Are providers going to run credit checks on you before they agree to take you on as a patient?
Require that you sign a document that gives them the right to garnish your wages for non-payment?
Require up-front payment for services?
Increase prices to cover the revenue lost to people that realize how little consequence there is for non-payment?
https://www.cms.gov/newsroom/fact-sheets/no-surprises-unders...
https://www.cms.gov/NOSURPRISES
https://www.consumerfinance.gov/about-us/blog/no-surprises-a...
I know providers will balk because they negotiate with different insurers, but if they know how much they’re going to bill after the fact surely they can give you an estimate before.
"Payment is due at the time services are rendered"
So you pay what they say it costs.
Then months later you get a random bill from them for more.
This is a screwed up system that leaves patients caught in the middle of commercial disputes. But providers do deserve be paid for services rendered and it would be unfair to just stiff them.
So fuck the patient? That's the current regime.
Let's say you crash your car and take it to an auto body shop for repair. If for some reason your auto insurance doesn't pay for the repairs would you tell the mechanic to fuck off and eat the cost? I understand there are issues in healthcare with price transparency and estimates, but the basic principle is the same. Regardless of insurance or lack thereof, customers are obligated to pay for services they receive.
> If for some reason your auto insurance doesn't pay for the repairs would you tell the mechanic to fuck off and eat the cost?
I have a free choice of both auto insurance and car mechanic. On the other hand I may not have a choice about health insurance company (usually from the employer) or the emergency room I'm sent in the ambulance to -- particularly if I'm unconscious.
e.g. Your payroll deduction is $50 per pay period. The deductible is $2000 per year. Out of pocket max $4000. The network is wide. This is because your employer is paying for the other 85% of this plan and employed people need less medical services on average than the public as a whole.
You switch to a plan off Healthcare.gov. It costs $500/mo. Deductible is $8000/year and out of pocket max is $15000. The network of providers is only in one state and only at one brand. I don't think anyone would actually reject a cushy employer plan for an exchange plan.
The debate around US healthcare often misses the point. We all agree it is too expensive. The next question we should ask is: how much does it cost? And the answer is we don't know. That is fundamentally an issue, because price discovery cannot occur if the price is unknown. Our current healthcare system is not a failure of capitalism; it is anti-capitalist. Collusion between big insurance, big pharma, and hospitals have captured the system.
We need robust price transparency legislation.
Like most [1] significant [2] healthcare legislation in the US, this was passed via budget reconciliation.
0 - https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
1 - https://en.wikipedia.org/wiki/Consolidated_Omnibus_Budget_Re...
2 - https://en.wikipedia.org/wiki/Health_Care_and_Education_Reco...
Since high deductible health plans become common (with multi-thousand deductibles) some hospitals and doctor's offices have required patient responsibility balances to be paid before the surgery or procedure. Some providers refuse service if you have past due bills with them. Providers in the medical-industrial complex already cherry pick customers by often not accepting Medicaid or Medicare. You may have noticed that doctor's offices are more likely to be opened in affluent areas. In effect your choices for local medical services can be affected by not just your health plan but the average purchasing power of the area!
So, while price gouging and insurance gouging are a thing, the actual hospitals may be poorly compensated in many places.
That's why rural areas are losing hospitals.
They help hospitals collect. Not saying that makes it right. Just that it has a purpose beyond greed and gouging.
Can they do this in any developed country?
>That's why rural areas are losing hospitals.
Maybe a system with only privately run hospitals is a stupid plan.
Medicare, Medicaid, govt supported controls on number of new doctors per year, so much regulation and red tape.
The US govt spends more on healthcare than most other nations. If that isn’t socialized medicine, I don’t know what is.
Thankfully we are just indirectly socialized unlike our neighbors to the North who suffer from many things like longer wait times for emergencies and vital surgeries.
Certain states are trying extra hard to exacerbate the problem by not expanding Medicaid.
How is that unique to America? What other developed nation doesn't have this rule?
If you don't bill Medicare you don't have to provide care to anyone.
https://www.aha.org/fact-sheets/2020-01-06-fact-sheet-uncomp...
That's not just unpaid emergency care that they are forced to provide, it's all their billing that isn't paid.
That's out of $1.3 trillion of hospital revenues in 2020:
https://www.cms.gov/data-research/statistics-trends-and-repo...
3% is a lot (because it's coming out of their net income from other procedures), but it shouldn't be driving hospitals out of business.
Yes. And they are being run into the ground by "venture capital" as if they were local newspapers.