Woman Taken To Wrong Hospital Faces Bankruptcy

You can be taken to the "right" hospital and still rank up charges out of the kazoo. There are plenty of cases where in-network hospital uses out-of-network doctors ON PURPOSE.

Here is a small example. There are other example of much larger bill.
http://www.nytimes.com/2014/09/29/u...er-is-in-network-but-the-doctors-are-not.html

The problem with a purely for profit health care system.

 

The healthcare system is a joke, but to call it a for profit system is incorrect.

It, like student loans and housing finance, is a mixed government and private market which usually consists of private healthcare business, doctors and the industry benefiting from governments inefficient policies.

There was a great story in the Wall St. Journal yesterday about how most pain doctors bill medicaid for drug testing for seniors and because they bill per test the elderly were tested for Angel Dust, MDMA, Esctasy etc. and every test was a separate bill and it is completely legal.

Millions of dollars of tax payer money to make sure grandpa is not on ecstasy and angel dust.

And these doctors and healthcare companies are laughing their way to the bank at the idiots in government and the American people.

 

At this point a single payer government controlled system is better than the garbage of a system we have now.

 

Duh. It would have been the better option in 1966.

 

Still doesnt mean its the best system. A competitive market brings down prices to everyone, government usually inflates prices through bureaucracy and provides crappy service equally to everyone.

Imagine a competitive landscape that the steel efficiency of CostCo, CVS or Walgreens runs the healthcare system. No bureacracy, competitive landscape and consumer choice and its not a tool for politicians to use.

People can decide if they want and can afford Taco Bell, Chipotle or Pappasitos, why can't they decide on their healthcare as well? They choose a Honda, a Ford or a Mercedes? When its consumers money at stake they'll make the best decisions for themselves and also will force them to be financially responsible for their health and their decisions made.

 

Pain management is extremely risky. Doctors can be used or charged with fellonies for "over prescribing narcotics." The drug testing is a way to prove that the physician wasn't fueling the cravings of a drug addict so he could bill the insurance companies. You'd be surprised at how small of a percentage Doctor's comprise of the overall healthcare cost
Btw.

 

For-profit simply mean they need to focus on making profit. You can easily then see how the goal of patient cares and profit can collide. And you just stated an example where profit driven health care provider maybe ordered unnecessary tests to the detriment of patients. Any provider in the for profit health care industry inevitably chooses profit over patient care. The two don't mix well, especially when the most expensive procedure often involve no choice from the patient (i.e. in an emergency, you get help as fast as you can wherever that might be) so the idea that for-profit competition help doesn't hold water.

Governments over the year creating multiple health care systems in the US (medicare, VA, private, ...) while Congress can't laid down some simple effective-for-patient rules cause more confusion and created more problems.

A single payer is the best solution. Other countries done it and provide better care at lower costs.

 

I don't blame the patient or Obama or out healthcare system. I blame insurane companies, all of them. They are the devil

 

Only the government would have these goofy holes in their system allowing this kind of nonsense.

Do you think a consumer would walk into a car dealership or restaurant and listen to the salesman/waiter and buy everything on the menu? When people become efficient consumers it makes the process more streamlined and more efficient. It also brings down prices on everything.

When deciding between Sprint/TMobile and AT&T, consumers will think about it and decide what is best. They should also be when choosing a healthcare plan to cover and we have a legal system for when the companies are bilking people based on fraud or deception.

 

Thats the stupidest thing i've ever heard. An insurance company takes money today and invests it and ultimately pays out more than it recieved in benefits whether its car insurance, medical insurance or anything.

If they just paid for everything they would go bankrupt. The only reason they still exist is that they have become better investors making money while they have it as they pay out more money than they take in. An easy exercise is think about your auto insurance annual premium and then any wrecks you've been involved in and the payout, they typically pay out more than they take in but get to invest that float while they have it.

Insurance is a contract between someone and a company. They pay out based on that contract and if they don't there are laws to protect consumers and a legal system to fight it.

How are they the devil?? Why not attack the healthcare companies overbilling the government and companies and the physicians, who are 8 of the 10 highest paid professions in this country while people are going bankrupt with healthcare bills??

 

"project manager for a manufacturing company" but cannot afford "difference between a $1,500 maximum out-of-pocket expense and the now-$50,000-plus she's facing in bills."

Her original 350K bill has been reduced to 50K. She didn't just visit the ER, she had some major probs.

Who is to say she would have lived at the other hospital? St. Mary's is bugger than Meriter and has performed almost twice as many inpatient surgeries.

Take me to the better hospital, I will cover the difference in cash. 48,500 is nothing for her.

 

This is the stupidest thing I've ever read. Insurance companies can pay what they want because of this so called contract. The hospital can bill $4000 for a procedure, but the insurance company can say, nope, I'm paying $500 (reasonable and customary as it says on the EOB), take it or leave it; assuming they even cover it at all. So, guess who gets stuck with the bill if its not covered. Also, they cannot cover a procedure for all kinds of stupid reasons. So again, the consumer gets stuck with the bill. All the while, your paying your high ass premiums, thinking your covered. But no, they'll deny and deny and deny....leaving you with cancer, HIV, or any other life threating disease thats catastrophic. Also, the laws to protect the consumer....lol. If you don't know anything about the appeal process, you’re screwed. Sure, call TDI while your sick or recovering. I can guarantee you the average consumer cannot even follow the Handbook that is given by the insurance company written by, well, lawyers. This mess is meant to be difficult to read. Your right, they are in business to make money, at the sake of others dying or being ill.

 

Bandwagoner, you are rationalizing the point of the story. The point is healthcare coverage should not be location/negotiated agreement dependent. It should cover average and reasonable costs and provide average and reasonable care. And, that health care decisions are not like regular consumer decisions, even more so when you are comatose.

 

If I have to buy a car to not die, I would buy the car and worry about the money later. Well, that's never the case when buying a car or shopping for a cell provider. That IS often the case for health.

 

Just simply lol.

A hospital refuses to enter into a contract with an insurance company because they want to be able to make money than an insurance company is willing to pay. That hospital gets used and the insurance company STILL pays them money, but the hospital just bills you for MORE, and somehow the insurance company is the devil.

Doctors are just looking out for your interests! If only we could get rid of the devil insurance companies and leave medical decisions to you and your doctor for whatever cost they want to charge you!

I don't think people have any idea how insurance works.

 

The insurance companies do pay based on "reasonable and customary" charges to out of network providers.

You want to create a single payer system, that's fine, but that doesn't stop a hospital from saying they won't participate in it. In this area in question, Blue Cross IS basically a single payer with 80% of the people in the area covered by their plan. Yet the hospital still chooses not to participate.

We have plenty of states in the country that are effectively single payer where hospitals and doctors simply refuse to participate in a network. Somehow the insurance company gets blamed for that instead of the hospitals and doctors.

Is your solution that there should be a federal single payer (like Medicare for all) and that all doctors and hospitals are by law only allowed to work with that single payer, no private pay at all? Because unless you are saying that, then this woman's example is proof positive that a single payer system that doesn't mandate participation by doctors and hospitals wouldn't have worked.

 

Yeah, I've been a pain management patient for years and get tested often. They bill insurance over $1k each time, but they end up actually paying a very small percentage. They seem to write off the difference, because thankfully they've never billed me.

 

I'm saying that. Insurance is not part of the single payer (well, it can be optional for those that can really afford it). Government is the single payer and health providers are required to participate. Government should also play a role in helping with education costs for dr, health workers and for re-training and transitioning the massive # of employee from health ins and other related health care into this single payer system...

Or we can continue to do patch work band-aid solutions that we have been doing for the last ever # of years. That might still work out (plenty of opp to improve the current system with patch work here and there) if Congress is serious about health reform.

 

People can choose the plans the way they would a Sprint/T-Mobile/AT&T plan to decide what is best for them.

Competition helps everyone and brings down the price to consumers in virtually every situation.

Also thats making it seem like all healthcare is life and death when most are routine procedures, that overly dramatic life or death in every scenario scares people into not thinking rationally.

People must choose to eat McDonalds, Fuddruckers or Perry's for a burger and each consumer weighs the tradeoffs which means each business above must provide value comensurate with capital spent per person.

Healthcare is great for doctors and healthcare businesses because no one knows what the hell is going to be spent and can't make any trade off decisions.