Texas Is Latest State to Attack Surprise Medical Bills | Hacker News Reader

Texas Is Latest State to Attack Surprise Medical Bills

npr.org

51 pointsHillaryBriss37 comments

Has a family member go to a private emergency room in Austin TX. When asking the ER if they accepted his insurance they said yes, many times. After the visit he recieved an $8000 bill. When confronted, the business stated they accepted the patients insurance however the insurance company would not accept the ER. Settled the $8000 bill for $300. Pretty sketchy.

It's not even a surprise for me anymore when this happens (3-4 times in my life). They make more money this way and I figure a ton of people either just default on the debt or eat the expense because they don't understand.

The worst part is that they will keep you on the phone sometimes for upwards of 8+ hours to settle this sorta crap - I am lucky to have a job that I can keep a phone on hold via speaker for hours and hours at a time.

Protip for anyone reading this - they put a "hey Mr. X, you still with us?" human bit spaced out by around 45 minutes-ish. Don't miss it or be on mute because they'll drop the call in about 2s if you don't immediately answer effectively making you start ALL over again.

The quick way to fix this is to open a complaint with your state’s insurance regulatory body, which begins a paper trail and starts a clock ticking for your insurance provider.

Always Be Creating A Paper Trail

Yep I agree. But here's the thing we all have lives and they're BANKING on that for this sort of abuse of the system.

I think a lot of people A) don't know about the state insurance regulatory body; and B) just want the nightmare to be over as soon as possible, so calling yet another person up is more time involved.

Every time it's happened to me it's staying on hold for an outrageous amount of time then saying something along the lines of, "I'm going to review this with my lawyer" when someone gets on the phone. It's the same with any bully - the moment they know you potentially have some teeth they leave you alone to go pick on a weaker target =(

I also have zero confidence in government employees so there's that too - I would just expect my case to end up on someone's desk indefinitely to never get addressed. Everything in this country is going towards anti-citizen and anti-consumer - hard not to be really bitter about it =(

My answer is single payer in the long term, and consumer protections in the short term. Sorry you don't trust government; citizens are who decide how government runs. Private insurance isn't accountable to anyone.

In a democracy the lowest common denominator of citizens determines policy. They are easily manipulated by moneyed interests and always insanely uninformed (not because they are stupid but because it is impossible to know everything). Knee-jerk, short-term policy is a given.

Private insurance companies are held accountable by the customer's ability to switch plans.

I understand that billing is an incredibly frustrating issue, but forcing people to participate in one master healthcare system would be devastating to people battling poorly understood diseases. People in this situation desperately need choice in their healthcare options.

The choice to have different private insurance companies deny them treatment?

> Sorry you don't trust government; citizens are who decide how government runs.

Yeah... That's really not how it works here in the US, especially when it comes to healthcare. Corporate interests decide how the government runs healthcare.

I've maxed out my FEC contributions to Bernie Sanders' campaign, have made significant donations to a PAC that supports Medicare For All, and am working towards running for office. I'm doing my part. I just ask that others make an attempt to do what they can.

Progress is a function of effort, not time. Things do not get better simply because a second hand tics by.

I'm also donating to Bernie's campaign, and... none of those other things because I'm starting a business hah... But I get it - we've gotta push forward with trying to be part of the solution.

The problem is we can play by the rules all we want, but it's just not effective at all if the guy at the top can blatantly break the law in the public eye and get away with it laughing. We've got an entire party successfully subverting just about everything I was sold in my highschool government classes as a "functioning democracy".

Political activism and starting a business are very similar :) Head down, eyes forward on the prize. Don't waste time on people dragging you down. Long road ahead. Best of luck with your startup, I wish you much success.

Note: If your insurance is provided through your employer, and your employer is large-ish (more than a few hundred employees) then they will very likely be a self-funded health plan. These are not state regulated health insurance products. You'll get a response back telling you your plan is regulated through the Department of Labor under ERISA law, which allows the companies to pretty much get away with murder.

Boy, imagine a system where part of your taxes could go towards a publicly funded healthcare system which would prevent problems such as this from arising in the first place.

I think you'll find that a running your healthcare expenses and approvals thru labyrinth of private, corporate bureaucracies, each siphoning off a portion of of the available money and incentivized to increase that amount however possible while offloading all expenses possible onto you, is in fact the ultimate expression of freedom. Please report to your local consumer reeducation camp for programming.

Yep - exactly this. Now imagine they're keeping you alive on with this system extracting as much money as they possibly can even though you're a terminal patient that is in pain 100% of their remaining days.

Healthcare in this country is a racket.

I sometimes feel that if Amiericans traveled more around the world it would help to eradicate false beliefs like these.

I’ve yet to travel to a country of 330 million people or more with flawless public healthcare. Perhaps you could point me to one?

Well there's only two other countries with more than 330 million people so that's a bit of a poor argument to make, and it assumes that the well-functioning systems in (most, if not all) other western countries won't scale - I'm not entirely sure where such an assumption comes from.

Probably a refusal to imagine it as a possibility in the first place, I suppose.

National level public healthcare would be difficult to implement in the US for the same reason a pan European standard would be hard to implement.

That said, if you do it on a state by state basis then qualify will vary just like it does between the different European countries.

But as the US is a single nation, the mere existence of variation will mean some people say the system is a failure.

Because it working in smaller countries means it could never work in a large one?

But, why not? How is population size relevant?

Well "flawless" is obviously a disingenuous expectation on your part.

I would direct you to the United States which has a pretty amazing public healthcare system called Medicare that has an 80+% approval rating among those lucky enough to be on it.

Did you miss the sarcasm?

My son had an emergency ER visit due to a cut right above his eye. The ER staff assured me repeatedly that they were in network. Turns out the ER was in network but they neglected to tell me that all the staff there were contractors and that the contract service company was out-of-network for my insurance.

So, a few months later I got hit with a surprise bill in the neighborhood of $2000... for what amounted to a few stitches.

I freaking hate the US health care system.

> In fact, getting a steep hospital bill is something more Americans say is their biggest financial fear.

This is a pretty bad thing. I can't imagine being sick and afraid of going to ER because there is a possibility of getting bankrupted.

Happens to loads of people. I hear about people getting shot and having someone drive them to the hospital to avoid the ambulance fee.

I was in a motorcycle accident and declined to even go to a hospital because I was uninsured at the time. Injuries were relatively minor (nothing broken but I didn't walk right for a while), but I had to make a judgement call moments after I flew through the air and hit my head enough to break the visor off my helmet. I got lucky, others have done the same and succumbed to internal injuries that weren't apparent.

I'm glad to see that more states are taking this more seriously. Finally we're starting to head in the right direction. Here is the solution: "When a hospital and insurer can't agree on a price, the two parties will have to work it out — without ever billing the patient."

Although I would like to see more action taken to prevent hospitals from billing so high in the first place. Otherwise we just end up paying for in the insurance premium.

Also, they should make it illegal for "out of network" personel/equipment to be used if you're in a in-network hospital. or just make out-of-network illegal all together.

A lot of credit for movement on this issue should go to Vox. They have invested time and money into a data-driven investigation of this issue: https://www.vox.com/2018/2/27/16936638/er-bills-emergency-ro...

It's a good example of the role that a vibrant press plays in a democracy, and it might warrant considering adding vox.com and similar outlets to your ad blocker's whitelist.

NPR also, in addition to TFA:

https://www.npr.org/sections/health-shots/2018/02/16/5855495...

https://www.npr.org/sections/health-shots/133188447/health-i...

Is it possible that this is an issue where the parties could find...agreement?

Health care is not a bazaar.

I have to say that this was one hope that I had for the current administration before he took office. Trump said the entire current health system was a mess before he got elected. Since he wasn’t beholden to either party and his strength came from his base, he could have pushed something good through and conservative politicians would have to go along.

Most of the ACAs faults were caused by Congress not being able to improve it without the parties working together.

It would have been an “only Nixon can go to China” moment.

I don't think the “only Nixon can go to China” was ever meant to be prescriptive. Using it as a voting tactic would basically always mean voting for the candidate opposed to your ideas.

It's also doubtful that it is even empirically correct: Nixon may have gone to China, but Obama went to Iran and Cuba, and also made the most progress on health care since medicare and medicaid. All that was required of Trump was not to destroy that progress, which is strictly easier than expecting any progress from him.

The phrase that “only Nixon could go to China” meant that since Nixon was well known as being anti-communist, no one would suspect him of being a “secret Communist”.

Even if Romney had been elected and tried to implement health care reforms, he couldn’t do it. He had to disown his own accomplishments as governor because he had to work within the political system, Trump didn’t.

In tech terms, the only CEO of Apple that could have made the deal with Microsoft and Gates in the 90s was Jobs. No one was going to doubt Jobs loyalties were with Apple or that he was just there for a paycheck.

Amelio did a lot of the legwork on that deal.

Nixon also didn’t do all of the legwork behind going to China. But he was the person seen making the deal.

But as far as Apple, who do you think was more effective? A random CEO who was at Apple for less than 100 days talking to random people at Microsoft or Jobs being able to call up Gates directly - someone who he worked with for both the Apple // plus (AppleSoft Basic was written by Microsoft) and with the introduction of the Mac - Gates was on stage at the introduction?

Amelio was at Apple for over a year; his memoir about it was titled, "On the Firing Line: My 500 Days at Apple". One of his claims was that the Microsoft thing was already a done deal by the time he left. The only "Nixon" thing about it was how Jobs could (just barely) get away with standing on the stage at Macworld with Bill Gates ominously looming over everyone like Big Brother.

Fair enough (100 vs 500). But by your own admission, the analogy still holds. While Jobs could “just barely” get away with it, can you imagine Amelio trying to get away with it at all among the few at the time remaining Apple faithful?

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