A sad lesson in asking for medical costs in advance!

This couple found out the hard way that you can be financially destroyed by some providers, especially if you are unfortunate enough to be out of network. Read it and weep, then get angry and let Representative Kilmer, Senator’s Cantwell and Murray know that you want this changed at the Federal level! No out of network billing fiascos. And while they are at it, they should look into breaking up the two companies that own the dialysis market. It is far more onerous than the high tech companies they are currently going after.

https://www.nbcnews.com/health/health-care/first-kidney-failure-then-540-842-bill-dialysis-n1034496

Here’s the latest on our instate new law, but you *can* be grossly overcharged before 2020!

https://www.insurance.wa.gov/surprise-medical-billing

“Am I a bad person?” Why one mom didn’t take her kid to the ER — even after poison control said to. Vox

I’ve heard this very refrain from single parents, especially moms. We have to make it clear that lower income people can come to our hospital without fearing being made bankrupt by a bill.

“I was sitting there thinking, am I a bad person?” Clark says. “I’m weighing my daughter’s life against how much the bill is going to cost.”

https://www.vox.com/health-care/2019/5/10/18526696/health-care-costs-er-emergency-room

We don’t need government-run healthcare to get affordable, universal coverage – Washington Post

A very interesting opinion piece (that dovetails with the last post of mine discussing that a large amount of lobbyists are out to kill the idea of Medicare for All). I don’t think that Third Way is a lobbying arm of the healthcare industry, but I would love to get some feedback by my readers as to what they think of this proposal. It does merit a good debate, I believe. It might even be possible to get a great many Americans on board with this, since they get to keep their doctor, it doesn’t put every medical professional into having to accept the uneconomic reimbursal rates of Medicare/medicaid, it eliminates medical bankruptcies, and it covers everyone in a way that is easy to implement. Thoughts? Am I missing something here?

From the article:

America can insure everyone without changing anyone’s existing health coverage. It won’t require replacing Obamacare with a single-payer, government-run system. Instead, we can build upon Obamacare with two simple, game-changing features: a universal cap on premiums and out-of-pocket expenses, and an automatic coverage system that places the uninsured in a plan they can depend on and afford.

UPDATE: After thinking about it, here’s my, and a medical friend’s thoughts:

A missing element in this is that it doesn’t change the issue that not everyone with insurance gets the coverage they need. Some providers don’t take more than one or two of the ACA options. Some don’t take any. Many things docs want to do arent covered by Obamacare, Medicare or independent insurers. If your doc says you need an MRI, and the ACA people say no, what then? Why is an insurance bureaucrat more knowledgeable about your care than your doctor? The devil is in the details in the current ACA & in this one too. In Canada, everyone who walks in the clinics or hospitals gets the same care. This proposal at least in the article, does not achieve that. Reimbursements in the ACA often barely cover the cost of treatment. That’s why some docs won’t take them. What about the caps? Meaning some programs only allow you to see a doc 4 or 5 times a year, then you are out of luck and out of pocket. Will it cover all needed coverage? So much missing in this article. Would love to have the authors point us to more indepth overviews of this. Interesting to read some of the comments, which seem to say that Third Way is a tool of the Right, some say it’s a tool of the Left. Wonder what the reality is? 

https://www.washingtonpost.com/opinions/2019/02/19/we-dont-need-government-run-health-care-get-affordable-universal-coverage/

What A French Doctor’s Office Taught Me about Health Care – New York Times

I have found in my conversations with Americans that very few have any understanding of how bad American health care is compared to other industrialized countries. While it’s true that we have great medical professionals, the actual cost to deliver that care is much higher than other similar countries, the outcomes are much worse. Here is a ground level view of a real patient who fled America because of her inability to afford care, and what she found in France.

Taking Surprise Medical Bills to Court – NY Times

With a growing number of people being sent to collections here in Jefferson County by JHC, this article points out a very interesting issue of whether the “contract” between a patient (especially one coming into an E.R.) and the hospital is a legal and binding contract for billing purposes. Can you have a binding agreement if the client/consumer doesn’t know the price they are paying when they sign the consent agreement?

 

Abuse of 340B Program Impacts Patient Care -Oncology Nursing News

Jefferson Healthcare and many other rural hospitals, take advantage of a Federal program called 340B.

As the article states:

This little-known federal program was created to help uninsured or vulnerable patients get access valuable medications regardless of their abilities to pay. This was done by providing certain participating hospitals or safety net clinics with discounted medicines. The 340B program has become an extremely important program for patients in need in this era of unaffordable and unsustainable drug prices.

The article lays out the problems with the 340B program and how some hospitals are abusing it to help themselves remain profitable.

While the point of sharing this article is not to infer that Jefferson Healthcare is in any way one of the ‘bad actors’ in the 340B debate, this article gives the average person a very good quick overview of the controversy.  The battle over 340B is playing out in Congress, and it’s outcome will affect JHC. JHC does a great deal charity care, including use of 340B funds, and the program to offer charity care has been recently reformatted to allow people who do not have the means to afford to get needed care. (More on that can be found at the JHC website, JHC Charity Care overview )

I will be looking into the local ramifications of this issue in upcoming months, and should have a more comprehensive overview on them  later.

But for now. Here’s a good quote:

For too many hospitals, the 340B program has become a road to profits, not a safety net and not a way to expand charity care for uninsured, indigent patients. For too many patients, particularly those with cancer, the 340B program has not reduced their cost of care 1 cent.

Read the whole opinion piece here:

https://www.oncnursingnews.com/web-exclusives/abuse-of-340b-program-impacts-patient-care