Originally Posted by
DogsWin
I'm surprised there has not been one comment in this thread about balance billing. The #1 cause of bankruptcy in the US is medical bills and allowing doctors to charge patients whatever they want to in emergency situations and insurance companies paying only to a certain point is what causes most of these bankruptcies.
For example, in 2008 on Thanksgiving Day I had to go to my Blue Cross Blue Shield in-network hospital due to severe abdominal pain. I had to have my gall bladder immediately removed per the ER doctor. Long story short- I was in the hospital for about 28 total hours and the entire cost of a routine gall bladder removal was ~$60,000! I had to pay out of pocket about $13,000. The ER doctor was not "in network" with the largest and arguably best health insurance provider in Texas. Why? Because he (and several other medical pros) REFUSE TO BE IN IT! They can make HUGE SUMS of money by not being limited by the insurance companies' agreed max payment amounts. The doctors, hospitals, etc just 'balance bill' the patient and this practice is illegal in several states. Also, hospitals negotiate with these "not in any network" doctors to give them exclusive rights to treat all emergency patients who arrive during their day on ER call. If a patient asks for an 'in network' doctor there will not be one, because he/she did not outbid the "not in network" doctor for the right to see ER patients for that day.
We are now repeating this same 'balance billing' process again with my son's ER visit which will cost at least $5,000 out of pocket (again with BCBS of Texas). Balance billing keeps coming up in many state legislatures to make this illegal in MEDICAL EMERGENCY situations where the patient has no choice to prequalify every entity to see if they are 'in network' or not. Every year the AMA lobbies to kill the bills that seek to kill balance billing.
Balance billing is a crooked and predatory practice that is destroying people financially. That is unless you are one of the doctors, hospitals, ambulatory service providers,... who are part of this activity.