HOME



Digby's Hullabaloo
2801 Ocean Park Blvd.
Box 157
Santa Monica, Ca 90405



Facebook: Digby Parton

Twitter:
@digby56
@Gaius_Publius
@BloggersRUs (Tom Sullivan)
@spockosbrain



emails:
Digby:
thedigbyblog at gmail
Dennis:
satniteflix at gmail
Gaius:
publius.gaius at gmail
Tom:
tpostsully at gmail
Spocko:
Spockosbrain at gmail
tristero:
Richardein at me.com








Infomania

Salon
Buzzflash
Mother Jones
Raw Story
Huffington Post
Slate
Crooks and Liars
American Prospect
New Republic


Denofcinema.com: Saturday Night at the Movies by Dennis Hartley review archive

January 2003 February 2003 March 2003 April 2003 May 2003 June 2003 July 2003 August 2003 September 2003 October 2003 November 2003 December 2003 January 2004 February 2004 March 2004 April 2004 May 2004 June 2004 July 2004 August 2004 September 2004 October 2004 November 2004 December 2004 January 2005 February 2005 March 2005 April 2005 May 2005 June 2005 July 2005 August 2005 September 2005 October 2005 November 2005 December 2005 January 2006 February 2006 March 2006 April 2006 May 2006 June 2006 July 2006 August 2006 September 2006 October 2006 November 2006 December 2006 January 2007 February 2007 March 2007 April 2007 May 2007 June 2007 July 2007 August 2007 September 2007 October 2007 November 2007 December 2007 January 2008 February 2008 March 2008 April 2008 May 2008 June 2008 July 2008 August 2008 September 2008 October 2008 November 2008 December 2008 January 2009 February 2009 March 2009 April 2009 May 2009 June 2009 July 2009 August 2009 September 2009 October 2009 November 2009 December 2009 January 2010 February 2010 March 2010 April 2010 May 2010 June 2010 July 2010 August 2010 September 2010 October 2010 November 2010 December 2010 January 2011 February 2011 March 2011 April 2011 May 2011 June 2011 July 2011 August 2011 September 2011 October 2011 November 2011 December 2011 January 2012 February 2012 March 2012 April 2012 May 2012 June 2012 July 2012 August 2012 September 2012 October 2012 November 2012 December 2012 January 2013 February 2013 March 2013 April 2013 May 2013 June 2013 July 2013 August 2013 September 2013 October 2013 November 2013 December 2013 January 2014 February 2014 March 2014 April 2014 May 2014 June 2014 July 2014 August 2014 September 2014 October 2014 November 2014 December 2014 January 2015 February 2015 March 2015 April 2015 May 2015 June 2015 July 2015 August 2015 September 2015 October 2015 November 2015 December 2015 January 2016 February 2016 March 2016 April 2016 May 2016 June 2016 July 2016 August 2016 September 2016 October 2016 November 2016 December 2016 January 2017 February 2017 March 2017 April 2017 May 2017 June 2017 July 2017 August 2017 September 2017 October 2017 November 2017 December 2017 January 2018 February 2018 March 2018 April 2018 May 2018


 

This page is powered by Blogger. Isn't yours?

Hullabaloo


Wednesday, December 28, 2016

 
And now for something completely frightening

by digby












From Ryan Cooper at The Week:

Perhaps the most monstrous thing about the American medical system — and the bar for that title is high indeed — is predatory billing.

A great many medical providers adjust their prices based on how defenseless the patient is, and bleed the weakest ones for every last red cent, often with preposterously inflated charges for things like aspirin and bandages. A 2015 study looked at the worst price gougers in the country and found 50 hospitals that charged uninsured people roughly 10 times the actual cost of care.

Key to this practice is something called "balance billing," and it's why the American Medical Association is strongly supporting Donald Trump's pick of Rep. Tom Price (R-Ga.) to lead the Department of Health and Human Services, which oversees Medicare. Balance billing is forbidden for Medicare enrollees, but Price wants to allow it — thus allowing doctors and hospitals to devour the nest eggs of thousands of American seniors.

So what is balance billing? It's the practice of billing the patient for the difference between the sticker price and what insurance will pay. So if a hospital visit costs $1,000, but your insurance will only cover $300, some providers will "balance bill" you for $700.

For unscrupulous providers, the method of exploitation is obvious: When doing any sort of expensive procedure, take a rough estimate of the absolute maximum the patient can pay, and jack up the price so the balance hits it. Or if you're short on time, just bill them into the stratosphere, and you'll get whatever the patient has during the bankruptcy proceeding.

Balance billing is basically illegal for Medicare patients, and heavily restricted for Medicaid patients. It was restricted under the Affordable Care Act as well, but only partially. Out-of-network care — increasingly common as insurance networks get narrower and narrower — can still be balance billed even if it is for an emergency, both for ACA plans and employer-provided ones, and doesn't have to be counted toward out-of-pocket limits. People being blindsided by immense out-of-network bills — going to an in-network hospital that employs an out-of-network surgeon they conveniently failed to tell you about, for example — is an increasingly common experience. That is why ObamaCare failed to stop people being bankrupted by medical debt (though it did slow medical bankruptcies substantially).

Permanently obliterating the financial security of helpless families with no or bad insurance as a loved one dies slowly and painfully of a chronic illness is a nice little profit center for providers. But it pales in comparison to the gravy train they might get if they can bring balance billing to Medicare. Seniors use far more care than the younger exchange population, and there are a lot more of them — 55.5 million, versus 12.7 million people on the exchanges. Perhaps most importantly, they're quite a bit richer on average. Many seniors have been scrimping their whole lives to save for retirement, in keeping with decades of agitprop from conservatives and Wall Street, and the more sociopathic among the health-care population are licking their chops at the prospect of being able to devour those nest eggs.

That brings me back to Tom Price and the AMA. In 2011, Price (an orthopedic surgeon himself) introduced a Medicare "reform" bill in Congress that, among other things, would have brought balance billing to the program. This would greatly increase provider and physician revenues, and the AMA eagerly lined up behind it. Physician salaries are of course already none too shabby: An average salary for a primary care doctor in 2015 was $195,000; for specialists it was $284,000. Hey, a few thousand grandparents might lose their retirement, but that fourth BMW isn't going to buy itself.

But balance billing would also go no small distance toward abolishing Medicare as an actual program of insurance. Because really, how can you be said to be insured if any provider can swipe your entire net worth simply by fiddling with the prices?

There's more if you can bear it.

I'm sure that there will be a huge pushback from various quarters, including the Democrats. But with polarization I can easily see elderly Republicans getting on board with this even though it will destroy them personally.

And, by the way, it won't just destroy the old people. It's going to wipe out entire families. If you haven't dealt with an elderly person lately you simply cannot imagine how much health care they need and how insanely expensive it is. The idea that we can be "wise consumers" when we're 85 is simply ridiculous. Unless, of course, they plan to implement those death panels after all. They're going to need them.

In any case, if this is actually proposed, we're going to find out if our politics are now simply a team sport in which people don't care at all about the details or if a direct assault on a prime GOP constituency will finally sober them up. I'm skeptical that anything will but you have to have some hope.

Oy. The hits just keep on coming.


Happy Hollandaise everyone.  :/