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Doctors fight balance-billing ban on out-of-network costs to survive

Posted Nov 14 2008 2:59pm

The battle continues on balance billing, but it comes down to someone just paying the bill for health care once more.  Are we looking for blood from a turnip here?  Hospitals need money, doctors need money, contracts keep getting lower every year,so if 50% of our hospitals in the US were not on the verge of being insolvent, some of this would not even be making the news. 

So we are back to who’s going to pay the bill once more.  If you have read the news of late, even hospitals in good financial standing are cutting back so as not to go over the edge.  This is truly a no win battle for everyone, patients should be covered and health providers paid for their time and if that were the case, this issue would not even exist. 

Problem is we are cutting costs, much of it being justified by using technology; however, the education process here is extremely lacking, so throw out the new bone for consumers to jump on and wish for the best?  That is pretty much what is happening here and the knowledge that is offered out there is so fragmented and changes daily, how can you win, you don’t. 

As fancier and more complicated algorithms are created and their interpretations sent to consumers, it’s not going to get any better any time soon and this just leaves way for more issues on who’s going to pay the bill, so have we finally reached bottom here?  Studies show that money can be saved, and yes there is truth in this, but the implementation and competition certainly is not doing more than just simple clouding the issues.  Every day you can log on and there’s someone new with a bigger and better plan, right?   Not really, just some new algorithms created to try and shuffle money used to pay Peter to now pay Paul.  The available money is not increasing, just the formulas for marketing healthcare is the challenge, and again they change with the direction of the wind, which leads me back to a prior post on the 2 Hot Words in Healthcare today, Algorithms and Whistleblowers, those who write them and those who catch the fallacies are the 2 making the money and the news today, while the poorly informed and educated consumers are the ones carrying the brunt of the system, less healthcare and fewer dollars to cover, and the stress and obnoxious processes in place to have to fight for one’s health. 

We are trying to help consumers take hold and take part in controlling their health and adding personal health records to help create more informed patients, but again where’s that at today?  Same thing, too many confusing markets and at a result nothing is getting done in a hurry and all the new data technology that is created to help the process just stifles, so until efforts are made to truly use technology and properly educate the US consumers, there appears to be no end to this battle as well, so all these reports on savings are not doing anyone any good at present as the bills continue to be debated and mount, and the algorithms and whistleblowers process continues.  BD 

California physicians are waging a campaign to block balance-billing regulations they say ignore health insurers' habitual underpayments for out-of-network care. The Dept. of Managed Health Care rules, in effect Oct. 15, prohibit physicians and hospitals from billing patients for outstanding out-of-network emergency care costs not covered by health plans. The move comes amid several legal challenges over balance billing and confusion about California laws that generally ban the practice for in-network services, but are vague on noncontracted care.

AMNews: Nov. 17, 2008. Doctors fight balance-billing ban on out-of-network costs ... American Medical News

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