[HN Gopher] Amid massive hospital sell-off, corporate giant cont...
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Amid massive hospital sell-off, corporate giant continues suing
patients
Author : hhs
Score : 96 points
Date : 2021-07-26 17:43 UTC (5 hours ago)
(HTM) web link (www.npr.org)
(TXT) w3m dump (www.npr.org)
| OrvalWintermute wrote:
| It is not well-known that some large insurance companies have a
| specific tactic that they employ against out-of-network medical
| groups even for pre-approved or emergency work (Some practices
| that are out-of-network will charge exponential multiples for
| services which is another grievious issue).
|
| The large insurer will send checks for goods & services directly
| to the patient, rather than to the practice(s) that performed the
| service, even if this is a fairly reasonable cost.
|
| Patients see a check for $8,000 and $25,000 that is supposed to
| go to the trauma surgeon's practice that initially stabilized the
| patient, followed by the Plastic Surgeon's practice that spent 16
| hours, 2 titanium plates, and a large number of titanium screws,
| and biologic implants reconstructing the patient's face. And,
| similar for the small consults $300 consults to Opthamology and
| Neurology that are common to severe head trauma involving optic
| nerves, relatively minor brain injures and significant facial
| trauma.
|
| Instead of providing it to the practice to pay for the
| plates/screws, and delivered services, the patient spends the
| money. Then the patient gets sued.
|
| This is not uncommon unfortunately - even for medical practices
| that TRY to be in-network with every single insurer, AND
| medicare/medicaid.
| wolpoli wrote:
| I reread this twice, but I am still not sure how this helps the
| insurance company through. Is there something I missed? Or is
| this intend to cause administrative issues for out-of-network
| medical groups?
| OrvalWintermute wrote:
| It puts the insurance company in the driver's seat when it
| comes to negotiations, and it severely hampers the
| administrative side of medical practice performing the
| services, because they are in the awkward position of having
| to sue a patient, or put liens/garnishments against a
| patient's income/house. Insurance companies may not be at all
| helpful in this process either.
| Sohcahtoa82 wrote:
| Hospitals suing patients to get them to pay medical bills is
| something that could only happen in America.
| asdfasgasdgasdg wrote:
| Are there other countries where a person might be responsible
| for their own bills? I think there are, right? This may be a
| bit of a silly question, but how do the systems in those
| countries collect from individuals who will not otherwise pay?
| codegeek wrote:
| " own bills"
|
| The problem is that Hospitals can charge any amount they feel
| is correct but you cannot find that out UNTIL AFTER the
| service is delivered. Yes you _could_ ask for cash prices but
| try doing that at a regular hospital and see how quickly you
| get them in a clear and concise manner.
| asdfasgasdgasdg wrote:
| I'm replying to you because you're the top comment, but
| this is a general response, because I feel like many
| replies have misconstrued my meaning.
|
| I am not asking what happens in countries with socialized
| healthcare. I'm also not asking what are the flaws of
| private healthcare. I am only asking, supposing that there
| are other countries where there is private healthcare, how
| those countries deal with nonpayment. If there are no other
| such countries the question is moot but I had been led to
| believe that there are some.
| aaomidi wrote:
| The same way America handles it when eventually enough people
| don't pay. They bail the companies out with a ton of tax
| payer money so the companies can continue their practices.
| loopz wrote:
| In many social democratic countries citizens will only pay a
| small fixed fee for necessary operations. For private bills,
| or if your travel-insurance doesn't cover medical bills in
| other countries, you could still get stuck with a hefty bill.
|
| In most cases, you pay peanuts and people get their health
| back so they can go back to work and live life as before.
| gruez wrote:
| But GP was talking about countries in general, not just
| wealthy western social democratic countries.
| Sohcahtoa82 wrote:
| In other countries, people don't get billed for their
| healthcare, or the bill is small enough to be insignificant
| for most of the population.
|
| But we can't have that in America, because half the country
| is convinced that would be _SOCIALISM!!_
| asdfasgasdgasdg wrote:
| I know that this is true for many other countries, but is
| this in fact true for _all_ other countries?
| markdown wrote:
| Not all, but most.
| tryingtogetback wrote:
| Dangerously ill-informed comment. Have you ever been to a
| hospital in a country that embraced socialism? In some
| countries you pay effectively zero for socialized
| healthcare. What an awesome, marketable for votes delusion.
|
| Guess what. You get exactly what you paid for. Chronic
| mismanagement, apathy, deteriorating conditions, lack of
| resources. Need to schedule a procedure? Get into a virtual
| line 10000 persons long. "Oh you are in pain? I'm sorry.
| Thermometers are the only medication we can offer". In CIS
| countries, the only way to get something done is to bribe
| an official (to move you up the line by a 100 or so) or a
| private clinic (but socialism is so great! right?) If a
| country with socialized healthcare manages float it's
| healthcare services on an "average" (aka meh) level, it's
| only because of the private donors, private insurances,
| private donations, and financial aid and subsidies from US
| (but capitalism is so awful, right??)
|
| Grass is always greener aka you have no idea what you are
| talking about
| parrellel wrote:
| I don't think the countries of the ex-USSR are what
| anyone is talking about when they're talking about
| socialized medicine.
| majormajor wrote:
| I have - I had an emergency procedure done within hours,
| without noticing particular mismanagement, apathy,
| deteriorating conditions, or lack of resources.
|
| It was annoying that they didn't want to give out
| narcotic painkillers, but given addiction rates here,
| understandable. Not a question of resources, just a
| different approach.
|
| Of course, as a foreigner who was going to have to pay
| cash, I can't be positive that the experience would be
| the same for citizens on Taiwan's national plan, but the
| people I was staying with said I was being treated the
| same as they'd seen anyone else...
| 908B64B197 wrote:
| > or a private clinic (but socialism is so great! right?)
|
| Having to pay out of pocket after paying 50%+ tax rate!
| Incredible!
| themolecularman wrote:
| To be fair America has the Veterans Affairs administration,
| which is socialized medicine, albeit for a small subset of
| the population, veterans.
|
| If you recall from Donald Trump's presidency, one of the
| things he campaigned on for veterans, is the ability to
| choose your own healthcare, such that they wouldn't be
| locked into the veterans affairs medical system, which was
| found to be far insufficient.
|
| This isn't an apples to apples but it's worth considering
| that there are examples of the alternative model not
| working in America either.
| jodison wrote:
| I, like many veterans, love the VA.
| https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5328
|
| My understanding is that that the veterans' choice
| private options would still have been payed for by the
| VA.
|
| https://www.va.gov/COMMUNITYCARE/providers/index.asp
| https://www.politifact.com/truth-o-
| meter/promises/trumpomete...
| dragonwriter wrote:
| > To be fair America has the Veterans Affairs
| administration, which is socialized medicine, albeit for
| a small subset of the population, veterans.
|
| It also has TriCare (military & dependents, ~10M),
| Medicare (Aged/Disabled, 61.2M in 2020), and Medicaid
| (medically indigent, 68M in 2020). With around 9M in
| Veteran Health Administration, the US has socialized
| medicine for nearly 150M people out of the 330M
| population.
| jdmichal wrote:
| Medicare and Medicaid are not exclusive. They call it
| "dual eligible".
|
| (PDF WARNING) https://www.cms.gov/Medicare-Medicaid-
| Coordination/Medicare-...
|
| This lists 20% of Medicare and 15% of Medicaid enrolled
| are dual eligible. So the total, using your numbers:
|
| 9 + (61.2 * .8) + (68 * .85) = 115 million
| slownews45 wrote:
| Totally false.
|
| If you are in Caribbean country for example, and get services,
| if you don't pay you will literally not be allowed to leave the
| country until you settle up.
|
| Generally the costs are fractions of what they are in the US.
| But they are not playing - they don't have confidence that once
| you are back in US or wherever that you'll pay.
|
| Some countries even have exit fees etc. You are there until you
| pay to leave.
| kilroy123 wrote:
| Lots of other countries do this as well, outside of the
| Caribbean.
| slownews45 wrote:
| Yeah - they "arrested" the vessel I was on once until
| someone's medical bill was settled up (not mine). Certainly
| worked, company involved wired money promptly.
|
| The other thing - you can be turned away for lack of
| payment more easily (or just not get great care) in other
| countries. In the US you can do a $10M bill on critical
| care at a hospital without paying anything - that just
| doesn't happen in some other countries in most cases - they
| don't have the $10M lying around etc or have more competing
| needs so you just can't stay on full support for years the
| way you might in US.
| [deleted]
| fidesomnes wrote:
| The only kind of hubris to get upvoted is ignorant anti-
| American dunks.
| renewiltord wrote:
| Factually incorrect. Travel abroad to Germany, get care, and
| then attempt to default on your bills. You will be threatened
| with legal action.
| ratsforhorses wrote:
| And then what? They send it to some collection agency, who
| sends you letters reminding you over 2-3 years...and..if the
| amount is a couple of hundredEUR drop the matter...it'd cost
| them more to pursue it further...
| hereforphone wrote:
| How many different countries do you hold law degrees (or even a
| rudimentary understand of law) in?
| mindslight wrote:
| The article makes no mention of the legal justification backing
| up any of these debts. They aren't due to straightforward
| _contracts_ like nearly every other bill, as that would require
| up-front rates. And so they must be due to some state law that
| empowers hospitals to create arbitrary post-facto charges for
| whatever amounts they feel like. Part of the focus of healthcare
| reform needs to be on these state laws that enable the arbitrary
| billing racket in the first place - if they were eliminated, much
| of the opaqueness of the healthcare industry would be forced to
| change.
| henriquez wrote:
| > But lawsuits are a rich man's game. She couldn't justify trying
| to find an attorney or fighting a big, publicly traded company
| that would pursue her for $2,700.
|
| This makes no sense and calls into question whether the article
| is being honest in its description of the debt in question. No
| superior court would waste its time over $2,700 - that's small
| claims territory, eg. no lawyers or fees for defendants.
|
| In general if you owe a debt to a company that gets acquired the
| debt doesn't just disappear. A bunch of fluff about the pandemic
| doesn't change that either. So my take is that the lede is
| disingenuous and the piece smells like agenda-pushing.
| tssva wrote:
| In my state and I assume many others the plaintiff can choose
| whether to file in small claims or the normal general district
| court. The defendant can file to have a case moved from small
| claims to general district but not the other way around. Judges
| also do not have the ability to move a case from small claims
| to the normal general district process unless the parties
| agree. Companies therefore usually file using the normal
| general district process in other to achieve the very result
| documented in this article.
| kmeisthax wrote:
| The _court_ doesn 't waste it's time; the _company_ does.
|
| Furthermore, these sorts of bulk lawsuits can be used as scare
| tactics to scare up settlements. _Obviously_ , prosecuting a
| lawsuit over a $2,700 debt makes no financial sense _if_ you
| were to carry the lawsuit to completion. But it _also_ makes no
| sense to defend against. Just settle. The vast majority of
| people do this and thus you can get lots of money by suing
| people this way.
|
| Indeed, they basically outright stated this:
|
| "As of January, the company has decided to take patients to
| court only if they make at least twice the federal poverty
| level -- or about $52,000 annually for a family of four."
|
| In other words, they target people who are most likely to
| settle and pay up.
|
| (Bonus points: this is intended to sound exonerating, until you
| realize that there is no such thing as a "federal poverty
| level". $52,000 is dirt poor in New York City or San
| Francisco.)
| gruez wrote:
| >In other words, they target people who are most likely to
| settle and pay up.
|
| Seems like they can't win. If they sue everyone then they're
| called out for "suing the poor" or whatever. If they sue only
| people above an arbitrary cut-off then they're called out for
| "target[ing] people who are most likely to settle and pay
| up".
| deathanatos wrote:
| > _this is intended to sound exonerating, until you realize
| that there is no such thing as a "federal poverty level"._
|
| https://aspe.hhs.gov/topics/poverty-economic-
| mobility/povert...
| omegaworks wrote:
| Who's going to take the time out to explain that to a
| defendant? Certainly not the people trying to sue.
| henriquez wrote:
| If you get served with a small claims lawsuit it is clearly
| labeled as such. And most small claims jurisdictions have no-
| cost mediation options to help people understand wtf is going
| on.
| anigbrowl wrote:
| _You_ know this, as do I. You are assuming everyone else
| knows it too, and knows enough to say 'eat my shorts, file
| a small claim or GTFO.'
|
| It's not the job of journalists to educate folk in this
| position, though a good journalist would point out such
| relevant facts to assist readers of the article who might
| be in a similar position nor or later. The primary job of
| the journalist is to report on the situation of their story
| subject, which might include a lack of financial or legal
| literacy.
| jermaustin1 wrote:
| The threat of a lawsuit is not a lawsuit, it is instead a
| demand letter that will state that if you do not pay, you
| will be sued. It will not say in sued in small claims, it
| just says you will be sued.
|
| So you would not get served to appear at a small claims
| court office, you will instead get a very scary letter on a
| law office's letter head, and you will pay the money.
| kirykl wrote:
| They file suit hoping to get a no show default judgement, and
| then file to garnish either wages or bank accounts. Most don't
| contest so it's only filing fees on the plaintiff
| travoc wrote:
| I don't think that's correct.
|
| https://www.columbiadailyherald.com/news/20191121/medical-de...
| JumpCrisscross wrote:
| > _When her summons arrived, panic set in for Cantwell.
|
| "My mind went immediately to the stimulus payments," she says.
| "At least I have a way to take care of this now."_
|
| FFS. Zero chance this was a coincidence.
| hereforphone wrote:
| I don't understand your assertion. Were stimulus payments
| instituted to indirectly pay the companies that own hospitals?
| Will any further stimulus payments be issued with the same
| motivation?
| [deleted]
| JumpCrisscross wrote:
| > _Were stimulus payments instituted to indirectly pay the
| companies that own hospitals?_
|
| No. But someone noticed stimulus payments were coming, looked
| up the debtors who owed amounts close to the stimulus amount
| and sent off aides to harass those people into turning over
| the money.
| toomuchtodo wrote:
| This is exactly what happened, due to a deficiency in
| statute.
|
| > Under the bill governing the second stimulus check, your
| funds could not be garnished to pay debts like child
| support, banks or private creditors. However, part of this
| rule changed with the third check.
|
| > The bill authorizing the third payout was pushed through
| using a process called budget reconciliation. Congressional
| Democrats used this legislative tool to more quickly pass
| the new COVID-19 relief bill and the third stimulus check
| that comes with it, since it allowed them to pass it with
| fewer votes. But because this process was used, the third
| checks aren't protected from all garnishment, although
| lawmakers are moving to fix this now.
|
| https://www.cnet.com/personal-finance/your-third-stimulus-
| ch...
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(page generated 2021-07-26 23:02 UTC)