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> St. David’s HealthCare defended its handling of Calver’s bill and sought to blame the school district and Aetna for offering such a narrow network. So while

by rdtsc 8y ago

> St. David’s HealthCare defended its handling of Calver’s bill and sought to blame the school district and Aetna for offering such a narrow network. So while dying of a heart attack he should have been negotiating with the ambulance driver, the paramedics, the nurses, each intern and doctor to make sure they are "in-network". > St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.” I You can pay $100k or just $700, whatever is cool with us. I guess, go to the media and try to shame everyone involved is your best hope? I can see if they did this to people buying luxury suites or yachts. Doing this to people who are dying of a heart attack is particularly disgusting. And it's not like anyone involved is going to be punished for this practice or learn a lesson. They'll turn around and do the same thing to the next patient.

FireBeyond 8y ago
> So while dying of a heart attack he should have been negotiating with the ambulance driver, the paramedics, the nurses, each intern and doctor to make sure they are "in-network". Absolutely! </s> I work in EMS. Thankfully, our Medic One system is funded entirely by property taxes and we simply do not bill (at all) for any treatment or transport. However, a few years ago United got a lot of grief over denying airlift transport claims from things like MVAs, or traumas in remote locations, stating that the "transport had not been pre-approved through the insurer". Apparently in their mind, us paramedics (or maybe the chopper pilot) should have been calling in between stabilizing our patient... "This is John, I'm a paramedic working on one of your patients who was hit by a truck. We would like to fly him to the hospital due to his extensive multisystem trauma but we need your approval. His name? Hang on, let me find his wallet. No, that's Smythe, S-M-Y-T-H-E, sorry, it's a bit loud with the jaws of life in the background... Yes, I can hold for a nurse consult..."
- AstralStorm 8y ago
  So, when will the rich and powerful start hiring teams units straight from cyberpunk novels? (their own helicopters included) At these rate differences it starts seeming prudent to medical airlift to the right hospital...
  - dan678 8y ago
    Hey! Cyberpunk 2077 had a sequence like this in the new game-play trailer, NSFW: https://youtu.be/MfW1WcuEI8Y?t=37m48s https://youtu.be/MfW1WcuEI8Y?t=37m48s
Rapzid 8y ago
I wouldn't pay them a single cent more. The 782.29 is just as bogus as the initial charges. There is pretty solid pricing data suggesting the insurance company already over paid.
sturgill 8y ago
I once got cut by a skate playing hockey. Showed up at the hospital pulsing blood from my leg. My first question to them, “Do you take X insurance?” Only after they assured me that my insurance would be accepted did I drag my bloody leg into the care room. Turns out the doctor that the hospital assigned to me did _not_ take my insurance. I got billed the full amount, yelled very loudly at lots of people, and when I “resubmitted” the claim ended up paying like $50 out of pocket. I’m pretty sure that every item in the hospital is purchased by a separate company and that the Venn diagram of approved insurance companies never intersects. My dad is a nurse and I grew up hearing how insurance was destroying health care. As a free market libertarian, I have no idea what to do about it. But next time I need stitches I think I’ll just opt for the super glue in my workshop...
- RyanCavanaugh 8y ago
  It's not a free market if you (literally) can't walk away from the transaction. Trying to apply free market principles to non-free markets is what got us into this mess in the first place.
- int_19h 8y ago
  > As a free market libertarian, I have no idea what to do about it. As someone who used to be a free market libertarian: take is as a data point, and make appropriate conclusions. Such as: free market doesn't solve every problem. It doesn't mean that we should ditch it - it's still the least invasive way to allocate resources, so it's a reasonable default. But we shouldn't elevate it to dogma. When it works, great! When it doesn't, regulate it. And thus, we can have the best of both worlds.
- kjs3 8y ago
  > As a free market libertarian, I have no idea what to do about it. The 'free market libertarian' would be thinking 'you're dying, and I can charge anything I want'. That's not a solution.
- sneak 8y ago
  A good start would have them providing a price list, up front, so you can intelligently request transport to a hospital that doesn’t have a 1000% markup on parts, and reasonable charges on labor.

by rdtsc 8y ago

FireBeyond 8y ago

> So while dying of a heart attack he should have been negotiating with the ambulance driver, the paramedics, the nurses, each intern and doctor to make sure they are "in-network". Absolutely! </s> I work in EMS. Thankfully, our Medic One system is funded entirely by property taxes and we simply do not bill (at all) for any treatment or transport. However, a few years ago United got a lot of grief over denying airlift transport claims from things like MVAs, or traumas in remote locations, stating that the "transport had not been pre-approved through the insurer". Apparently in their mind, us paramedics (or maybe the chopper pilot) should have been calling in between stabilizing our patient... "This is John, I'm a paramedic working on one of your patients who was hit by a truck. We would like to fly him to the hospital due to his extensive multisystem trauma but we need your approval. His name? Hang on, let me find his wallet. No, that's Smythe, S-M-Y-T-H-E, sorry, it's a bit loud with the jaws of life in the background... Yes, I can hold for a nurse consult..."

AstralStorm 8y ago
So, when will the rich and powerful start hiring teams units straight from cyberpunk novels? (their own helicopters included) At these rate differences it starts seeming prudent to medical airlift to the right hospital...
- dan678 8y ago
  Hey! Cyberpunk 2077 had a sequence like this in the new game-play trailer, NSFW: https://youtu.be/MfW1WcuEI8Y?t=37m48s https://youtu.be/MfW1WcuEI8Y?t=37m48s

Rapzid 8y ago

I wouldn't pay them a single cent more. The 782.29 is just as bogus as the initial charges. There is pretty solid pricing data suggesting the insurance company already over paid.

sturgill 8y ago

I once got cut by a skate playing hockey. Showed up at the hospital pulsing blood from my leg. My first question to them, “Do you take X insurance?” Only after they assured me that my insurance would be accepted did I drag my bloody leg into the care room. Turns out the doctor that the hospital assigned to me did _not_ take my insurance. I got billed the full amount, yelled very loudly at lots of people, and when I “resubmitted” the claim ended up paying like $50 out of pocket. I’m pretty sure that every item in the hospital is purchased by a separate company and that the Venn diagram of approved insurance companies never intersects. My dad is a nurse and I grew up hearing how insurance was destroying health care. As a free market libertarian, I have no idea what to do about it. But next time I need stitches I think I’ll just opt for the super glue in my workshop...

RyanCavanaugh 8y ago
It's not a free market if you (literally) can't walk away from the transaction. Trying to apply free market principles to non-free markets is what got us into this mess in the first place.
int_19h 8y ago
> As a free market libertarian, I have no idea what to do about it. As someone who used to be a free market libertarian: take is as a data point, and make appropriate conclusions. Such as: free market doesn't solve every problem. It doesn't mean that we should ditch it - it's still the least invasive way to allocate resources, so it's a reasonable default. But we shouldn't elevate it to dogma. When it works, great! When it doesn't, regulate it. And thus, we can have the best of both worlds.
kjs3 8y ago
> As a free market libertarian, I have no idea what to do about it. The 'free market libertarian' would be thinking 'you're dying, and I can charge anything I want'. That's not a solution.
sneak 8y ago
A good start would have them providing a price list, up front, so you can intelligently request transport to a hospital that doesn’t have a 1000% markup on parts, and reasonable charges on labor.