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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, Insightful) by Anonymous Coward on Monday October 08 2018, @10:21PM
Posted rate is posted rate like anything else you buy. If the can on the self is marked $.50 but the computer says a dollar then the rate is $.50 period. Save here.
Single payer gets rid of all the crap of which insurance is has wahat special rate. Ins company become price brokers, insuring coast and coverage is just for standardization across the region and county. More of a Kasier Healthcare.
single payer does not mean - US GOV is running... just reg to insure equal teeat meant of all.
BUT single payer as can mean single tax for all - like FICA. So all have same health care. The tax is "tax" that companies are paying heathcare today, upto 40% of salaries. This money pooled will pay for medical for ALL of US... from BLACK LUNG minors, to QUADs from accidents. It can be funneled into schools for common support for H/C in local public schools - even to NUSRES again in the schools. Also travelling doctors in rural America, where dental and health are functions of the schools.
Yes it can get to a Doc Martin style of GP and hospital structure that UK has. Or it can go the way of Medicare to Kasier Healthcare. Of Humana with dental included.
BUT THE KEY it does do... is give every American healthcare as in "Life, Library and Pursut of Happiness". or if you preffer... "...provide for the company defense and promote the GENERAL WELFARE, and insure the blessing of library for ourself and ..". Once all are insured, all can work since there is no barrier for employement to pregent, injured or other workers from working - since the healthcare will not be affected. by bring them all Also mean healthcare "slaves" can change jobs to improve their and their childrens lot in life.
Its is the cherry picking of risks -- to maximumize profit, versus single rate. that destroyed the health that I was raised with in the 60's.