Monday, September 29, 2014

Hospital Financial Trap Even When Patients Insured

Elisabeth Rosenthal | New York Times--
Costs Can Go Up Fast When E.R. Is in Network but the Doctors Are Not"... Texas demanded some data from insurers last year, they learned that up to half of the hospitals that participated with UnitedHealthcare, Humana and Blue Cross-Blue Shield — Texas’s three biggest insurers — had no in-network emergency room doctors. Out-of-network payments to emergency room physicians accounted for 40 to 70 percent of the money spent on emergency care at in-network hospitals.."
I wrote about this before, but felt it worth reminding people of this financial trap again. While this article specifically mentions the E.R. past experience indicates this can be a problem patients may run into with any of the doctors throughout their treatment.

What Can you Do About it?
Not much. Anyone who's ever experienced the medical system can attest how many doctors confusingly end up getting involved. A patient who's treatment becomes complicated is often referred to other hospitals in other cities for specialized treatment. Unless someone at their most vulnerable moment has an outside expert 'medical advocate' who they can afford or are BFF's with one who can look out for them chances are after recovering from what ails, they'll need a whole lot of financial recovery afterwards as well.

So much for the private sector policing itself
It would be really swell if legislators got off their rumps and passed some regulations. Regulations could come in one of two forms. Either require all doctors working at a in-network hospital actually be in one. Or at the very least require hospitals to notify patients which doctors are not part of their plan. I don't think the latter is to much to ask even for those who favor less government.

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