5 ms·

What are going to be the second-order consequences of such a policy? Are providers going to run credit checks on you before they agree to take you on as a pati

What are going to be the second-order consequences of such a policy? 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?

jfghi 3y ago
Be less profitable by not price gouging?
- cyanydeez 3y ago
  In America, hospitals cannot refuse emergency care. 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.
  - jfghi 3y ago
    I agree entirely but just don’t think that credit reports solve or help anything in this domain.
    - JumpCrisscross 3y ago
      > don’t think that credit reports solve or help anything in this domain They help hospitals collect. Not saying that makes it right. Just that it has a purpose beyond greed and gouging.
      - jfghi 3y ago
        I’d have to see data in order to confirm this is true. Once a delinquency gets placed on a credit report paying the bill doesn’t help the person that owes. It also assumes that the people not paying are choosing to do so rather than not being able to. Given the debts are sold at a steep discount, I’d say it’s more efficient to have lower prices up front which could potentially be affordable for more of the customers.
        supertrope 3y ago
        When one is applying for a mortgage one of the conditions is to pay off any debt in collection status. I agree that lack of universal healthcare with reasonable out of pocket costs is the underlying issue.
  - p_j_w 3y ago
    >In America, hospitals cannot refuse emergency care. 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.
    - cyanydeez 3y ago
      Sorry, forgot to clarify: most other places provide socialized medicine.
      - cscurmudgeon 3y ago
        So too in the US. You are probably not aware of the insane socialized mess that is the US health system due to initial good intentions. 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.
    - supertrope 3y ago
      It is hard to operate a rural hospital. Rural areas not only are dwindling in population but tend to be poorer. There's a higher mix of Medicaid/Medicare plans versus employer health plans. With our current fee for service medical service economic model, rural hospitals that don't do as many surgeries or have to transfer people to the city hospital literally send patients and the revenue they bring in off to big cities. Recruiting staff is harder due to in demand professionals wanting the services and opportunities a big city provides. County hospital are partially local taxpayer supported but once again rural areas have a thinner tax base. HHS sends Federal dollars but this is limited. Certain states are trying extra hard to exacerbate the problem by not expanding Medicaid.
  - flangola7 3y ago
    > In America, hospitals cannot refuse emergency care. How is that unique to America? What other developed nation doesn't have this rule?
    - maxerickson 3y ago
      The way it is funded in the US is probably special. EMTALA is enforced by making it mandatory part of Medicare participation. If you don't bill Medicare you don't have to provide care to anyone.
  - maxerickson 3y ago
    Meh, hospitals put uncompensated care at about $40 billion a year in 2020: https://www.aha.org/fact-sheets/2020-01-06-fact-sheet-uncompensated-hospital-care-cost 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-reports/national-health-expenditure-data/nhe-fact-sheet 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.
  - blendergeek 3y ago
    > That's why rural areas are losing hospitals. Yes. And they are being run into the ground by "venture capital" as if they were local newspapers.
bushbaba 3y ago
Please do upfront pricing. It’s so annoying getting a bill afterwards how the fully covered treatment was actually not covered and multiple thousands. Leading to haggling with the insurance company and hospital.
- toomuchtodo 3y ago
  > Starting in 2022, there are new protections that prevent surprise medical bills. If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front, before your visit. If you disagree with your bill, you may be able to dispute the charges. Here’s what you need to know about your new rights. https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills https://www.cms.gov/newsroom/fact-sheets/no-surprises-unders... https://www.cms.gov/NOSURPRISES https://www.cms.gov/NOSURPRISES https://www.consumerfinance.gov/about-us/blog/no-surprises-act-how-we-are-protecting-people-from-side-effects-surprise-medical-bills/ https://www.consumerfinance.gov/about-us/blog/no-surprises-a...
  - darth_avocado 3y ago
    The problem is that disputing claims is hard and puts an unnecessary burden on the patient at a time when they are struggling elsewhere. Companies operate in bad faith and more needs to be done to regulate companies (hospitals and insurers).
  - Auracle 3y ago
    Why the hell shouldn’t that apply to people that are going to use insurance? The reason our healthcare costs are so high is because everyone with insurance past their deductible is price insensitive. People might at least care about their copay enough to make a difference. 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.
- flutas 3y ago
rqtwteye 3y ago
How about the insurers and providers working together on reasonable billing and not make patients pay random charges over which they had no control and information about cost?
ISL 3y ago
Probably charging everyone more to accommodate the potential lost revenue.
supertrope 3y ago
A pull back in "credit." This rule is a blunt instrument. It will reduce medical debt stress caused by the way American healthcare is financed. It will also allow more people to default on their medical bills even the ones that are reasonably priced and correctly coded. It's kind of like how the CARES Act for COVID-19 banned reporting mortgage forbearance to credit. Then Chase Bank narrowed new business to 20% down and excellent credit score in response to the future reduced information environment. 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!

jfghi 3y ago

Be less profitable by not price gouging?

cyanydeez 3y ago
In America, hospitals cannot refuse emergency care. 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.
- jfghi 3y ago
  I agree entirely but just don’t think that credit reports solve or help anything in this domain.
  - JumpCrisscross 3y ago
    > don’t think that credit reports solve or help anything in this domain They help hospitals collect. Not saying that makes it right. Just that it has a purpose beyond greed and gouging.
    - jfghi 3y ago
      I’d have to see data in order to confirm this is true. Once a delinquency gets placed on a credit report paying the bill doesn’t help the person that owes. It also assumes that the people not paying are choosing to do so rather than not being able to. Given the debts are sold at a steep discount, I’d say it’s more efficient to have lower prices up front which could potentially be affordable for more of the customers.
      - supertrope 3y ago
        When one is applying for a mortgage one of the conditions is to pay off any debt in collection status. I agree that lack of universal healthcare with reasonable out of pocket costs is the underlying issue.
- p_j_w 3y ago
  >In America, hospitals cannot refuse emergency care. 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.
  - cyanydeez 3y ago
    Sorry, forgot to clarify: most other places provide socialized medicine.
    - cscurmudgeon 3y ago
      So too in the US. You are probably not aware of the insane socialized mess that is the US health system due to initial good intentions. 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.
  - supertrope 3y ago
    It is hard to operate a rural hospital. Rural areas not only are dwindling in population but tend to be poorer. There's a higher mix of Medicaid/Medicare plans versus employer health plans. With our current fee for service medical service economic model, rural hospitals that don't do as many surgeries or have to transfer people to the city hospital literally send patients and the revenue they bring in off to big cities. Recruiting staff is harder due to in demand professionals wanting the services and opportunities a big city provides. County hospital are partially local taxpayer supported but once again rural areas have a thinner tax base. HHS sends Federal dollars but this is limited. Certain states are trying extra hard to exacerbate the problem by not expanding Medicaid.
- flangola7 3y ago
  > In America, hospitals cannot refuse emergency care. How is that unique to America? What other developed nation doesn't have this rule?
  - maxerickson 3y ago
    The way it is funded in the US is probably special. EMTALA is enforced by making it mandatory part of Medicare participation. If you don't bill Medicare you don't have to provide care to anyone.
- maxerickson 3y ago
  Meh, hospitals put uncompensated care at about $40 billion a year in 2020: https://www.aha.org/fact-sheets/2020-01-06-fact-sheet-uncompensated-hospital-care-cost 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-reports/national-health-expenditure-data/nhe-fact-sheet 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.
- blendergeek 3y ago
  > That's why rural areas are losing hospitals. Yes. And they are being run into the ground by "venture capital" as if they were local newspapers.

bushbaba 3y ago

Please do upfront pricing. It’s so annoying getting a bill afterwards how the fully covered treatment was actually not covered and multiple thousands. Leading to haggling with the insurance company and hospital.

toomuchtodo 3y ago
> Starting in 2022, there are new protections that prevent surprise medical bills. If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front, before your visit. If you disagree with your bill, you may be able to dispute the charges. Here’s what you need to know about your new rights. https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills https://www.cms.gov/newsroom/fact-sheets/no-surprises-unders... https://www.cms.gov/NOSURPRISES https://www.cms.gov/NOSURPRISES https://www.consumerfinance.gov/about-us/blog/no-surprises-act-how-we-are-protecting-people-from-side-effects-surprise-medical-bills/ https://www.consumerfinance.gov/about-us/blog/no-surprises-a...
- darth_avocado 3y ago
  The problem is that disputing claims is hard and puts an unnecessary burden on the patient at a time when they are struggling elsewhere. Companies operate in bad faith and more needs to be done to regulate companies (hospitals and insurers).
- Auracle 3y ago
  Why the hell shouldn’t that apply to people that are going to use insurance? The reason our healthcare costs are so high is because everyone with insurance past their deductible is price insensitive. People might at least care about their copay enough to make a difference. 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.
flutas 3y ago

rqtwteye 3y ago

How about the insurers and providers working together on reasonable billing and not make patients pay random charges over which they had no control and information about cost?

ISL 3y ago

Probably charging everyone more to accommodate the potential lost revenue.

supertrope 3y ago

A pull back in "credit." This rule is a blunt instrument. It will reduce medical debt stress caused by the way American healthcare is financed. It will also allow more people to default on their medical bills even the ones that are reasonably priced and correctly coded. It's kind of like how the CARES Act for COVID-19 banned reporting mortgage forbearance to credit. Then Chase Bank narrowed new business to 20% down and excellent credit score in response to the future reduced information environment. 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!