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Oh no, I can't afford to live to continue to pay tribute to my landed lord! The bosses from my 3 part time jobs will be so disappointed I left them short handed. What about the profits I could have generated shareholders?
Alas, I have let down all these dependants in my life by being to poor to afford health care.
Yes...it should. The only answer to this problem is universal healthcare...period. if this were implemented poor people will be in crippling debt the rest of their lives and once again the middle class will eat even higher insurance premiums to make up for it.
Big healthcare will get aggressive around settling it's debts and it will squeeze blood from a stone if it has to.
Universal Healthcare or nothing.
I'd be happier if there and actual identity control system in our credit system. Identity theft is stupidly difficult to clean up.
America. You ok bro?
Never have been.
No we are not ok.
I don't think they should be even able to bill if the insurance does not accept the charge. They should have to work it through insurance first and if insurance denies it they can get a signature of the patient to say they will pay but the form they sign must show the response from the insurance company to show they went through the process and determined it cannot be done with insurance. It can't be some sort of standard form every patient is required to sign before even being seen.
This. I had to get an MRI done to diagnose severe stenosis in my neck. I had to wait 3 excruciating months for the appointment, I had lost almost all ability to care for myself, couldn't walk, couldn't use my left hand due to the muscle spasms. I go to the hospital the day of my appointment, the desk clerk says
"sign this for that says you'll agree to pay if insurance denies the procedure"
"Ok, I have insurance and (in hindsight) I'm going to die if I don't get emergency surgery soon, insurance should cover that right (signs)?"
"Sure"
2 months later...
Hospital "Insurance denied your claim because we didn't bother to submit a pre-auth, you owe us $6500."
"Ok I can't pay that, can I pay a little while I try to work with insurance"
"Sure, go ahead and agree to this 60 month payment plan, it's only $100/mo"
"Ok, I'll do that for now while I try to negotiate with everyone"
Bank that now owns my debt and cannot be negotiated with: "No negotiations, we own $6500 in debt, we want $6500"
Even if they submit the pre-auth I have had so many denials that show up a month after the procedure was done and for things were it could have waited. It had to be done and maybe its way worse to wait but this is america so it can wait (not yours but things from my family). I can budget for maximum out of pocket each year but not for maximum out of pocket and someone unknown amounts that has no upper ceiling. and to get off topic I love the we won't cover this pretty cheap and easy thing that has been around for awhile and has a proven track record to work or improve outcomes but we will this big expensive surgery that you know oftentimes work but if it doesn't, woa baby your quality of life is sunk. but hey your choice. its like a game of chicken. their cost versus your willingness to risk aweful outcomes.
If we had a proper healthcare system then getting sick wouldn't impact your financial situation so severely
If you had a proper healthcare system you wouldn't get crazy bills at all...
But people exploiting it start screaming "socianism!" and everyone starts booing and suddenly forgets it's plain how a nationwide insurance works.
The flip side of this debate is that by banning all medical debt from credit reports, patients will have no incentive to pay their medical bills and instead just skip them entirely, forcing hospitals to demand payment up front, raise prices even further, etc.
What do I say to that? Fuck 'em.
First, stop jacking up the prices of mundane items. Asprin shouldn't be costing me $20+ per pill just to cure a headache. That doctor that stopped in for 3 seconds to ask how I was doing shouldn't run me $2500.
Second, make sure bills are (a) accurate, and (b) easy to read. Don't just stick some medical jargon and some huge number as a line item and expect patients to just blindly pay it without question. At best, expect them to question it (which is how most of the inaccuracies are found), and at worst, they'll just ignore the bill entirely, especially if it's out of their financial reach. Giving the patient a clean, easy to understand, reasonable and most importantly accurate hospital bill would at least give hospitals some chance of getting some of the money.
Third, if they want to go after someone for the money, go after the god damned insurance companies. Tell them to cover what they said they were going to cover. Tell them to stop weaseling out of paying by using semantics and doublespeak to get away with not paying on a technicality. Tell them to stop with the sky-high deductibles. But you were never going to get any of the money by harassing and ruining the credit of a mother of two who was already struggling to make ends meet before whatever health issues brought her to the hospital in the first place. That $12,000 bill you sent her? Might as well have been for $12,000,000,000. You had the exact same chances of that person being able to pay off either one in the first place: 0.
And finally, stop sending multiple bills that are days, weeks, or even months apart. I don't care how "independent" your doctors are or whatever the case is. I should expect to get one hospital bill, not half a dozen spread out over months. How you accomplish this shouldn't be my problem. But if you're going to continue doing this, don't be surprised when those bills go unpaid or are lost in the shuffle because the patient thinks they already handled that and just proceed to ignore it. Patients shouldn't suffer because hospitals can't figure out how the hell to even bill their patients properly.
If hospitals want their money, let them get it from the insurance companies that we're paying thousands of dollars a month to in the first place, not the people who never wanted to be in a situation where they needed hospital care and would never have the resources to pay it back in the first place. Let the patients try to rebuild their lives, and go after the insurance companies that we're paying to handle this for us.
That's a whole Lotta words to say universal Healthcare
Had to have my ankle put back together in November after breaking it super bad. Almost all of the bills have gone to collections because there are too many separate bills for me to keep up with. I'd also just get them randomly and new ones keep popping up every so often. Sometimes I cry just thinking about it.
forcing hospitals to demand payment up front, raise prices even further, etc.
Which means for scheduling care they'll have to either explain all the charges or they won't get business. But for emergency care they are still fucked. They can't deny emergency care regardless of payment ability.
Just because it's not on a report doesn't mean providers have no recourse when it comes to seeking compensation. If they so choose they can take anyone to court and obtain a legal judgement. The frequent calls and letters from collectors are no picnic either.
The biggest issue I have with paying bills on time is the stupid billing systems. Like 30% of the time I either can't find the payment option in their portal, login doesn't work, don't see any record of services (i.e. just give us money), or the total amount owed is different from the paper bill. Life is distracting, and if I can't assess what I'm paying for and get to the "Submit Payment" button in 10 mins then don't expect me to remember 8 hours later when I again have free time.
Just because it’s not on a report doesn’t mean providers have no recourse when it comes to seeking compensation.
No, but most of the time it's simply not worth it for hospitals to fight. Either they'd spend more time and money on lawyers, arbitration, etc. than they'd be able to collect if they win, or the patient is poor and all but judgement-proof.
If they so choose they can take anyone to court and obtain a legal judgement. The frequent calls and letters from collectors are no picnic either.
If I recall reading the updated proposal from the CFPB correctly, it's supposed to be putting a stop to the debt collectors too. The only recourse left, if I'm reading everything correctly, would be for the hospitals to sue patients directly, and that would probably only be for bills high enough to make seeking legal action worth it and if they feel the patient has the resources to pay. The latter is the most important part -- whether the bill is for $100 or eleventy billion dollars won't matter if the patient is, for example, and elderly woman on disability with no possible way to repay anything.
Or even better, single payer where the patient doesn't have to do anything about the cost. Why should cancer patients and people with traumatic brain injuries need to worry about costs?
Why should single mothers? Why should any person who needs treatment?
This I agree with, but it's not the system we have. Right now, under our current and shitty system, hospitals have two options: They can go after the insurance companies or they can go after the patients. I say fuck 'em and make them go after the insurance companies if they want their money. Isn't that what we're supposed to be paying them for? And if hospitals don't like the fact that they have to deal with insurance companies if they want to get paid at all, then they can join the push for a single payer system in this country that ensures they get paid without having to harass and ruin the lives of the patients.
FWIW, Cigna insurance tells its insured people that health care providers are never supposed to send bills to patients.
This is really the only logical answer. When else is someone allowed to force you to agree to unknown terms at the consequence of your health? That matches every definition of extortion I can find...
When else is someone allowed to force you to agree to unknown terms at the consequence of your health?
You're not even "agreeing" to the unknown terms a lot of the time. Your "agreement" is just assumed. How the hell can you "agree" to anything if you're unconscious and being brought to the hospital in an ambulance after a car accident? Or when you're literally in the middle of a heart attack?
99.99% of people who are going to hospitals aren't exactly in any condition to shop around, make informed choices, or "agree" to anything at all, and most of the services they're being billed for were most likely for services rendered while the patient was still incapacitated or otherwise unable to agree to anything. And what if you disagree? You die? And if you don't like the prices your hospital is going to charge, what are you going to do if it's the only hospital in your area?
If you were to enter literally any other "agreement" in this country when there are no competing hospitals in your area to shop around for, the terms of the agreement are unknown until weeks or months after services are rendered, and you are in no way capable of giving informed consent at the time the agreement is made, it would be thrown out of court for being made under duress and for being too one-sided.
Exactly. I do agree with you, except possibly on your comments about only doing what insurance pays for. I feel that would go the opposite of the way I imagine you are picturing.
As you said, if someone is dying, unconscious, etc, nobody will be able to tell what, if any, insurance you have. Also, with some of the crappier plans out there, especially the barebones "Anti-Obamacare" plans red states are pushing, you might be having a very unpleasant visit if no one from insurance can confirm in a timely manner what they will cover, or if you can only get an Ibuprofen after your surgery instead of a narcotic, etc.
I assume your plan would be more like, the medical team does the same job they'd do on you as anyone else, and then insurance is stuck with that bill. But as we all have some form of tiered insurance as it is, if we have any at all, that's about as moot as discussing single payer. And that is why single payer is the only reasonable way to go forward. Any games going on are between the hospital and the fed, where they belong. We're all mostly out of the equation then. Except for medical procedures still deemed political, in which the list for that seems to be growing and ever changing as well. But that's a story for another time....and not from me, that's too heated for me!
Hospitals jacking up prices is kind of a function of the insurance industry. Insurance says "We're only going to pay you ten percent of what you've actually billed," so health care providers take the amount that they're willing to receive for the services and add a zero to the end. This becomes the "retail price," and you don't get access to the insurance price. Only the insurance companies do, and you have to pay them a monthly "protection fee," whether you require healthcare that month or not.
Do insurances only pay a set % of charged? Because in that case hospitals would just charge whatever arbitrary amount they wanted.
I think insurances set hard limits on paying individual types of tasks and procedures. Hospitals and doctors bill whatever they want, insurance pays X that's allowed, tells the insured what they owe, and the rest is written off by the doctor because no one is obligated to pay it.
This is what procedure codes are for. Technically, they only apply to Medicare but im sure insurance uses them. As far as I know there is a catalog of every possible procedure and the insurance company has an agreement with the hospital that they will pay a specific amount for each. There are also loose guideleines as for what procedures are appropriate in what circumstances.
Your hospital send insurance a bill with procedure codes, then insurance decides whether the procedure appears appropriate and in theory pays
That’s why one of the first things to try is for the medical personnel to re-code your record. maybe there’s a similar one that’s more appropriate to the illness or to what the hospital did
This is the best summary I could come up with:
Too often, patients receive bills filled with hard-to-interpret codes and outright errors — where a mistake can add thousands of dollars in costs but require weeks of persistence to unravel.
Over the past decade, research from the Consumer Financial Protection Bureau (CFPB) and independent experts has demonstrated that medical bills should be treated differently than other kinds of debt.
If the CFPB finalizes the rule as proposed, we estimate this action will remove $49 billion of medical debts that unfairly lower the credit scores of 15 million Americans.
We expect that people affected by the change will see their credit scores rise by an average of 20 points and that lenders will be able to approve approximately 22,000 additional safe mortgages every year.
States like Colorado and New York have reached similar conclusions and passed laws banning all medical debt from appearing on credit reports.
Companies that produce credit scoring models, like VantageScore and FICO, which are financially incentivized to assess the predictive value of medical debt, have also reduced their reliance on this junk data.
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