Hospital gouging (Huntsville, Madison: 2013, lawyer, pros and cons)

[NoleFanHSV]

The top 50 hospitals that gouge patients the most - Washington Post

As far as people not paying, I thought everyone HAD to have insurance?

[maillemaker]

My son is having surgery this week. I tried to call and get an estimated cost of the procedure - no one could tell me. Not the provider, and not the insurance company.

How can anyone shop around for health care if you can't get quotes on prices?

[DvlsAdvc8]

^Exactly. I tried to do the same for maternity costs. Answer: voodoo.

[SarahBellum]

Even if you get a quote, it doesn't mean a hill of beans. I had a procedure a few months ago. Beforehand, I called the hospital to get an estimate. I was told it would require a co-pay of $100 and the remainder, about $2000, should be covered by my insurance. When I got there that morning, the co-pay was $300. A couple of weeks later, I got a hospital bill for $2400 and a doctor bill for $700. Three months later, I got a call from a collection agency that I hadn't paid a $400 radiology bill - that I never received a bill for. After several phone calls, I found out the radiology bill went to some random address in another town, despite me filling out reams of forms at check in. (So much for patient privacy, huh?) Only when I complained to the billing office at the hospital did someone there say that I should ask to have my hospital bill resubmitted to my insurance because "it's really very common" to have coding errors or typos that result in claims either not covering as much as they should or being completely rejected.

Sorry if that went off topic a bit and sounded like a rant. 'Cause it kinda' was one. :/

[Becky2517]

Originally Posted by NoleFanHSV

The top 50 hospitals that gouge patients the most - Washington Post

As far as people not paying, I thought everyone HAD to have insurance?

You're kidding, right? Many have opted to pay the fine instead of getting insurance... "can't afford it, don't want it, no one can tell me what to do, ACA sucks..." the list goes on

[FatTails]

Hospitals behave just like any other business; they charge what the market will bear. Every hospital/doctor/lab charges a ridiculous amount to have it knocked down by insurance. It amazes me how Americans think our current system is acceptable.

[MisterEd51]

Originally Posted by Becky2517

You're kidding, right? Many have opted to pay the fine instead of getting insurance... "can't afford it, don't want it, no one can tell me what to do, ACA sucks..." the list goes on

Begin Quote
The fee for not having coverage in 2015

If you don’t have coverage in 2015, you’ll pay the higher of these two amounts:

* 2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a Bronze plan.
* $325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975.
End Quote

The fee you pay if you don't have health coverage
https://www.healthcare.gov/fees-exem...being-covered/

You can get out of paying the so called "fee" if you apply for and are given an exemption. The list is quite long so anybody with a creative mind should be able to qualify for an exemption.

An couple examples of hardships that qualify for an exemption is:
Begin Quote
11. You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act
12. Your individual insurance plan was cancelled and you believe other Marketplace plans are unaffordable
End Quote

A low income person in Alabama who would financially be eligible for Medicaid would be eligible for the exemption because Alabama didn't expand Medicaid.

No problem if you had health insurance that was cancelled. If you say you can't afford an available plan in the Marketplace then you get an exemption.

Hardship exemptions from the fee for not having health coverage
https://www.healthcare.gov/fees-exem...ip-exemptions/

[MisterEd51]

Originally Posted by maillemaker

My son is having surgery this week. I tried to call and get an estimated cost of the procedure - no one could tell me. Not the provider, and not the insurance company.

How can anyone shop around for health care if you can't get quotes on prices?

It's not just hospitals. I have yet to find a doctor or clinic that will give a price for their services ahead of time.

Years ago a guest on the Tonight Show said you should be able to go into a doctor's office and negotiate a price if you pay cash. I have tried that at several different places and have been told they either couldn't do it or couldn't come up with a fixed amount for their services.

One time I asked how much physical therapy cost at the Huntsville Hospital Medical Mall if I paid cash. They said they didn't know. I called the Huntsville Hospital business office and couldn't get an amount from them either. They implied that all amounts are set by reimbursement rates by insurance companies. Doesn't it sound crazy that they were unwilling to deal with me if I wanted to pay cash?

[Becky2517]

That is nuts...my GF went to the hospital in GF, MT - needed a mammogram, it was $325 for no insurance, she told them she couldn't afford the $325, so they told her if she had cash, it would be $125.00...which she gladly paid. IF there was a single payer system in the US there would also be the same charges for every medical establishment/procedure & no gauging allowed (no bashing allowed, I am just stating a fact )

[MisterEd51]

Originally Posted by Becky2517

IF there was a single payer system in the US there would also be the same charges for every medical establishment/procedure & no gauging allowed (no bashing allowed, I am just stating a fact )

Well Medicare is a single payer. Last I read it was full of waste, fraud and abuse. Should we model a system on that?

Note that government already pays for at least 60% of all healthcare in the United States.