Adventures in the "free market" of healthcare 2.0 (attorney, how much, insurance)

[ovcatto]

Following up on a previous thread that I can't seem to find...

To recap, I was admitted to the hospital on two back to back occasions for a bacterial infection. Both times I was admitted through the emergency room, which by definition precluded my ability to "shop around" for the best price for services (hence the emphasis on the economics of a free market).

I am insured by a major health insurance company so this isn't intended to be any sort of pity party, in fact I my view of the whole thing as being humorously Kafkaesque (if that is possible).

In the first installment I wrote about how I facetiously tested the free market by asking the nurses and doctors how much each procedure, medication, personal item was going to cost me. Sometimes they were amused and other times they weren't. Little did I know that I should have been far more serious in my inquires, which brings us to the current update.

We just received a denial of payment for 8 doctors (EIGHT) who treated me over a period of four days. Why, well the hospital was "in network" but the doctors were not!

Now I didn't ask for any doctor much less eight of them, nor was my wife (attorney and expert - at least she thought - on federal law regarding pensions, and Employee Retirement Income Security Act (ERISA) that I was required to ask each and every doctor if they were covered under my plan. Which is weird since I would be asleep or sedated and suddenly my room would be filled with a bunch of doctors asking the same damned questions that I was ask when the last batch of white coated strangers stood unannounced at my bed side.

So how is the "market" supposed to work under these conditions? Apparently under the law, a doctor can enter your hospital room, order a bunch of tests and then charge you for their work even though you never asked them to much less come up with a price for the services you didn't request?

Well it doesn't it seems.