More in an endless stream of horror stories about the bullshit American health care delivery system:
When Kristy Uddin, 49, went in for her annual mammogram in Washington state last year, she assumed she would not incur a bill because the test is one of the many preventive measures guaranteed to be free to patients under the 2010 Affordable Care Act. The ACA’s provision made medical and economic sense, encouraging Americans to use screening tools that could nip medical problems in the bud and keep patients healthy.So when a bill for $236 arrived, Uddin — an occupational therapist familiar with the health-care industry’s workings — complained to her insurer and the hospital. She even requested an independent review.“I’m like, ‘Tell me why am I getting this bill?’ ” Uddin recalled in an interview. The unsatisfying explanation: The mammogram itself was covered, per the ACA’s rules, but the fee for the equipment and the facility was not...Over the past several years, the medical industry has eroded the ACA’s guarantees, finding ways to bill patients in gray zones of the law. Patients going in for preventive care, expecting that it will be fully covered by insurance, are being blindsided by bills, big and small...Peter Opaskar, 46, of Texas, went to his primary-care doctor this year for his preventive-care visit — as he’d done before, at no cost. This time, his insurer paid $130.81 for the visit, but he also received a perplexing bill for $111.81. Opaskar learned that he had incurred the additional charge because when his doctor asked if he had any health concerns, he mentioned that he was having digestive problems but had already made an appointment with his gastroenterologist. So, the office explained, his visit was billed as both a preventive physical and a consultation. “Next year,” Opasker said in an interview, if he’s asked about health concerns, “I’ll say ‘no,’ even if I have a gunshot wound.”
I see similar billings as described in the last P - all sorts of consultations and preventives. I kinda don't care, as Medicare pays, but I would like those to be longer than just 'Do you still have this condition?' and that's it, presto-bango, $DDD.CC on the bill.
ReplyDeleteSimilar story about colonoscopy on NPR this morning:
ReplyDeletehttps://www.npr.org/sections/health-shots/2024/01/25/1226552799/the-colonoscopies-were-free-but-the-surgical-trays-came-with-600-price-tags
If you are paying for those trays, you should get to take them home with you!
ReplyDeleteHospitals and health care facilities have become juicy targets for private equity funds. Take control, use it as collateral for a loan or mortgage and leave the facility struggling to pay it off.
ReplyDeletexoxoxoBruce
I had something similar happen to me more than 10 years ago. A local hospital advertised free screenings for vulnerabilities of future strokes. Being that I was in my late 50s and having some history in my immediate family, I decided to go for it. The screening was done, I got encouraging results and went on with my life. Several months later, I got a past due notice for a bill to some doctor I’d never heard of. After a few days of digging I found that I was being billed for this guys services in reading the results of my scan. I complained to the hospital and they told me they couldn’t do anything about it because the doctor’s bill was separate from what they covered in their “free” screen. There was nothing in their original promo about additional charges being applicable so an attorney friend of mine called the hospital on my behalf, letting them know we were willing to pursue the matter in court. Suddenly, they changed their story to it being a “clerical error”.
ReplyDeleteOops. While I was reviewing/approving comments this morning I accidentally deleted someone's comment about the more favorable situation in France. If you care to rewrite it, I'll be careful not to make the same mistake again.
ReplyDeleteI'm now almost 68. In the last quarter of my life I've been very close to six people at end of life, to include being literally at bedside for the death of my parents. In all cases there were long medical histories involved. Had I kept a diary of every medical fuck-up I would have 300 pages of notes.
ReplyDeleteMedical errors are the third leading cause of death in the US, last I checked. Somewhere around 400,000 people per year; and that's the part that's "in the record." For this we pay twice per capita what's spent in the rest of the developed world, to include many systems clearly superior to our own.
This is not the only area of American life where a system is simultaneously becoming much more expensive as it delivers worse results. Unfortunately, across the board, someone is winning at the expense of the end-consumer--who, in one way or another, is paying for this shit storm.
https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us
DeleteI live in New Zealand.
ReplyDeleteA few years ago I was feeling a bit off ... every time I slightly exerted myself I felt a bit short of breath and sort of queasy, like I'd eaten a fish dish from some street vendor in a third world country.
So I popped in to see the doctor.
After a few questions they wired me up for an ECG.
Mid way through that they call an ambulance and I get taken to hospital, where I spend a few weeks and have a heart bypass operation.
Obviously I survived the operation, but then the bills came in.
$25 for the doctor's visit and $88 for the ambulance ride.
The ambulance trip took an hour and twenty minutes, 95kms, so quite a cheap price I reckon, but as I was laid up recuperating for a few months, the government paid for the ambulance.
I had to scrape the $25 for the doctor's myself.
Oh, and the government paid me a benefit while I was recuperating.
We pay taxes, around 19% for the average person, and a 15% 'Goods and Services Tax' on ... well, goods and service.
But it is really quite good that you get your heart fixed pretty much for free.
But all that improved health, better maternal care, pernatal care etc is going to lead to higher populations in the future. We, OTOH, are doing our part to contribute to zero population growth.
DeleteAnd let’s not forget about “grandfather” health plans that do not need to conform to portions of the ACA like no cost preventative care or no lifetime limits. Most recent number I’ve found (2019) shows about 13% of covered workers are still under one of these plans.
ReplyDeleteCOVID vaccines are free for all (i.e. paid for by government) but I know people who skipped them because they "couldn't afford it." Pharmacies have such a habit of advertising things as "free" when they mean "often covered by insurance" that people don't believe when things actually ARE free.
ReplyDelete