Click through for the cute picture of the fawn in front of the hospital.
When I saw the headline and the first line, I thought you'd had an accident or a sick kid. Don't do that. I'm nervous this week.
2nd 2. Except I wasn't worried, because I had a productive and nonbankrupting interaction with socialized healthcare this week.
I'm just narcissistic like that.
I really want to travel west next summer. Except for a couple of work trips, I haven't been west where I was raised in two decades.
I told my wife this week that any time we go to an ER we have to ask if all doctors who might treat us or kids are in-network. We're probably not at risk as we're in a well-funded wide HMO network and at world famous hospitals that don't need to pull shit like this. This is exactly the kind of "consumer-driven" behavior conservatives claim to want, and it pisses off people at the hospitals, partly because it signals "I think you're trying to rip me off", and because they don't want it to be their job to deal with it. They aren't even equipped to do so- AIHMHB, I asked one time prior to an outpatient procedure and the billing person said they couldn't even say or guarantee anything about network coverage.
Yes. It's similar to which Mexican restaurants will just give you chips and salsa vs. the small, horrible minority that charge you.
Yeah, I've had very little contact with medical care in my life, but my one moment of trying to be an educated consumer was when I was signing a form saying I was responsible for the cost of the surgery to take a bit of skin cancer off my neck if my insurance didn't cover it. So I asked what the cost of the surgery was -- not down to the dollar, but if they had an estimate. No one in the office had any idea and they were confused and offended that I'd asked.
If you ask questions about the part of the consent form where it says "this could kill you to death," they also get all confused and offended.
Of course, not many Mexican restaurants require consent forms yet.
Just the ones with the really hot salsa.
California just had a law take effect that protects people in a majority of plans (not ERISA self-insured) from the out-of-network doctor bill abuse. https://ww2.kqed.org/stateofhealth/2017/06/27/you-are-now-protected-from-nasty-surprise-bills/
I bet you also have better Mexican food that we do, at least if you avoid people who put rice in perfectly good burritos.
I would think that something like in 8 would represent a best-case scenario for consumer-driven markets in health care prices. People going into the emergency room would find it much hard than people going in for a scheduled surgery.
Right. I mean, if I'd been better at it, I would have demanded to know when I made the appointment, rather than on the day of. That is, I went ahead without an answer because what was I going to do, go home? They probably still wouldn't have told me without a long delay and maybe switching providers, not to find a better price, but to find one who would give me a price at all.
Plus, you have the inevitable upsell if every starts asking. "The base surgery is $1,424.43, but for an extra $576.25 we can guarantee that the scar left behind will not look like a swastika."
I'm not typing well today. "Every" s/b "every one".
This is basically the strategy* (implemented on much smaller scale) that drove me from my dentist office of 25 years. (I still think i owe them money.) After a 3-4 year gap finally have an appointment with another dentist next month.
*From my perspective anyway. Came about when two dentistsons took over from their father.
Well, I did take the upsell. There was one kind of surgery, which would have been fine but would have left a scar, or Mohs, which was more expensive but was supposed to leave a smaller scar. I was told there was a price difference, but not what either price was.
Turns out even the Mohs scar was fairly noticeable, so the cheaper version might not have made a difference.
Of course, there are also valid reasons for doctors not to know how much certain things will cost because they don't know what complications there might be. I think issuing price lists with medians and interquartile ranges would be the most accurate way to do it but also objectively unworkable.
18: I still go to my current dentist because he has only once asked me if I wanted my teeth to be whiter.
19: They probably didn't even offer you the cheapest option because you didn't look like someone willing to tolerate a swastika.
A CA policy that doesn't seem to have ever done much on its own, from last decade, was disclosure of hospital chargemasters, as well as the average list price of hospitals' 25 most common procedures. A little basis for comparison, at least; but it's more likely to cause sticker shock than anything else given list price inflation. (For example, Stanford University Hospital: ER visit low-to-moderate severity $1,469; basic metabolic panel $350; abdominal CT scan $6,857; catheter placement internal carotid artery $22,242.)
If you want a cheap catheter placement, they'll try to go up the urethra.
All of this is of even greater interest to me as I've had two recent emergency hospitalizations while traveling in the US. Naturally, with my luck, they're out of network. (My insurance says they'll cover part, but which parts remains unclear. More time-consuming phone calls. ) The bills are starting to arrive. A few hundred here, a few thousand there, it's all real money. Frankly, it's depressing to even contemplate.
Kid broke a wrist earlier this year while traveling away from our home base in Europe, so out of network ER visit. Cost to us: $0 because what kind of society charges for emergency care for kids.
If care for kids in emergency situation is covered at 100%, what incentive will parents have not to expose their kids to danger?
It will incentivize parents to find activities that are dangerous enough to injure them but usually not kill them. Like playing football. The NFL should totally support full CHIP funding.
29, 30: Right according to economic theory it should be impossible to find an unhurt child in that scenario.
In Wisconsin.
If you want to hurt a child in Wisconsin, take away his cheese hat.
6; won't help. I did that when my daughter went for surgery and even with promises from the intake staff, the anesthesiologist was OON, and we got billed an extra $5000 for his 15 minute services.
When I went for surgery, I refused to sign the surgical consent until I spoke with the business office and got a signed paper that everyone was in network. THey still billed me for OON surgical assistant and told me that I had agreed verbally while waiting for the OR. After I had the happy drugs. I had to have a lawyer write a letter to get that $11,000 charge dropped.
"Morally bankrupt", indeed.
My local hospital has sworn to me multiple times that every provider there is in-network for my insurer, but I still check every time.
In related news, I went to my Young Adult Cancer Survivor support group last night, and we spent most of it talking about how stressed and upset the O-care repeal debates were making us. Even with the ACA, so many of my group members have been financially devastated by their illness, and several had to postpone life-saving treatment until they could work out payment. Words really can't express how furious this makes me.
23: Huh, interesting. We're looking at possibly doing a similar price transparency thing here. Do you know of any lessons learned from the CA experience that could help with program design, or is this just something that is inherently unlikely to do much on its own?
33 is one of the things that gets me super pissed off*. No matter how smart, careful, informed you are (and honestly it's not the fault of people who aren't informed that they don't have time to stay on top of this crap) there's nothing you can do to stop someone from taking all your money because you were hit by a car or whatever. Only way out is to be born rich or powerful enough that you can hit back or absorb the loss.
*Another in the "Pushes My Fuck the System Button" category is stripping citizenship/deporting people so they end up with no citizenship anywhere.
35: and....what is anyone meant to do with this? Hope the chest pain goes away?
I want to know who "hospital leaders" in the OP are, where they live, what they filed for taxes, what their excuses are, why isn't there a permanent vigil on their driveway. Who are these people? Am I right in thinking they are hiding behind a pile of Nice Doctor Respectability and need a perp walk or else spat on a bit?
33: MA is way simpler that way. If you're in a hospital that's in network, the doctor's will be too. The only big exception is that the psychiatrists in my hospital system take fewer insurances than their medical and surgical colleagues. But I bet you'd be ok for an inpatient med-psych consult.
Around here they almost never admit. There's no space; they put you in observation units instead. Once I wanted to get admitted to get out of my ER co-pay, but even though they kept me overnight, I was never admitted, so no dice.
Thanks for the good wishes. I am quite ready to declare bankruptcy if necessary and will tell my creditors that. I haven't worked in a while and my assets are shrinking fast.
I think you do need to threaten and such. I'm sorry I have no useful advice on how to go about it, but the standard billing rate is already comically high so that they insurance companies can allegedly get a discounted rate for what they cover. The whole thing is fucked.
Yes, like everyone else this really pure rageahol. I fantasize I am the judge who hears a case of an anaestheologist office trying to collect this and can order them to be paid minimum wage for their 15 minutes.
25
Dispute every thing, multiple times. If it's disputed by you, the clock stops on it working its way to collections,and you might get lucky.
Gather it all (hard to do), and offer to pay cents on the dollar. Tell them you simply can't afford to pay and they can either get cents on the dollar now or after it goes to collections in 2 years, their choice.
So the other week when I had to extend my stay in NY an extra week and at considerable expense to change my ticket because I had shingles with a raging fever and was highly contagious and in pain? My employer took that week out of my annual leave allowance rather than my sick leave even though I have a signed letter from the doctor I saw in NY and when I got back and reported to work I was asked to report to the clinic because I still was not well and the doctor here immediately sent me home for the and told me not to come back to work for 2 days. HR at my workplace expects the letter from the doctor in NY to be officially attested by the ministry of health of the Arrakis embassy before they will grant the sick leave. This is effectively a policy of saying do not get sick overseas or you're completely fucked. Bastards.
You can drink the water (most places) and eat the food, but don't get sick in America.
The embassy in DC? Anyway, wouldn't the health provider at the embassy only be for Arrakin embassy employees so not likely to do this anyway? Bonkers.
46 It's completely fucked. People are averse to making waves here but I'm pissed and intend to escalate this on principle.
Is it too late to give them all shingles?