21 October 2014

This is the Best Idea that I have Heard all Day

The canvassing board in Michigan has just certified the language for a petition to prevent hospitals to overcharge the uninsured:
The Board of State Canvassers on Monday unanimously approved the form a statewide ballot initiative petition that aims to prohibit a health care provider from charging a higher price to some for medical goods or services.

A group called Stop Overcharging is backing the "citizen initiated" legislation, which would limit a hospital or provider to charging somebody any more than 150 percent of the lowest amount the provider had accepted as payment in full.

The example they give is if somebody was charged $2,000 for an MRI but the provider accepted $600 as payment in full, the provider couldn't force an uninsured person or auto accident victim to pay more than $900.

It's something that has come up in the discussion of no-fault reforms. The petition is designed to incite action from the state legislature on that topic.

"We would hope that they would, we would wish that they would, but we're preparing if they wouldn't," said Rocky Raczkowski, a former state lawmaker who is heading up the petition drive.


The Board of State Canvassers unanimously approved the petition as to form, meaning it meets state guidelines and can be circulated.

The group can start collecting signatures after the Nov. 4 election, and Raczkowski said they plan to move quickly. Asked if paid circulators would be circulating the petitions, he said the group was still examining its options.
There is some political baggage along with this, it seems to be associated with insurance "Reforms" that favor the auto insurance industry, but the idea that part of the healthcare delivery problem in the USA is the price of healthcare appears to be gaining currency, and this is a good thing.

The idea that, for example, the cost of an identical service can vary by over an order of magnitude at the same hospital in the is much, if not most of the problem here.

The New York Times revealed something very similar recently, when it discovered that many hospitals employed ER physicians who were out of network, who then price gouged patients, since they were not covered by any agreement with insurance carriers:
When Jennifer Hopper raced to the emergency room after her husband, Craig, took a baseball in the face, she made sure they went to a hospital in their insurance network in Texas. So when they got a $937 bill from the emergency room doctor, she called the insurer, assuming it was in error.

But the bill was correct: UnitedHealthcare, the insurance company, had paid its customary fee of $151.02 and expected the Hoppers to pay the remaining $785.98, because the doctor at Seton Northwest Hospital in Austin did not participate in their network.

“It never occurred to me that the first line of defense, the person you have to see in an in-network emergency room, could be out of the network,” said Ms. Hopper, who has spent months fighting the bill. “In-network means we just get the building? I thought the doctor came with the E.R.”

Patients have no choice about which physician they see when they go to an emergency room, even if they have the presence of mind to visit a hospital that is in their insurance network. In the piles of forms that patients sign in those chaotic first moments is often an acknowledgment that they understand some providers may be out of network.
Note that this sort of shenanigans is why ER doctors income has gone up in recent years.

ER's are going Wall Street, and the only people who win in this game are the worst among us.


Post a Comment