It’s not yet time to say that the political debate over this year’s effort at health insurance reform has reached its low, since we’re sure to hear more hyperbolic charges about socialized medicine, meddlesome government bureaucrats that might replace meddlesome corporate bureaucrats — and how we shouldn’t tax the rich because after all, they create jobs!
The snarky sarcasm fairly drips off the page!
Any sentient person might wonder where all these jobs are, and why this upper-crust, job-creation engine should be spared a tax surcharge to finance insurance coverage for those who do not now have it. But that would be a digression.
What we apparently are supposed to be talking about is when health legislation should be passed — before the August congressional break? Just after that? Never?
Congress already is moving — barely moving, and not necessarily to a triumphal finish — toward expanding coverage, reordering convoluted medical payment systems that breed inefficiency and raise costs, and cleaning up some messes in Medicare created when the Republicans controlled Congress and gave away billions to drug makers and the insurance industry.
Still, Congress is managing a start. And despite whatever distortions you may hear, the House bill now moving through a series of committees is the best of this year’s starts.
Apparently they’re teaching that sarcasm is interchageable with critical thought and rebuttal speech in journalism school today. I feel like I need a shower after that.
So it shouldn’t be surprising that The Post-Tribune has THIS article on how five, count them, FIVE patients were socked with high physician’s bills from their local ER:
- Yates said on April 9 her husband, Bruce, a 30-year deputy U.S. marshal, was deathly ill, suffering from end-stage liver cancer. She phoned her family doctor, who urged her to take him directly to Porter hospital’s emergency room. “When we checked in nobody mentioned anything about the new ER physicians or any insurance payment problems. “
- “I feel like telling Porter and their ER doctors not to get me in the middle of their fight with Anthem,” said (Roberta) Kicinski, a special education teacher who received a similarly unexpected bill. “But that’s exactly what they’ve done. I have no control over the physicians who treat me there. Nobody told me they were out of network. I had no choice. How would I know?”
- Judith Cieslak of rural Valparaiso, a retired employee of the City Colleges of Chicago living on a fixed income, believed she suffered an adverse reaction to her chemotherapy treatment when a friend brought her in to Porter’s ER. But nobody told my friend or me that the ER doctors were not in my network. I pay almost $700 per month for Anthem health insurance and this has never happened before. I had no reason to question the network status of the ER doctors. “
- Valparaiso University music professor Linda Ferguson said she went to Porter’s ER around 2 a.m. on March 17 for acute appendicitis, had surgery and was released days later.”The bill for the ER doctor was bigger than the bill for the surgeon who performed the appendectomy,” Ferguson said.
- Rick Hathaway of Valparaiso, a plant engineer at ArcelorMittal’s Burns Harbor facility, went to Porter’s ER on a Sunday morning with chest pain. “We didn’t know there was a problem here and people should have known they should go someplace else if they couldn’t afford this. I think people should have been forewarned about this situation.”
Why were they hit with big bills? Anthem Blue Cross and The Physician’s company couldn’t agree on reimbursements:
The pay dispute is between Anthem, the nation’s largest Blues plan and the state’s biggest health insurer, and Apollo MD, an Atlanta-based physician outsourcing firm that does business as Indiana Physicians Services. Apollo physicians began covering Porter’s emergency room Feb. 1, but the group is not a preferred provider in the Anthem network, though Porter hospital is.
Apollo MD has not yet signed a contract with Anthem, saying the billion-dollar insurer is offering unfairly low reimbursements. Anthem said the ER group is seeking too much and a stalemate has resulted, leaving unsuspecting patients with large bills.
And to those readers in Porter County Indiana? How’s that “selling-the county-hospital-thing” working out for ya? I don’t seem to recall these kind of contract disputes before the County commissioners sold off the hospital to a private owner.
Good luck with that.