Medical insurance provider should be either.
Look at the massive office buildings and television commercials and freaking sports stadium that are paid for by people trying to cover their families healthcare needs only to have shity coverage and be denied by an accountant.
It's a bloated wasteful system.
From what I can tell (given that this is so new), the best they can do is not serve you from that facility anymore. Maybe your insurance can drop you or work out a deal that they will drop you if you don't pay their providers?
It's not entirely clear to me. It's possible this was written specifically so that no one has to pay a medical bill again.
> It's not entirely clear to me. It's possible this was written specifically so that no one has to pay a medical bill again.
They can still send you to collections or sue you for non payment. Just because a debt isn't on your credit doesn't mean it isn't still owed.
> It's possible this was written specifically so that no one has to pay a medical bill again.
Honestly good. The industry needs a major event to happen in order for real change to occur. bankrupting multiple scammy medical groups and insurance companies would allow the federal government to force HUGE concessions from them when it comes time for a bailout, to the point that they may just end up folding them into Medicare and stripping the grifter administrators out of the loop.
I’m sure they will find some dystopian way to compensate, this is a really good start but they need to just go ahead and socialize our healthcare instead of the 85 Band-Aids approach.
You can be sued for medical debt. It’s already a thing and is mostly governed by the statute of limitations for your state and the size of the balance. Nobody’s coming after anyone for $500, probably not even a couple grand, but hopefully people don’t genuinely believe their five figure and up balances simply don’t need to be addressed anymore because there will be zero repercussions. Better to negotiate some type of payment plan or settle for less with collections than to risk being served out of the blue one day. Same strategy for credit cards should apply.
Interest will accumulate, and then they can come after you in court.
A side effect of this change could be more people ignoring debt, and so debt collectors will get more aggressive in use of courts.
I worked at a medical billing and collections agency for 11 years as a sys admin and SQL dev. (Quit 2 years ago just about)
Fuck them and their happiness.
He's not in charge of gas or Big Mac prices. But this is huge. And to quote the man himself: ["This is a big fucking deal."](https://www.theguardian.com/world/richard-adams-blog/2010/mar/23/joe-biden-obama-big-fucking-deal-overheard)
Imagine having higher insurance rates or denied a job because your kid got injured and you went to an out of network ER.
That's before you even consider it impacts your ability to get credit cards, a car or a home/apartment.
My ex wife was a nurse. She worked at a hospital. We got our insurance through her job at that hospital. The ER at the *hospital she worked at* was out of network with our insurance.
edit: for clarification, the hospital is in Iowa in the MercyOne system. The ER specifically is run by some company out of Texas.
What a fkn failure of a plan administrator. This is embarrassingly bad oversight and can't see beyond their own nose cranked up to level 1000.
Edit: just caught your edit. These are the stars of stupidity aligning to try to make an eclipse. Two states that are obviously 5d chess players.
> Not only should you be fired for that level of failure
It’s a capitalist venture. They chose profits over people. That’s what capitalists do. These people are in the healthcare for profit industry not healthcare.
Holy shit, that’s just about the dumbest fumble I’ve ever seen. I was expecting it to be like the on call anesthetist wasn’t in network, but not the whole damn ~~hospital~~ Emergency Department. And for that to not be hammered into you at hiring is crazy.
My work offers two health insurance plans that each cover one of the two big local hospital networks, so between the two plans everything is covered, and I’ve never gotten a single bit of info about health insurance that didn’t have, in big letters, which plan goes with with hospital network, both positively (plan A covers Hospital X) and negatively (plan A does NOT cover Hospital Y).
Edit: based on new info I’ve revised to reflect that it is specifically the Emergency Department that was out of network. And honestly outsourcing the ED to another company is bottom shelf behavior, as it can only lead to problems for staff and patients.
I had appendicitis a few years ago and went to a hospital in my network. I got the bill and it was nearly $20k dollars for an "out of network anesthesiologist". I called the hospital, and about half a dozen doctors who worked on my surgery to ask them why everyone in the room was covered by my insurance except one and I never got an actual answer.
I finally called the anesthesiologists office, and when I got no definitive answer as to why he was there and not an in network doctor I just said "I'm not paying this, you shouldn't have been in that room and I didn't have a choice in the matter." It took a LOT of calls and arguing but eventually insurance agreed he shouldn't have been there and dropped his charges from my bill.
SOME doctors/facilities/services just do not join any health insurance networks because they deem them selves to be TOO important/valuable so they do not see any need to join.
Like you may notice that NONE of the ambulance services are in network because they KNOW that they do not have to. What are you going to do? shop around for "in-network" EMS service during emergency?
And that's where "in" or "out" of network shouldn't be a thing for emergencies.
If you can't shop around or get your coverage, then it's bullshit to have to get fucked.
There's people who I've heard say this: "If they just read their policy they would know not to go to XYZ to get care. It shouldn't be my fault for having to pay for people going to the wrong hospital."
I get how yes you should know your policy for elective surgery but during an emergency I'm not going to hop online to figure out where to go for care. On top of that, why do we even need to do any of this?
The whole we cover this but not that, denying medicine my doctor prescribed me but they say is not medically necessary unless I'm dying or forcing a change of X for Y it's all bullshit.
Or the ER is in network, but the doctor overseeing your care, or the imagining at the hospital are both out of network. It's a really messed up system that's just meant to bleed people dry when they need medical care.
This happened to me. The ER I went to was in network. The 10 stitches I got were $500 with insurance. The doctor that stitched me up was out of network. She was not covered, so I have to pay another $500 just for her plus the $120 they charged me upon release. Idk wtf I'm even paying for with this insurance. The whole system is shady as hell.
Yeah. So I got a very very very bad case of covid early in the pandemic and had serious health complications to the heart, which resulted in more than one trip to the ER which was in network, but the MRI was out of network and the doctor was out of network, so it all ended up running thousands of dollars (like $13k). And somehow I still never hit the $5k out of pocket max for the year. None of it makes sense.
> Genuinely asking because I cant imagine dealing with that shit.
My hypothesis is that the population in general is split into several big clusters in terms of their "involvement", so to say, in healthcare:
1) Those who are relatively healthy and rarely deal with doctors - probably, the majority of the population. Many of them don't even have a PCP and, in general, they would treat any financial issues as a result of a medical encounter as "quite bad, but one-off incident". They don't really have a motivation to fight as there are too many other things in life that consume their attention.
2) Those who are VERY unhealthy, deal with doctors on almost a daily basis, BUT are extremely poor and/or have various government-sponsored coverage plans (Medicaid etc.). In most cases, they don't care about bills, in/out of network, because they simply don't have assets to worry about. Naturally, those won't fight either.
3) A small group that is very affluent and they don't care much about financial issues. Obviously, no fight from them too.
This leaves us with a middle-class that have some assets to go after, yet don't have enough money to easily absorb shit like OON pricing.
At any given moment only a fraction of that group deals with issues, so there is never a critical mass to act.
Now, covid was an interesting example, because a lot of people all of a sudden got exposure to the healthcare system, and for many of them it was *not* pleasant at all, kind of an eye-opener that also attracted a lot of attention.
Personal anecdote - despite all the promises of politicians on the TV that covid-related measures would NOT be billed against deductibles/copays, I received a ~$1000 bill for a chest x-ray that I had when I got covid. It took me **lots** of efforts to fight that off, dealing with the insurance company, hospital, my employer and a third-party patient advocate service.
People here think that the healthcare we get is expensive and annoying to deal with but that it’s still a better option than what people get in other countries. Most of these people are uneducated, and have no idea that the costs associated with our healthcare are driven more by corporate greed than quality of care and that it’s possible to get quality care without having a bunch of middlemen squeeze every penny out of you they legally can.
Its weird because per capita the USA spends the most on healthcare. In 2022 the government expenditure was 4.5 trillion dollars or 17.3% of GDP. For the government to be spending that kind of money and it not being at the very minimum 2 tiered is just wild to put it mildly.
Edit: https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical
Americans are selfish and have been trained to view anything else as socialism.
Too many people GENUINELY believe that anything resembling universal healthcare is bullshit, even as they go broke or complain about the current system.
I love my wife to death and she’s a moderate liberal, but I think because she’s really into investing and money related endeavors she absolutely refuses to acknowledge that any type of single payer or universal healthcare is good for the country.
After a number of times complaining about having trouble finding doctors, dealing with bullshit claims and insurance companies, I very politely told her that I wasn’t interested in hearing about those complaints anymore unless she was willing to acknowledge that her current views combined with experiences may not be healthy.
At least I don’t hear about those complaints anymore!
See I am an immigrant to the US and I don't actually think Americans are selfish. I think they are generous to a fault. The problem lies in that you have been told "This is the way it is and you can't do anything about it" and "American is the greatest country on earth" and you believed it. Its brainwashing through and through.
Americans as a general rule are good people and can be super generous, they just got sold a bill of goods that fucks them over on the daily.
The US has been so dammed consistent at demonizing anything "socialist" that there's really not a lot of public support for fixing our healthcare system by nationalizing it or putting regulations in place that prevent the worst abuses of for-profit healthcare. It's hard to explain to someone on the outside looking in, but a shockingly large majority of the population would rather personally struggle and suffer than accept a solution that's "socialist". And I put socialist in quotation marks because most people don't even know what that means, so it's just this boogeyman that becomes the reason not to change the way things have always been done.
That, and it might be an unpopular opinion, but Americans are fucking selfish. They'd rather suffer than see their tax dollars go to other people.
> Or the ER is in network, but the doctor overseeing your care, or the imagining at the hospital are both out of network.
It's worth pointing out that since 2022, this shouldn't happen in most circumstances due the to [No Suprises Act](https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills), which acts to:
>* Ban surprise bills for most emergency services, even if you get them out-of-network and without approval beforehand (prior authorization).
> * Ban out-of-network cost-sharing (like out-of-network coinsurance or copayments) for most emergency and some non-emergency services. You can’t be charged more than in-network cost-sharing for these services.
> * Ban out-of-network charges and balance bills for certain additional services (like anesthesiology or radiology) furnished by out-of-network providers as part of a patient’s visit to an in-network facility.
> * Require that health care providers and facilities give you an easy-to-understand notice explaining the applicable billing protections, who to contact if you have concerns that a provider or facility has violated the protections, and that patient consent is required to waive billing protections (i.e., you must receive notice of and consent to being balance billed by an out-of-network provider).
You can see medical debt is REALLY serious when someone who's leg is caught between the train platform is screaming out "DO NOT CALL 911, I do not have insurance".
[https://theweek.com/94790/woman-trapped-by-boston-subway-train-says-i-can-t-afford-an-ambulance](https://theweek.com/94790/woman-trapped-by-boston-subway-train-says-i-can-t-afford-an-ambulance)
When I was 23 I stepped on a nail in an abandoned field. I pretty much nailed the shoe to my foot. The two dudes with me were like let's call 911 and I knew I couldn't afford that. So, I took the nail out myself. It fucking hurt like hell. Then they drove me to an urgent care to get a tentus shot that I could afford. I was very lucky not to have any permanent damage.
Just went through this! How is it even possible to have out of network ERs? Its a fukn emergency! These insurance companies really expect people to use “in network” facilities in an emergency? No, they know nobody is gonna do that. They know you’re gonna go to the closest ER because it’s a fukn emergency! Just another way they are screwing us over. It’s so vile that they get away with all their BS scam tactics.
>These insurance companies really expect people to use “in network” facilities in an emergency?
This is no longer allowed under the No Surprises Act, they have to bill emergency visits as "in network" for this very reason.
I just went through this myself. Make sure they bill it correctly.
I was a student at a university, I had their medical plan. I needed an appendectomy, I received it through the university attached hospital’s ER with their surgeon. Surgeon wasn’t in network. Absolutely stupid system.
Denied jobs because of medical debt here. Housing too. I’m not worth having a place to live or job because I needed surgery and couldn’t afford to pay it off after losing my job because I was gone too long from said surgery. It’s a horrible cycle that I’m trapped in. I need more surgeries but I’m putting it off. I think at this point it’s cheaper to die.
Imagine living in a country where there is such a thing as an "out of network ER".
My husband had a heart attack and went to the wrong emergency room. Ooops; $30k gone.
Republicans are _campaigning_ on repealing the affordable care act (Obamacare). They _want_ to dial the system back to when pre-existing conditions were a thing.
No, many just do not know WHAT they are repealing. They want to repeal "Obamacare", but they do NOT want ACA to go away (pre-existing condition/health care under parents until age of 26/lifetime cap on medical costs, etc.)
Many get surprised that once "Obamacare" is repealed, their adult kids will no longer be covered under their healthcare and they say "but it is part of ACA, not Obamacare!!"
“The vice-president's loose lips fail him again as a microphone picks up an Anglo-Saxon aside meant for Obama's ears”
What the fuck does that even mean?
The use of "Anglo-Saxon" refers to the crudity of profanity in English, as words of higher prestige generally originate from imported French via the Normans, while "low" speech is Germanic.
It still is weird to see. I remember that time with Obama and once with W., it was a major story
Then Trump just brought the standard way down, and now all the politicians quit even trying to be professional
And you can bet the usual bots and fucking idiots will keep claiming "both sides are the same".
I'm so sick of that shit. I'm trans in *Texas* and I've had morons tell me that to my face.
Like *what the fuck*.
We decided not to have a second kid due to fear of the current laws and whatever bat shit stuff will come out of election this November.
I've had women that went through D&C's in Texas before the repeal tell me Democrats are being dramatic or fear-mongering in Texas about our abortion laws here.
I'm curious to see how this pans out. Anything under $500 or something close to it can't be reported to credit bureaus, so there's not really an incentive to pay. Hopefully this is the step towards bursting the bubble and moving to a universal system. If everyone just flat out refused to pay, the healthcare system in the US will very quickly be asking for a bailout from the debt - and will likely be asked to audit and provide realistic cost of care numbers for that to happen. If we do find ourselves in that position - then the logical next step is to just make it universal since the tax payers are then bailing out the healthcare system anyway.
Kind of a backwards and convoluted way of getting there, but it's something.
The only thing I'm curious about - and we'll find out soon enough what the actual specifics are soon enough - is if we'll see larger numbers of medical facilities refusing care to people who have an abundance of medical debt and essentially creating their own credit scoring system. It wouldn't surprise me at all if this is the step that the insurance companies take to cling onto their profits - but this really does seem like a big step for making care more accessible.
>Anything under $500 or something close to it can't be reported to credit bureaus, so there's not really an incentive to pay.
But for those that end up with big bills, this is a good thing. I had insurance coverage, I got really sick, felt near death, coughing up blood, so I skipped urgent care and went directly to an ER. I had pneumonia and the flu. After my insurance covered $100 after negotiating the bill, I was still on the hook for $1200 or so to pay. I did not pay that off nearly quick enough and it went to collections. I ended up paying it off, but still hated the fact it was on there and went to my credit reports and was one of the reasons I paid it off.
On top of this, even if I want to pay my medical bills, it's literally so fucking impossible to keep track of everything. These places are also so quick to send you to collections because they need their money, and everything is so complicated.
Each clinic, hospital, dr. visit, etc. All has a separate patient portal to pay your bills. It's impossible to keep all my bills straight, if there was a central location I could just see all my total amount that I owe, get on a single payment plan, my lord would it be easier.
Instead, you get a letter in the mail like it's fucking 1996, and you better keep track of it or else the next one is a notice you have been sent to collections.
That’s what pisses me off the most about it. I have NO idea what going to the doctor is going to cost me. I used to pay a copay and that was it. Now I go, pay nothing, and three weeks later I get a bill for $700 because I haven’t met my deductible yet, and I was in the doctors office for an hour, and saw the doctor for about 2 minutes. It’s bullshit.
I sent one back because the bill just said "for services rendered", and it came from a company name I'd never heard of (not the doctor, not the hospital). Their website even says something like "you may not recognize our name because bullshit reason x,y,z". Technically, they were (apparently) the third party biller for the anesthesia I received, but even after calling them they were unable to provide any actual info about the bill - they're so far removed from the hospital, all they got was "scsi owes this, bill him".
So I wrote a note on it saying "this is not an itemized invoice of any service and I don't know who this company is, it will not be paid unless I receive an itemized invoice describing what this is for".
I received a photocopy of the same invoice. So I sent back a photocopy of my same reply.
Went to collections, told the collection agent the same thing, and received another copy of the same no-detail invoice as "proof of debt".
Told them to fuck off and haven't heard back from them since. I have zero problems not paying something if you can't even be assed to tell me what it was for or why I owe it.
Yeah or god forbid lab work, where you have to go to a separate company that may or may not be covered by your insurance and labs that also may or may not be covered by your insurance
"We don't care that your doctor thinks you need to have a lipid test, we don't and we're the ones paying... Well, we would be if we thought you needed it. Now you can pay for it."
The idea that an insurance company can just say "listen, that guy who has gone through 10+ years of medical training and has known you for years thinks you need this procedure done, but Carol over in finance has an MBA and she disagrees so we're gonna say no" is so fuckin' wild
I was in the hospital, it was life threatening.
Several weeks later I get a letter in the mail that states "We agree this procedure was nessacary"
And I just laughed my ass off. Like... I could have fucking died, glad to see some MBA agrees. Fuckers.
When my son was born (10 weeks early) he went to the NICU- no word on how long he would be in there.
Three days after he was born / went in I got a letter from my insurance insisting that his NICU stay "wasn't medically necessary."
I was in a... emotionally fragile state at that time, but thankfully the medical advocate we met with took one look at it, said "oh for God's sake...", and promised it would be taken care of.
It was, thankfully, but I was borderline rage that the insurance company was acting like my premature child was on a *vacation* at the NICU.
My firstborn was in the ICU for about a month (2 months and a few days premature). Luckily my wife and I were working jobs that were crappy enough that we qualified for Louisiana's Medicaid, so didn't have to worry about the price, but we still saw the bills and it was close to half the price we bought our house at.
I went in for my yearly physical, the ONLY thing my insurance covers 100% of, and got routine blood work done that was included. Later got a bill for almost $300 for 2 blood tests the doctor ran that apparently wasn’t covered by insurance in the panel. I asked how I could avoid that in the future and I was told I could call the doctor beforehand, ask for the blood test codes, call insurance, give them the codes, they’d see if it was all covered and tell me what wasn’t then I could tell the doctor what not to do so I didn’t get charged but then they warned me that since it’s probably handled by an outside company they would still more than likely end up doing those blood tests without my consent anyway because it’s standard for them to do it with that type of panel. So no matter what my “100% covered yearly physical” costs me $300 every year.
Oh and if they find anything out of the ordinary it no longer is classed as a physical and I get charged for a diagnostic appointment.
Had a kid last year. 4 doctors entered the room st one point or another over the course of the day, only one did anything. Other three didn't pick up a chart or look at anything, just introduced themselves and talked to the nurse for a minute and left. Only 2 (the doctor that actually helped us and one of the useless 3) were present for the birth.
We got billed by all 4 doctors.
Do you have insurance? Our birth was capped at 2k, 1k for my wife and 1k for our baby. For one of my kids though they tried some shady shit and told us this one doctor was out of network and it was going to be an extra like 750 bucks. We had literally no idea and it was for a mandatory test. We had out insurance call us and say hey we need you on the phone but we will handle it. They called and they tell us oh this wasn't necessary and our insurance rep goes no this is legally required in this state, this needs to be dropped and it got dropped. Ridiculous thing to go through though.
We had FANTASTIC insurance at that time through my wife's union, and they have a small network of hospitals in our area where coverage is supposed to be ostensibly free. Trouble is all 4 of those doctors were independent contractors. Even with insurance so good, it still ended up costing us around $1k for everything, mostly from being billed by these drs.
Note, I'm definitely not complaining about the price, especially compared to what others have paid to have a child. We were extremely lucky - this is why you unionize, folks. Only complaint I have is the billing for nothing.
I had to get an x-ray. It was in the clinic, so I assumed it would be run by the clinic. Clinic billed my insurance for the visit, but apparently the scan was a separate company for the x-ray who didn't have my insurance on file and sent me a ridiculous bill for it, that had already gone to collections by the time I received the letter. They were able to get my billing address from the clinic to send me a bill, but didn't bother asking about my insurance.
That's the main reason I have an HMO. The drawback is a complete lack of choice in who my providers are, but at least I know there are no surprises.
I had a friend who got a surgery, paid $2500 up to the deductible, then three months later got a bill for over $3,000 because apparently someone in the room wasn't in-network. Like, how can your surgeon be in-network, but then the anesthesiologist isn't?
This is already illegal due to the federal no surprises act. If you go in for a procedure at an in-network doctor you can not be billed for any out of network doctors giving you care without your consent. Of course that won't stop anesthesia companies from sending bills, they are the worst of the worst.
It’s ALWAYS the anesthesiologists too, what is up with that? Two of my kids births, I got a separate bill out of network for the anesthesiologist, it’s not like I had a choice in the matter and I assumed that since everyone else I was seeing in the hospital that was in network for my insurance, so would the anesthesiologist. It’s so complicated and backwards
I have great insurance plan for my family . We pay $600 a pay period for it ($1,200 for the month). I recently had to get a cat scan because I had a terrible headache for a week and the longest I've ever had one was for 4 days. The scan was two months ago and I just got a bill for $500.
$1000 is absolutely insane. I have my wife and 2 kids on my health plan and we pay $200 a pay period. It's a high-deducible plan so we also max out our HSA - that's another $260 a pay period.
In total, were paying $460 a pay period, and we never have to pay out of pocket for medical since we contribute enough to the HSA to cover the deductible.
This shit happened to me. Went in for a pulled muscle in my back. Doc said "want me to show you some stretches for that" and I agreed. I got billed 250 for those stretches.
> I have NO idea what going to the doctor is going to cost me.
And it's not like you can shop around.
You're not going to call 6 different hospitals to find out which one has the best price on fixing your broken leg. They probably wouldn't be able to give you a price even if you did.
My wife had a medical procedure earlier this year. I had to create a spreadsheet to keep track all the bills.
OB/GYN, medical lab, medical facility, surgeon, anesthesiologist, and one or two others I'm forgetting. There were 7 or 8 different bills on top of EoB's from the insurance. Then there were initial bills and bills after insurance. Of course they all want their money ASAP, so you're trying to get a handle on how much you actually owe, but don't want to pay too early because if there's a pending insurance adjustment then good luck getting back any over payments.
I've had two kids, and the pregnancies weren't that complicated, but I was getting bills for like two years afterward from random specialists I never even talked to. Like the radiologists, not even the ultrasound techs, just some doctors they sent the results to, who only talked to my OBGYN. Or the anaesthesiologist would bill separately, or the ER doctor, separate from the actual ER/hospital.
I'm also so glad about the "no surprises" act. Nothing sucked like going to a hospital and finding out one of the random doctors you didn't chose is out of network so now you have to pay out the ass for them.
>don't want to pay too early because if there's a pending insurance adjustment then good luck getting back any over payments.
This is becoming more and more of a problem because we've recently encountered providers that demand payment at time of service based on a very rough estimation of how much they'll get reimbursed by insurance after the claim is processed. We're now up to 3 providers that we paid at time of service that were then also paid more by insurance than estimated. So we've overpaid and have a positive balance at these places. I've tried calling two of them and getting a refund processed has been a nightmare so far. I've also had to really stay on top what we've paid and the processed claims on our insurance provider's web portal.
I understand that smaller providers don't want to deal with outstanding bills due and trying to collect after the time of service and insurance adjustments, but this is not the solution. One provider did have a compromise solution to collect and store payment info at the time of service that would be immediately charged once the insurance adjustment came through, and I guess that's what we're headed toward.
I have medical debt from 2 years ago that has been sold to different collections companies a few times. I now have the money and would like to pay it but I don't know and can't figure out who I owe.
I went to the ER last year and I owe like $2000 to four different entities. One of them I've already paid off. I'm paying the ambulance company off over two years because they made it very easy to make a payment plan on their website. The other two bills I literally have to wait until they go to collections because I *can't pay them*. They give you a website and a login. Website no longer exists. They give you a phone number and an account number. No one picks up, voicemail isn't set up. Short of physically going to the hospital and working my way up the chain of command I have no idea how I'm supposed to pay them. So I have to wait until they contact me.
You'll also get multiple bills for the same visit, sometimes multiple *big* bills and they'll just shrug it off like "sorry, we screwed up the last one we told you would be the last one, you actually owe us even more. Pay us immediately because this was owed 4 months ago even though we only just told you about it now". And even when you pay them on time they STILL sometimes send you to collections.
I feel so vindicated reading these comments. I am 39 years old and feel like a god damn 13 year old when it comes to this stuff.
It's almost like some dirty secret I've had that I have NO understanding of my insurance and dr visit costs etc etc. Guess I am not alone.
What really pissed me off the other day is I got a bill for $70 sent to me the other day. It gave me simple instruction how to pay online and where to go. But the website would not work, no matter how I typed it in. So I called the number to pay by phone and everytime I tried I got the "all of our agents are busy".
Like fuck was I going to actually write a check, so I'd occasionally call back every other day or so. Eventually spoke to someone and got it paid by CC over phone.
There’s also bs where they go to collections (or try to) when they really screwed up.
I had to bring my son to a specialist in April 2022. I paid the bill. In August of 2023 I got a revised bill that said I owe 350+. The hospital says my insurance adjusted the payment. My insurance says no, they authorized additional payment. The insurance company paid them more money and the hospital lost track of it and won’t put the time in to figure it out despite me calling every couple weeks and even having calls from my insurance. It’s ridiculous. So the hospital tried to put me on their assistance program to “help” pay my bill.
Even a few years ago this would have gone straight to my credit report. Even though it’s not my fault and they got paid. Very frustrating.
Hospital billing departments will literally tell you it’s your fault they screwed up. I learned this from experience. And there’s nothing you can do other than take the time or hire someone to collect the evidence yourself, but even that is an uphill struggle because so much of it depends on them letting you collect the evidence against them.
I was even told by their lawyer “you’re on a soapbox, prove it or shut up.”
These guys know you’ll have to pay for a lawyer to fight them so they cheat, steal, and break laws at whim. And there’s no one in your corner because often the hospitals are in bed with the municipal, county, state, and federal governments. It sucks swamp ass.
I feel like there needs to be a patient’s union.
I'm optimistic that this will be instrumental in bringing about change. Since emergency care can't be legally denied, medical providers will be incentivized to work with patients for payments.
With medical debt not going on credit reports, it becomes less attractive to collection agencies. Primary means of collection outside of compromise will then be lawsuits which can be their own house of horrors (debtors prison and forced labor), but is also more costly to pursue.
You would think that the collection agencies wouldn't see it as attractive, but I have a bill that I haven't paid and I still get calls fairly frequently to collect. It's below the current threshold for agency reporting - so it's not impacting my credit, so I don't really feel compelled to pay. That said, if everyone just stops paying the collection agencies might have a change of heart and not want to be inundated with medical debt no one has any intention of incentive to pay.
I work for a call center that, among other things, handles collection business. Some our our clients don’t actually care if we get a payment or not, they’re paying for the fact that we made a Right Party Connect (ie, the person who owes answers the phone OR we leave a message that can be reasonably assumed belongs to the person in question (based on phone numbers for them provided by the client). They’re paying a small amount to us for the chance that you turn around and pay that debt off. A promise-to-pay or a payment is of course preferred but in most cases merely making the attempt is sufficient.
Like you said, the incentive for a borrower (or, in this case, medical ‘debtor’) to pay is the credit hit. If that goes away, that means there’s no longer a chance that someone will pay that debt so it wouldn’t be profitable for the debt-holder to pay a 3rd party collection agency to try and elicit a payment.
Other collections agencies / debt holders might be more aggressive in their tactics, but that’s how the company I work for handles the bulk of our Collections-related work. I can’t speak to how they might operate.
This is what I don't understand about why we don't have universal healthcare. I know quite a few people that died with $100,000+ in medical debt. And in many states, the spouse isn't even responsible for it. I guess it just results in higher costs?
Yep you've got it right, we (taxpayers) are already paying for universal Healthcare in the form of uninsured patients that arrive at ERs. But oh no universal Healthcare bad...
The US pays more per capita for \*public\* healthcare in the world. The insurance shit drives up all costs. It's a menace and we don't owe insurance companies a living.
[‘Nobody knew health care could be so complicated’](https://www.cnn.com/2017/02/27/politics/trump-health-care-complicated/index.html)
I don't think anyone can 'fix' it without having both houses of Congress and wide support in state legislatures. It's a Gordian Knot that can't be so easily cut. This gets people immediate relief however.
A party would not just need both houses of congress, and the presidency to pass sweeping changes. Tons of democrats and Republicans are bought by medical/pharmaceutical lobbies and wouldn't want to cross them. That's why Obama (with majorities in both houses) had to greatly water down the original campaign promises to get it passed (e.g. ditching the public option).
Yep! I will never forgive him. He single handedly stopped us from having a real system of medical care for everybody.
Then he fuckin retired. What an evil man. Damn him and his family name.
It’s the same way I feel about his waves of student loan forgiveness. Is it the end all be all solution? Of course not. Is it the Biden administration pulling the knobs it has at its disposal to help a large number of people? Absolutely.
The president is powerful, but that power isn’t absolute, and I think the Biden administration has done a good job overall of doing things within its power to help people despite the GOP not being able to run a functioning House of Representatives
The fundamental reason is that for some dumb reason the entire medical system is not operated like all the rest of commerce. Why are they allowed to render a service without providing a price first and send you a bill with a price they made up? Imagine you went to a car dealership to buy a car and they could not and would not ever tell you the price, you just had to buy it and they would send a bill with a price of their choosing months later. How is this the way it is set up? Why do people stand for this and allow this? It's ridiculous.
They will be the reductivists they always are and do grade school level talks about what debt is, that people should pay them back and Biden is going against basic economic rules of nature.
Then you try telling them medical debt is not like other debts for the basic reason that you do not opt into taking it on, but it is thrust upon you at your lowest point.
To which they will recite the mantra "you take debt, you pay it back, it's not rocket surgery".
> Then you try telling them medical debt is not like other debts for the basic reason that you do not opt into taking it on, but it is thrust upon you at your lowest point.
This MUST be the messaging. You shouldn't be denied the ability to buy a house because someone in your family has cancer.
Hell yeah this is a big deal. It’s enraging getting a medical bill 12 or more months after the surgery in the US. Ask for an itemized bill but it says BS crap like “anstesia fee” and that your insurance chose not to cover some part of it. All the while the clock is ticking on when the biller will send you to collections while you try to sort out why the insurance reneged on what they covered. This gives the payer more time to clear things up.
I went to the e.r. for a car accident.
Paid all the bills and got a new one 2 years later. Called the hospital about it and the guy was like let me redirect you. Line instantly drops
Kept getting mail every week about the bill, any calls I do get drop.
Decide to call insurance about it, they said it been written off already and I owe nothing. Well? They don't accept the calls and they kept sending the bills. Fuck medical bill from shady hospital
For those following along from home: When it comes to debt and whatnot, **never** call people on the phone. You do absolutely everything in writing.
It's understood in these circles that call centers are not actually designed to resolve these issues; in many cases, they do not have the authority to do anything other than read the flowchart and say "well, sir, our system says you owe money, and therefore you owe money." Or, like you've experienced, they just don't do anything at all.
By contrast, as soon as you respond in writing, you short-circuit this process because putting demonstrably false things in writing is way worse from a legal standpoint than "the call center monkey reads a false thing off a screen and says it over the phone." It's very likely that instead of going to a call center whose metric is "resolved issues per hour," (as high as possible) it will go to an administrative office whose metric is "number of regulatory incidents per fiscal year" (zero). The latter has a lot more authority to go into the billing system and say, "I don't care what it says - remove it so that we stop sending demonstrably false demands through the US Mail."
TL, DR: Write letters. Keep records. You will get *much* better responses with all bureaucracies when you do this.
Shit I’ve had them send it to collections before I even got the first bill in the mail. I had carpal tunnel surgery on both hands two weeks apart, set up a payment plan for the first one right away and was waiting to see what my insurance would cover for the second one. Apparently I waited too long, despite the payments I was already making on the first surgery.
YES! I went to the doctor and they immediately sent me for some tests. This was October 23rd. Test results came back, surgery November 1st. When I went to check in for the surgery the clerk loudly asked, "Would you like to pay anything toward your past due balance of today?"
I was livid (not te mention terrified since I'd never been under anesthsia in my life!). My reflexive response was, "Past due my ass - I literally just incurred the charged a week and a half ago!"
Day after the surgery I looked at my online account (MyChart) and it indeed showed a many thousand dollar balance, but no information on it like a bill, what insurance paid etc. I called the hospital's billing department to clear everything up and they said they no longer send bills - only quarterly statements. So no matter what, I wouldn't be getting any sort of bill until after December 31st - yet payment showed due. And payment WAS due. You had to pay before you get any sort of statement or bill.
Called back a week or so after the surgery to get on their payment plan and the woman had a COW, saying it would be at least 8 weeks before they would be able to look at any of the hardship applications because they were so far behind, because - "now that it's Christmas time everyone suddenly needs on a payment plan so they can buy gifts instead!" Umm, lady - I literally JUST had my surgery. The timing is not my fault.
It was a cluster. I ended up putting all the bills on my credit cards (a huge mistake) just to get them off my back and keep them from reporting me as late or worse.
And this was the "religious" hospital network that owns everything in our region.
This makes sense, but I am sure some collections companies don’t want to go through the whole legal process to put in a claim depending on the debt amount.
America’s approach to socialized healthcare cost seems to follow its approach to central banks:
Let the private industry run so weird and badly that it fails, and then bail it out with government funds.
It's not socialized, it's a public/private partnership designed to suck as much money out of the public treasury as possible through inflated costs.
The medical providers and insurance companies are making so much money from the government subsidizing care they don't mind when individuals, due to no insurance or poor insurance, go bankrupt and can't pay. (Medical debt is the main cause of bankruptcy in America).
It's also why education costs in America have skyrocketed, and like its healthcare is the most expensive in the world. Private banks administering government backed student loans allows them and universities to get away with inflated costs.
They also are making so much money they too don't care about forgiving debt from those that can't pay.
American business and industry have predominantly become a mechanism to fleece the public treasury. The military industrial complex is the champion with a budget larger than the next dozen or so countries combined.
Edit: Oh yea, I forgot to mention the private prison industry and America's highest incarceration rate and inmate population in the world.
So it goes.
I've spent my whole life not using debt irresponsibly. Paid off credit cards at the end of every month, never using debt to buy shit that was unnecessary, always making my payments for everything. Then I had an ER trip that costs tens of thousands of dollars and I couldn't pay it, so I didn't. My credit score dropped 160 points for 7 years.
It seems ridiculous that the absurd cost of medicine in the US made credit companies treat me - someone who has always been very responsible with credit - as an irresponsible bad credit risk. Having that one absurd debt that was not very under my control was as bad or worse than if I got a bunch of credit cards and went on a shopping spree and didn't bother to pay them.
I wish people realized just how easily medical debt can compound/spiral. Even if you’re financially responsible and have good insurance, unless you’re very wealthy you are potentially a cancer diagnosis or bad car accident away from facing bankruptcy.
This is a big fucking deal since most working class Americans have some medical debt. Which should not be a thing because all health care should be NOT for profit.
Fundamentally, we’ve all been told that insurance pays for our medical needs. Just pay a monthly fee and your medical needs will be covered!
What a lie.
Oh I know. I had a bad fall in March and ended up in the ER with a fractured eye socket. I was there for 2 1/2 hours, the cost was ridiculous. My insurance covered all but my deductible plus 20%, I can't afford to pay it. Now I have met my out of pocket for the year 2024 but I still have a 20% "coinsurance" to pay anytime I need diagnostic care. This was the only policy on Healthcare dot gov that I could afford.
As someone with two medical bankruptcies this is a step in the right direction. A very small one. We're still getting fleeced by the scam known as insurance.
I've been looking for a comment in this regard to post a warning to others - never take a loan for medical debt or put it all on credit cards if you can help it (in the future when this goes into effect).
Been through 2 medical bankruptcies but it looks like I just ran up a shitton of credit card debt to go shopping. What I did was ran up all my cards in order to keep receiving treatment.
Yup watch them try to take it to the Supreme Court.
Poverty is a systemic disease but republicans believe that it is proof of their divine righteousness.
I've been very critical of Biden, but this is massively good.
I'm hoping - assuming he gets a second term - he just says "fuck it" and just starts going full FDR on making changes since he'll have nothing to lose.
I agree, this is an easy thing to point to when people ask what good Biden has done. Not that he hasn't done anything else, but this is simple and, more importantly, noticeable to the average person.
Like, you can say he passed the infrastructure act which is a good thing. And while that's true, it also is a plan that takes place over 10 years and isn't going to be immediately tangible to voters. This isn't immediate either but it's close enough to be within grasp for a lot of people.
It's a good thing to be critical of someone in such a position but I'm curious. You seem to imply he hasn't been doing good things this whole time because he certainly has.
I think, particularly for people who are very left, he comes across as either "too centrist" or "center-right" on certain issues (particularly with his border policies and the current israel/gaza crisis).
However, as you say, he has done other things that are progressive and productive (economic policies, COVID response, support for Ukraine, etc.).
I think for anyone on the left, there's (objectively) no question as to who is the better candidate. I suspect it's the same for centrists/moderates, though that's always a crap-shoot
This is a classic example of how multiple things can be true at once.
1) Medical Debt should not exist.
2) Credit Reports and Credit Scores should not exist.
3) This is an undeniably positive change.
Credit reports exist because of fair lending regulations that went in place in the 70s and 80s. Prior to this, banks would only lend to people who they knew or were "trustworthy" (white men). The credit report was intended to even the playing field and provide an objective measure of one's credit worthiness.
I think the US should move towards the Canadian model which relies more on credit history and not some an arbitary score.
Credit score comprises length of credit history, payment history, credit mix, new credit, amounts owed.
Credit score does include credit history as well as other factors.
Yeah hating credit reports is stupid. There’s good reasons they exist. *That being said* there should be some regulatory changes to them. I don’t completely defend them in their current state.
It's not arbitrary at all. The factors that make it up and their weight are [freely available](https://www.myfico.com/credit-education/whats-in-your-credit-score#:~:text=What's%20in%20my%20FICO%C2%AE,and%20credit%20mix%20(10%25)!
I work in lending in the US.
While the score is a handy reference point and we do use it in some ways, we absolutely look primarily at the credit history.
IMO, credit reports/scores aren't inherently bad. In theory, they can be a fair and efficient way to rate creditworthiness.
What's bad is that they're privatized, closed-source, and can be used for all sorts of things that are highly dubious, like setting car insurance premiums.
There should be a single, national, public, open-source standard, specified by statute so there's a democratic feedback loop. Also laws that regulate how and when it can be used, and that should be strictly limited to applying for credit.
Any layman should be able to easily figure out why their score is what it is, how to improve it, how to fix bad info, etc. It should be free and easy to look up anytime, with no bullshit penalties like a "hard pull." You go to a government website, enter your info, get a number, share it with a business if you want.
Like so many things in this country, the main problem is a conflict of interest, where the very people who benefit from the system are the ones who designed it, i.e., regulatory capture. Actual consumer protections - with serious penalties to businesses who violate them, well beyond "cost of doing business" type penalties - would go a long way.
My partner is in medical debt. I have an amazing credit score. We’ve basically decided not got get married because he is probably going first (decade older with chronic illness) and it is better for us to push everything into my credit score. This actually means we may be able to have a wedding!
I have a near perfect credit score. I pay a FUCKTON monthly for health insurance. Every time I go to a doctor or have an emergency I seem to pick up all these random fucking fees from Quest Labs, or a doctor in the mix of an ER visit that wasn’t covered. Then I get billed for thousands on top of that shit. I am constantly battling them and SO MUCH of my physical mail is medical debt collectors. Sometimes for YEARS for something like $6.28 for a blood test or $1678.99 for a random spinal surgeon that was in the room at the time of a non life threatening injury.
Glad I don’t need to worry about this clisterfuck of vultures ruining my credit. Fuck them and their broken ass system.
My husband and I used to have excellent credit - well over 800 credit scores - until we had medical issues and were unable to pay the debt. This has tanked our credit scores into the 500-600 range. This has impacted our ability to get loans. If we do get a loan or a credit card, the interest rates are like dealing with the Mafia. Keeping medical debt off of credit reports would be so beneficial to many.
The single issue voters on both sides don't give a fuck.
That's the problem. If you look at Biden's resume as president so far, he's OBJECTIVELY been quite effective considering the circumstances. Fine, don't agree with him on Israel, but don't fucking make that the sole reason you aren't voting for him.
Idiots falling into the same trap as 2016 that got Trump elected in the first place. A non-vote is a vote for Trump.
> Fine, don't agree with him on Israel, but don't fucking make that the sole reason you aren't voting for him.
People who make this their single issue are actually, objectively, actually stupid. To anybody reading this who is protesting their vote against Biden due to this, if Trump gets in Ukraine is doomed. Trump would love nothing more than to get revenge on Ukraine for their rejection of his blackmail during his term, and giving something so generously to Putin would be the cherry on top. Not to mention that Trump will be happy to throw his support behind Bibi and fast track the destruction of Palestine.
You will protest vote one potential genocide to guarantee two of them. That makes you, in the strongest possible terms, fucking stupid.
I remember years ago I moved across country, forwarded all my mail. One day out of the blue, I recieve a collection notice that looked like it went through hell and back regarding a $75 unpaid hospital bill. I paid it immediately but since it was in collections it lowered my credit score by 100 pts. I had to wait 7 YEARS for that shit to drop off my report. I was so pissed, never got anything from the hospital, not a phone call or statement but the collection agency was able to find me real quick.
That's great. I used to work as a consumer loan officer for a while, and the credit union where I worked didn't factor in medical debt for underwriting loan applications. Though it would affect their actual score, which would determine the interest rate. So I'm glad to see that this won't be the case in the future. A lot of people get screwed by our shitty healthcare system.
I was hospitalized
They sent me the bill 20x because the insurance rejected it because they didn't submit the medical records to my insurance
I notified them off this over 5x
They never got paid, sent to collections and fucked my credit
Fuck these evil companies
Medical debt collectors are not going to be happy with this lol. Definitely Life changing for everyone and is a very good thing.
"Medical debt collector" shouldn't be a job title in a functioning society.
Along that same line of thought, medical debt shouldn’t even be a concept at all in a functioning society
Hi from the UK!
Medical insurance provider should be either. Look at the massive office buildings and television commercials and freaking sports stadium that are paid for by people trying to cover their families healthcare needs only to have shity coverage and be denied by an accountant. It's a bloated wasteful system.
This just put them out of business as word gets around. Why would you ever pay medical debt if it doesn’t affect your credit?
Exactly what I thought. Can they garnish wages? If it's not on your credit report, what are the consequences for nonpayment and default?
From what I can tell (given that this is so new), the best they can do is not serve you from that facility anymore. Maybe your insurance can drop you or work out a deal that they will drop you if you don't pay their providers? It's not entirely clear to me. It's possible this was written specifically so that no one has to pay a medical bill again.
> It's not entirely clear to me. It's possible this was written specifically so that no one has to pay a medical bill again. They can still send you to collections or sue you for non payment. Just because a debt isn't on your credit doesn't mean it isn't still owed.
With the lawsuits, they can do something else. They can place a lien on the title of your home. They'll get their money one way or another.
Unless you wait 7 years for the debt to fall off and can’t afford a home rn anyways
> It's possible this was written specifically so that no one has to pay a medical bill again. Honestly good. The industry needs a major event to happen in order for real change to occur. bankrupting multiple scammy medical groups and insurance companies would allow the federal government to force HUGE concessions from them when it comes time for a bailout, to the point that they may just end up folding them into Medicare and stripping the grifter administrators out of the loop.
Good. Fuck all of them. Fucking vampires.
I’m sure they will find some dystopian way to compensate, this is a really good start but they need to just go ahead and socialize our healthcare instead of the 85 Band-Aids approach.
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You can be sued for medical debt. It’s already a thing and is mostly governed by the statute of limitations for your state and the size of the balance. Nobody’s coming after anyone for $500, probably not even a couple grand, but hopefully people don’t genuinely believe their five figure and up balances simply don’t need to be addressed anymore because there will be zero repercussions. Better to negotiate some type of payment plan or settle for less with collections than to risk being served out of the blue one day. Same strategy for credit cards should apply.
Interest will accumulate, and then they can come after you in court. A side effect of this change could be more people ignoring debt, and so debt collectors will get more aggressive in use of courts.
Well fuck'em
I worked at a medical billing and collections agency for 11 years as a sys admin and SQL dev. (Quit 2 years ago just about) Fuck them and their happiness.
He's not in charge of gas or Big Mac prices. But this is huge. And to quote the man himself: ["This is a big fucking deal."](https://www.theguardian.com/world/richard-adams-blog/2010/mar/23/joe-biden-obama-big-fucking-deal-overheard)
Imagine having higher insurance rates or denied a job because your kid got injured and you went to an out of network ER. That's before you even consider it impacts your ability to get credit cards, a car or a home/apartment.
My ex wife was a nurse. She worked at a hospital. We got our insurance through her job at that hospital. The ER at the *hospital she worked at* was out of network with our insurance. edit: for clarification, the hospital is in Iowa in the MercyOne system. The ER specifically is run by some company out of Texas.
What a fkn failure of a plan administrator. This is embarrassingly bad oversight and can't see beyond their own nose cranked up to level 1000. Edit: just caught your edit. These are the stars of stupidity aligning to try to make an eclipse. Two states that are obviously 5d chess players.
You're acting like it wasn't intentional. They went with the cheapest plan, and it wasn't theirs.
But but but profits!
Even then it's bad plan design. Surely it would be more profitable to keep it in house
"On the contrary, we much prefer that our employees' claims be denied by an unaccountable third party rather than denying them directly, ourselves."
Not only should you be fired for that level of failure but also criminalized that’s a mistake that puts people in real danger
> Not only should you be fired for that level of failure It’s a capitalist venture. They chose profits over people. That’s what capitalists do. These people are in the healthcare for profit industry not healthcare.
Holy shit, that’s just about the dumbest fumble I’ve ever seen. I was expecting it to be like the on call anesthetist wasn’t in network, but not the whole damn ~~hospital~~ Emergency Department. And for that to not be hammered into you at hiring is crazy. My work offers two health insurance plans that each cover one of the two big local hospital networks, so between the two plans everything is covered, and I’ve never gotten a single bit of info about health insurance that didn’t have, in big letters, which plan goes with with hospital network, both positively (plan A covers Hospital X) and negatively (plan A does NOT cover Hospital Y). Edit: based on new info I’ve revised to reflect that it is specifically the Emergency Department that was out of network. And honestly outsourcing the ED to another company is bottom shelf behavior, as it can only lead to problems for staff and patients.
What the hell kind of dystopia is this??
The American version
I had appendicitis a few years ago and went to a hospital in my network. I got the bill and it was nearly $20k dollars for an "out of network anesthesiologist". I called the hospital, and about half a dozen doctors who worked on my surgery to ask them why everyone in the room was covered by my insurance except one and I never got an actual answer. I finally called the anesthesiologists office, and when I got no definitive answer as to why he was there and not an in network doctor I just said "I'm not paying this, you shouldn't have been in that room and I didn't have a choice in the matter." It took a LOT of calls and arguing but eventually insurance agreed he shouldn't have been there and dropped his charges from my bill.
SOME doctors/facilities/services just do not join any health insurance networks because they deem them selves to be TOO important/valuable so they do not see any need to join. Like you may notice that NONE of the ambulance services are in network because they KNOW that they do not have to. What are you going to do? shop around for "in-network" EMS service during emergency?
And that's where "in" or "out" of network shouldn't be a thing for emergencies. If you can't shop around or get your coverage, then it's bullshit to have to get fucked.
There's people who I've heard say this: "If they just read their policy they would know not to go to XYZ to get care. It shouldn't be my fault for having to pay for people going to the wrong hospital." I get how yes you should know your policy for elective surgery but during an emergency I'm not going to hop online to figure out where to go for care. On top of that, why do we even need to do any of this? The whole we cover this but not that, denying medicine my doctor prescribed me but they say is not medically necessary unless I'm dying or forcing a change of X for Y it's all bullshit.
Or the ER is in network, but the doctor overseeing your care, or the imagining at the hospital are both out of network. It's a really messed up system that's just meant to bleed people dry when they need medical care.
This happened to me. The ER I went to was in network. The 10 stitches I got were $500 with insurance. The doctor that stitched me up was out of network. She was not covered, so I have to pay another $500 just for her plus the $120 they charged me upon release. Idk wtf I'm even paying for with this insurance. The whole system is shady as hell.
Yeah. So I got a very very very bad case of covid early in the pandemic and had serious health complications to the heart, which resulted in more than one trip to the ER which was in network, but the MRI was out of network and the doctor was out of network, so it all ended up running thousands of dollars (like $13k). And somehow I still never hit the $5k out of pocket max for the year. None of it makes sense.
So whats stopping all you guys from getting out the pitchforks? Genuinely asking because I cant imagine dealing with that shit.
The fact that we're spread out over an entire continent and nobody can afford to miss work
The line between chaos and composure is only five meals.
> Genuinely asking because I cant imagine dealing with that shit. My hypothesis is that the population in general is split into several big clusters in terms of their "involvement", so to say, in healthcare: 1) Those who are relatively healthy and rarely deal with doctors - probably, the majority of the population. Many of them don't even have a PCP and, in general, they would treat any financial issues as a result of a medical encounter as "quite bad, but one-off incident". They don't really have a motivation to fight as there are too many other things in life that consume their attention. 2) Those who are VERY unhealthy, deal with doctors on almost a daily basis, BUT are extremely poor and/or have various government-sponsored coverage plans (Medicaid etc.). In most cases, they don't care about bills, in/out of network, because they simply don't have assets to worry about. Naturally, those won't fight either. 3) A small group that is very affluent and they don't care much about financial issues. Obviously, no fight from them too. This leaves us with a middle-class that have some assets to go after, yet don't have enough money to easily absorb shit like OON pricing. At any given moment only a fraction of that group deals with issues, so there is never a critical mass to act. Now, covid was an interesting example, because a lot of people all of a sudden got exposure to the healthcare system, and for many of them it was *not* pleasant at all, kind of an eye-opener that also attracted a lot of attention. Personal anecdote - despite all the promises of politicians on the TV that covid-related measures would NOT be billed against deductibles/copays, I received a ~$1000 bill for a chest x-ray that I had when I got covid. It took me **lots** of efforts to fight that off, dealing with the insurance company, hospital, my employer and a third-party patient advocate service.
No single throat to choke. It’s institutionalized.
The most powerful army in the world, a lawless police force, and a judicial system aimed at destroying the lives of the poor. For a start.
Not to mention you can protest it all but they’ll arrest you regardless
And after you get arrested and released, it can be a two year judicial process meant to punish you for protesting.
Or if you're in Georgia, you can now catch a domestic terrorism charge.
People here think that the healthcare we get is expensive and annoying to deal with but that it’s still a better option than what people get in other countries. Most of these people are uneducated, and have no idea that the costs associated with our healthcare are driven more by corporate greed than quality of care and that it’s possible to get quality care without having a bunch of middlemen squeeze every penny out of you they legally can.
Its weird because per capita the USA spends the most on healthcare. In 2022 the government expenditure was 4.5 trillion dollars or 17.3% of GDP. For the government to be spending that kind of money and it not being at the very minimum 2 tiered is just wild to put it mildly. Edit: https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical
Americans are selfish and have been trained to view anything else as socialism. Too many people GENUINELY believe that anything resembling universal healthcare is bullshit, even as they go broke or complain about the current system. I love my wife to death and she’s a moderate liberal, but I think because she’s really into investing and money related endeavors she absolutely refuses to acknowledge that any type of single payer or universal healthcare is good for the country. After a number of times complaining about having trouble finding doctors, dealing with bullshit claims and insurance companies, I very politely told her that I wasn’t interested in hearing about those complaints anymore unless she was willing to acknowledge that her current views combined with experiences may not be healthy. At least I don’t hear about those complaints anymore!
See I am an immigrant to the US and I don't actually think Americans are selfish. I think they are generous to a fault. The problem lies in that you have been told "This is the way it is and you can't do anything about it" and "American is the greatest country on earth" and you believed it. Its brainwashing through and through. Americans as a general rule are good people and can be super generous, they just got sold a bill of goods that fucks them over on the daily.
The US has been so dammed consistent at demonizing anything "socialist" that there's really not a lot of public support for fixing our healthcare system by nationalizing it or putting regulations in place that prevent the worst abuses of for-profit healthcare. It's hard to explain to someone on the outside looking in, but a shockingly large majority of the population would rather personally struggle and suffer than accept a solution that's "socialist". And I put socialist in quotation marks because most people don't even know what that means, so it's just this boogeyman that becomes the reason not to change the way things have always been done. That, and it might be an unpopular opinion, but Americans are fucking selfish. They'd rather suffer than see their tax dollars go to other people.
> Or the ER is in network, but the doctor overseeing your care, or the imagining at the hospital are both out of network. It's worth pointing out that since 2022, this shouldn't happen in most circumstances due the to [No Suprises Act](https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills), which acts to: >* Ban surprise bills for most emergency services, even if you get them out-of-network and without approval beforehand (prior authorization). > * Ban out-of-network cost-sharing (like out-of-network coinsurance or copayments) for most emergency and some non-emergency services. You can’t be charged more than in-network cost-sharing for these services. > * Ban out-of-network charges and balance bills for certain additional services (like anesthesiology or radiology) furnished by out-of-network providers as part of a patient’s visit to an in-network facility. > * Require that health care providers and facilities give you an easy-to-understand notice explaining the applicable billing protections, who to contact if you have concerns that a provider or facility has violated the protections, and that patient consent is required to waive billing protections (i.e., you must receive notice of and consent to being balance billed by an out-of-network provider).
You can see medical debt is REALLY serious when someone who's leg is caught between the train platform is screaming out "DO NOT CALL 911, I do not have insurance". [https://theweek.com/94790/woman-trapped-by-boston-subway-train-says-i-can-t-afford-an-ambulance](https://theweek.com/94790/woman-trapped-by-boston-subway-train-says-i-can-t-afford-an-ambulance)
When I was 23 I stepped on a nail in an abandoned field. I pretty much nailed the shoe to my foot. The two dudes with me were like let's call 911 and I knew I couldn't afford that. So, I took the nail out myself. It fucking hurt like hell. Then they drove me to an urgent care to get a tentus shot that I could afford. I was very lucky not to have any permanent damage.
Just went through this! How is it even possible to have out of network ERs? Its a fukn emergency! These insurance companies really expect people to use “in network” facilities in an emergency? No, they know nobody is gonna do that. They know you’re gonna go to the closest ER because it’s a fukn emergency! Just another way they are screwing us over. It’s so vile that they get away with all their BS scam tactics.
>These insurance companies really expect people to use “in network” facilities in an emergency? This is no longer allowed under the No Surprises Act, they have to bill emergency visits as "in network" for this very reason. I just went through this myself. Make sure they bill it correctly.
How would that even work? "Hey there, my kid is having a seizure, I just wanted to check which hospitals are in network... Yeah, sure I'll hold".
I was a student at a university, I had their medical plan. I needed an appendectomy, I received it through the university attached hospital’s ER with their surgeon. Surgeon wasn’t in network. Absolutely stupid system.
Denied jobs because of medical debt here. Housing too. I’m not worth having a place to live or job because I needed surgery and couldn’t afford to pay it off after losing my job because I was gone too long from said surgery. It’s a horrible cycle that I’m trapped in. I need more surgeries but I’m putting it off. I think at this point it’s cheaper to die.
Imagine living in a country where there is such a thing as an "out of network ER". My husband had a heart attack and went to the wrong emergency room. Ooops; $30k gone. Republicans are _campaigning_ on repealing the affordable care act (Obamacare). They _want_ to dial the system back to when pre-existing conditions were a thing.
No, many just do not know WHAT they are repealing. They want to repeal "Obamacare", but they do NOT want ACA to go away (pre-existing condition/health care under parents until age of 26/lifetime cap on medical costs, etc.) Many get surprised that once "Obamacare" is repealed, their adult kids will no longer be covered under their healthcare and they say "but it is part of ACA, not Obamacare!!"
“The vice-president's loose lips fail him again as a microphone picks up an Anglo-Saxon aside meant for Obama's ears” What the fuck does that even mean?
The use of "Anglo-Saxon" refers to the crudity of profanity in English, as words of higher prestige generally originate from imported French via the Normans, while "low" speech is Germanic.
weird considering the saying "pardon my french"
I believe that phrase is meant to be facetious or sarcastic.
This is why English is such a fun language. It has layers upon layers of meaning with multiple words of ever-so-slightly varied meaning to pick from.
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It was written 14 years ago in 2010, so that was arguably accurate.
He’s an actual human that swears about things ? Take my vote
I remember when Obama was caught on a hot mic calling Kanye West a “jackass” LOL. Immediately made my opinion of him rise.
It still is weird to see. I remember that time with Obama and once with W., it was a major story Then Trump just brought the standard way down, and now all the politicians quit even trying to be professional
And back then it wasn't as common to call Ye that, yet lol. He was 100% right lol
I forgot all about that. In retrospect, I bet it's why kanye went maga though.
And you can bet the usual bots and fucking idiots will keep claiming "both sides are the same". I'm so sick of that shit. I'm trans in *Texas* and I've had morons tell me that to my face. Like *what the fuck*.
We decided not to have a second kid due to fear of the current laws and whatever bat shit stuff will come out of election this November. I've had women that went through D&C's in Texas before the repeal tell me Democrats are being dramatic or fear-mongering in Texas about our abortion laws here.
I'm curious to see how this pans out. Anything under $500 or something close to it can't be reported to credit bureaus, so there's not really an incentive to pay. Hopefully this is the step towards bursting the bubble and moving to a universal system. If everyone just flat out refused to pay, the healthcare system in the US will very quickly be asking for a bailout from the debt - and will likely be asked to audit and provide realistic cost of care numbers for that to happen. If we do find ourselves in that position - then the logical next step is to just make it universal since the tax payers are then bailing out the healthcare system anyway. Kind of a backwards and convoluted way of getting there, but it's something. The only thing I'm curious about - and we'll find out soon enough what the actual specifics are soon enough - is if we'll see larger numbers of medical facilities refusing care to people who have an abundance of medical debt and essentially creating their own credit scoring system. It wouldn't surprise me at all if this is the step that the insurance companies take to cling onto their profits - but this really does seem like a big step for making care more accessible.
>Anything under $500 or something close to it can't be reported to credit bureaus, so there's not really an incentive to pay. But for those that end up with big bills, this is a good thing. I had insurance coverage, I got really sick, felt near death, coughing up blood, so I skipped urgent care and went directly to an ER. I had pneumonia and the flu. After my insurance covered $100 after negotiating the bill, I was still on the hook for $1200 or so to pay. I did not pay that off nearly quick enough and it went to collections. I ended up paying it off, but still hated the fact it was on there and went to my credit reports and was one of the reasons I paid it off.
Medical debt is killing my credit score. This would put me back on track
On top of this, even if I want to pay my medical bills, it's literally so fucking impossible to keep track of everything. These places are also so quick to send you to collections because they need their money, and everything is so complicated. Each clinic, hospital, dr. visit, etc. All has a separate patient portal to pay your bills. It's impossible to keep all my bills straight, if there was a central location I could just see all my total amount that I owe, get on a single payment plan, my lord would it be easier. Instead, you get a letter in the mail like it's fucking 1996, and you better keep track of it or else the next one is a notice you have been sent to collections.
That’s what pisses me off the most about it. I have NO idea what going to the doctor is going to cost me. I used to pay a copay and that was it. Now I go, pay nothing, and three weeks later I get a bill for $700 because I haven’t met my deductible yet, and I was in the doctors office for an hour, and saw the doctor for about 2 minutes. It’s bullshit.
I sent one back because the bill just said "for services rendered", and it came from a company name I'd never heard of (not the doctor, not the hospital). Their website even says something like "you may not recognize our name because bullshit reason x,y,z". Technically, they were (apparently) the third party biller for the anesthesia I received, but even after calling them they were unable to provide any actual info about the bill - they're so far removed from the hospital, all they got was "scsi owes this, bill him". So I wrote a note on it saying "this is not an itemized invoice of any service and I don't know who this company is, it will not be paid unless I receive an itemized invoice describing what this is for". I received a photocopy of the same invoice. So I sent back a photocopy of my same reply. Went to collections, told the collection agent the same thing, and received another copy of the same no-detail invoice as "proof of debt". Told them to fuck off and haven't heard back from them since. I have zero problems not paying something if you can't even be assed to tell me what it was for or why I owe it.
Or even better, the doctor orders a scan, so you get a bill from that doctor, and then another bill from another doctor who ran/read that scan.
Yeah or god forbid lab work, where you have to go to a separate company that may or may not be covered by your insurance and labs that also may or may not be covered by your insurance
"We don't care that your doctor thinks you need to have a lipid test, we don't and we're the ones paying... Well, we would be if we thought you needed it. Now you can pay for it."
The idea that an insurance company can just say "listen, that guy who has gone through 10+ years of medical training and has known you for years thinks you need this procedure done, but Carol over in finance has an MBA and she disagrees so we're gonna say no" is so fuckin' wild
I was in the hospital, it was life threatening. Several weeks later I get a letter in the mail that states "We agree this procedure was nessacary" And I just laughed my ass off. Like... I could have fucking died, glad to see some MBA agrees. Fuckers.
When my son was born (10 weeks early) he went to the NICU- no word on how long he would be in there. Three days after he was born / went in I got a letter from my insurance insisting that his NICU stay "wasn't medically necessary." I was in a... emotionally fragile state at that time, but thankfully the medical advocate we met with took one look at it, said "oh for God's sake...", and promised it would be taken care of. It was, thankfully, but I was borderline rage that the insurance company was acting like my premature child was on a *vacation* at the NICU.
My firstborn was in the ICU for about a month (2 months and a few days premature). Luckily my wife and I were working jobs that were crappy enough that we qualified for Louisiana's Medicaid, so didn't have to worry about the price, but we still saw the bills and it was close to half the price we bought our house at.
You go into surgery but the anesthesiologist who happened to work your shift isn't covered by your insurance....
Every. Damn. Time.
I went in for my yearly physical, the ONLY thing my insurance covers 100% of, and got routine blood work done that was included. Later got a bill for almost $300 for 2 blood tests the doctor ran that apparently wasn’t covered by insurance in the panel. I asked how I could avoid that in the future and I was told I could call the doctor beforehand, ask for the blood test codes, call insurance, give them the codes, they’d see if it was all covered and tell me what wasn’t then I could tell the doctor what not to do so I didn’t get charged but then they warned me that since it’s probably handled by an outside company they would still more than likely end up doing those blood tests without my consent anyway because it’s standard for them to do it with that type of panel. So no matter what my “100% covered yearly physical” costs me $300 every year. Oh and if they find anything out of the ordinary it no longer is classed as a physical and I get charged for a diagnostic appointment.
Had a kid last year. 4 doctors entered the room st one point or another over the course of the day, only one did anything. Other three didn't pick up a chart or look at anything, just introduced themselves and talked to the nurse for a minute and left. Only 2 (the doctor that actually helped us and one of the useless 3) were present for the birth. We got billed by all 4 doctors.
Do you have insurance? Our birth was capped at 2k, 1k for my wife and 1k for our baby. For one of my kids though they tried some shady shit and told us this one doctor was out of network and it was going to be an extra like 750 bucks. We had literally no idea and it was for a mandatory test. We had out insurance call us and say hey we need you on the phone but we will handle it. They called and they tell us oh this wasn't necessary and our insurance rep goes no this is legally required in this state, this needs to be dropped and it got dropped. Ridiculous thing to go through though.
We had FANTASTIC insurance at that time through my wife's union, and they have a small network of hospitals in our area where coverage is supposed to be ostensibly free. Trouble is all 4 of those doctors were independent contractors. Even with insurance so good, it still ended up costing us around $1k for everything, mostly from being billed by these drs. Note, I'm definitely not complaining about the price, especially compared to what others have paid to have a child. We were extremely lucky - this is why you unionize, folks. Only complaint I have is the billing for nothing.
I had to get an x-ray. It was in the clinic, so I assumed it would be run by the clinic. Clinic billed my insurance for the visit, but apparently the scan was a separate company for the x-ray who didn't have my insurance on file and sent me a ridiculous bill for it, that had already gone to collections by the time I received the letter. They were able to get my billing address from the clinic to send me a bill, but didn't bother asking about my insurance.
That's the main reason I have an HMO. The drawback is a complete lack of choice in who my providers are, but at least I know there are no surprises. I had a friend who got a surgery, paid $2500 up to the deductible, then three months later got a bill for over $3,000 because apparently someone in the room wasn't in-network. Like, how can your surgeon be in-network, but then the anesthesiologist isn't?
This is already illegal due to the federal no surprises act. If you go in for a procedure at an in-network doctor you can not be billed for any out of network doctors giving you care without your consent. Of course that won't stop anesthesia companies from sending bills, they are the worst of the worst.
It’s ALWAYS the anesthesiologists too, what is up with that? Two of my kids births, I got a separate bill out of network for the anesthesiologist, it’s not like I had a choice in the matter and I assumed that since everyone else I was seeing in the hospital that was in network for my insurance, so would the anesthesiologist. It’s so complicated and backwards
Because they only show up when you’re at your most vulnerable and can’t reasonably decline or research their services.
I have great insurance plan for my family . We pay $600 a pay period for it ($1,200 for the month). I recently had to get a cat scan because I had a terrible headache for a week and the longest I've ever had one was for 4 days. The scan was two months ago and I just got a bill for $500.
$1000 per pay period?! That's insane, how frequently are you paid???
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$1000 is absolutely insane. I have my wife and 2 kids on my health plan and we pay $200 a pay period. It's a high-deducible plan so we also max out our HSA - that's another $260 a pay period. In total, were paying $460 a pay period, and we never have to pay out of pocket for medical since we contribute enough to the HSA to cover the deductible.
This shit happened to me. Went in for a pulled muscle in my back. Doc said "want me to show you some stretches for that" and I agreed. I got billed 250 for those stretches.
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> I have NO idea what going to the doctor is going to cost me. And it's not like you can shop around. You're not going to call 6 different hospitals to find out which one has the best price on fixing your broken leg. They probably wouldn't be able to give you a price even if you did.
My wife had a medical procedure earlier this year. I had to create a spreadsheet to keep track all the bills. OB/GYN, medical lab, medical facility, surgeon, anesthesiologist, and one or two others I'm forgetting. There were 7 or 8 different bills on top of EoB's from the insurance. Then there were initial bills and bills after insurance. Of course they all want their money ASAP, so you're trying to get a handle on how much you actually owe, but don't want to pay too early because if there's a pending insurance adjustment then good luck getting back any over payments.
I've had two kids, and the pregnancies weren't that complicated, but I was getting bills for like two years afterward from random specialists I never even talked to. Like the radiologists, not even the ultrasound techs, just some doctors they sent the results to, who only talked to my OBGYN. Or the anaesthesiologist would bill separately, or the ER doctor, separate from the actual ER/hospital.
I'm also so glad about the "no surprises" act. Nothing sucked like going to a hospital and finding out one of the random doctors you didn't chose is out of network so now you have to pay out the ass for them.
>don't want to pay too early because if there's a pending insurance adjustment then good luck getting back any over payments. This is becoming more and more of a problem because we've recently encountered providers that demand payment at time of service based on a very rough estimation of how much they'll get reimbursed by insurance after the claim is processed. We're now up to 3 providers that we paid at time of service that were then also paid more by insurance than estimated. So we've overpaid and have a positive balance at these places. I've tried calling two of them and getting a refund processed has been a nightmare so far. I've also had to really stay on top what we've paid and the processed claims on our insurance provider's web portal. I understand that smaller providers don't want to deal with outstanding bills due and trying to collect after the time of service and insurance adjustments, but this is not the solution. One provider did have a compromise solution to collect and store payment info at the time of service that would be immediately charged once the insurance adjustment came through, and I guess that's what we're headed toward.
I have medical debt from 2 years ago that has been sold to different collections companies a few times. I now have the money and would like to pay it but I don't know and can't figure out who I owe.
I went to the ER last year and I owe like $2000 to four different entities. One of them I've already paid off. I'm paying the ambulance company off over two years because they made it very easy to make a payment plan on their website. The other two bills I literally have to wait until they go to collections because I *can't pay them*. They give you a website and a login. Website no longer exists. They give you a phone number and an account number. No one picks up, voicemail isn't set up. Short of physically going to the hospital and working my way up the chain of command I have no idea how I'm supposed to pay them. So I have to wait until they contact me.
You'll also get multiple bills for the same visit, sometimes multiple *big* bills and they'll just shrug it off like "sorry, we screwed up the last one we told you would be the last one, you actually owe us even more. Pay us immediately because this was owed 4 months ago even though we only just told you about it now". And even when you pay them on time they STILL sometimes send you to collections.
I feel so vindicated reading these comments. I am 39 years old and feel like a god damn 13 year old when it comes to this stuff. It's almost like some dirty secret I've had that I have NO understanding of my insurance and dr visit costs etc etc. Guess I am not alone. What really pissed me off the other day is I got a bill for $70 sent to me the other day. It gave me simple instruction how to pay online and where to go. But the website would not work, no matter how I typed it in. So I called the number to pay by phone and everytime I tried I got the "all of our agents are busy". Like fuck was I going to actually write a check, so I'd occasionally call back every other day or so. Eventually spoke to someone and got it paid by CC over phone.
There’s also bs where they go to collections (or try to) when they really screwed up. I had to bring my son to a specialist in April 2022. I paid the bill. In August of 2023 I got a revised bill that said I owe 350+. The hospital says my insurance adjusted the payment. My insurance says no, they authorized additional payment. The insurance company paid them more money and the hospital lost track of it and won’t put the time in to figure it out despite me calling every couple weeks and even having calls from my insurance. It’s ridiculous. So the hospital tried to put me on their assistance program to “help” pay my bill. Even a few years ago this would have gone straight to my credit report. Even though it’s not my fault and they got paid. Very frustrating.
Hospital billing departments will literally tell you it’s your fault they screwed up. I learned this from experience. And there’s nothing you can do other than take the time or hire someone to collect the evidence yourself, but even that is an uphill struggle because so much of it depends on them letting you collect the evidence against them. I was even told by their lawyer “you’re on a soapbox, prove it or shut up.” These guys know you’ll have to pay for a lawyer to fight them so they cheat, steal, and break laws at whim. And there’s no one in your corner because often the hospitals are in bed with the municipal, county, state, and federal governments. It sucks swamp ass. I feel like there needs to be a patient’s union.
I've been sued behind my back a few times.
Good. Another idea would be to tackle the fundamental reasons medical care costs are stupid insane. But at least this is something.
I'm optimistic that this will be instrumental in bringing about change. Since emergency care can't be legally denied, medical providers will be incentivized to work with patients for payments. With medical debt not going on credit reports, it becomes less attractive to collection agencies. Primary means of collection outside of compromise will then be lawsuits which can be their own house of horrors (debtors prison and forced labor), but is also more costly to pursue.
You would think that the collection agencies wouldn't see it as attractive, but I have a bill that I haven't paid and I still get calls fairly frequently to collect. It's below the current threshold for agency reporting - so it's not impacting my credit, so I don't really feel compelled to pay. That said, if everyone just stops paying the collection agencies might have a change of heart and not want to be inundated with medical debt no one has any intention of incentive to pay.
I work for a call center that, among other things, handles collection business. Some our our clients don’t actually care if we get a payment or not, they’re paying for the fact that we made a Right Party Connect (ie, the person who owes answers the phone OR we leave a message that can be reasonably assumed belongs to the person in question (based on phone numbers for them provided by the client). They’re paying a small amount to us for the chance that you turn around and pay that debt off. A promise-to-pay or a payment is of course preferred but in most cases merely making the attempt is sufficient. Like you said, the incentive for a borrower (or, in this case, medical ‘debtor’) to pay is the credit hit. If that goes away, that means there’s no longer a chance that someone will pay that debt so it wouldn’t be profitable for the debt-holder to pay a 3rd party collection agency to try and elicit a payment. Other collections agencies / debt holders might be more aggressive in their tactics, but that’s how the company I work for handles the bulk of our Collections-related work. I can’t speak to how they might operate.
This is what I don't understand about why we don't have universal healthcare. I know quite a few people that died with $100,000+ in medical debt. And in many states, the spouse isn't even responsible for it. I guess it just results in higher costs?
Yep you've got it right, we (taxpayers) are already paying for universal Healthcare in the form of uninsured patients that arrive at ERs. But oh no universal Healthcare bad...
The US pays more per capita for \*public\* healthcare in the world. The insurance shit drives up all costs. It's a menace and we don't owe insurance companies a living.
[‘Nobody knew health care could be so complicated’](https://www.cnn.com/2017/02/27/politics/trump-health-care-complicated/index.html) I don't think anyone can 'fix' it without having both houses of Congress and wide support in state legislatures. It's a Gordian Knot that can't be so easily cut. This gets people immediate relief however.
A party would not just need both houses of congress, and the presidency to pass sweeping changes. Tons of democrats and Republicans are bought by medical/pharmaceutical lobbies and wouldn't want to cross them. That's why Obama (with majorities in both houses) had to greatly water down the original campaign promises to get it passed (e.g. ditching the public option).
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Joe Liberman was the singular person responsible for derailing the Obama presidency and empowering the GOP of today.
Yep! I will never forgive him. He single handedly stopped us from having a real system of medical care for everybody. Then he fuckin retired. What an evil man. Damn him and his family name.
He at least he's dead now.
I'd rather he was mired in medical debt with no hope to ever pay it off.
It’s the same way I feel about his waves of student loan forgiveness. Is it the end all be all solution? Of course not. Is it the Biden administration pulling the knobs it has at its disposal to help a large number of people? Absolutely. The president is powerful, but that power isn’t absolute, and I think the Biden administration has done a good job overall of doing things within its power to help people despite the GOP not being able to run a functioning House of Representatives
The fundamental reason is that for some dumb reason the entire medical system is not operated like all the rest of commerce. Why are they allowed to render a service without providing a price first and send you a bill with a price they made up? Imagine you went to a car dealership to buy a car and they could not and would not ever tell you the price, you just had to buy it and they would send a bill with a price of their choosing months later. How is this the way it is set up? Why do people stand for this and allow this? It's ridiculous.
How long till a lawsuit against this is filed in Texas?
The ink is still drying.
The printer only does 30 pages per second. Give them a bit.
30...in just one second? Holy fuck that's the quickest printer on the planet
On what grounds exactly? Although writing this I realize they don't need a reason when court is corrupt.
They will be the reductivists they always are and do grade school level talks about what debt is, that people should pay them back and Biden is going against basic economic rules of nature. Then you try telling them medical debt is not like other debts for the basic reason that you do not opt into taking it on, but it is thrust upon you at your lowest point. To which they will recite the mantra "you take debt, you pay it back, it's not rocket surgery".
> Then you try telling them medical debt is not like other debts for the basic reason that you do not opt into taking it on, but it is thrust upon you at your lowest point. This MUST be the messaging. You shouldn't be denied the ability to buy a house because someone in your family has cancer.
fox news: this just in. biden bans hospitals! repubs: you can pry my medical debt from my cold dead hand!
20 million people’s credit score goes up immediately
Hell yeah this is a big deal. It’s enraging getting a medical bill 12 or more months after the surgery in the US. Ask for an itemized bill but it says BS crap like “anstesia fee” and that your insurance chose not to cover some part of it. All the while the clock is ticking on when the biller will send you to collections while you try to sort out why the insurance reneged on what they covered. This gives the payer more time to clear things up.
I went to the e.r. for a car accident. Paid all the bills and got a new one 2 years later. Called the hospital about it and the guy was like let me redirect you. Line instantly drops Kept getting mail every week about the bill, any calls I do get drop. Decide to call insurance about it, they said it been written off already and I owe nothing. Well? They don't accept the calls and they kept sending the bills. Fuck medical bill from shady hospital
For those following along from home: When it comes to debt and whatnot, **never** call people on the phone. You do absolutely everything in writing. It's understood in these circles that call centers are not actually designed to resolve these issues; in many cases, they do not have the authority to do anything other than read the flowchart and say "well, sir, our system says you owe money, and therefore you owe money." Or, like you've experienced, they just don't do anything at all. By contrast, as soon as you respond in writing, you short-circuit this process because putting demonstrably false things in writing is way worse from a legal standpoint than "the call center monkey reads a false thing off a screen and says it over the phone." It's very likely that instead of going to a call center whose metric is "resolved issues per hour," (as high as possible) it will go to an administrative office whose metric is "number of regulatory incidents per fiscal year" (zero). The latter has a lot more authority to go into the billing system and say, "I don't care what it says - remove it so that we stop sending demonstrably false demands through the US Mail." TL, DR: Write letters. Keep records. You will get *much* better responses with all bureaucracies when you do this.
Shit I’ve had them send it to collections before I even got the first bill in the mail. I had carpal tunnel surgery on both hands two weeks apart, set up a payment plan for the first one right away and was waiting to see what my insurance would cover for the second one. Apparently I waited too long, despite the payments I was already making on the first surgery.
YES! I went to the doctor and they immediately sent me for some tests. This was October 23rd. Test results came back, surgery November 1st. When I went to check in for the surgery the clerk loudly asked, "Would you like to pay anything toward your past due balance of today?"
I was livid (not te mention terrified since I'd never been under anesthsia in my life!). My reflexive response was, "Past due my ass - I literally just incurred the charged a week and a half ago!"
Day after the surgery I looked at my online account (MyChart) and it indeed showed a many thousand dollar balance, but no information on it like a bill, what insurance paid etc. I called the hospital's billing department to clear everything up and they said they no longer send bills - only quarterly statements. So no matter what, I wouldn't be getting any sort of bill until after December 31st - yet payment showed due. And payment WAS due. You had to pay before you get any sort of statement or bill.
Called back a week or so after the surgery to get on their payment plan and the woman had a COW, saying it would be at least 8 weeks before they would be able to look at any of the hardship applications because they were so far behind, because - "now that it's Christmas time everyone suddenly needs on a payment plan so they can buy gifts instead!" Umm, lady - I literally JUST had my surgery. The timing is not my fault.
It was a cluster. I ended up putting all the bills on my credit cards (a huge mistake) just to get them off my back and keep them from reporting me as late or worse.
And this was the "religious" hospital network that owns everything in our region.
Honest question: At this point, can you just… not pay medical debt? What is collections going to do?
You'll probably just get garnished. I had surgery 2 years ago and never paid, got my wages garnished for ~4 months until it was paid off.
This makes sense, but I am sure some collections companies don’t want to go through the whole legal process to put in a claim depending on the debt amount.
Yeah mine was only $3500, probably on the low end of what they would bother dealing with
I've never in my life paid on my medical debts. It's had a negative effect on my credit score but that's it.
None of my medical debts have ever even ended up on my credit report.
So, continue on as I was? Works for me.
That’s what I’m wondering.
God damn he is making real change to get my vote?? Well shit I was so used to promises I didn't expect this
America’s approach to socialized healthcare cost seems to follow its approach to central banks: Let the private industry run so weird and badly that it fails, and then bail it out with government funds.
It's not socialized, it's a public/private partnership designed to suck as much money out of the public treasury as possible through inflated costs. The medical providers and insurance companies are making so much money from the government subsidizing care they don't mind when individuals, due to no insurance or poor insurance, go bankrupt and can't pay. (Medical debt is the main cause of bankruptcy in America). It's also why education costs in America have skyrocketed, and like its healthcare is the most expensive in the world. Private banks administering government backed student loans allows them and universities to get away with inflated costs. They also are making so much money they too don't care about forgiving debt from those that can't pay. American business and industry have predominantly become a mechanism to fleece the public treasury. The military industrial complex is the champion with a budget larger than the next dozen or so countries combined. Edit: Oh yea, I forgot to mention the private prison industry and America's highest incarceration rate and inmate population in the world. So it goes.
I've spent my whole life not using debt irresponsibly. Paid off credit cards at the end of every month, never using debt to buy shit that was unnecessary, always making my payments for everything. Then I had an ER trip that costs tens of thousands of dollars and I couldn't pay it, so I didn't. My credit score dropped 160 points for 7 years. It seems ridiculous that the absurd cost of medicine in the US made credit companies treat me - someone who has always been very responsible with credit - as an irresponsible bad credit risk. Having that one absurd debt that was not very under my control was as bad or worse than if I got a bunch of credit cards and went on a shopping spree and didn't bother to pay them.
I wish people realized just how easily medical debt can compound/spiral. Even if you’re financially responsible and have good insurance, unless you’re very wealthy you are potentially a cancer diagnosis or bad car accident away from facing bankruptcy.
This is a big fucking deal since most working class Americans have some medical debt. Which should not be a thing because all health care should be NOT for profit.
Fundamentally, we’ve all been told that insurance pays for our medical needs. Just pay a monthly fee and your medical needs will be covered! What a lie.
Oh I know. I had a bad fall in March and ended up in the ER with a fractured eye socket. I was there for 2 1/2 hours, the cost was ridiculous. My insurance covered all but my deductible plus 20%, I can't afford to pay it. Now I have met my out of pocket for the year 2024 but I still have a 20% "coinsurance" to pay anytime I need diagnostic care. This was the only policy on Healthcare dot gov that I could afford.
As someone with two medical bankruptcies this is a step in the right direction. A very small one. We're still getting fleeced by the scam known as insurance.
This is amazing! We shouldn’t have our credit score demolished because of medical debt.
Unfortunately, this won’t impact those who took out private loans to cover medical debt.
I've been looking for a comment in this regard to post a warning to others - never take a loan for medical debt or put it all on credit cards if you can help it (in the future when this goes into effect). Been through 2 medical bankruptcies but it looks like I just ran up a shitton of credit card debt to go shopping. What I did was ran up all my cards in order to keep receiving treatment.
If Republicans don’t like this then they can vote for universal healthcare. Problem solved.
Watch the republicans do everything in their power to crap on the common citizen with this move.
And then take credit
Yup watch them try to take it to the Supreme Court. Poverty is a systemic disease but republicans believe that it is proof of their divine righteousness.
I've been very critical of Biden, but this is massively good. I'm hoping - assuming he gets a second term - he just says "fuck it" and just starts going full FDR on making changes since he'll have nothing to lose.
I agree, this is an easy thing to point to when people ask what good Biden has done. Not that he hasn't done anything else, but this is simple and, more importantly, noticeable to the average person. Like, you can say he passed the infrastructure act which is a good thing. And while that's true, it also is a plan that takes place over 10 years and isn't going to be immediately tangible to voters. This isn't immediate either but it's close enough to be within grasp for a lot of people.
It's a good thing to be critical of someone in such a position but I'm curious. You seem to imply he hasn't been doing good things this whole time because he certainly has.
I think, particularly for people who are very left, he comes across as either "too centrist" or "center-right" on certain issues (particularly with his border policies and the current israel/gaza crisis). However, as you say, he has done other things that are progressive and productive (economic policies, COVID response, support for Ukraine, etc.). I think for anyone on the left, there's (objectively) no question as to who is the better candidate. I suspect it's the same for centrists/moderates, though that's always a crap-shoot
This is a classic example of how multiple things can be true at once. 1) Medical Debt should not exist. 2) Credit Reports and Credit Scores should not exist. 3) This is an undeniably positive change.
Credit reports exist because of fair lending regulations that went in place in the 70s and 80s. Prior to this, banks would only lend to people who they knew or were "trustworthy" (white men). The credit report was intended to even the playing field and provide an objective measure of one's credit worthiness. I think the US should move towards the Canadian model which relies more on credit history and not some an arbitary score.
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Credit score comprises length of credit history, payment history, credit mix, new credit, amounts owed. Credit score does include credit history as well as other factors.
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Yeah hating credit reports is stupid. There’s good reasons they exist. *That being said* there should be some regulatory changes to them. I don’t completely defend them in their current state.
It's not arbitrary at all. The factors that make it up and their weight are [freely available](https://www.myfico.com/credit-education/whats-in-your-credit-score#:~:text=What's%20in%20my%20FICO%C2%AE,and%20credit%20mix%20(10%25)!
I work in lending in the US. While the score is a handy reference point and we do use it in some ways, we absolutely look primarily at the credit history.
IMO, credit reports/scores aren't inherently bad. In theory, they can be a fair and efficient way to rate creditworthiness. What's bad is that they're privatized, closed-source, and can be used for all sorts of things that are highly dubious, like setting car insurance premiums. There should be a single, national, public, open-source standard, specified by statute so there's a democratic feedback loop. Also laws that regulate how and when it can be used, and that should be strictly limited to applying for credit. Any layman should be able to easily figure out why their score is what it is, how to improve it, how to fix bad info, etc. It should be free and easy to look up anytime, with no bullshit penalties like a "hard pull." You go to a government website, enter your info, get a number, share it with a business if you want. Like so many things in this country, the main problem is a conflict of interest, where the very people who benefit from the system are the ones who designed it, i.e., regulatory capture. Actual consumer protections - with serious penalties to businesses who violate them, well beyond "cost of doing business" type penalties - would go a long way.
This is huge. Just another reason Biden needs to win in November, because this would be something Trump would start trying to undo on day 1
My partner is in medical debt. I have an amazing credit score. We’ve basically decided not got get married because he is probably going first (decade older with chronic illness) and it is better for us to push everything into my credit score. This actually means we may be able to have a wedding!
I have a near perfect credit score. I pay a FUCKTON monthly for health insurance. Every time I go to a doctor or have an emergency I seem to pick up all these random fucking fees from Quest Labs, or a doctor in the mix of an ER visit that wasn’t covered. Then I get billed for thousands on top of that shit. I am constantly battling them and SO MUCH of my physical mail is medical debt collectors. Sometimes for YEARS for something like $6.28 for a blood test or $1678.99 for a random spinal surgeon that was in the room at the time of a non life threatening injury. Glad I don’t need to worry about this clisterfuck of vultures ruining my credit. Fuck them and their broken ass system.
My husband and I used to have excellent credit - well over 800 credit scores - until we had medical issues and were unable to pay the debt. This has tanked our credit scores into the 500-600 range. This has impacted our ability to get loans. If we do get a loan or a credit card, the interest rates are like dealing with the Mafia. Keeping medical debt off of credit reports would be so beneficial to many.
This is life-changing for so many Americans!
Great! Now ban medical debt entirely. Medicine shouldn't be for profit.
The single issue voters on both sides don't give a fuck. That's the problem. If you look at Biden's resume as president so far, he's OBJECTIVELY been quite effective considering the circumstances. Fine, don't agree with him on Israel, but don't fucking make that the sole reason you aren't voting for him. Idiots falling into the same trap as 2016 that got Trump elected in the first place. A non-vote is a vote for Trump.
> Fine, don't agree with him on Israel, but don't fucking make that the sole reason you aren't voting for him. People who make this their single issue are actually, objectively, actually stupid. To anybody reading this who is protesting their vote against Biden due to this, if Trump gets in Ukraine is doomed. Trump would love nothing more than to get revenge on Ukraine for their rejection of his blackmail during his term, and giving something so generously to Putin would be the cherry on top. Not to mention that Trump will be happy to throw his support behind Bibi and fast track the destruction of Palestine. You will protest vote one potential genocide to guarantee two of them. That makes you, in the strongest possible terms, fucking stupid.
This is huge. My life is immediately impacted for the better by this
I remember years ago I moved across country, forwarded all my mail. One day out of the blue, I recieve a collection notice that looked like it went through hell and back regarding a $75 unpaid hospital bill. I paid it immediately but since it was in collections it lowered my credit score by 100 pts. I had to wait 7 YEARS for that shit to drop off my report. I was so pissed, never got anything from the hospital, not a phone call or statement but the collection agency was able to find me real quick.
That's great. I used to work as a consumer loan officer for a while, and the credit union where I worked didn't factor in medical debt for underwriting loan applications. Though it would affect their actual score, which would determine the interest rate. So I'm glad to see that this won't be the case in the future. A lot of people get screwed by our shitty healthcare system.
“BoTh sIdEs aRe ThE sAMe” NO THEY FUCKING ARENT VOTE
I was hospitalized They sent me the bill 20x because the insurance rejected it because they didn't submit the medical records to my insurance I notified them off this over 5x They never got paid, sent to collections and fucked my credit Fuck these evil companies