3 ms·

The way anesthesia costs get offloaded onto (American) patients is nuts enough as it is... Like, I'll absolutely grant that it's not cheap to knock people out—

The way anesthesia costs get offloaded onto (American) patients is nuts enough as it is... Like, I'll absolutely grant that it's not cheap to knock people out—my friend's father growing up was an anesthesiologist assistant and he made good money doing it, which is fair enough considering it's a job where you literally hold people's lives in your hands. I don't want the guy feeding me propofol to be an underpaid grunt. But in addition to the already-too-high healthcare costs in this country (specifically the way that those costs get passed onto patients), it sucks getting a separate anesthesiologist bill on top of whatever you paid for the procedure that warranted going under in the first place. Especially when the cost of the initial procedure was insulting to begin with. And I don't think it's solely a matter of outpatient surgery centers using third-party anesthesia techs. A few years back I was meant to get a bronchoscopy (basically a colonoscopy for your lungs) at a prestigious local hospital, but the anesthesiologist never showed up (and they weren't gonna put a tube down my trachea while I was awake, lol) so they had to send me home. Turns out there was a scheduling snafu and the anesthesiologist who was supposed to be there never got notified that they were on duty. How does a hospital not have in-house anesthesiologists? Are they really cutting costs by scheduling medical technicians like they're picking up shifts at Taco Bell?

genmud 3y ago
> How does a hospital not have in-house anesthesiologists? Are they really cutting costs by scheduling medical technicians like they're picking up shifts at Taco Bell? Don’t work in healthcare, but if I were to venture a guess it’s around liability. If the patient is in a surgery and dies the anesthesiologist is probably one of the first to get blamed.
lotsofpulp 3y ago
The 2022 No Surprises act means you should not be getting out of network bills for anesthesiologists: https://www.cms.gov/nosurprises https://www.cms.gov/nosurprises https://www.cms.gov/medical-bill-rights https://www.cms.gov/medical-bill-rights
- ledauphin 3y ago
  in practice, they just make you sign a notice and consent form in order to receive care. if all the local hospitals do this (and they do) then you no longer have any option but to sign the form. we really need to eliminate this absolutely ludicrous distinction legislatively. EDIT: i stand corrected with regard to anesthesiologists. I maintain that hospitals and providers are quickly learning how to maneuver patients into scenarios where they will be subjected to surprise billing anyway. I also maintain that the concept of out-of-network services is mostly ridiculous, since the median patient is very rarely in a position to make actual choices about most of the care they receive.
  - lotsofpulp 3y ago
    I do not think those protections can be waived for anesthesiologists’ (and many other) services. https://www.cms.gov/files/document/faq-providers-no-surprises-rules-april-2022.pdf https://www.cms.gov/files/document/faq-providers-no-surprise... See top right of page 3 and the third paragraph of #7 on page 10.
    - ledauphin 3y ago
      I appreciate the correction and reference!
  - scotty79 3y ago
    > in practice, they just make you sign a notice and consent form in order to receive care Is there a concept of illegal agreement clauses in US? Where even after signing an agreement the signee can claim that such and such clause was illegal and if the court confirms it the whole agreement (or just the clause) is void?
    - lotsofpulp 3y ago
      Yes, you cannot sign away many rights in the US.
- mindslight 3y ago
tiahura 3y ago
Anyone that's sat in on a surgery knows that the anesthesiologist literally does nothing. The assistant does the challenging work of turning the knob clockwise when heart rate increases and counterclockwise when it decreases, and I'd bet that if the heart stops someone else gives the epinephrine shot.

genmud 3y ago

> How does a hospital not have in-house anesthesiologists? Are they really cutting costs by scheduling medical technicians like they're picking up shifts at Taco Bell? Don’t work in healthcare, but if I were to venture a guess it’s around liability. If the patient is in a surgery and dies the anesthesiologist is probably one of the first to get blamed.

lotsofpulp 3y ago

The 2022 No Surprises act means you should not be getting out of network bills for anesthesiologists: https://www.cms.gov/nosurprises https://www.cms.gov/nosurprises https://www.cms.gov/medical-bill-rights https://www.cms.gov/medical-bill-rights

ledauphin 3y ago
in practice, they just make you sign a notice and consent form in order to receive care. if all the local hospitals do this (and they do) then you no longer have any option but to sign the form. we really need to eliminate this absolutely ludicrous distinction legislatively. EDIT: i stand corrected with regard to anesthesiologists. I maintain that hospitals and providers are quickly learning how to maneuver patients into scenarios where they will be subjected to surprise billing anyway. I also maintain that the concept of out-of-network services is mostly ridiculous, since the median patient is very rarely in a position to make actual choices about most of the care they receive.
- lotsofpulp 3y ago
  I do not think those protections can be waived for anesthesiologists’ (and many other) services. https://www.cms.gov/files/document/faq-providers-no-surprises-rules-april-2022.pdf https://www.cms.gov/files/document/faq-providers-no-surprise... See top right of page 3 and the third paragraph of #7 on page 10.
  - ledauphin 3y ago
    I appreciate the correction and reference!
- scotty79 3y ago
  > in practice, they just make you sign a notice and consent form in order to receive care Is there a concept of illegal agreement clauses in US? Where even after signing an agreement the signee can claim that such and such clause was illegal and if the court confirms it the whole agreement (or just the clause) is void?
  - lotsofpulp 3y ago
    Yes, you cannot sign away many rights in the US.
mindslight 3y ago

tiahura 3y ago

Anyone that's sat in on a surgery knows that the anesthesiologist literally does nothing. The assistant does the challenging work of turning the knob clockwise when heart rate increases and counterclockwise when it decreases, and I'd bet that if the heart stops someone else gives the epinephrine shot.