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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: 0) by Anonymous Coward on Tuesday October 09 2018, @07:52PM
That's because your physicians are still honest, mostly.
Find me anyone, anywhere who will rightfully and honestly tell you what the bill to fix your car will be beforehand. Or your washing machine.
The best you will hope for is someone to tell you, "Well, if it is *X*, and *X* only, and there are no other complications that take more time, it will cost $Y." More likely you will hear, "It depends on what is wrong." Straightforward things like getting your oil changed, where they know there is no way it will take more time or knowledge or skill, those can be quoted. But medicine? Yeah.
What you'll hear from an honest practitioner is, "I won't know what it will cost until after we've had our meeting because I don't know how my of my time your health will take for me to work through your issues and I don't fully know what if any therapy or diagnostics you will need in my office at the time of your visit."
Anyone who tells you upfront, "Yeah, we'll see you for $Y" is likely overcharging on average - covering the more complex cases up with charging less complex more. Anyone who shops around for their healthcare on discount is likely to get discount healthcare.