an insurance company means that they accept a contracted rate from the payer (rather than the fully inflated amount that’s normally billed) and that they won’t balance bill the patient for anything more than the payer says they owe. In exchange for those concessions, they get listed in the payer’s provider network directory, which steers patients their way. It’s not really a contract on behalf of the patient – it’s ordinarily considered that the patient would be free to go to an in- or out-of-network provider (assuming the patient is conscious and the medics aren’t forced by other circumstances to take someone to a non-preferred hospital). What happens if a patient goes to a doctor or hospital that’s not in their insurance network is stuff like what happened to the woman in this article. The insurance will only pay the same amount they’d pay to their contracted providers (or even less in many cases) but the provider can balance bill the patient for the rest instead of having to write off a big chunk of it.

The system is truly broken. I once had a brief hospital stay in a hospital that accepted my insurance, but it later turned out that one of the doctors who treated me wasn’t contracted with my insurance, and I got stuck with the all of the bill for his services. And people without insurance are screwed all around. The hospital will charge the full amount, not the amount they’d charge to an insurance company they contract with. People with low income can qualify for free or reduced care, but even if you get free care from the hospital, you still get billed by the emergency room doctor who treated you, the radiologist who read your x-rays, etc.

The article seems to be almost implying that the Affordable Care Act is the cause of the problem, but it’s not – it existed long before Obamacare ever came along. The part of the act that’s quoted says that for emergency services for out-of-network patients, the insurer has to pay “the greater amount between the in-network rate and what Medicare would cover” but that balance billing is still allowed. Pre-Obamacare, the bill would have been paid at a probably lower out-of-network rate and she would have been stuck with even more of the bill. Not that this makes a big difference when the lower bill still puts you in bankruptcy. That change is a little bit of help but it doesn’t go far enough.

(edited repeatedly because apparently my words are all scramblated today)

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I’m lucky; Newcastle has a dental teaching hospital, or I’d be fucked. Going for a free crown next week :slight_smile:

That’s a really interesting take on it. I’m not so sure insurers want the price to go up however. After all, that means they have to pay more to the hospital which cuts in to their profit margin. Besides, we have an insurance mandate now so the necessity is built in to the system. It no longer requires high charges to make it so. With mandated insurance, insurers have a great chance for increased profits if the hospitals lower their charges.

I’;m hoping there will be riots to make the poll tax shenanigans look like a teddybears picnic if they try, but I doubt it…

Let’s not forget another important component of what makes a market: the participants are there voluntarily. When it comes to healthcare the majority of patients are not there voluntarily. Healthcare is not a market: one side has highly specialized knowledge, hidden pricing and a labyrinthian billing system, while the person other side is in no position to negotiate or comparison shop, may be facing death or permanent disability, and may not even be conscious.

An insured person facing medical bankruptcy following an emergency is a national disgrace. I am frankly embarrassed that so many other countries have figured this out and manage to cover their citizens for far less money while getting better results, using a variety of different methods. There are a variety of examples right in front of us, functioning for decades, yet we are too stupid, stubborn, selfish, greedy, shortsighted and/or brainwashed to do what’s right for our citizens health and our country’s finances.

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Insurers don’t lose money when the prices go up, the people who pay insurers lose money. Which would an insurer rather sell you: A life insurance policy where they pay you $25k for an accidental death or one where they pay $500k for an accidental death? The answer is the latter for the same reason that a car dealer would rather sell you a more expensive car than a cheaper one. The price to you isn’t the cost of the thing you are buying plus the cost of the insurer’s time, it is the cost of the thing you are buying plus a percentage.

So since everyone wants/needs health insurance, insurers would rather than the price of health services be as high as possible. That way they sell larger policies and get a larger cut. Home insurance companies probably cheer for the housing market to go up too.

I’m sure there are insurers who simply decide that they want a larger cut, but I’d be surprised if there were many legit companies out there who didn’t work on a percentage model - higher value of thing insured, higher profit for insurer.

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Maybe, maybe not. If she had a previous policy that covered all hospitals which was quashed by Obamacare, and could only afford a replacement with a narrow network, then yes. If she was previously uninsured, then no.

Sing it, sister.

This happened to me this summer in an outpatient procedure - I had been extra, extra careful to make sure that the facility, the doctor, the anesthesiologist, etc. were all in network. A month later, I get a $11,000 bill from some guy whom I never saw, met, heard about, or signed off on - apparently he’s the person who read my test results, and guess what? Not in network. I was FURIOUS.

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