> UPDATE: Monday, shortly after publication and broadcast of this story by Kaiser Health News and NPR, St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.”
Sounds all fine and dandy until you realize that these charges will just be made up for by people that aren't able to get NPR to publish a story about them.
When you realize that the hospital was charging $19,000 for a stent that cost $1,500, you realize that painting Calver as someone who is going to cost us all money is misdirected anger.
And, to be clear, they charged $19,000 for the stent, not "stent plus theater time to place it plus surgeon, anesthesiology, OR nurses", of course not. Those are all absolutely billed separately.
There is a whole industry of "medical billing advocates" you can pay to find what is likely thousands if not tens of thousands of dollars of completely made up charges on any given US hospital bill and "negotiate" them away. You don't necessarily need press coverage though it obviously helps.
Hell one time I got a $15k bill for something insurance should have covered. Called the hospital, turns out insurance had covered it and I didn't actually owe any money at all. How many people get this kind of stuff and just pay it anyway?
Not always. My mom had a quadruple bypass about 6 years ago during a gap year where she stopped working but didn't have Medicare yet. Unlucky. I think she was billed for around $180k.
She told them "I'm on Social Security for $1000/mo, I'll pay you $50/mo". It was basically that or sending it to collections and never getting a dime from a retiree. So they accepted and told her a "non-profit" paid for the doctor's portion of the bill, which was all but about $40k.
She'll probably be around another 10 years max, which means she'll end up paying about $10k of that balance.
Medical debt is the least concerning type of debt for most lenders. If you ever fall into this hole, don't sweat it. [Unsolicited advice.] Just let it go to collections. You'll get harassed for a little over a year. Debt older than a year is almost never pursued by collections agencies. After things quiet down start sending letters to the credits agencies saying the collections debt has been settled. The collections agency will usually slip up and not respond at some point and it'll be gone from your credit history.
> Sounds all fine and dandy until you realize that these charges will just be made up for by people that aren't able to get NPR to publish a story about them.
No, St. David's has already fully recouped their costs and then some. They were simply trying to extract as much money as the stone could bleed.
The power of companies. They write words and numbers on a stamped letter and now it's god spell.
I once played dumb to an importer abusing fees, after monthes of bouncing mails to different people babbling the same thing over and over, then dealing with a 'lawyer firm' who behaved the same (basically nobody knew precisely what they were talking about). They suddenly accepted to give me a rebate of NN%. So I received a new bill with 100$ - '80$ promotional deal' = 20$ (normal fee). A very partial grin ensued.
>Sounds all fine and dandy until you realize that these charges will just be made up for by people that aren't able to get NPR to publish a story about them.
> In a statement, the hospital said this offer was contingent on Calver submitting his application for a discount based on his household finances. Calver disputed that he owes any additional money to St. David’s and said this situation should have been resolved long before now.
I might be misreading, but is this saying that Calver isn't going to accept even the $700 charge, just to make a statement? I obviously side with him but this seems like a crazy stand to take on principle alone.
Sounds like the usual billing practice of "send him a bill for everything he'll ever have and then graciously negotiate it down merely everything he's got now".
I think this is pretty common. If you get a hospital bill and the insurance already paid a lot, call up the hospital and complain, and it will often be lowered. This happened to me once, a $15k bill was reduced to $3k. The insurance had already paid $50k or so. Hospitals don't really seem to care about the extra portion the patient is supposed to pay. The try to get it, but don't make much fuss when you challenge it, since they already got what they really wanted, the insurance company's money.
> St. David’s HealthCare defended its handling of Calver’s bill and sought to blame the school district and Aetna for offering such a narrow network.
So while dying of a heart attack he should have been negotiating with the ambulance driver, the paramedics, the nurses, each intern and doctor to make sure they are "in-network".
> St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.” I
You can pay $100k or just $700, whatever is cool with us. I guess, go to the media and try to shame everyone involved is your best hope? I can see if they did this to people buying luxury suites or yachts. Doing this to people who are dying of a heart attack is particularly disgusting. And it's not like anyone involved is going to be punished for this practice or learn a lesson. They'll turn around and do the same thing to the next patient.
My father had a heart attack 4 months ago, and he’s been in and out of the ICU for 3 of those months. Everyone likes to think “oh, I’m insured. I’ll be fine.” But let me tell you, you won’t be fine. 3 months of ICU at Robert Wood Johnson was billed for $4Mn. BCBS-NJ only paid out $750k. The headache begins there- from a personal financial standpoint, and Tri-party incentive standpoint. Ignoring the difference of $3.25Mn “owed” to the hospital (technically, this $4Mn is an exaggerated number by RWJ to recoup as much as they can), the insurance company is essentially denying basic/reasonable services. The doctors have been fighting with insurance to get him to an LTACH, but the most they’ll pay for is a nursing home.
Insurance is a business. They aren’t looking out for you, or your loved ones. I hate to sound cynical, but boy, these past 4 months have shown me the deepest, ugliest side of commerce that inevitably results from aligning incentives with profits.
After a reporter made inquiries, St. David’s said collection efforts were put on hold, and a hospital representative called Calver, offering to help him apply for a discount based on his income.
I refuse to believe that the US medical system is run by humans, and not trolls we pulled from under a nearby bridge.
How is a regular person who has other things to do than to read and understated all the details and traps of his health insurance supposed to navigate this insane system?
From what I read going to a hospital is pretty much a gamble that has a certain probability to bankrupt you and there is pretty much nothing you can do about it.
There should be bipartisan agreement that these practices are just not acceptable and that there must be a way for a patient to get binding information upfront.
Looking at the bill, here is some ridiculous: NaCl (basically salted water) costing around $300/liter.
That's outrageous. These guys are protected by your politicians and make use of mercenary tactics. Villains in doctors clothing.
I'm for free markets but we are kinda going over the limit here. Maybe have fixed rates for emergency where you can't get the approval of the patient. Maybe give the patient the possibility to pay for these ridiculously priced items after.
I mean if I get you 1l of NaCl we'd be cool. And fix the rates for emergency.
The US is proof that a free-market system for healthcare does not work. This is also illustrated by all the stories here.
For free-market to work, a consumer needs to be able clearly understand what he is buying and how much it will cost before he consumes whatever he buys. This allows him to shop around, and find the best seller and price.
The current system just drives prices up instead of down, as the seller, who is in it for the profit, can set his prices after the goods have been bought. Ofcourse prices will go up, there's no competition anymore, as the buyer has already consumed the goods.
Trying to make this transparent before an operation would not work. It would just turn healthcare into another IT project, where seller will offer you the lowest prices, and then come up with extra-work that also needs to be done. Image being operated on, and the surgeon informs you they've discovered some required extra work, asking you if you will agree with the additional cost...
It's clear to me that healthcare and free-market are an incompatible combination, it needs to be heavily regulated, and probably single-payer.
I feel like whenever I hear crazy stories like this about healthcare it usually involves these weird in or out of network issues. I'm certainly not an expert on healthcare, but is there no way to attack the problem from this angle?
If you have a hospital with a certain list price for a particular procedure, why is it legal for them to charge one insurance company 5% of that price and charge another insurance company or someone without insurance full price? It seems like exactly the kind of scenario that price discrimination laws are meant to prevent.
Similarly for the insurance plans themselves, why can you sell basically the same plan to employees of a large company for much cheaper than you sell it to employees of a small company? (This one might need to be a new law specific to insurance companies, because clearly there are many other products that give group discounts when selling to large companies, but I think health insurance should be treated differently).
I'm sure I'm missing what some of the downsides might be, but it seems like making these kinds of backroom network-based deals illegal in health insurance would go a long way in making prices more understandable/predictable, and that might allow for more fair competition on price to emerge.
> I feel like whenever I hear crazy stories like this about healthcare it usually involves these weird in or out of network issues. I'm certainly not an expert on healthcare, but is there no way to attack the problem from this angle?
Because hospitals, and physicians, have decided that, for the most part, it is better for each of them for physicians to be "independent contractors", so the situation of "your hospital is in network, but your physician was not".
Or for me, most recently, going to my doctor for a checkup on my hypertension at an Urgent Care/Family Practice hybrid. Facility? In network? Physician/Assistant? In network? Lab in the same building (to be clear, it wasn't a multi-tenant complex, this was a medical practice) that they sent me for CBC draws? Out of network. Boom, hundreds of dollars in lab bills.
Prices, more and more, are negotiated between very few providers and customers. It's like there are 3 fruit stands and 3 buyers of fruit, and those three buyers of fruit are willing to buy huge quantities of fruit (provide a hospital business with lots of patients) as long as the fruit stand meets their price demands. The fruit stand can take it our leave it. If they leave it, they lose out on 1/3 of their potential sales. They go through this kind of negotiation with each of the three fruit sellers every so often.
All this is a bit surreal (Canadian here), but it prompts the question: why won't people sue in a class action to refund money they gave to the insurance in the first place?
I realize it's a complex subject, but at the end of the day, the insurance companies advertise and sell: insurance.
You think someone who is staring at bankruptcy is going to say to themselves "I know what I'll do, I'll spend thousands of dollars I don't have on a lawyer to solve this problem for other people in 5 years"?
Here's the deal. Insurance is a simple concept. Take house fires. They are fairly rare, but they do happen. We could all just save up enough money to cover a house fire ourselves, or, since we know that house fires are rare, we can pool our money together as friends and neighbors and when one of us in that pool gets unlucky and has their house burn down, it can be covered by insurance. A lot of us pay a little money for peace of mind that if a rare catastrophic event does hit us, we'll be OK.
This same concept applies to some medical issues, but there are a lot of medical issues it does not apply to. Getting a routine infection and needing antibiotics? Everyone is going to need that. It makes no sense to pool our money and pay out for the rare person that needs money for that. How many other medical expenses are like that? Even things that are rare for a group of 20-year olds like heart attacks are actually a lot less rare (more common than house fires, probably) for an older age group. So while it might make sense for a group of 20-year olds to pool money together to pay for the rare heart attack amongst that group, it might not make any sense for an over-50 group of people to do that same. It definitely doesn't make sense for a 20-year old to join that group. Yet this is exactly what we do. We all pool our money together and use it to pay for every medical expense that comes up. Minor infection? Use insurance! Need a couple stitches? Use insurance. Routine screening? Wow, didn't see that coming, good thing I have insurance.
This is insane, and this is the root of all our problems.
From outside of the US, it baffles me ( and I'm sure others ) why the US doesn't embrace governement based healthcare. We pay the same kinds of tax rates etc and don't have to pay for health insurance on top of that(though you can get extra health insurance for pretty cheap if you want). It's kind of like governement education which the US does pay for up to a certain point. Not only is it worth educating your population, it's worth looking after their health as well.
The amount of misery and unpayable debt it seems to cause people who live in the US seems really unecessary. Not to mention nearly everyone in good heealth has a certain level of anxiety about whether their insurance is good enough and will cover them.
Mind you guns also seem unecessary yet the general response to that seems to be, It's ok, we will live with our fear and everyone should be carrying guns and make it so everyone needs to be prepared to kill other people in gun fights. If you get wounded of course, then prepare for living the rest of your life in medical debt.. :I
> From outside of the US, it baffles me ( and I'm sure others ) why the US doesn't embrace governement based healthcare.
The US has had majority public support for fully-public healthcare for at least ~30 years.
What it has lacked—even among politicians championing “healthcare reform” like Bill Clinton and Barack Obama—is politicians willing to challenge the insurance industry even with the backing of majority public support.
> Industry analysts and consumer advocates say St. David’s has a reputation for exorbitant billing and for trying to collect big payouts as an out-of-network provider.
Sounds just like St. David’s Medical Center in Austin, TX is run by crooks. I like the take-home message that "Faced with a surprise bill or a balance-billing situation, don’t rush to pay any medical bills you receive."
The insurance company is basically saying, you should still choose the in-network provider even if you are unconscious or don't have a choice or we'll fuck you financially. I've had this happen to me, appealed, and after many months, actually won. In my case I was unconscious and the ambulance and hospital were out of network. I was lucky the hospital was willing to wait over a year and not send it to collections. It was hell. Why the fuck isn't there a law against this kind of shit? Do we expect people who are unconscious or having a heart attack to say, "oh no, take me to an in-network provider so I don't go bankrupt?" Fucking absurd the healthcare in this country and the lack of proper regulation. How long are we going to allow these insurance companies to get rich while people die and go bankrupt?
> The insurance company is basically saying, you should still choose the in-network provider even if you are unconscious or don't have a choice or we'll fuck you financially.
Actually, they are saying if you choose to cut premium costs by selecting a narrow provider network, well, there's a reason why the premium costs are low.
> Why the fuck isn't there a law against this kind of shit?
Because Republicans actively oppose any attempt at health security, and Democrats keep ignoring the majority support for single-payer that polls have shown for close to 30 years in favor of Rube Goldberg solutions that keep private insurers and this type of network-based limitation as central features, despite the fact that hey have less public support and are thus more subject to being politically sabotaged before passage (Clinton) and after (Obama).
Though there's signs of potential for that to change on the Democratic side in the near future...
> Why the fuck isn't there a law against this kind of shit?
There's a pretty clear answer to this question almost every single time it's asked... the people who benefit are wealthy and the people hurt are poor. The latter structurally lack the ability to fight it or lobby their congresspeople to change the law to help them. Until a mass movement steps forward to say "no, we will not tolerate this", nothing can possibly change. We have no recourse but each other and collective action.
This is why I plan on moving to Texas: creditor protection.
At any point in time I could require medical services and have medical service providers simply decide that I owe them a truly massive amount of money. The only route I have to mitigate that risk is through creditor protection laws.
In Texas, wage garnishment is limited to child support, unpaid taxes, and some other limited categories that medical billing doesn't have access to. Creditors can sue you, but they can only seize bank accounts, brokerage accounts, and the like - your primary residence is completely exempt, as are employer-sponsored retirement plans and IRAs.
So my emergency medical debt plan is to liquidate all taxable investments and close out bank accounts, send the cash from that to pay down a mortgage, and tell them to pound sand. The only real consequence is having to head to Walmart each month to cash paychecks and mail out money orders to pay bills.
Another easy solution, file for bankruptcy. No sane judge will kick a family out of their house over a medical bill. That would be counter productive to their recovery and cause undue hardship. If you don't see the utility in bankruptcy, just remember our President has used it several times over decades.
Edit: it's also known as unsecured-debt, which means the worst thing anyone can try to do to you is ruin your credit score. This isn't worth dying over and America is designed to bear the cost.
Bankruptcy really is the ultimate medical insurance. In fact, when so many people don't even have $2k in liquid assets, it almost makes more sense to skip paying actual medical insurance, and just declare bankruptcy in the event of massive medical bills.
What that doesn't help with, though, is something like being diagnosed with a chronic condition where pills cost $800 a pop.
Creditors can do more than ruin your credit score. It's state dependent, but they can also sue you to seize bank accounts, garnish your wages, etc.
Fortunately, it's Texas, so wage garnishment is out, as is seizing your primary residence. So is seizure of retirement accounts. Really the practical amount of debt is what the creditor can force you to pay, which is capped at your liquid assets.
Just cut the gordian knot and nationalize the system already. It's a political no-brainer. There are very few Americans, even conservative ones, who are in love with the intricacies of paying medical bills. The only people beholden to the status quo are those paid to defend it.
[+] [-] jtokoph|7 years ago|reply
Sounds all fine and dandy until you realize that these charges will just be made up for by people that aren't able to get NPR to publish a story about them.
[+] [-] FireBeyond|7 years ago|reply
And, to be clear, they charged $19,000 for the stent, not "stent plus theater time to place it plus surgeon, anesthesiology, OR nurses", of course not. Those are all absolutely billed separately.
[+] [-] opencl|7 years ago|reply
Hell one time I got a $15k bill for something insurance should have covered. Called the hospital, turns out insurance had covered it and I didn't actually owe any money at all. How many people get this kind of stuff and just pay it anyway?
[+] [-] achoped|7 years ago|reply
She told them "I'm on Social Security for $1000/mo, I'll pay you $50/mo". It was basically that or sending it to collections and never getting a dime from a retiree. So they accepted and told her a "non-profit" paid for the doctor's portion of the bill, which was all but about $40k.
She'll probably be around another 10 years max, which means she'll end up paying about $10k of that balance.
Medical debt is the least concerning type of debt for most lenders. If you ever fall into this hole, don't sweat it. [Unsolicited advice.] Just let it go to collections. You'll get harassed for a little over a year. Debt older than a year is almost never pursued by collections agencies. After things quiet down start sending letters to the credits agencies saying the collections debt has been settled. The collections agency will usually slip up and not respond at some point and it'll be gone from your credit history.
[+] [-] jhayward|7 years ago|reply
No, St. David's has already fully recouped their costs and then some. They were simply trying to extract as much money as the stone could bleed.
[+] [-] samfisher83|7 years ago|reply
[+] [-] agumonkey|7 years ago|reply
I once played dumb to an importer abusing fees, after monthes of bouncing mails to different people babbling the same thing over and over, then dealing with a 'lawyer firm' who behaved the same (basically nobody knew precisely what they were talking about). They suddenly accepted to give me a rebate of NN%. So I received a new bill with 100$ - '80$ promotional deal' = 20$ (normal fee). A very partial grin ensued.
[+] [-] FactolSarin|7 years ago|reply
[+] [-] badcede|7 years ago|reply
Sounds a bit like getting support from Google.
[+] [-] apetresc|7 years ago|reply
> In a statement, the hospital said this offer was contingent on Calver submitting his application for a discount based on his household finances. Calver disputed that he owes any additional money to St. David’s and said this situation should have been resolved long before now.
I might be misreading, but is this saying that Calver isn't going to accept even the $700 charge, just to make a statement? I obviously side with him but this seems like a crazy stand to take on principle alone.
[+] [-] noonespecial|7 years ago|reply
[+] [-] BLanen|7 years ago|reply
[+] [-] hellofunk|7 years ago|reply
[+] [-] maxerickson|7 years ago|reply
[+] [-] Marazan|7 years ago|reply
[+] [-] rdtsc|7 years ago|reply
So while dying of a heart attack he should have been negotiating with the ambulance driver, the paramedics, the nurses, each intern and doctor to make sure they are "in-network".
> St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.” I
You can pay $100k or just $700, whatever is cool with us. I guess, go to the media and try to shame everyone involved is your best hope? I can see if they did this to people buying luxury suites or yachts. Doing this to people who are dying of a heart attack is particularly disgusting. And it's not like anyone involved is going to be punished for this practice or learn a lesson. They'll turn around and do the same thing to the next patient.
[+] [-] treyfitty|7 years ago|reply
Insurance is a business. They aren’t looking out for you, or your loved ones. I hate to sound cynical, but boy, these past 4 months have shown me the deepest, ugliest side of commerce that inevitably results from aligning incentives with profits.
[+] [-] lainga|7 years ago|reply
I refuse to believe that the US medical system is run by humans, and not trolls we pulled from under a nearby bridge.
[+] [-] maxxxxx|7 years ago|reply
From what I read going to a hospital is pretty much a gamble that has a certain probability to bankrupt you and there is pretty much nothing you can do about it.
There should be bipartisan agreement that these practices are just not acceptable and that there must be a way for a patient to get binding information upfront.
[+] [-] 0x7f800000|7 years ago|reply
If I think you are trying to extort me, I am just going to go to another hospital.
[+] [-] csomar|7 years ago|reply
That's outrageous. These guys are protected by your politicians and make use of mercenary tactics. Villains in doctors clothing.
I'm for free markets but we are kinda going over the limit here. Maybe have fixed rates for emergency where you can't get the approval of the patient. Maybe give the patient the possibility to pay for these ridiculously priced items after.
I mean if I get you 1l of NaCl we'd be cool. And fix the rates for emergency.
[+] [-] ako|7 years ago|reply
For free-market to work, a consumer needs to be able clearly understand what he is buying and how much it will cost before he consumes whatever he buys. This allows him to shop around, and find the best seller and price.
The current system just drives prices up instead of down, as the seller, who is in it for the profit, can set his prices after the goods have been bought. Ofcourse prices will go up, there's no competition anymore, as the buyer has already consumed the goods.
Trying to make this transparent before an operation would not work. It would just turn healthcare into another IT project, where seller will offer you the lowest prices, and then come up with extra-work that also needs to be done. Image being operated on, and the surgeon informs you they've discovered some required extra work, asking you if you will agree with the additional cost...
It's clear to me that healthcare and free-market are an incompatible combination, it needs to be heavily regulated, and probably single-payer.
[+] [-] donretag|7 years ago|reply
From my experience, it is completely legal for any medical practitioner to say they accept an insurance even though they really do not.
[+] [-] dcosson|7 years ago|reply
If you have a hospital with a certain list price for a particular procedure, why is it legal for them to charge one insurance company 5% of that price and charge another insurance company or someone without insurance full price? It seems like exactly the kind of scenario that price discrimination laws are meant to prevent.
Similarly for the insurance plans themselves, why can you sell basically the same plan to employees of a large company for much cheaper than you sell it to employees of a small company? (This one might need to be a new law specific to insurance companies, because clearly there are many other products that give group discounts when selling to large companies, but I think health insurance should be treated differently).
I'm sure I'm missing what some of the downsides might be, but it seems like making these kinds of backroom network-based deals illegal in health insurance would go a long way in making prices more understandable/predictable, and that might allow for more fair competition on price to emerge.
[+] [-] FireBeyond|7 years ago|reply
Because hospitals, and physicians, have decided that, for the most part, it is better for each of them for physicians to be "independent contractors", so the situation of "your hospital is in network, but your physician was not".
Or for me, most recently, going to my doctor for a checkup on my hypertension at an Urgent Care/Family Practice hybrid. Facility? In network? Physician/Assistant? In network? Lab in the same building (to be clear, it wasn't a multi-tenant complex, this was a medical practice) that they sent me for CBC draws? Out of network. Boom, hundreds of dollars in lab bills.
[+] [-] krupan|7 years ago|reply
This is far from an ideal free market.
[+] [-] unknown|7 years ago|reply
[deleted]
[+] [-] quickben|7 years ago|reply
I realize it's a complex subject, but at the end of the day, the insurance companies advertise and sell: insurance.
[+] [-] lotsofpulp|7 years ago|reply
[+] [-] InclinedPlane|7 years ago|reply
[+] [-] unknown|7 years ago|reply
[deleted]
[+] [-] noelsusman|7 years ago|reply
[+] [-] FactolSarin|7 years ago|reply
[+] [-] krupan|7 years ago|reply
This same concept applies to some medical issues, but there are a lot of medical issues it does not apply to. Getting a routine infection and needing antibiotics? Everyone is going to need that. It makes no sense to pool our money and pay out for the rare person that needs money for that. How many other medical expenses are like that? Even things that are rare for a group of 20-year olds like heart attacks are actually a lot less rare (more common than house fires, probably) for an older age group. So while it might make sense for a group of 20-year olds to pool money together to pay for the rare heart attack amongst that group, it might not make any sense for an over-50 group of people to do that same. It definitely doesn't make sense for a 20-year old to join that group. Yet this is exactly what we do. We all pool our money together and use it to pay for every medical expense that comes up. Minor infection? Use insurance! Need a couple stitches? Use insurance. Routine screening? Wow, didn't see that coming, good thing I have insurance.
This is insane, and this is the root of all our problems.
[+] [-] keithnz|7 years ago|reply
The amount of misery and unpayable debt it seems to cause people who live in the US seems really unecessary. Not to mention nearly everyone in good heealth has a certain level of anxiety about whether their insurance is good enough and will cover them.
Mind you guns also seem unecessary yet the general response to that seems to be, It's ok, we will live with our fear and everyone should be carrying guns and make it so everyone needs to be prepared to kill other people in gun fights. If you get wounded of course, then prepare for living the rest of your life in medical debt.. :I
[+] [-] dragonwriter|7 years ago|reply
The US has had majority public support for fully-public healthcare for at least ~30 years.
What it has lacked—even among politicians championing “healthcare reform” like Bill Clinton and Barack Obama—is politicians willing to challenge the insurance industry even with the backing of majority public support.
[+] [-] jimbokun|7 years ago|reply
https://www.cnbc.com/2018/08/28/most-americans-now-support-m...
[+] [-] kimsk112|7 years ago|reply
Sounds just like St. David’s Medical Center in Austin, TX is run by crooks. I like the take-home message that "Faced with a surprise bill or a balance-billing situation, don’t rush to pay any medical bills you receive."
[+] [-] mabbo|7 years ago|reply
[+] [-] mnm1|7 years ago|reply
[+] [-] dragonwriter|7 years ago|reply
Actually, they are saying if you choose to cut premium costs by selecting a narrow provider network, well, there's a reason why the premium costs are low.
> Why the fuck isn't there a law against this kind of shit?
Because Republicans actively oppose any attempt at health security, and Democrats keep ignoring the majority support for single-payer that polls have shown for close to 30 years in favor of Rube Goldberg solutions that keep private insurers and this type of network-based limitation as central features, despite the fact that hey have less public support and are thus more subject to being politically sabotaged before passage (Clinton) and after (Obama).
Though there's signs of potential for that to change on the Democratic side in the near future...
[+] [-] acomar|7 years ago|reply
There's a pretty clear answer to this question almost every single time it's asked... the people who benefit are wealthy and the people hurt are poor. The latter structurally lack the ability to fight it or lobby their congresspeople to change the law to help them. Until a mass movement steps forward to say "no, we will not tolerate this", nothing can possibly change. We have no recourse but each other and collective action.
[+] [-] dboreham|7 years ago|reply
Because the laws are made by people bought and paid for by the people perpetrating this fraud?
[+] [-] alkonaut|7 years ago|reply
[+] [-] ThrustVectoring|7 years ago|reply
At any point in time I could require medical services and have medical service providers simply decide that I owe them a truly massive amount of money. The only route I have to mitigate that risk is through creditor protection laws.
In Texas, wage garnishment is limited to child support, unpaid taxes, and some other limited categories that medical billing doesn't have access to. Creditors can sue you, but they can only seize bank accounts, brokerage accounts, and the like - your primary residence is completely exempt, as are employer-sponsored retirement plans and IRAs.
So my emergency medical debt plan is to liquidate all taxable investments and close out bank accounts, send the cash from that to pay down a mortgage, and tell them to pound sand. The only real consequence is having to head to Walmart each month to cash paychecks and mail out money orders to pay bills.
[+] [-] megamindbrian2|7 years ago|reply
Edit: it's also known as unsecured-debt, which means the worst thing anyone can try to do to you is ruin your credit score. This isn't worth dying over and America is designed to bear the cost.
[+] [-] chatmasta|7 years ago|reply
What that doesn't help with, though, is something like being diagnosed with a chronic condition where pills cost $800 a pop.
[+] [-] ThrustVectoring|7 years ago|reply
Fortunately, it's Texas, so wage garnishment is out, as is seizing your primary residence. So is seizure of retirement accounts. Really the practical amount of debt is what the creditor can force you to pay, which is capped at your liquid assets.
[+] [-] paulcole|7 years ago|reply
Got there and asked at admittance, "Do you take my insurance?" Was assured they did.
Got a big bill a few months later and it turned out the doctor working in the covered ER was not covered by my insurance.
[+] [-] jim-jim-jim|7 years ago|reply