I’m tempted to find the cheapest catastrophic you get in a car accident or leukemia plan and do everything else cash - going to Mexico if necessary.
This was my wife’s experience with Kaiser too. I found them to be fine with routine physicals and eye exams and whatnot, but when she needed actual care it was a hassle and they also kept kicking her off to the online nurse appointments or whatever.
Interestingly, Kaiser used to have a good reputation. They’ve REALLY cut costs by making primary care gatekeepers all NP/PA types, which works in terms of $$ but can be somewhat problematic if you’re actually sick or have a complicated issues. I’ve spoken to several ER docs who worked for Kaiser, and they uniformly hated it (which is why they’re no longer there, I suppose.) I hear pretty good things about their cancer care, though.
MM MD
4 days in NICU. Great fucking country we have here. Your kid survives near death and then you get this.
Is this your kid RM? If so, sorry to see something like that.
What exactly is included in Nursery Charges? Somebody to look at your kid and change diapers?
Not mine. Reposting from twitter.
It’s not an itemized bill. That would be the size of a phone book, except you (myself included) couldn’t begin to interpret it - and multiple erroneous charges would be on the bill.
MM MD
Out of curiosity what does a speech pathologist do with a newborn? I really don’t know.
speech pathologists also deal with problems infants have swallowing while being fed. We use the same parts of our anatomy for both processes.
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https://twitter.com/jillpromoli/status/1214562521023037445
I spent some time with anti-vaxxers over New Years. They live off the grid on an “eco-village” in Baja - which is basically just a patch of land they’re trying to tame and sell off lots to other like-minded souls. Not bad people - just suspicious of everything the govt puts out and any chemicals or man-made improvements to our health and basic needs.
I hate to say it but I completely understand how they wound up where they are. How are normal people supposed to parse the obvious times the govt lies to us (endless war, yellow cake uranium, pesticides, grain-based food pyramid, ketchup is a vegetable, etc.) from the times they aren’t lying to us?
These people actually believe the elites don’t vaccinate their kids. And all kinds of other stuff - basically anything natural is good, man-made is bad. Sunscreen - bad. One of them even thought sunglasses are bad. Ok she might be far out there by even anti-vaxx standards. I thought about saying “Yeah - and fuck toilet paper too! We were meant to have turds clinging to our butt hairs!” - but thought better of it. I guess you could argue we evolved using leaves or splashing water in our butts or something.
But she had her first kid vaccinated and he’s the one with all the health and behavior problems. The second kid is super balanced and healthy and he only had one vaccination - which made him sick - so Mom said no more (she actually prayed for God to give her a sign and then the kid got super sick - sigh - you’ll never counter that with facts). And these kids are in high school, so this isn’t such a new phenomenon among the off the grid/natural bullshit/whatever crowd apparently.
I don’t blame them nearly as much as I blame people who should know better for sowing the seeds of doubt. The world is too complicated now. Most people are profoundly ignorant on most subjects. They need to be nudged and herded in the right direction. Allowing people to spread anti-vaxx stuff should be like yelling fire in a crowded theater - it’s too dangerous. Same goes for hate speech.
And of course if Putin really is behind some of this - we’re just fucked. Humans aren’t wired to resist sophisticated propaganda on something like that when they’re already justifiably suspicious of the govt. It’s reverse cargo cult - devastatingly effective.
One of them is a great, truly open-minded guy who I met a couple years ago on my trip and how I know these people. He’s not nearly as hardcore but he tends to think that natural is better - which I can’t really fault. He talks about “doing his own research” (which is just such an easy trap for already suspicious non-propaganda-savvy people to fall into) and finding out that most people who get sick in these outbreaks were already vaccinated and how no one died.
Well turns out you can still get the disease in most cases (90-95% prevention), but when you do it’s going to be less severe - which prevents deaths. But that’s nuance - so when the govt tries to scare people reporting an outbreak - they leave out that people were already vaccinated - which of course makes it easy fodder for the already suspicious crowd to point and claim chicanery. So it’s almost like dueling propaganda - how are normal people supposed to see that and know which side’s propaganda is benign?
And then fucking FoxNews is even jumping in pointing out that everyone who got Whooping Cough in one outbreak was vaccinated. JFC - I doubt they go full anti-vaxx, but I could see them going “legitimate debate” vaxx which is just as bad.
At some point the anti-vaxx crowd could become a big enough voting bloc that no one wants to piss them off. If we aren’t there already.
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This right here is why the government needs to lose the ability to keep secrets and lie to people. Social trust is way more important than whatever advantages they get by having lies in their range. Seriously the more research they do on the economic value of social trust the more ridiculously important it appears.
Yeah I’m suggesting they should declassify everything and make telling a direct lie to the American people as an American official a major felony. Extreme problems need extreme measures.
https://twitter.com/wendellpotter/status/1214590242667278336
But choice though… This right here is 1000% of why the health plan we selected had decent out of network benefits. I used to work for a health insurance company 10+ years ago and this shit was common then.
This is so easy to fix, which is why it infuriates docs. Cap out of network at 10 (or 15, or 20)% over in network charges, and requires hospitals that provide specific specialty care (stroke, trauma etc) to be paid at par. Insurers can compete on the margin for insured, whether on cost/quality/metrics, and people can have some degree of choice as to where they get care when appropriate. And the scumbag insurers can’t then just decide to refuse to declare, “yeah, our offer is fuck you” which is what we’ve gone through in the past.
MM MD
Or maybe “out of network” shouldn’t be a thing.
Sure - I was just noting if that for some reason you wanted to, you could, for competition purposes. But whatever.
MM MD
It is absolutely infuriating that balance billing is legal.
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Mostly.
We’ve run into the issue with a company called grue kros who refused to negotiate with hospitals/providers and said they would pay under medicaid rates and if you didn’t fuck you that’s why. Since medicaid rates pay essentially less than nothing ( during a Medical iteration a while back, our billing group figured out that by the time we submitted a bill, they routinely declined it (not that they wouldn’t pay, they just wanted to run the calendar out to delay payment), we appealed it, they lost the paperwork/fucked around with us for months before finally sending us a check, we were objectively losing money on every patient visit. Their advice was to just give up. Not surprisingly, this seemed to be a bad way to pay salaries, buy equipment, and stuff like that. This works out especially well for people who find out their “insurance” doesn’t pay for much.
So like a lot of this stuff, it’s complicated
MM MD
I’ll drop this here for anyone who didn’t see it… (WaPo article syndicated at Seattle Times.)
Not news, but:
Despite paying $8,000 more a year than anyone else, American families do not have better health outcomes, the economists argue. Life expectancy in the United States is lower than in Europe.
“We can brag we have the most expensive health care. We can also now brag that it delivers the worst health of any rich country,” Case said.
The study authors actually go pretty hard against doctors. Sorry Hobbes.
Don’t take it personally - I understand the article, which for the most part I feel was mostly reasonable.
The surprise billing stuff is reprehensible, but won’t be fixed until insurers change what they’re doing. The article strongly suggests that psychiatric/drug issues are grossly underfunded/treated, which would be probably the quickest way to help out the biggest number of people helped efficiently and cost-effectively that society could do as a whole. Plenty of blame to go around.
MM MD