Comments on: American hospitals turn to bedside, emergency room debt-collectors http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html Brain candy for Happy Mutants Fri, 24 May 2013 21:20:00 +0000 hourly 1 http://wordpress.org/?v=3.4.1 By: Antinous / Moderator http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1407915 Antinous / Moderator Fri, 27 Apr 2012 20:18:00 +0000 http://boingboing.net/?p=156588#comment-1407915 <blockquote>Practically speaking, the cost of your education is only a few years of your income.</blockquote>Four years of pre-med. Four years of med school. Four to ten years of residency. Zero to four years of fellowship. A bottom-tier GP doesn't finish education until about age 30. A surgical specialist will be close to 40. Some of that is paid work, but you still have to figure that physicians are in apprenticeships for a very long time, and pay reflects that once they finally finish their education.

Practically speaking, the cost of your education is only a few years of your income.

Four years of pre-med. Four years of med school. Four to ten years of residency. Zero to four years of fellowship. A bottom-tier GP doesn’t finish education until about age 30. A surgical specialist will be close to 40. Some of that is paid work, but you still have to figure that physicians are in apprenticeships for a very long time, and pay reflects that once they finally finish their education.

]]> By: Rod Sullivan http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1407457 Rod Sullivan Fri, 27 Apr 2012 16:39:00 +0000 http://boingboing.net/?p=156588#comment-1407457 The cost of a medical education in the U.S. _is_ high, relative to the costs of other fields of education. But, the cost of a medical education is only a fraction of the income of a medical professional over their lifetime of work. Put into numbers, you may rack up $200,000-$400,000 in student loans to become a doctor. But you make $100,000-$500,000 or more, every year, when you reach your peak earnings. Practically speaking, the cost of your education is only a few years of your income. It is this huge earnings potential that still draws many, many intelligent and hard-working people to the call of being a doctor (in addition to the common desire to help other people.) If a doctor's education is made free, I do not see their fees dropping by a considerable amount. They will still charge what the market will bear. The cost of a medical education in the U.S. _is_ high, relative to the costs of other fields of education. But, the cost of a medical education is only a fraction of the income of a medical professional over their lifetime of work.

Put into numbers, you may rack up $200,000-$400,000 in student loans to become a doctor. But you make $100,000-$500,000 or more, every year, when you reach your peak earnings.

Practically speaking, the cost of your education is only a few years of your income. It is this huge earnings potential that still draws many, many intelligent and hard-working people to the call of being a doctor (in addition to the common desire to help other people.)

If a doctor’s education is made free, I do not see their fees dropping by a considerable amount. They will still charge what the market will bear.

]]> By: First L http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1406414 First L Thu, 26 Apr 2012 22:00:00 +0000 http://boingboing.net/?p=156588#comment-1406414 Oddly enough the point at which cancer patients are deemed "incurable" tends to correlate with the month in which they run out of money. Oddly enough the point at which cancer patients are deemed “incurable” tends to correlate with the month in which they run out of money.

]]> By: First L http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1406410 First L Thu, 26 Apr 2012 21:57:00 +0000 http://boingboing.net/?p=156588#comment-1406410 There is always a work-around or a loop-hole.  Many hospitals in low-income areas intentionally under-staff their ERs so that the average time in the waiting room is between 5-7 hours.  This is intended to discourage the indigent from seeking medical care that is "not worth" waiting 7 hours for.  In my father's case it worked - he passed a kidney stone while we were waiting so we left after waiting more than 7 hours.  Some patients die waiting which also helps control ER costs.  I wonder how many people with pneumonia go back home to die peacefully in their bedrooms. There is always a work-around or a loop-hole.  Many hospitals in low-income areas intentionally under-staff their ERs so that the average time in the waiting room is between 5-7 hours.  This is intended to discourage the indigent from seeking medical care that is “not worth” waiting 7 hours for.  In my father’s case it worked – he passed a kidney stone while we were waiting so we left after waiting more than 7 hours.  Some patients die waiting which also helps control ER costs.  I wonder how many people with pneumonia go back home to die peacefully in their bedrooms.

]]> By: First L http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1406389 First L Thu, 26 Apr 2012 21:47:00 +0000 http://boingboing.net/?p=156588#comment-1406389 You forget how our free market works.  As soon as everybody has the mandated insurance, the insurance companies are going to deny every single doctor visit, treatment, or procedure, as "not medically necessary".  It has already happened to me three times in just the past year, even though the "in-network" doctor that the insurance company contracts with INSISTS that the treatments WERE medically necessary.  Hospitals will continue to pursue patients directly even if we all have insurance.  Your "in-network" doctor will all of a sudden have an "out-of-network" facility, and bill you the balance of $35k when the insurance pays $600.  Or the doctor delivering your baby will be "in-network" but nobody will tell you that the neonatalogist is out of network and charges a flat $2,000.00 fee per delivery, not negotiable.  Think it's bad now?  It will get worse until profit is no longer the foundation for how health care is provided today. You forget how our free market works.  As soon as everybody has the mandated insurance, the insurance companies are going to deny every single doctor visit, treatment, or procedure, as “not medically necessary”.  It has already happened to me three times in just the past year, even though the “in-network” doctor that the insurance company contracts with INSISTS that the treatments WERE medically necessary.  Hospitals will continue to pursue patients directly even if we all have insurance.  Your “in-network” doctor will all of a sudden have an “out-of-network” facility, and bill you the balance of $35k when the insurance pays $600.  Or the doctor delivering your baby will be “in-network” but nobody will tell you that the neonatalogist is out of network and charges a flat $2,000.00 fee per delivery, not negotiable.  Think it’s bad now?  It will get worse until profit is no longer the foundation for how health care is provided today.

]]> By: First L http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1406127 First L Thu, 26 Apr 2012 19:17:00 +0000 http://boingboing.net/?p=156588#comment-1406127 I waited in an ER room in a less-than-affluent part of town for 7 hours when my elderly father was having severe abdominal and back pain.  The ER had a uniformed officer standing guard by the main door between the waiting room and the ER exam rooms.  I saw one elderly man try to walk out and the guard asked to see his discharge papers, which he didn't have.  Then the guard pushed him back in and wouldn't let him leave.  Fortunately my dad passed his kidney stone and started to feel much better so we left the ER without ever being seen.  We followed up with the family doctor the next morning.  My advice is that if you ever really have a medical emergency, stay where you are and call an ambulance.  Though I'm sure it will be only a matter of time before debt collectors are embedded in 911 call centers to run your debit card number over the phone as you wait for the paramedics. I waited in an ER room in a less-than-affluent part of town for 7 hours when my elderly father was having severe abdominal and back pain.  The ER had a uniformed officer standing guard by the main door between the waiting room and the ER exam rooms.  I saw one elderly man try to walk out and the guard asked to see his discharge papers, which he didn’t have.  Then the guard pushed him back in and wouldn’t let him leave.  Fortunately my dad passed his kidney stone and started to feel much better so we left the ER without ever being seen.  We followed up with the family doctor the next morning.  My advice is that if you ever really have a medical emergency, stay where you are and call an ambulance.  Though I’m sure it will be only a matter of time before debt collectors are embedded in 911 call centers to run your debit card number over the phone as you wait for the paramedics.

]]> By: First L http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1406121 First L Thu, 26 Apr 2012 19:02:00 +0000 http://boingboing.net/?p=156588#comment-1406121 Sadly, some of the most egregious abuses come from "non-profit" "charity" hospitals.  But for every non-profit there is an executive staff that expects to be paid the same as the executive staff for a for-profit operation of equivalent size.  And these managers will defend their cash cows to the death.  Some of the aggressive collection practices of these "non-profits" have come under scrutiny recently.  In some cases debtors are pursed to the point of having them jailed for not paying.  This is very uncommon, since the US abolished debtors prisons long ago, but debtors can still face jail when they refuse to pay a judgment on the basis that they are in contempt of a court order. Sadly, some of the most egregious abuses come from “non-profit” “charity” hospitals.  But for every non-profit there is an executive staff that expects to be paid the same as the executive staff for a for-profit operation of equivalent size.  And these managers will defend their cash cows to the death.  Some of the aggressive collection practices of these “non-profits” have come under scrutiny recently.  In some cases debtors are pursed to the point of having them jailed for not paying.  This is very uncommon, since the US abolished debtors prisons long ago, but debtors can still face jail when they refuse to pay a judgment on the basis that they are in contempt of a court order.

]]> By: Samsa http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1406091 Samsa Thu, 26 Apr 2012 18:33:00 +0000 http://boingboing.net/?p=156588#comment-1406091 No, it doesn't. No, it doesn’t.

]]> By: savagejen http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1406083 savagejen Thu, 26 Apr 2012 18:26:00 +0000 http://boingboing.net/?p=156588#comment-1406083 I wonder if doctors would still require so much money if their eduction was free. I wonder if doctors would still require so much money if their eduction was free.

]]> By: donovan acree http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405898 donovan acree Thu, 26 Apr 2012 16:21:00 +0000 http://boingboing.net/?p=156588#comment-1405898 Hospitals have been doing this for some time now. The only new thing here is that the debt collector isn't employed by the hospital but rather contracted for the work. Hospitals have been doing this for some time now. The only new thing here is that the debt collector isn’t employed by the hospital but rather contracted for the work.

]]> By: cdh1971 http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405621 cdh1971 Thu, 26 Apr 2012 08:19:00 +0000 http://boingboing.net/?p=156588#comment-1405621 Was this 'Peace Health' of the Pac. NW? Wouldn't be surprised if it was. Was this ‘Peace Health’ of the Pac. NW? Wouldn’t be surprised if it was.

]]> By: Cowicide http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405552 Cowicide Thu, 26 Apr 2012 05:12:00 +0000 http://boingboing.net/?p=156588#comment-1405552 <blockquote>To the complaint(s) about doctors are only in it for the money</blockquote>The nice thing is it's actually pretty difficult to find an organized group of doctors who are against a single payer system.  I've met some far right wing doctors who are against it, <a href="http://freemarketcure.com/singlepayermyths.php" rel="nofollow">but they're basically idiots</a>. Most doctors (even fiscal conservatives) are smart enough to understand the benefits of a single payer system for economic and humane reasons. Shoot, even try a google search for "doctors against a single payer system" just brings up a bunch of results of doctors who are for it for the most part. https://www.google.com/search?&q=doctors+against+a+single+payer+system&oq=doctors+against+a+single+payer+system This gives me hope that the majority of the doctors aren't just in it for the money.

To the complaint(s) about doctors are only in it for the money

The nice thing is it’s actually pretty difficult to find an organized group of doctors who are against a single payer system.  I’ve met some far right wing doctors who are against it, but they’re basically idiots.

Most doctors (even fiscal conservatives) are smart enough to understand the benefits of a single payer system for economic and humane reasons.

Shoot, even try a google search for “doctors against a single payer system” just brings up a bunch of results of doctors who are for it for the most part.

https://www.google.com/search?&q=doctors+against+a+single+payer+system&oq=doctors+against+a+single+payer+system

This gives me hope that the majority of the doctors aren’t just in it for the money.

]]> By: Cowicide http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405539 Cowicide Thu, 26 Apr 2012 04:54:00 +0000 http://boingboing.net/?p=156588#comment-1405539 <blockquote>I'm wondering if the stress caused by debt collectors to a sick person might actually cause them to become more ill</blockquote>Absolutely, <b>YES</b>.  I've seen it nearly literally kill a loved one.

I’m wondering if the stress caused by debt collectors to a sick person might actually cause them to become more ill

Absolutely, YES.  I’ve seen it nearly literally kill a loved one.

]]> By: Cowicide http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405534 Cowicide Thu, 26 Apr 2012 04:47:00 +0000 http://boingboing.net/?p=156588#comment-1405534 <blockquote>I would call him a grifter</blockquote> @boingboing-66331188710fdd63ee45cdf931f793ca:disqus , you're too kind.  I would call him a piece of shit (for starters).

I would call him a grifter

@boingboing-66331188710fdd63ee45cdf931f793ca:disqus , you’re too kind.  I would call him a piece of shit (for starters).

]]> By: Cowicide http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405527 Cowicide Thu, 26 Apr 2012 04:40:00 +0000 http://boingboing.net/?p=156588#comment-1405527 It really is a marvel to <a href="http://www.huffingtonpost.com/wendell-potter/does-the-us-have-the-best_b_1116105.html" rel="nofollow">behold</a>. It really is a marvel to behold.

]]> By: Guest http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405495 Guest Thu, 26 Apr 2012 04:12:00 +0000 http://boingboing.net/?p=156588#comment-1405495  touché.  touché.

]]> By: Kimmo http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405444 Kimmo Thu, 26 Apr 2012 03:08:00 +0000 http://boingboing.net/?p=156588#comment-1405444 There are so many jobs in the US that would make me want to kill myself. This joint expects low-paid workers to beg for tips from customers to subsidise their shitty wages, co-opts and brands basic courtesy into some grotesque 'greeter' job description, drapes sandwich boards over the desperate, and basically pisses all over fundamental human decency in the drive to disenfranchise, humiliate, and grind into the dust anyone who's down on their luck. Give me your tired, your poor, Your huddled masses, yearning to breathe free, The wretched refuse of your teeming shore, Send these, the homeless, tempest tossed, Because I need someone to shit on. There are so many jobs in the US that would make me want to kill myself.

This joint expects low-paid workers to beg for tips from customers to subsidise their shitty wages, co-opts and brands basic courtesy into some grotesque ‘greeter’ job description, drapes sandwich boards over the desperate, and basically pisses all over fundamental human decency in the drive to disenfranchise, humiliate, and grind into the dust anyone who’s down on their luck.

Give me your tired, your poor,
Your huddled masses, yearning to breathe free,
The wretched refuse of your teeming shore,
Send these, the homeless, tempest tossed,
Because I need someone to shit on.

]]> By: PeaceLove http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405399 PeaceLove Thu, 26 Apr 2012 02:05:00 +0000 http://boingboing.net/?p=156588#comment-1405399 Best argument I've seen yet for patients bringing guns into hospitals... Best argument I’ve seen yet for patients bringing guns into hospitals…

]]> By: Deidzoeb http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405366 Deidzoeb Thu, 26 Apr 2012 01:17:00 +0000 http://boingboing.net/?p=156588#comment-1405366 Please indicate on the anatomically correct doll where the invisible hand of the market touched you. (This joke ripped off from Tank Riot podcast.) Please indicate on the anatomically correct doll where the invisible hand of the market touched you. (This joke ripped off from Tank Riot podcast.)

]]> By: Deidzoeb http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405362 Deidzoeb Thu, 26 Apr 2012 01:15:00 +0000 http://boingboing.net/?p=156588#comment-1405362 Check out the book excerpt linked on BB yesterday called "My breast has fallen off. Can you reattach it?" It tells about a woman who didn't go to the hospital for years because she couldn't afford it, maybe partly because she feared doctors. This is the kind of atmosphere that in-hospital debt collectors would contribute to. http://boingboing.net/2012/04/24/my-breast-has-fallen-off-c.html  Check out the book excerpt linked on BB yesterday called “My breast has fallen off. Can you reattach it?” It tells about a woman who didn’t go to the hospital for years because she couldn’t afford it, maybe partly because she feared doctors. This is the kind of atmosphere that in-hospital debt collectors would contribute to.
http://boingboing.net/2012/04/24/my-breast-has-fallen-off-c.html 

]]> By: Deidzoeb http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405359 Deidzoeb Thu, 26 Apr 2012 01:10:00 +0000 http://boingboing.net/?p=156588#comment-1405359 The second definition of Accretion on Merriam-Webster had the kind of example I was looking for: "a product of accretion; especially : an extraneous addition {accretions of grime}" Other things that accrete might include crust or scum. The second definition of Accretion on Merriam-Webster had the kind of example I was looking for:

“a product of accretion; especially : an extraneous addition {accretions of grime}”

Other things that accrete might include crust or scum.

]]> By: Antinous / Moderator http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405208 Antinous / Moderator Wed, 25 Apr 2012 21:50:00 +0000 http://boingboing.net/?p=156588#comment-1405208 We haven't live under the <i>rule of law</i> for quite some time.  Nobody who has any authority gives a shit anymore. I have yet to get a monitor on for an episode of probable SVT because it takes too long for them to get my AMEX card info.  You'd think they'd have it on file by now. We haven’t live under the rule of law for quite some time.  Nobody who has any authority gives a shit anymore.

I have yet to get a monitor on for an episode of probable SVT because it takes too long for them to get my AMEX card info.  You’d think they’d have it on file by now.

]]> By: Antinous / Moderator http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405183 Antinous / Moderator Wed, 25 Apr 2012 21:33:00 +0000 http://boingboing.net/?p=156588#comment-1405183 <blockquote> Character assassination is always the hallmark of a strong point.</blockquote>Can you assassinate character if it doesn't exist?

Character assassination is always the hallmark of a strong point.

Can you assassinate character if it doesn’t exist?

]]> By: gracchus http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405175 gracchus Wed, 25 Apr 2012 21:26:00 +0000 http://boingboing.net/?p=156588#comment-1405175 And low-income or not, a hospital patient isn't in the sort of physical and mental condition to get into a protracted debate. I'd like to think that, were I in this position, I'd ask if the person was a hospital employee and ask to see an ID and make legal threats or call security if he continued bothering me. But chances are I'd be too debilitated by pain or pain killers or just plain fear to have the presence of mind to do so. Often, friends and family who might otherwise act as advocates for the patient are just as frightened. Accretive "Health" is no doubt aware of these things, and trains its bill collectors accordingly. And low-income or not, a hospital patient isn’t in the sort of physical and mental condition to get into a protracted debate. I’d like to think that, were I in this position, I’d ask if the person was a hospital employee and ask to see an ID and make legal threats or call security if he continued bothering me. But chances are I’d be too debilitated by pain or pain killers or just plain fear to have the presence of mind to do so. Often, friends and family who might otherwise act as advocates for the patient are just as frightened.

Accretive “Health” is no doubt aware of these things, and trains its bill collectors accordingly.

]]> By: gracchus http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405164 gracchus Wed, 25 Apr 2012 21:18:00 +0000 http://boingboing.net/?p=156588#comment-1405164 I don't know what you would call an individual who dresses in a misleading manner, employs a script designed to confuse, and tries to squeeze money from people when they're at their most vulnerable and infirm and frightened. I would call him a grifter or confidence artist without any concern about character assassination. I don’t know what you would call an individual who dresses in a misleading manner, employs a script designed to confuse, and tries to squeeze money from people when they’re at their most vulnerable and infirm and frightened. I would call him a grifter or confidence artist without any concern about character assassination.

]]> By: Guest http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405166 Guest Wed, 25 Apr 2012 21:18:00 +0000 http://boingboing.net/?p=156588#comment-1405166 Theory always trumps my lying eyes, that's for sure. Theory always trumps my lying eyes, that’s for sure.

]]> By: Guest http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405162 Guest Wed, 25 Apr 2012 21:17:00 +0000 http://boingboing.net/?p=156588#comment-1405162  That's not what the man on the television says  That’s not what the man on the television says

]]> By: Antinous / Moderator http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405150 Antinous / Moderator Wed, 25 Apr 2012 21:12:00 +0000 http://boingboing.net/?p=156588#comment-1405150 <blockquote>What kind of creep would take a job where your duty is to harass seriously ill people for money?</blockquote>Candidates that the TSA rejected for not being sufficiently 'people oriented'?

What kind of creep would take a job where your duty is to harass seriously ill people for money?

Candidates that the TSA rejected for not being sufficiently ‘people oriented’?

]]> By: Brian Bishop http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405146 Brian Bishop Wed, 25 Apr 2012 21:10:00 +0000 http://boingboing.net/?p=156588#comment-1405146 If your hospital's ER requires a credit card before seeing you, it would be a violation of EMTALA law. EMTALA requires emergency departments to provide an examination by a physician and to stabilize patients before discharge or transfer, regardless of ability to pay. They can ASK for payment information, but medical services cannot be delayed or refused. If your hospital’s ER requires a credit card before seeing you, it would be a violation of EMTALA law. EMTALA requires emergency departments to provide an examination by a physician and to stabilize patients before discharge or transfer, regardless of ability to pay.

They can ASK for payment information, but medical services cannot be delayed or refused.

]]> By: Antinous / Moderator http://boingboing.net/2012/04/25/american-hospitals-turn-to-bed.html#comment-1405075 Antinous / Moderator Wed, 25 Apr 2012 20:04:00 +0000 http://boingboing.net/?p=156588#comment-1405075 Doctors haven't run hospitals for many, many decades.  They have <i>administrators</i> to do that.  It's more efficient because they can work in any industry with equal lack of knowledge. Doctors haven’t run hospitals for many, many decades.  They have administrators to do that.  It’s more efficient because they can work in any industry with equal lack of knowledge.

]]>