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from the meanwhile-don't-get-sick-or-hurt dept.
The bipartisan plan to end surprise ER bills, explained:
The policy proposal, which you can read here, essentially bars out-of-network doctors from billing patients directly for their care. Instead, they would have to seek payment from the insurance plan. This would mean that in the cases above, the out-of-network doctors couldn't send those big bills to the patients, who'd be all set after paying their emergency room copays.
The doctors would instead have to work with patients' insurance, which would pay the greater of the following two amounts:
- The median in-network rate negotiated by health plans
- 125 percent of the average amount paid to similar providers in the same geographic area
The Senate proposal would also require out-of-network doctors and hospitals to tell patients that they are out of network once their condition has stabilized, and give them the opportunity to transfer to an in-network facility.
[...] it's pretty good policy too! That's the general feedback I got from Zack Cooper, an associate professor at Yale University, who, along with his colleague Fiona Scott Morton, has done a lot of pioneering research to uncover how frequently and where these surprise bills happen.
"It is fantastic that they're doing something, and that it's bipartisan," he says. "It's one of those areas where we can agree what is happening now is not good, and this gets us 80 percent of the way to fixing it."
[...] "My concern here is that in-network rates are already quite high, so we're cementing that into the system," he says. "The current world gives emergency physicians tremendous power in negotiating higher in-network rates."
See also: Emergency room visit costs: what's the price of care?
(Score: -1, Flamebait) by Anonymous Coward on Monday October 08 2018, @10:05PM (14 children)
You like socialism. There are many countries where you can enjoy this. You are not prohibited from leaving the USA to seek the worker's paradise of your dreams.
I don't like socialism, anarchy, Islamic theocracy, or communism. There is only one country for me. I'm stuck here fighting to preserve what I like. Leave me alone. Quit trying to take my choice away.
(Score: 5, Insightful) by Immerman on Monday October 08 2018, @10:07PM (3 children)
Why do you claim they have less right to to choose the direction of their supposedly democratic homeland than you do?
(Score: 0) by Anonymous Coward on Monday October 08 2018, @10:54PM (1 child)
Where does this idea that the US is supposed to be a democracy come from? Just because people vote doesnt make it a democracy.
In the US the constitution is supposed to trump the will of the people (but there are mechanisms to amend the constitution if enough people want it to happen):
https://en.wikipedia.org/wiki/United_States [wikipedia.org]
(Score: 0) by Anonymous Coward on Monday October 08 2018, @11:59PM
Welcome to the 21st century, Rip van Winkle! I am very sorry to inform you, but for quite a while now, SCOTUS has used the following process:
1. Would the Ninth or Tenth Amendment prohibit the law? If yes, proceed to the next step. If no, proceed to the next step.
2. Does the law involve commerce of some kind (interstate, intrastate) or can it potentially involve commerce or is it regard something that somebody could conceivably put up for auction or sell to a neighbor? If yes, the interstate commerce clause allows the law to stand. If no, proceed to the next step.
3. Is it a state law that upon first glance would be outside of the jurisdiction of the federal government? If yes, the equal protection clause of the Fourteenth Amendment prohibits the law. If no, proceed to the next step.
4. If yes was obtained for the first step, the due process clause of the Fourteenth Amendment prohibits the law.*
5. Otherwise, the necessary and proper clause allows it.
Any questions?
* Note: Step 4 may be changing soon! Huzzah for ASS-JUSTICE Kavanaugh!
(Score: 0) by Anonymous Coward on Tuesday October 09 2018, @05:57AM
I can't go anywhere else in the world to get my freedom. The USA is all there is. If the USA falls, then I don't have freedom.
If you hate freedom, you have so many choices! Take the UK for example. You get the NHS, you're totally safe in London because it is prohibited to carry knives, cameras are everywhere so you're doubleplus safe, and you can get your conservative opponents sent to die in jail if they suggest that Islam kind of sucks. It's like that all over the world, or sometimes with even less of that annoying freedom! Go. Be happy.
(Score: 4, Insightful) by PartTimeZombie on Monday October 08 2018, @10:19PM (2 children)
You have drunk the kool-aid.
Keep pretending the awful health system you're stuck with is the "best", or that you have a "choice" nobody is buying it though. [internationalinsurance.com]
FYI, I don't live in the US, and never have. I have visited however. Can I extend an invitation for you to visit my country? You never know, it might open your eyes.
(Score: 4, Touché) by c0lo on Monday October 08 2018, @10:24PM (1 child)
But then... how can he have the perpetual American dream with the eyes opened?
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 3, Insightful) by Anonymous Coward on Tuesday October 09 2018, @12:43PM
“It's called the American dream because you have to be asleep to believe it”.
(Score: 0) by Anonymous Coward on Monday October 08 2018, @10:41PM (2 children)
we have socialized medicament TODAY. You nit.
VA is socialized medicine
Military is socialized medicine.
Medicare us socialized medicine
...
There quacks in there just is in real life. So do not bang your frying pans to make noise.
With single payer for example means "single" rate everywhere. There maybe to add-ons for NY for cost of housing. Or rural area getting a bonus - like paying off your student loans. outside of base rates. But that would to help defuse the medical to ALL, versus just Mayo or Chicago.
Look to Kaiser Healthcare, setup in WWI to help keep ship builders to build ships in Richmond Calif. It is defined and codified in US LAW even. It has great power in keeping costs low, since it is getting paid a flat amount take covers all functions the population that has signed up need. Even including $15,000 boot for 6'10" with an amputation. No rate increase it is part of the plan.
Hell look at your auto insurance... you are at fault for $500,000 in a accident. YOu have nevered paid $500,000 in the system... but you will take that out. Staying with company will have minor up tick in how much you are paying... but to recovery $500,000. Health ins should be not different. Equal spread of the cost over ALL. For ALL to work - ALL must in in the plan. So as in Auto/home/Life insurance comapny spread the risk to other insurance companies to handle spikes. Healthcare can be thought of same.
Now get of my lawn and play in traffic!
(Score: 2, Touché) by Anonymous Coward on Tuesday October 09 2018, @12:01AM
Good thing single payer fell out of favor. It's all about Medicare for all these days.
(Score: 0) by Anonymous Coward on Tuesday October 09 2018, @10:07AM
20-30 years ago, I would have agreed with you. The rates for kaiser have steadily increased while the quality of care of kaiser has steadily decreased for the past 2.5-3 decades.
And I say this as someone who had excellent pediatric care from them for most of my first decade of life, including a lifesaving operation by a specialist who even a big name research hospital was impressed by the surgical precision of.
Today, Kaiser is a pale imitation of what it once was.
(Score: 4, Interesting) by Runaway1956 on Tuesday October 09 2018, @01:52AM (3 children)
That sounds nice. But - what are your choices?
A: go to the doctors and use the facilities that your insurance company permits you to use
B: pay higher copay and/or pay out of pocket for costs that you won't be reimbursed for
I've had a number of insurance plans over the past 30 years plus. Recently, the company dropped blue cross / blue shield, and moved to United, which all the rest of the parent company uses. EVERYTHING is different, starting with the doctor I've been seeing since I moved to Arkansas. He won't take United - says it takes much longer for him to get paid, if he gets paid. Out of system? WTF? Where is MY choice?
(Score: 2) by PartTimeZombie on Tuesday October 09 2018, @02:08AM (1 child)
Wow, that's appalling. Your insurance company gets to decide which doctor you see.
(Score: 3, Informative) by Runaway1956 on Tuesday October 09 2018, @02:33AM
Indirectly, of course. They don't just come out and tell me that I can't see Dr. Nguyen - instead they make life difficult for the doctor, and cheat him out of money. The doctor can't stay in business if he doesn't get paid. Nor can he spend all his time playing the telephone game, trying to get paid. Nor can he pay a full time employee to play the game for him.
TBH - Dr. Nguyen will probably be shuttering his doors soon. The old guy doesn't arrive at the office until 10:00 or later most of the time. He just doesn't come in some days. I've forgotten just how old he is, but he was a practicing doctor in Vietnam before the fall of Saigon. The wife and I have talked about finding a new doctor, but haven't done so.
(Score: 0) by Anonymous Coward on Tuesday October 09 2018, @06:03AM
Before shit hits the fan, I could decide to buy a different insurance.
I can get a cheap crappy one, saving the money. It's a gamble I ought to be allowed to take. Who are you to stop me? I can even take that to the extreme, getting no insurance at all.
I can get a fancy one, with special on-call services. If I want to blow my money on that, who are you to stop me?
As for "the company dropped", yeah, that's fucked up. Your employer is involved in your health insurance because of wage controls that were imposed many decades ago. Adding employee benefits was a work-around, competition made it universal, and Obamacare wrote it into our law. That is really shit. Your employer should have nothing to do with your health insurance.