But besides overhauling the whole system, I don’t know how we keep this from happening.
The story: http://www.channel3000.com/news/woman-taken-to-wrong-hospital-faces-bankruptcy/29648000.
If something like this happened to you, what would you do? And how do you prevent this from happening? Wear a dogtag engraved with the hospitals in your insurer’s network? My tongue is in my cheek, but just a little bit. I honestly don’t know how the consumer is supposed to keep this from happening.
Only 50k? I was afraid it was a gazillion.
Waaah. She had every right to be transferred to her in-network hospital when stabilized, and didn’t go. Too bad so sad.
Your empathy is overwhelming.
Sure - and given that she was unconscious when she arrived in the ED and spent “…10 days in a medically-induced coma and another six days in the cardiac unit”, she was obviously remiss in not figuring out the minutiae of her health insurance coverage and demanding to be transferred to a medical facility more convenient for her insurer. :dubious:
It was about 20 years ago, but we had a not-quite-so large problem with my husband’s bypass operation. He was in a hospital for an angiogram, pre-approved by insurance. A life-threatening nearly complete blockage in the main coronary artery was discovered. He was in surgery within 6 hours. I immediately contacted the insurance co. and was told the procedure would be covered. Later on, they tried to deny coverage, saying he should have been moved to an in-network hospital the following day because by then it was no longer an emergency.
I said “Excuse me? He was still on life support the following day. Are you really saying he should have been transported 20 miles to your preferred hospital? I don’t think so!” It took over two years, but I eventually succeeded in getting the whole bill covered.
ETA: I just checked the article, and surprise, surprise: We also had Blue Cross/Blue Shield. Just keep fighting.
Insurance networks should be forced to not cover physical areas. Anyone should be able to go to any hospital and be billed for the cheapest one
Can you not read, or are you just a complete asshole? It must be one or the other, and neither reflects well on you.
It’s no secret that the US healthcare system is one huge clusterfuck.
I can’t wait to see what our new congress does to fuck it up even more…
Where was God? Some years back, St Mary’s, a Catholic hospital ran an ad campaign suggesting God favored them and their patients.
I suppose in this economy, God must be having some cash flow issues.
It can be only one?
The New York Times had a related expose in September. People have surgery in an in network hospital, which just happens to bring along an assistant physician from an out of network hospital.
Zing!
So instead of the bill being about $2000 for the insurance company, it’s more like $150,000. Seriously: those are the round numbers. Kevin Drum summarizes:
This is reason #234 why you need insurance in the US. The list prices for medical procedures are wholly untethered from reality.
You lost me on this last sentence. All of these examples are cases where people did have insurance. Even with insurance, prices can still be crazy.
I haven’t had the horrific experiences linked in this thread, but I can tell you it’s fucking next to impossible to make sure all your care is in-network, even if you have all the time in the world to work at it. A few years ago I scheduled a pretty intensive bit of education/doctor visits/lab work - 4 days worth, scheduled 3-4 months out. I did all my homework; I called my insurance company, I got a list of all the names of all the docs I’d be seeing, along with the medical coding numbers of everything I’d be doing, and made sure everything was covered and in-network.
While there, they sent a bit of lab work to another lab, completely unbeknownst to me, that happened to be out of network. The vast majority of the lab work was done in the hospital I was working with, but for some reason, this couple of tests had to be sent to another lab. No mention of this was ever said to me, either before they were done or after they were sent off. The first time I heard of it was when I got the $600 bill.
I fought with the insurance company, but ultimately lost and had to pay the $600 out of pocket. $600 is nothing compared to the other stories, but still, I don’t know what else I could have done to prevent it or even know about it before it happened. And this was when I wasn’t sick and had all kinds of time to check on things.
Yeah, things are broken. The ADA is a step in the right direction, but it’s only one step. The rest of the world laughs at us; one of the basics responsibilities of government IMO is to make sure their citizens have access to basic health care (and don’t go broke getting it.)
I had something similar happen, for an even smaller dollar amount, but it speaks to the inherent ridiculousness and inefficiency of our “free market” system. You can’t actually shop around for anything, because it’s nigh impossible to know in advance what something is going to cost.
You would need to force multiple doctors and their administrators to walk through every step of your procedure in detail, identify every step, every code, every lab, every test, then go to your insurance company with this information and force THEIR administrators to identify all the costs and coverages in detail for each doctor and lab you might use.
It’s hilariously inefficient. All that time, hours of work spent just to figure out how much a procedure is going to cost.
This is if you already have insurance, forget shopping around for insurance itself, how are you going to find out what they pay for these procedures, and how much you’re responsible for? Sure, you can get a percentage of the negotiated price, but what if one insurer has a better negotiated price for procedures you’re going to have?
Last year I had a heartattack requiring angiogram, angioplasty, and a stent. My uncovered cost was around a thousand, but it would have been far worse if I wasn’t so viciously proactive. My stress test was done at one hospital, and my eventual surgeon worked at another, about ten miles away. They wanted to send me there in an ambulance, but I balked because I didn’t know if it was covered. I was going to get dressed and drive. A hospital admin guy investigated and found that my ambulance trip would be covered if I used a specific service, so that’s what I did.
On arriving at the second hospital, one of my cardiologist’s team members smirked at one of my questions about my upcoming procedure and commented that I didn’t really have a choice. I went a bit ballistic, pointing out that I could remove my IV, get dressed, and walk out the fucking door if I chose to. He was working for me. He apologized as did I and we went on from there. It’s a shame it currently has to be that way.
But wait! Didn’t Obamacare fix health care by requiring everyone to have insurance?
Obamacare made things better for health care in the US, but it didn’t fix everything.
The problem here isn’t Obamacare, ya knucklehead. Unless you’re saying this woman would have been better off being uninsured …
The problem is our relatively insane health insurance system and its complicated convolutions. The design of Obamacare actually exacerbated some of that, continuing to throw bennies to the insurance industry, in an effort to gain more widespread support.
Frankly, the answer to problems like this is single-payer. Glad to hear you’re onboard, Saint Cad.
Exactly. One of the many reasons I supported single-payer, too. Until last year, when I got on my wife’s plan, I’ve paid for health insurance my whole adult life working in the US (I have my own business.) It really is a pain in the ass trying to make sure all your care is in-network, and even if you go to an in-network hospital (as I discovered with our child’s birth), not all doctors, tests, etc., performed by the hospital are necessarily in-network, too. It’s a byzantine process, and I’m thankful I just haven’t had a real medical emergency where I don’t have the luxury of time or consciousness to explore all my options. I have no idea why people put up with this shit.