Help with Health Insurance/Medical Bills

Almost all hospitals take Medicare because it's a large proportion of their business. You can't pick and choose which patients you'll see, you either opt in or opt out of taking Medicare patients.

I don't know that much about hospitals taking Medicaid but I'm pretty sure it's the same.

Health care providers and clinics, on the other hand, do opt out often.

What I meant by there are ways, that was including GoFundMe and other charity sources.

 

Again, it depends on where the person lives, but no, there really aren't options. The person can try to start a GoFundMe, but only if they have a really well done campaign with someone who knows PR will it succeed. It takes a lot of time and energy to do that.

Actually, Medicare reimbursements are so small, not all doctors and hospitals take it. Particularly private hospitals, and especially private cancer centers. Hospitals try to lessen, not increase the numbers of Medicare patients because the reimbursements are so small, and because patients are older and more likely to die, it affects the hospital mortality rates and outcome percentages for doctors. That's why Cancer Treatment Centers of America don't take medicare patients, for example, or didn't as of two years ago when I was working on this. It affects how their cure rates look on paper.

Nope, not true with Medicaid. For ER, yes, they will accept the patient in an emergency, but after you're stabilized, you're transferred out to County. Cedars Sinai in West Los Angeles is a prime example of this. I have a relative who worked at Cedars. They don't do Medicaid (which in CA is called MediCal). ETA: You can't just walk in with a MediCal card and get treated anywhere, just as you can't walk in anywhere with whatever insurance card you have. For a life threatening emergency, the law is they only have to stabilize you so you don't die. After that, it's the hospital's discretion.

Patient dumping is a huge problem in Los Angeles. There are many horror stories, some of which make the news.

 

Cancer Treatment Centers of America are an exception. They not only advertise like they have miracle cures, even private insurance companies are unhappy with CTCA's excessive charges. In other words they are into making big bucks.

I don't understand your cynicism about Medicare.

Kaiser, who takes Medicare patients: Primary Care Physicians Accepting Medicare: A Snapshot

In addition there's a whole new insurance market for Medicare Advantage. Essentially the government gives the insurance company ~$800/month per patient and the patient pays for various levels of coverage with the $800 subsidy.

I don't have time to find the best link to show you actually how many hospitals take Medicare but if you think about it, everyone over 65 has the option to use Medicare in this county. Can you imagine hospitals turning away every patient over the age of 65? Seriously?

Modern Health Care: On the margins of Medicare - Analysis: Despite overall gap, some hospitals are profiting on the program

But this is off topic so maybe we should agree to disagree.

All hospitals, public or private, are required by law to take patients who show up in the ED. As for patient dumping, that's a whole discussion in itself which is also off topic here. The problem isn't being seen in the ED, the problem is patients who then need admission to the hospital.

Patient Dumping and the Elderly has a discussion on the matter for anyone interested.

 

It's not not "cynicism about Medicare. " That would indicate it's an abstract idea. Perhaps you don't understand because you've never had knowledge of how it actually works in practical terms? Or interviewed or talked with people who have? What I'm saying is based on practical, working knowledge of the system and how it really works. It's having a sister who worked in health care for a doctor's organization (last two letters in the organization name: MA) that helped write legislation in these matters, and having a mother who battled leukemia with medicare. It's having interviewed doctors and patients so I could lobby for better healthcare myself. I couldn't even move my mom to L.A. to be near me when she had leukemia because her healthcare resources were fewer there, and her quality of care would have suffered there. Her state had better care, had more resources for medicare patients, and had better doctors within the system. Her oncologist there was a top researcher. No way would that have happened in L.A.. As I said in my original post, the resources vary vastly depending on where you live. The system is extremely uneven.

You do understand that when someone gets Medicare, that's not the insurer, right? The Medicare recipient chooses a plan from a list of contracted insurance companies. Is your insurance card accepted everywhere? No. In some places, like Los Angeles, the options are far fewer for seniors with Medicare, or the quality of care within those options isn't great. In other places, the number of options, and the quality within them, is pretty good.

And I said, the law for ER is that they only have to stabilize the patient to keep them from dying. (ETA: That is what is meant in the piece you quoted by "emergency condition.")After that it's hospital discretion. The average ER wait in Los Angeles a few years ago was 16.5 hours. It's going down, dramatically in some places, but that's uneven too, and some hospitals are still 5-7 hours. Kaiser hovers at 4-5. ERs don't have time or resources to treat every illness, and there's no followup. Google the two patients who died in L.A. ER waiting rooms while waiting to be seen. There's video of the one woman collapsing on the floor.

I could tell you stories about Cedars that would curl your hair, and they're one of the best hospitals in Los Angeles.

Do you actually know anyone who's ever been treated at Kaiser in Los Angeles? I do. In L.A., they're not known as a hospital one would willingly choose. Is it a huge company? Yep. that doesn't mean I'd want the one in L.A. treating me. Choosing between them and County would be tough, depending on which county hospital we're talking about. Frankly, I'd probably go County USC.

You're welcome to "disagree" but I've lived this and have interviewed many more who have, on both the doctor and patient side. I'll take real human stories and talking to people any day. Which goes back to the original point of the topic: healthcare in the US is very uneven in terms of resource distribution, quality, and availability.

 

[QUOTE="Homer Potvin, post: 1651671, member: 80728"my wife is a nurse employed by a healthcare agency for fuck's sake. But it's all about the deductible now. A $5k nut sounds like a lot until you need a $100k surgery. In that case, I'd be tap dance my way to the billing desk and slap 50 fazools on the counter with alacrity.
The thing to remember is that healthcare (including pharmaceuticals) is something like one-sixth of the US economy. There's more money to be made there than anyplace else. Let's hear it for capitalism! (and for having to buy shit that you really, really need)[/QUOTE]

I know, right? It's insane. My sis worked in for a doctor's organization and had to call in favors with doctor friends just to get me seen for cash when I was uninsured, and I never could get a neurologist until after I had insurance. (Who needs a neurologist when they suddenly go dyslexic, right? )

 

Lots of good stuff upthread, but part of the problem of the high bills is people using the ER when they should have gone to a regular doc three days (or months, or years) prior. The ER is the only department that can't turn you away due to an inability to pay, and since many (citation needed) Americans don't have proper health insurance, they wait until the problem is an ER level thing, then bail on their bills. A (citation needed) $100 dollar fix with a GP turns into a $5000 dollar fix in the ER, which doesn't get paid for, which is part of why the $100 dollar fix wasn't $10 in the first place.

Not trying to get debate room-y, there are many other more serious issues in US healthcare, but that is one of them.

 

Well, "should have" if they had the insurance or the ability to pay. I realize you mention that, but I wanted to emphasize that this is very often not a voluntary action--a "should" that's impossible is, IMO, not really a "should".

 

Yeah, sorry, I meant medically "should", not morally. Poorly phrased on my part.

 

There isn't much I can add, in truth I'm a bit soulless in this Department. But that might be my cynicism towards Humanity. But when the opportunity presented itself and it's not my fault I'm taking death and if any Hospital resuscitate me, I'll sue their asses.

But I still enjoy knowing the hospital that caused my dad's death will never get paid for their incompetence. I admit some of it was his fault but still they're supposed to be trained professionals. They tried to collect by saying his soul could rest easier knowing his debt was paid, however the hospital doesn't know my dad and he's laughing his ass off.