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"Slow Pay, Low Pay or No Pay": Blue Cross Approved Surgeries Then Refused to Pay

(www.propublica.org)
167 points ceejayoz | 6 comments | 12 Apr 25 14:25 UTC | HN request time: 0s | source | bottom
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CamperBob2 ◴[12 Apr 25 15:13 UTC] No.43665080[source]▶
There is basically no way to make progress here, as far as I can see. If the insurance companies weren't running open-loop before, they certainly are now.
replies(1): >>43665119 #
candiddevmike ◴[12 Apr 25 15:17 UTC] No.43665119[source]▶
Stop having employer provided insurance and make health insurance like buying car insurance ("free market") or do single payer ("communism"). The current status quo of insurance cartels is terrible for everyone involved--employers/employees get fleeced, providers get stiffed, and America gets more unhealthy.
replies(7): >>43665156 #>>43665202 #>>43665214 #>>43665248 #>>43665288 #>>43665360 #>>43665474 #
1. burkaman ◴[12 Apr 25 15:27 UTC] No.43665214[source]▶
> make health insurance like buying car insurance ("free market")

This option doesn't work because healthcare can't be a free market. Car insurance companies have to compete not only with each other but with alternatives like not owning a car at all. There is no alternative to being alive, so health insurance companies can effortlessly collude to raise prices across the industry knowing that they have the most captive customer base possible.

replies(5): >>43665285 #>>43665712 #>>43665961 #>>43666061 #>>43666161 #
2. zeroonetwothree ◴[12 Apr 25 15:36 UTC] No.43665285[source]▶
(a) in most of the US not owning a car isn’t an option

(b) if we had a reasonable market then some people could have an alternative like paying out of pocket

3. SoftTalker ◴[12 Apr 25 16:19 UTC] No.43665712[source]▶
But things like deductibles and covered treatments are negotiable. The majority of health care is not “you will die without this specific treatment” there are usually options.
4. gruez ◴[12 Apr 25 16:42 UTC] No.43665961[source]▶
>Car insurance companies have to compete not only with each other but with alternatives like not owning a car at all. There is no alternative to being alive, so health insurance companies can effortlessly collude to raise prices across the industry knowing that they have the most captive customer base possible.

US healthcare has to compete against cheap healthcare in mexico or whatever

5. franktankbank ◴[12 Apr 25 16:55 UTC] No.43666061[source]▶
Its the doctors who need to compete and fucking advertise 1 single price. We need a market first, not random ass prices based on some n-dimensional rubric which oh we don't actually follow anyway that was just there to confuse you. Now go sit on hold for a part-time job shitface.
6. ndriscoll ◴[12 Apr 25 17:05 UTC] No.43666161[source]▶
This is nonsense that continues the status quo. We were recently trying to understand our options for something time-sensitive, and no one could tell us with any certainty it would cost $2k or $20k if insurance denied it. We were fully willing to pay thousands out of pocket (the price insurance apparently usually pays after "negotiations"), but couldn't get any assurance about the cost or even whether they could correctly bill just this one procedure at their out-of-pocket rate (and what that might be) when everything else was with insurance. It's not like we were the first to ever get it done. The system is just full of blatant unmitigated racketeering.

A good first step would be banning price discrimination for medical procedures. Right now you get three different prices for "I pay", "insurance pays", and "insurance denies and I pay". People can't tell you what those prices will be. The whole point of insurance is supposed to be to derisk these kinds of decisions, not increase uncertainty and risk. Attempting to use insurance and getting denied can 10x your cost, so what is the purpose of the insurance?