patrick.net

A health insurer that wouldn’t pay

In America?

That’s their business model: to deny payment and thrust you in to bankruptcy. Capitalism lulz

A lot of people abuse the Emergency Room access. It raises insurance costs for everyone.
Nevertheless, our health care system is screwed up.

Her mistake was not calling the nurse line first and describing the symptoms. She would either get an urgent care appointment right away or nurses' advice to to go ER, effectively covering her ass from the shit like described in the article.

Satoshi_Nakamoto says

Her mistake was not calling the nurse line first and describing the symptoms. She would either get an urgent care appointment right away or nurses' advice to to go ER, effectively covering her ass from the shit like described in the article.

Uh huh, and a person would know to follow these instructions you presented how?

errc says

Capitalism lulz

HealthCare is anything but Capitalism at this point in time, if it was, there would be far more transparency.

Goran_K says

errc says

Capitalism lulz

HealthCare is anything but Capitalism at this point in time, if it was, there would be far more transparency.

That’s quite a yuge and vital sector of the economy to not be Capitalist yet we still call our economy Capitalism.

What is left of Capitalism in this “Capitalist” society?

Goran_K says

HealthCare is anything but Capitalism at this point in time, if it was, there would be far more transparency.

How would transparency have helped in this case? Someone who thinks they have are in the midst of appendicitis is going to go surgery shopping?

WineHorror says

Satoshi_Nakamoto says

Her mistake was not calling the nurse line first and describing the symptoms. She would either get an urgent care appointment right away or nurses' advice to to go ER, effectively covering her ass from the shit like described in the article.

Uh huh, and a person would know to follow these instructions you presented how?

First of all this is fucking common sense: instead of hightailing to ER and spending shitload of time there in line waiting to be triaged, calling the nurse line and asking for advise and maybe appointment at the urgent care facility saves that person shitload amount of time (and money, as we can see). Secondly, this is usually fucking printed on a fucking 1-page pamphlet when a person gets their insurance documents. And sometimes it's even fucking printed on a fucking insurance card. We are living in the world when a call can be made hands-free voice-dialed from a fucking moving car but people still want to just drop in into the fucking ER and just seat there for hours instead of making the fucking call and talking to an actual nurse right away.... Fucking insane.

anon_8f378 says

How would transparency have helped in this case? Someone who thinks they have are in the midst of appendicitis is going to go surgery shopping?

Transparency keeps prices down. The reason the bill was so high in the first place was because the item list of things they do is so over priced (doctor examination: $1500, second doctor took a look: $2000).

Over time, the market would adjust to a more reasonable level since information would be available, and over time prices for emergency room visits would be much lower since consumers would make better decisions on where to go for care.

anon_8f378 says

How would transparency have helped in this case? Someone who thinks they have are in the midst of appendicitis is going to go surgery shopping?

The solution is to split healthcare into two parts:

1. emergency treatment
2. all other treatment

There can never be a market for emergency treatment, since shopping and price/quality comparison is impossible in an emergency. Therefore emergency prices must be regulated, or they simply become extortion (the current situation).

For non-emergency treatment, the best first step toward a market would be the requirement that all prices be published instead of hidden and difficult to discover like they are now.

errc says

What is left of Capitalism in this “Capitalist” society?

Not very much is pure capitalism anymore. Too many statist who want government to take over everything. This is the result, a mix-bag of pseudo capitalism mixed with public sector inefficiency. It's terrible, but it's not too late to change and become better voters.

#Socialism #NotEvenOnce

Goran_K says

HealthCare is anything but Capitalism at this point in time, if it was, there would be far more transparency.

transparency? Since when capitalists want to show what they are doing?
US healthcare is optimized to do exactly what capitalists everywhere do: they maximize the lifetime profits made on their customers. It works well - according to capitalistic principles.

Since there is no market (and no competition) for emergencies, and they can charge whatever they want. There is simply no reason not to charge a fortune. There is simply no reason for insurance companies, not to deny your claims for futile reasons.

As long as Americans think medicine is the same as manufacturing a widget, and as long as they think "capitalism" by default is always beneficial to them, they'll continue to lose track of the plot, and will continue to get fleeced.
It's not something new. But Americans don't learn.

Satoshi_Nakamoto says

First of all this is fucking common sense: instead of hightailing to ER and spending shitload of time there in line waiting to be triaged, calling the nurse line and asking for advise and maybe appointment at the urgent care facility saves that person shitload amount of time (and money, as we can see). Secondly, this is usually fucking printed on a fucking 1-page pamphlet when a person gets their insurance documents. And sometimes it's even fucking printed on a fucking insurance card. We are living in the world when a call can be made hands-free voice-dialed from a fucking moving car but people still want to just drop in into the fucking ER and just seat there for hours.... Fucking insane.

Fucking a

Patrick says

We are all vulnerable to shit like this, even with insurance.

I would trust a single payer more so than a private insurance. Either give the consumer power by making prices and coverage transparent or give a single payer the ability to keep ERs honest. Anything less is ass raping of consumers.

anon_61c8a says

Either give the consumer power by making prices and coverage transparent or give a single payer the ability to keep ERs honest. Anything less is ass raping of consumers.

---

Absolutely!

Medical care is perhaps the biggest ass-raping racket in America at the moment, driven by funneling extorted profits into campaign contributions for corrupt Congressmen to make sure that the racket continues indefinitely.

I'm going to definitely start a site where we can comment on the votes and potential corruption of each individual Congressman.

Heraclitusstudent says

As long as Americans think medicine is the same as manufacturing a widget, and as long as they think "capitalism" by default is always beneficial to them, they'll continue to lose track of the plot, and will continue to get fleeced.
It's not something new. But Americans don't learn.

As long as Americans compare our healthcare system to a free market system (lolz), they will collectively miss the plot.

Our govt spends more per capita on healthcare than any country in the world. Add on a mountain of regulation and voila, we have today's healthcare mess. It is a failure of govt intervention.

Heraclitusstudent says

transparency? Since when capitalists want to show what they are doing?
US healthcare is optimized to do exactly what capitalists everywhere do: they maximize the lifetime profits made on their customers. It works well - according to capitalistic principles.

I'm talking about price transparency, if that wasn't clear.

Capitalism does maximize profits, but that is also a built in price control, the most efficient ever seen by modern society. People always say "Capitalism is all about profits", but the truth is, it's also about competition. No one remembers that part though, at least those who view capitalism as evil due to profit seeking.

They should have taken vitamins and be more proactive in their health upkeep.
Obamacare FIXED ER visits, they unilaterally decided if you ate right, exercised and didn't smoke, you should never have to go to the ER again and if you did it's your fault.

This doesn't affect me John Q Liberals he should have taken care of himself that's what healthcare is for.

Goran_K says

errc says

Capitalism lulz

HealthCare is anything but Capitalism at this point in time, if it was, there would be far more transparency.

I really have to cringe at the left these days. I have come to realize they were the Goth kids that thought the Che shirts were cool and scribbled the Anarchy "A" on everything, and hung out with Chad the Liberal high school History Teacher, who was the local communist chapter president. They were the hip kids everyone thought was so progressive and popular they were going to grow up and be the bright ones. They never grew up, they actively perusing every "What if?" They asked themselves at 14 when they had no idea how the world works, other than what Chad told them about Capitalists. These are the guys running for office and most politically active in the Democrat elections.

The only place where you find cost after service is a hospital. Ridiculous.

I remember years ago they sent me a 25k bill for an X-ray and a bandaid. That’s such a scam. We just threw that bill out. Never paid it, and they never followed up.

Patrick says

For non-emergency treatment, the best first step toward a market would be the requirement that all prices be published instead of hidden and difficult to discover like they are now.

I was recently on Sutter's website and almost did a spit take when I came across this price list. Certainly not comprehensive, but better than a kick in the head. They even post wait times at their Urgent Care centers as well.

Wow, a price list is pretty rare. I commend them.

Patrick says

Emergency room prices need to be regulated by law, because there is certainly no market at work here.

Regulation is everywhere in our current sickcare system, I don't see it helping reduce costs. There is absolutely a free market at work for any service that's truly needed, it's impossible for there not to be one, as black markets have proven.
Lower costs require the AMA to stop choking the supply of competent doctors, and stop limiting the scope of treatments and health practices available. Flood the market with choices, and prices will go down. As long as the insurance cartel, pharma cartel, and regulation cartel is allowed to operate, don't expect any improvement.

Our current system is much closer to single payer then it is to a free market. Everyone over 65 gets medicare (single payer). Most other people pay for medical care via insurance, which is just single payer only it's your company that is paying.

Our system is a mess because of insurance companies, not capitalism. Doctors over treat and overbill to maximize profits. Pharmaceutical companies overcharge for drugs knowing insurance companies will pay. They both rely on the fact that nobody complains when they see the bill because they aren't paying it, it's all covered by the insurance. Because we are missing that feedback mechanism, providers get away with it.

Who looks at this system and wants to double down by letting the government become the national insurance provider for everyone?

- Regulations on price gouging in emergency situations are great.
- Some type of safety net should be in place for the very poor
- Everyone else should just pay their own way out of pocket and maybe hold a catastrophic policy in case they get cancer.

anon_4e80d says

Who looks at this system and wants to double down by letting the government become the national insurance provider for everyone?

Funny, every other civilized country has found a way to make it work for half the cost. Better outcomes, lower costs.

So, I would bet a lot of people would look at the rest of the world and think exactly that.

What's interesting is that she is a government employee, but instead of using her gold plated government employee plan, she was on her husband's insurance plan.

Goran_K says

Capitalism does maximize profits, but that is also a built in price control, the most efficient ever seen by modern society.

This is true. It's called competition.
Have you thought through how competition and price transparency work in emergencies?
- you get there, they don't know what you have, so no price.
- $2000 to checkin. "triaging is work, you know".
- they want 1 specialist to look at you, which will be $500. Do you pay or do you try a different hospital?
- 3 specialists look at you.
- they decide they need a scan. price $1500. Do you leave then? You are in pain. Ok you pay.
- the results are inconclusive. They want a x-ray and a blood test. $1500. Ding.
- They decide you need a surgery for $35,000 + surrounding cares. You could try a different hospital, but they say you might die if they delay.
- "screw it! the insurance will pay"
Insurance: "screw the policy holders, they'll pay their premium increases as they always do.". "But hey let's deny that moron, he had it coming".

Goran: "Continue betting on capitalism. Continue hoping for the best."
But remember: being able bodied is a temporary circumstance. You think you're invulnerable until you end-up at that hospital door, with the leeches waiting for you.

Patrick says

Emergency room prices need to be regulated by law, because there is certainly no market at work here.

Yuuuup.

Heraclitusstudent says

Goran_K says

Capitalism does maximize profits, but that is also a built in price control, the most efficient ever seen by modern society.

This is true. It's called competition.
Have you thought through how competition and price transparency work in emergencies?
- you get there, they don't know what you have, so no price.
- $2000 to checkin. "triaging is work, you know".
- they want 1 specialist to look at you, which will be $500. Do you pay or do you try a different hospital?
- 3 specialists look at you.
- they decide they need a scan. price $1500. Do you leave then? You are in pain. Ok you pay.
- the results are inconclusive. They want a x-ray and a blood test. $1500. Ding.
- They decide you need a surgery for $35,000 + surrounding cares. You could try a different hospital, but they say you might die if they delay.
- "screw it! the insurance will pay"
Insurance...

Socialism. Never once, not even a little bit. Except everywhere always because muh Capitalism keeps failing