Off Campus Hospital Scam
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A Good Day To Advocate for Better Healthcare
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Claims denial is in work and so is a piece on the availability of psychiatric beds.
Videos of these newsletters appear on Youtube on this channel.
Osteoporosis News (Japan)
Osteoporosis is a skeletal condition that leads to the weakening of bones, making them porous, fragile, and prone to breakage. A whopping 8.9 million fractures are caused by osteoporosis annually, with one fracture occurring every three seconds! The aging population is the most vulnerable to primary osteoporosis, given, their frailty, and often, requires long-term therapy and support.
The parathyroid hormone (PTH)-derived peptide -- teriparatide has demonstrated strong bone promoting effects. However, it is also to known to exert bone-resorbing effects. A new study uncovers a novel PTH-inducible target gene -- Gprc5a which suppresses the proliferation and differentiation of 'osteoblasts' or bone-forming cells, and may serve as a therapeutic target in the treatment of osteoporosis. You can read more in Science Daily. The work was done at Tokyo Science University.
Rural Health - Chronic Disease Management Toolkit
Some of you live in rural areas and are involved with patients. The RHIHUB has just published a toolkit to help manage chronic diseases in rural settings. It is here. It contains a number of links to medical networks that are successfully helping their patients with chronic medical conditions - see module 3 and then follow the links therein.
Off Campus Hospital Charges - SCAM Alert
Here is a link to a recent NY times article - Even Doctors Like Me Are Falling Into This Medical Bill Trap. The quick summary is that this doctor took her daughter to an urgent care for an x-ray. The bill should be about $100. It was over $1000. The reason was that the facility is associated with a hospital and so they get to charge outrageous hospital rates.
Hospitals are allowed to do that, and they do practice such over pricing to cover their infrastructure costs as well as covering the costs of patients who are unable to pay.
If there were a way to make sure that their infrastructure costs were covered then this kind of scam billing at “All the Traffic Will Bear” prices would stop.
PS this kind of shenanigans is everywhere. - Here is a link to a report in the National Institute for Health Care Reform on the subject of pricing at Hospital Outpatient locations. They found that average hospital outpatient department prices for common imaging, colonoscopy and laboratory services can be double the price for identical services provided in a physician’s office or other community-based setting, according to a study by researchers at the former Center for Studying Health System Change (HSC).
Using private insurance claims data for about 590,000 active and retired nonelderly autoworkers and their dependents, researchers found, for example, that the average price for magnetic resonance imaging (MRI) of a knee was about $900 in hospital outpatient departments compared to about $600 in physician offices or freestanding imaging centers. Likewise, the average hospital outpatient department price for a basic colonoscopy was $1,383 compared to $625 in community settings. For a common blood test—a comprehensive metabolic panel—the average price in hospital outpatient departments was triple the price—about $37 compared to $13 in community settings. These are 2014 prices.
Of course, there is a way to fix this - it is section 611 of HR 3421, the bill proposing a national single payer health insurance. system The title of that section is “Payments to institutional providers based on global budgets”. Global budgets are the payments the insurance trust would make to hospitals and other financial networks to cover their infrastructure costs. Such costs include rent, utilities, salaries, supplies etc. Also included in HR 3421 is the establishment of regional committees to make sure that facilities are provided with fair reimbursement. Once that’s done there is no need to charge $1000 for a $100 x-ray. (Thanks to the Health Justice Monitor).
ACTION
We all deserve to have quality healthcare that is affordable. The global budgets of HR 3421, the vastly improved Medicare for All Act, can help make that a reality. Let’s remind our Congresspeople and Senators of how we are being scammed and what they can do to protect us, like enacting a National Single Payer Healthcare System. They need to hear this over and over to know that it matters. Here is their contact info, https://www.usa.gov/elected-officials.
Or use RESISTBOT on your cell phone and send this message. Just text SIGN PSCWYB to 50409.
“I am your constituent and I just learned that many off campus, outpatient medical facilities associated with hospitals are allowed to charge hospital rates for common procedures. Colonoscopies, lab work, and MRIs are frequently 2X the cost at such facilities. A recent NY times article documented a case where an X-Ray was 10X the usual outpatient cost.
Hospitals bulk up costs to cover their infrastructure and their associated off campus offices take advantage and charge hospital rates. This is madness and the costs are not tied to reality.
If we had a global budgeting system, as documented in section 611 of HR 3421, the vastly improved Medicare for All Act, such facility costs as rent, utilities, salaries, supplies etc. would be taken covered. Once that’s done there is no need to charge $1000 for a $100 x-ray. I want you to read the bill, it is at https://www.congress.gov/118/bills/hr3421/BILLS-118hr3421ih.pdf, and then I want you to enact it. Your constituents deserve health care that is affordable, not unobtanium. Thank you.”
CBO Report on Health Insurance (Forecast)
This morning the Congressional Budget Office (CBO) released their forecast regarding health insurance for the next 10 years. Here is a link to their presentation to Congress. Don’t use the arrow beneath the slides just use your mouse or finger to swipe left or right on them (that worked for me).
In 2023, 7.2 percent of the population did not have health insurance, CBO estimates. That share is projected to rise to 8.9 percent by 2034 because Medicaid’s continuous eligibility provisions end, enhanced marketplace subsidies expire, and immigration surges.
Enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) is projected to decline significantly, from 92 million in 2023 to 79 million in 2034. Enrollment through marketplaces is projected to reach an all-time high of 23 million people in 2025. Employment-based coverage will continue to be the largest source of health insurance, while enrollment in Medicare will grow significantly, from 60 million in 2023 to 74 million in 2034 as the population ages.
So not a pretty picture - almost 9% of the population without health insurance of any kind in 2034, 11 million fewer children getting Medicaid and employer health plans grow. That means increasing copays and deductibles and insurance you can’t have when you lose your job or consider training for a new field. You are essentially a slave to insurance.
SIGH another good reason for universal healthcare.
Resources
Find My Elected Officials
Contact State and Federal Representatives - phone and email
Healthcare Advocacy (Us) Website
Our Newsletter resources including reproductive healthcare - Healthcare Advocacy Reading List
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
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
Disinformation Management
Cybersecurity Infrastructure Security Agency
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
Learn About Healthcare Policy
The Kaiser Family Foundation has put together an online course about healthcare policy. It is called Health Policy 101. It is free and here is the link to their course page. I will keep this note here for a few days.
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