The clinic where my wife works charges $25 for an opiod urine test. This is another good argument for (horror of horrors) – socialized medicine and price controls.
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What’s worse than godless communism is godless capitalism.
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Credit rating be damned, I would tell them they aren’t getting one cent, and I’d also tell them to f**k themselves and the horse they rode in on, and that if they want to urine-test someone they can urine-test the horse (but that would probably cost $20K)
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Yeah, what the heck. That test sure isn’t for my benefit. If they doctor is curious, he’s welcome to pay the bill out of his own pocket. Not only that, but workplaces order routine drug tests for employees all the time and they cost almost nothing.
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The problem with privatization of core services is that in practice it often works out to "If you do worse, you keep your multi-million dollar bonuses, declare bankruptcy, and it’s back on us again
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I’m guessing it has something to do with how FUBAR American medicine is in general; with that being the baseline, all manner of outrages seem less outrageous.
None of those numbers justify a financial attack and anti-service on a patient who engaged a doctor for medical service.
If I go to KFC and order a bucket of chicken, the person at the register is not to order me a $10k cholestorol test because of numbers about the population and my safety, etc.
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Almost this same thing happened to me. A doctor ordered tests on a day I was covered under Insurer #1, but they were processed the next day - when I was covered under Insurer #2. The lab was in-network for both Insurers, but they both initially refused to cover it – insisting the other was responsible.
The lab took the position that, since both insurers initially rejected the bill, they would bill me the out-of-network rate. This inflated a $100 in-network ‘discount’ rate (which had a $10 copay) to around $2000.
There’s a standard line in almost all ‘new patient’ forms with physicians, where you consent to pay for all ordered tests in full. The lab just kept pointing to that.
The insurers needed a few months to work things out, but the lab would only wait 30 days before sending me to collections at that point. They wanted me to pay 2k and deal with reimbursements/adjustments. The collections company was actually nice and gave me a few 30 day ‘holds’ when I furnished proof the insurers were negotiating.
Eventually they got $10 from an insurer, because I wouldn’t cave in.
I learned that labs basically compete with each other on prices to sign deals with insurers so they get volume, and then try to make money with posturing and threats . While the ‘fair cost’ of most blood panels is in the $10-100 range (what they contract to insurers), they put a public sticker price on panels 20-30x higher to use as a basis in lawsuits and collections to pad their overhead and make extra profit. If you are uninsured or there’s a hiccup in processing, they’ll immediately bill you the higher price. Many people will settle for around 1/3, but if they refuse and the claim goes to collections – they’ll almost always win because of how contract law works and the standards in medical consent forms, and will get around 1/3 to 1/2 the price after the collections agency takes their cut.
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I must say I’m rather fond of socialised medicine. And working in a country with decent consumer protection. And relatively less interest in credit rating.
My ex once got a price gouge bill of 7k when her mobile network didn’t make it clear it was counting roaming charges for internet in 10mb increments (1 kB is standard here)
So they called her and she said “No, I’m not paying it. And I’ll speak with consumer protection”
And they said “okay we’ll settle for $500”
And she said “No and this matter has been referred”
And so they dropped it
Can’t say it always works. Have had a company take us to court over inappropriate charges despite consumer protection intervention - ultimately we were successful but it relies on the fact that court fees are higher than the bill and people can’t get time off work.
But you know, we also have decent industrial relations law so we COULD get time off…
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Question - why is the data collection for this issue not tracking where the ‘prescription opiates’ originated? Because of how it’s worded, the assumption is that they were acquired by Rx, when that term simply denotes that pills (regardless of origin) were taken.
I wonder because I am a chronic pain patient - and simply because I am a compliant patient that is easy to track, I get an awful lot of messages from my health care providers regarding that issue.
The opioid epidemic justifies doctors speaking to their patients about it. It does not justify involuntary drug surveillance.
Just ordering that test was a massive violation of medical ethics.
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I’m not sure it is.
There is not a lot of details about that part of this, so any comments about why the doctor ordered the test is mostly speculation. For sure there are cases where it is 100% justified, which is where the test results are needed for the doctor to treat the patient properly. This might be if the patient is returning for further treatment that might result in prescribing opioids, or if the doctor is worried that opioids might interfere with some other treatment.
As a generic follow up to any opioid perscription, I am not sure how I feel, but I think I am coming down on the side of “it is a reasonable test”. Nobody would hesitate if a surgeon ordered a test to detect internal bleeding after surgery that was “only” a 1% chance. Depending on who you ask, somewhere around 1% of people with no medical history of substance abuse will end up with an addiction. The numbers are much higher if the person does have a history of substance abuse – but alcoholics sometimes need surgery too, and they need and deserve pain medication to help them recover. But it seems responsible for a doctor prescribing them to a high risk individual to take steps to ensure that it doesn’t become a damaging addiction, and I don’t think testing is automatically an unreasonable part of that.
It should go without saying that the results of such a test, and in fact even its very existence are protected medical information and shouldn’t be shared with anyone such as law enforcement, employers, or journalists.
In this particular case the circumstantial evidence such as the other tests certainly sound like someone committed malpractice and/or fraud, whether the doctor or the lab or both, that suggests that the doctors motivation for the opioid test might not be genuine either.
Settling this case was a spectacular mistake. I would have attempted to bring charges for fraud, and failing that, would have sued them into oblivion. NOT OK.
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There’s an even simpler one. Mandate that all healthcare providers operating within the U.S. be considered in-network. If they want to operate out of network, they can move to another country. Meanwhile, insurance companies can still use out-of-network price gouging, but only for healthcare provided out of country. Totally fixes the problems within the country, and has that “if you don’t like it leave” and “charge the foreigners more” nationalistic vibe that the current administration and it’s supporters would approve of.
I wonder how many medical bills end up in court vs timing out due to statute of limitations.
I have a vague assumption that companies’ whose business plan primarily consist of extortion, blackmail, and intimidation probably mostly operate more like traditional schoolyard bullies and will write it off as a loss if their intimidation fails, focusing instead on the plentiful easier prey.
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There are circumstances which could justify ordering those tests. Those circumstances do not justify ordering the test without the patient’s informed consent.
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What about normal consumer protection? Isn’t it illegal to rip consumers off?
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My latest medical urine test (together with a blood test, ECG and abdominal ultrasound exam for my routine biennially check-up): 0€
At least you have guns …
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Or, and I’m just spitballing here, you could build some sort of, I don’t know, single payer, that would have the ability to decline these sort of overcharges.
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That’s great, but the direction of payment is nuts! Blue cross like, recused itself?
At that rate how can you send your lab techs to Vegas every year? It’s just unsustainable. [Everyone just put your own Other Vegas images in here.]
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