There can be multiple reasons why someone is inflating their bills. A kickback scheme is one possibility. That might have been what was going on in this particular case. That is illegal.
But giving a different price to different payers depending on what kind of contract they have, or don’t have, with your facility is not illegal, as far as I know, even if the markup to some consumers winds up being outrageous.
That’s a much more accurate and typical cost for an opioid test.
What made this urine test so expensive is that rather than send the urine to an opioid testing lab for a simple test (as he should have done), he sent it to a lab for a comprehensive screening. They performed more than 5,000 individual tests on her urine, and charged as much as they could for each one. Since many charges get challenged by insurers, labs jack up their costs in the hopes that they might get paid once in awhile. Thus a $17k urine test.
And this is why we think socialized medicine is “too expensive” in the US. We think this stuff costs what we pay for it. It doesn’t. It’s artificially inflated, because they can.
Every time I watch Call The Midwife, and the women are attending some poor mother with complications who has 4 kids in a one-bedroom tenement and they tell her “we’re calling an ambulance and booking you into the maternity home” I feel horror. Because I expect her to say that she can’t possibly afford that.
And then I remember the show is set in London in the late 50’s and England had the NHS already. It’s so alien to me.
Texas is famous for this kind of medical price gouging and unnecessary testing.
There and Florida are the hotbeds for healthcare fraud. Part of it is because both states have large military populations and ripping off TriCare (essentially Medicare for vets) has historically been fairly easy and fraudsters target low hanging fruit.
That’s not how it works - there is a reason that insurance isn’t universal - because the company negotiated that ‘in network’ discount based on patient volume and outcomes and other data points with the hospital. Just saying everyone has to take ‘in network’ payments would bankrupt the system - not because it’s unfair, but because the insurance companies would just change the rates for ‘in network’ to 0.
The discount for Hospital A is different than Hospital B etc.
There is a much simpler solution really. Make healthcare a fucking public service. A third party shouldn’t get rich off the suffering and sickness of other people.
"Combined, the nation’s top six health insurers reported $6 billion in adjusted profits for the second quarter. " (source: https://www.cnbc.com/2017/08/05/top-health-insurers-profit-surge-29-percent-to-6-billion-dollars.html)
This is blood money.
When the bill gets in the $17800 range isnt it cheaper to hire a lawyer and counter-sue them for fraud?
From each according to their vulnerability
To each according to their greed
My wife works as a volunteer ski patroller at a small ski resort. As I understand it, if they call an ambulance for someone, that patient is only charged for the EMS service if they get a ride in the bus. If EMS shows up and either they say it’s not critical, or the patient refuses transport, they are not charged.
Well, I hope that whatever system we get here is more like Germany’s or Switzerland’s (excellent) as compared to Canada’s (so-so) or Britain’s (increasingly resembling a dog’s breakfast).
I’ve had so many health issues in a last few years. I couldn’t possible imagine the stress I would be under if I lived in the US.
That would depend on the scale of the rip-off scheme.
My stepson lives with his mother for most of the year. He’s diabetic and has celiac disease. Last summer, he got a continuous glucose monitor that was, literally, life-changing for him. We always knew his blood sugar level, and we could see if he was trending up or down without making him test every 15 minutes (there’s a phone app that shares this info).
Sent him back home to mom at the start of the school year. It turns out, the medical supply company mom was using to get the subcutaneous sensors for the CGM wasn’t in-network. So the insurance paid for about 2/3 of the costs and suddenly she was slapped with a huge bill. So she quit making him wear it. Because regular test strips and lancets are 100% covered and available at Wal-Mart and the specialized equipment for the CGM is not.
I’ve sent her a list of in-network providers, but it’s out of my hands until he comes back to us. This one small thing that could make his life so much easier has been made so much more difficult, because his insurance is through US, so they won’t talk to HER, and they send ME reimbursement checks that I then have to forward.
My boyfriend works for an insurance company, and when his partner recently got sick and they had to call an ambulance, his first question was “how much will this cost?”, and when they said they didn’t know, we started making plans to take a Lyft. Even transport to a hospital can be thousands of dollars that isn’t covered by insurance, if they decide to call you a private ambulance.
This topic was automatically closed after 5 days. New replies are no longer allowed.
