Hospital Shenanigans (Again)
A free public service for a better community
Happy TuesdayHealthcare Advocates
Still requesting inputs from state insurance commissioners on the rate of health insurance denial in their state. I’m not receiving too many. I will publish what I learn here. Please post subjects you’d like to see by clicking the comment button at the bottom of the newsletter. Any comments you have for me are most welcome.
Hospital Two Step
When you buy something you ask the price. You might negotiate the price but pretty much each person is charged the same price.
When insurance is involved all bets are off. Here is an example. If you had a small fender bender on your car, you might take it to a body shop and they give you a price. Usually they assume that insurance is involved. Your deductible might be high so you could ask “How much for cash?”. Sometimes the case price is less than the deductible and off you go. The effort of dealing with a 3rd party to pay can sometimes lower the price.
A recent study, published yesterday for Health Affairs, was done of about 1/3 of the hospitals in the US. They decided to see if there was a difference between what hospitals demand for payment when Medicare Advantage (part C private insurance) or just private insurance is billed.
There is a difference. The private insurance (ACA plan, plan from work, short term high deductible plan) was billed almost twice as much. The median commercial prices for 46 procedures and services offered in 2022 were 1.8 to 2.7 times more expensive than Medicare Advantage prices. Not all hospitals are transparent about prices. The study used data from from 2,434 of the 4,331 hospitals with disclosed prices. Independent and rural hospitals were underrepresented. However, there are only about 7000 hospitals and so this is the case in about 1/3. (reference link to Axios Story)
I think employers and people who have to purchase their own insurance should be more than a little upset. Of course, all of this multi level pricing that depends on the kind of insurance you have disappears when we all have the same kind of insurance - Public insurance paying private providers - Universal Healthcare.
ACTION
Let’s remind our Congressperson and Senators that hospitals are cooking the books and jacking up prices. That employers and those of us with private health plans are getting cheated. Their contact info is here.
You can use RESISTBOT to send the email below to them. On your cell phone send a text message to 50409. The message is SIGN PPAPCH.
I am your constituent and I just discovered that a recent study of hospital charges shows that private insurance is billed 1.8 to 2.7 times more than Medicare Advantage private plans. Employer sponsored plans (and employees) and those of us with private plans are being cheated. Look all of this goes away when we have public insurance paying private providers. Cosponsor and enact HR 3421 or S 1655 the much improved Medicare for All Act so we can stop the cheating.
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
https://www.commoncause.org/find-your-representative/addr/
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Plan
Reproductive Health
NARAL - Pro Choice America
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water Resistbot write up