As far as “balance billing” goes, I agree with banning it because it does not address the real problem. If the insurance company doesn’t pay enough, the solution is not to drive the patient into bankruptcy. The solution is to make the insurer pay better rates. Hospital associations and doctors’ associations need to be doing a better job of addressing this problem, not chasing patients who probably can’t pay their bills anyway.

Expecting “educated consumers” to solve the problem ignores the fact that many Americans simply aren’t educated enough, savvy enough, or (in the face of a serious illness) emotionally stable enough to do so. The Medicare Part D problems demonstrated that graphically, as confused seniors turned to public librarians to find out which plan to sign up for. (I was a public librarian at the time, and I got these questions, which I was supposedly qualified to answer after a 2-hour seminar). Oh yeah, that’s a great way to determine what plan will help you most with your complex drug costs.

Finally, we as a nation need to face that death is a fact of life. So much medicine is futile (such as my fathers CABG — he also had advanced emphysema, so he died in 2 months anyway) or merely prolongs life with no quality.

I successfully stopped my 85+ year old (now 90 YO) grandmother’s doctor from having a pacemaker implanted in her. She’s blind, mostly deaf, severely arthritic, and housebound, and says every day that she wants God to take her because her quality of life is pretty much zero. A pacemaker? Why? So her heart arrhythmia can’t kill her? Great, then she can live who knows how many miserable years until cancer, infected bedsores, or pneumonia manages to kill her more slowly and painfully instead. At some point one has to accept the inevitable and go with dignity. As it happens, my grandmother has both Medicare and private insurance, and it wouldn’t have cost us anything to get the pacemaker — it wasn’t the $$$ that motivated this consumer, it was quality of life.

but heaven forbid a lawyer have to do so in the name of due process!

http://www.nacdl.org/public.nsf/defenseupdates/florida064?opendocument

For years I wanted to go to medical school. I’ve been told many times I would be a good doctor. I didn’t get in the first time I applied due to a snafu with my college advisor, and I never re-applied. Mainly because I don’t want to deal with this kind of stuff. Helping people is a noble calling, and I do that as an EMT and firefighter. Both of which pay less than an MD, but have a hell of a lot less overhead and less expensive schooling to get there.

Who control the price of goods. Is it the seller or the buyer. You are the buyer and you pay through your insurance company. Your “insurance” is cheating the seller buy paying only a third of what the product is worth. The seller bills you for the rest, now you are upset with the seller. Be upset with your insurance who is keeping 2/3 or more of your money so they can live the high life. If you look closer at their pocket you might see the hands of lawyer, judges and politicians in it.

But you’re not upset with them, just us lousy thieves.

I’m sure the balance billing ruling will make it marginally worse, but I’d still say it was the right call. My wife recently spent almost two weeks in ICU after a sudden and serious medical problem. We went to the ER covered by our insurance. Drove past a Kaiser facility to get there (though only ‘cuz we didn’t know how sick she was). She survived, thank god, but only barely. And a week or so after she was discharged I got a balance bill from a practice I’d never heard of.

Don’t doubt for a second they provided vital services and deserve every penny. But I have no control over who consults or provides other services, and I understood that the hefty premiums and large deductible would cover everything.

I’m sure the insurance companies are robbing docs, and I don’t have a good solution, but getting a surprise bill because I didn’t stand at the doorway and quiz practictioners about their affiliations 24/7 ain’t right. (‘just a sec. Hmmm, let me check. Oh, seems your practice and my insurer are beefing. Let’s have the attending call another provider…’)

I am also in the process of completing my doctoral degree with an emphasis on health policy, and organizational behaviour, and there are some pretty serious changes that are going to be coming down the pike.

Eventually, the change may come, but the government seems to think that the answer to a problem is more government intervention, even if the original problem was too much government intervention.