"If you have your checkbook in your car I will be happy to wait for you."
April 24, 2012 5:44 PM Subscribe
Hospitals in Minnesota have hired a collections company that plants its employees in the ER, squeezing money out of patients before they can get further care.
Minnesota gets a lot of bad press unfortunately. This is a national debt collector; it happens that they were caught in Minnesota. The state has a pretty reasonable health care system overall; there are no for-profit hospitals in the state, and there is a relatively decent safety net.
posted by miyabo at 5:48 PM on April 24, 2012 [5 favorites]
posted by miyabo at 5:48 PM on April 24, 2012 [5 favorites]
this is just awful.
from the article:
As a growing number of hospitals struggle under a glut of unpaid bills, they are turning to companies like Accretive. To win promised savings, all hospitals have to do is turn over the management of their front-line staffing — ranging from patient registration to scheduling and billing — and their back-office collection activities. Accretive says it has such arrangements with some of the country’s largest hospital systems to help reduce their costs.
Indistinguishable from medical staff members, Accretive employees register patients, take down sensitive health information and champion aggressive bill collection goals with incentives like gift cards for staff members, the company records show.
posted by nadawi at 5:50 PM on April 24, 2012 [1 favorite]
from the article:
As a growing number of hospitals struggle under a glut of unpaid bills, they are turning to companies like Accretive. To win promised savings, all hospitals have to do is turn over the management of their front-line staffing — ranging from patient registration to scheduling and billing — and their back-office collection activities. Accretive says it has such arrangements with some of the country’s largest hospital systems to help reduce their costs.
Indistinguishable from medical staff members, Accretive employees register patients, take down sensitive health information and champion aggressive bill collection goals with incentives like gift cards for staff members, the company records show.
posted by nadawi at 5:50 PM on April 24, 2012 [1 favorite]
something something single-payer healthcare ...
something something complete.
posted by cupcake1337 at 5:51 PM on April 24, 2012 [23 favorites]
something something complete.
posted by cupcake1337 at 5:51 PM on April 24, 2012 [23 favorites]
Burn in hell, fuckers.
posted by rtha at 5:54 PM on April 24, 2012 [17 favorites]
posted by rtha at 5:54 PM on April 24, 2012 [17 favorites]
This is my non-surprised face.
posted by oneswellfoop at 5:55 PM on April 24, 2012
posted by oneswellfoop at 5:55 PM on April 24, 2012
While I think this is outrageous, I actually think it's great advertising for single-payer care. It's only gonna get worse, and I hope all of it gets tons of media attention.
posted by Rykey at 5:56 PM on April 24, 2012 [21 favorites]
posted by Rykey at 5:56 PM on April 24, 2012 [21 favorites]
From their web site:
Accretive Health believes that the single most important opportunity to strengthen the financial position of healthcare providers lies in a dramatically improved, end-to-end, technology-underpinned execution of the Revenue Cycle for now and for the future.
"execution of the Revenue Cycle"....???!!
And: "Six Sigma Process Control and Metrics Adapted for Yield
That's some scary language there!
posted by HuronBob at 5:57 PM on April 24, 2012 [1 favorite]
Accretive Health believes that the single most important opportunity to strengthen the financial position of healthcare providers lies in a dramatically improved, end-to-end, technology-underpinned execution of the Revenue Cycle for now and for the future.
"execution of the Revenue Cycle"....???!!
And: "Six Sigma Process Control and Metrics Adapted for Yield
That's some scary language there!
posted by HuronBob at 5:57 PM on April 24, 2012 [1 favorite]
But we can't have single-payer because THE GOVERNMENT might choose your doctors, wouldn't you rather have a private company threatening to break your knees in the lobby? After all, you can just take your business elsewhere.
posted by Ghostride The Whip at 6:00 PM on April 24, 2012 [28 favorites]
posted by Ghostride The Whip at 6:00 PM on April 24, 2012 [28 favorites]
Why did they choose a name that sounds so.... medical?
"I'm sorry, Mr. Hansen, but our tests show that the tumor is accretive."
posted by escabeche at 6:01 PM on April 24, 2012 [9 favorites]
"I'm sorry, Mr. Hansen, but our tests show that the tumor is accretive."
posted by escabeche at 6:01 PM on April 24, 2012 [9 favorites]
I don't know what to say other than :(((((( ... and up against the wall, mother-fuckers.
How does this jive with EMTALA? if you're stalling people and coercing them into, say, leaving. lawyers in the house?
posted by circle_b at 6:05 PM on April 24, 2012 [2 favorites]
How does this jive with EMTALA? if you're stalling people and coercing them into, say, leaving. lawyers in the house?
posted by circle_b at 6:05 PM on April 24, 2012 [2 favorites]
Just remember, if they can't turn away deadbeats from the Emergency Room, the hospital builds up unpaid bills, resulting in the need to raise prices for the rest of us! The more people who die without proper care, the more savings for the rest of us! The only way to truly reduce the cost of Health Care is to only provide it to those who can afford it!
posted by oneswellfoop at 6:13 PM on April 24, 2012 [2 favorites]
posted by oneswellfoop at 6:13 PM on April 24, 2012 [2 favorites]
Let me put it this way: it's a good thing, for their own sake, that said debt collectors are in close proximity to an emergency room.
posted by Inspector.Gadget at 6:13 PM on April 24, 2012 [2 favorites]
posted by Inspector.Gadget at 6:13 PM on April 24, 2012 [2 favorites]
But we can't have single-payer because THE GOVERNMENT might choose your doctors, wouldn't you rather have a private company threatening to break your knees in the lobby? After all, you can just take your business elsewhere.
I've been buying my insurance from the mafia for years, I'm glad to see my model finally taken seriously.
posted by IvoShandor at 6:14 PM on April 24, 2012 [4 favorites]
I've been buying my insurance from the mafia for years, I'm glad to see my model finally taken seriously.
posted by IvoShandor at 6:14 PM on April 24, 2012 [4 favorites]
Indistinguishable from medical staff members, Accretive employees register patients, take down sensitive health information
I if they're trained for and HIPA compliant?
from HHS.org:
How Is This Information Protected
*Covered entities must put in place safeguards to protect your health information.
*Covered entities must reasonably limit uses and disclosures to the minimum necessary to accomplish their intended purpose.
*Covered entities must have contracts in place with their contractors and others ensuring that they use and disclose your health information properly and safeguard it appropriately.
*Covered entities must have procedures in place to limit who can view and access your health information as well as implement training programs for employees about how to protect your health information
posted by Nauip at 6:14 PM on April 24, 2012
I if they're trained for and HIPA compliant?
from HHS.org:
How Is This Information Protected
*Covered entities must put in place safeguards to protect your health information.
*Covered entities must reasonably limit uses and disclosures to the minimum necessary to accomplish their intended purpose.
*Covered entities must have contracts in place with their contractors and others ensuring that they use and disclose your health information properly and safeguard it appropriately.
*Covered entities must have procedures in place to limit who can view and access your health information as well as implement training programs for employees about how to protect your health information
posted by Nauip at 6:14 PM on April 24, 2012
This is pretty damned unethical and a poor advertisement for Capitalism.
posted by Katjusa Roquette at 6:17 PM on April 24, 2012 [3 favorites]
posted by Katjusa Roquette at 6:17 PM on April 24, 2012 [3 favorites]
Minnesota gets a lot of bad press unfortunately. This is a national debt collector; it happens that they were caught in Minnesota.
I feel confident that no hospital in Massachusetts would dare allow employees of a collection agency to impersonate medical staff. If this is occurring as advertised, Minnesota isn't getting shamed enough.
posted by Mayor Curley at 6:24 PM on April 24, 2012 [4 favorites]
I feel confident that no hospital in Massachusetts would dare allow employees of a collection agency to impersonate medical staff. If this is occurring as advertised, Minnesota isn't getting shamed enough.
posted by Mayor Curley at 6:24 PM on April 24, 2012 [4 favorites]
A bit over a year ago I sprained my back, with increasingly nasty muscle spasms, and after about six hours of trying to wait it out I went to the ER. Well, two emergency rooms; the first wouldn't treat me, but the second did.
I can't honestly remember why they wouldn't do it - something about me being uninsured and them demanding a payment up front before I could even have a Tylenol. (If I had three hundred bucks sitting there taking up space I'd spend it on fucking insurance, people.)
They made me sign... some piece of paper, I'm not sure exactly what... about me leaving without being treated because I chose not to pay them. I scribbled in that I was signing it under duress, and I'm pretty sure I called the ER staff something along the lines of opportunistic fuckwit parasites who were unwilling to do their jobs.
I wonder if it was the same sort of scumbags. And I wonder if I should (or can, even) get a copy of that paper. I'd like to have a look at it when I am capable of thinking straight.
Rot in hell, Memorial of Tampa. Rot. In. Hell.
posted by cmyk at 6:27 PM on April 24, 2012 [9 favorites]
I can't honestly remember why they wouldn't do it - something about me being uninsured and them demanding a payment up front before I could even have a Tylenol. (If I had three hundred bucks sitting there taking up space I'd spend it on fucking insurance, people.)
They made me sign... some piece of paper, I'm not sure exactly what... about me leaving without being treated because I chose not to pay them. I scribbled in that I was signing it under duress, and I'm pretty sure I called the ER staff something along the lines of opportunistic fuckwit parasites who were unwilling to do their jobs.
I wonder if it was the same sort of scumbags. And I wonder if I should (or can, even) get a copy of that paper. I'd like to have a look at it when I am capable of thinking straight.
Rot in hell, Memorial of Tampa. Rot. In. Hell.
posted by cmyk at 6:27 PM on April 24, 2012 [9 favorites]
From the article (emphasis added):
"No, you don't understand. We aren't doing anything. These goons we hired are the ones doing it. So we're in the clear, see?"
posted by mhum at 6:30 PM on April 24, 2012
To patients, the debt collectors may look indistinguishable from hospital employees, may demand they pay outstanding bills and may discourage them from seeking emergency care at all [...]"Wait, wait. What about 'First, do no harm'?"
"No, you don't understand. We aren't doing anything. These goons we hired are the ones doing it. So we're in the clear, see?"
posted by mhum at 6:30 PM on April 24, 2012
Yay, an opportunity for me to tell my immigrant/medicare story. I was in an emergency room in Tennessee (no I am not going to name the hospital, since I now work for them), with whiplash from a motor vehicle accident, with no insurance. They told me that before they could treat me, I would have to sign a form indicating that I understood that if I didn't pay them, I was promising to apply for Tenncare so that Tenncare would pay them. I explained that when I immigrated, I promised that I would not apply for any type of government aid for the first ten years I was in the country, and so if I signed their form, I would be committing fraud. They said they couldn't treat me if I didn't sign the form, and I said that I was in an emergency room and they were obligated to treat me. We went back and forth like this a couple times until they produced a second form, which said that I was refusing to sign the first form. I signed the second form. They gave me stellar care from there on, but I was still appalled by this - somebody who was in worse shape, or understood their rights (or English) less could well have been browbeaten into committing an act for which they would risk deportation. Probably the Feds wouldn't bother, but afaik they can.
posted by joannemerriam at 6:33 PM on April 24, 2012 [17 favorites]
posted by joannemerriam at 6:33 PM on April 24, 2012 [17 favorites]
"Wait, wait. What about 'First, do no harm'?"
That is the doctor's credo.
I believe the debt collectors credo is "First, do as much harm as is necessary."
posted by Joey Michaels at 6:36 PM on April 24, 2012 [6 favorites]
That is the doctor's credo.
I believe the debt collectors credo is "First, do as much harm as is necessary."
posted by Joey Michaels at 6:36 PM on April 24, 2012 [6 favorites]
Accretive is one of the few companies specializing in hospital debt collection that is publicly traded. Last year, it reported $29.2 million in profit, up 130 percent from a year earlier.
So you too can profit off the poor health and misfortune of others...
The whole concept of American healthcare as it currently stands continues to horrify me.
posted by lizbunny at 6:45 PM on April 24, 2012 [14 favorites]
So you too can profit off the poor health and misfortune of others...
The whole concept of American healthcare as it currently stands continues to horrify me.
posted by lizbunny at 6:45 PM on April 24, 2012 [14 favorites]
I'm sorry, Mr. Hansen, but our tests show that the tumor is accretive."
And we all know the only treatment for accretive cancer is a complete cashectomy.
posted by GenjiandProust at 6:48 PM on April 24, 2012 [7 favorites]
And we all know the only treatment for accretive cancer is a complete cashectomy.
posted by GenjiandProust at 6:48 PM on April 24, 2012 [7 favorites]
How does this jive with EMTALA?
It doesn't jive, which is part of the reason for the lawsuit. The law states that people in the U.S. are entitled to emergency medical care regardless of their ability to pay.
I if they're trained for and HIPA[A] compliant?
They're not, which is another part of the reason for the lawsuit. This more local report from MN notes that the debt collectors were given information from patients' medical records, information that could be used coercively to bully people into paying. "In one case, Accretive debt collectors could see that a depressed man owing recently tried to commit suicide."
I work for a hospital in Minnesota, and I'm so glad it's not part of the systems implicated in this article.
posted by vytae at 6:51 PM on April 24, 2012 [4 favorites]
It doesn't jive, which is part of the reason for the lawsuit. The law states that people in the U.S. are entitled to emergency medical care regardless of their ability to pay.
I if they're trained for and HIPA[A] compliant?
They're not, which is another part of the reason for the lawsuit. This more local report from MN notes that the debt collectors were given information from patients' medical records, information that could be used coercively to bully people into paying. "In one case, Accretive debt collectors could see that a depressed man owing recently tried to commit suicide."
I work for a hospital in Minnesota, and I'm so glad it's not part of the systems implicated in this article.
posted by vytae at 6:51 PM on April 24, 2012 [4 favorites]
If this is occurring as advertised, Minnesota isn't getting shamed enough.
The hospital broke the law. It's getting sued by the state. That's what's supposed to happen. The headlines should be about the other states that chose not to act.
posted by miyabo at 7:09 PM on April 24, 2012 [7 favorites]
The hospital broke the law. It's getting sued by the state. That's what's supposed to happen. The headlines should be about the other states that chose not to act.
posted by miyabo at 7:09 PM on April 24, 2012 [7 favorites]
"Six Sigma Process Control and Metrics Adapted for Yield"
Achieve the Four Modernisations!
posted by Pinback at 7:18 PM on April 24, 2012 [6 favorites]
Achieve the Four Modernisations!
posted by Pinback at 7:18 PM on April 24, 2012 [6 favorites]
I am diabetic. I wear an insulin pump. I need supplies to run the pump and I buy those supplies from a company that is OWNED by my insurance company - so they are definitely in network. I have been severely underemployed for 3 years now; for all intents and purposes I'm unemployed, so every dollar counts. I haven't been able to afford test strips for a while so I usually just buy everything but those.
About a year ago, the supplier said "just get a scrip from your doctor for the strips and your insurance will cover it or, better yet, we'll call him and get the scrip". I agreed with the explicit understanding that if there were going to be any charges beyond my co-pay, I couldn't afford it, and please don't send me anything I would have to pay extra for. They sent everything, and all was well in the world. 2 months later, I get a bill with 4 line items on it: all the exact same description (very generic) with 3 lines having $0.00 balances and 1 line having a balance due of $600.00. I called and said I wouldn't even consider paying without an EOB explaining what I was paying for.
Needless to say, I never received an EOB, but I have received dunning letters , a ding on my credit, and LITERALLY 2, sometimes 3 calls A DAY on my cell phone from the supplier. All the calls are recordings and they call 6 days a week. FOR OVER A YEAR. They fill up my voicemail every 3 days. This is from a "reputable" company, even though what they are doing is FUCKING ILLEGAL. They can trash my credit and my reputation; they will never get a fucking dime from me.
posted by Benny Andajetz at 7:18 PM on April 24, 2012 [13 favorites]
About a year ago, the supplier said "just get a scrip from your doctor for the strips and your insurance will cover it or, better yet, we'll call him and get the scrip". I agreed with the explicit understanding that if there were going to be any charges beyond my co-pay, I couldn't afford it, and please don't send me anything I would have to pay extra for. They sent everything, and all was well in the world. 2 months later, I get a bill with 4 line items on it: all the exact same description (very generic) with 3 lines having $0.00 balances and 1 line having a balance due of $600.00. I called and said I wouldn't even consider paying without an EOB explaining what I was paying for.
Needless to say, I never received an EOB, but I have received dunning letters , a ding on my credit, and LITERALLY 2, sometimes 3 calls A DAY on my cell phone from the supplier. All the calls are recordings and they call 6 days a week. FOR OVER A YEAR. They fill up my voicemail every 3 days. This is from a "reputable" company, even though what they are doing is FUCKING ILLEGAL. They can trash my credit and my reputation; they will never get a fucking dime from me.
posted by Benny Andajetz at 7:18 PM on April 24, 2012 [13 favorites]
I'm not sure if it's a testimony to the cool tempers and iron wills of Americans, or to our collective cowardice that our country has reached this point without more widespread violence. Both, maybe. But given the number of free-floating guns we have, I'm actually a touch surprised that people aren't starting to get shot.
posted by tyllwin at 7:24 PM on April 24, 2012 [4 favorites]
posted by tyllwin at 7:24 PM on April 24, 2012 [4 favorites]
tyllwin - sadly the powers that be seem really good at orchestrating misdirection, so people are getting shot - it's just the wrong people.
posted by nadawi at 7:26 PM on April 24, 2012 [4 favorites]
posted by nadawi at 7:26 PM on April 24, 2012 [4 favorites]
i understand that they're in a tough spot but tactics like this are not serving their community.
posted by nadawi at 7:29 PM on April 24, 2012 [1 favorite]
posted by nadawi at 7:29 PM on April 24, 2012 [1 favorite]
Late Tuesday afternoon, Accretive announced it had won a contract to provide "revenue cycle operations" for Catholic Health East.
Would never happen if the nuns were in charge.
posted by TheShadowKnows at 7:34 PM on April 24, 2012 [7 favorites]
Would never happen if the nuns were in charge.
posted by TheShadowKnows at 7:34 PM on April 24, 2012 [7 favorites]
Tomorrow morning, somewhere, probably many somewheres, someone, probably many someones, is going to get out of bed, take a shower, grab a cup of coffee, and head to work. Where they'll spend their day cadging money out of poor sick people. Bleeding people. People in shock. People in pain. These someones will do their best to get as much money out of the poor sick suffering people as possible. They have quotas to meet. It's a tight job market. And after a rough day of bullying the poor, they'll head back home. Maybe they'll think about what a good job they did. How they helped a struggling hospital keep its doors open. How they made hard-nosed realistic decisions about bottom lines, when everyone was all touchy-feely because these deadbeats were claiming to be sick. Gotta be tough. Gotta be strong. Gotta plan ahead and make good decisions and accept the consequences. Yeah, the consequences. That's it. These deadbeats just want someone to clean up their messes. Shouldn't be out using that chainsaw if you don't have the sense to wear eye protection, Mr. Eye Splinter. Should've thought twice to brace that ladder, Mrs. Neck Brace. Maybe use a potholder next time, Ms. Third Degree Burn. Hey, Sweet Tooth, you should've saved up from those three part-time jobs and paid for a doctor's appointment and you'd still have that foot. Some people. Just can't plan ahead. And expect US to pick up their slack. Like medical care is a basic human right or something. Stupid shiftless lazy thoughtless people, a whole sea of them, trying to swamp our hospital with their despair and their needs and their empty wallets and their tears.
Someone's gotta do the dirty work. Hold 'em accountable. Make 'em pay. Someone's gotta harden their heart into a fist and see past the pain and the need and into the pocketbook.
Or the whole thing collapses. The whole system. Crash.
They just play stick while the nurses hand out carrots. They're realists. There's no room for compassion or idealism in their world. There's just tomorrow's quota. Tomorrow's tide of blood and phlegm and bile and tears to wade through until they find the wallets.
They sleep well at night. They're part of the solution.
This is what we've become.
posted by BitterOldPunk at 7:36 PM on April 24, 2012 [36 favorites]
Someone's gotta do the dirty work. Hold 'em accountable. Make 'em pay. Someone's gotta harden their heart into a fist and see past the pain and the need and into the pocketbook.
Or the whole thing collapses. The whole system. Crash.
They just play stick while the nurses hand out carrots. They're realists. There's no room for compassion or idealism in their world. There's just tomorrow's quota. Tomorrow's tide of blood and phlegm and bile and tears to wade through until they find the wallets.
They sleep well at night. They're part of the solution.
This is what we've become.
posted by BitterOldPunk at 7:36 PM on April 24, 2012 [36 favorites]
In today's economy, financial meltdown, cash-strapped consumers, lucky to have a job, ordinary working Americans, food on the table, job creators, jargon jargon.
posted by Nomyte at 8:31 PM on April 24, 2012
posted by Nomyte at 8:31 PM on April 24, 2012
If I ever end up with one of these people at my bedside, the resulting scene is going to be quite a spectacle. They won't get in a word edgewise. They want me to stop, they can leave. No one should put up with this shit.
posted by azpenguin at 8:46 PM on April 24, 2012
posted by azpenguin at 8:46 PM on April 24, 2012
"Job creator" raises my blood pressure to the point where I look like a victim of strangulation. I'm sure the next brilliant piece of doublespeak will push me over the edge. Good thing I don't have health insurance.
posted by feloniousmonk at 9:24 PM on April 24, 2012
posted by feloniousmonk at 9:24 PM on April 24, 2012
We're a nation of assholes. I say this because the majority of us keep voting in douchewallops who think deadbeats and poor people--many of whom vote for said douchewallops lest they be thought unmanly or ungodly--should die rather than get care.
posted by maxwelton at 10:31 PM on April 24, 2012 [3 favorites]
posted by maxwelton at 10:31 PM on April 24, 2012 [3 favorites]
I'm not sure if it's a testimony to the cool tempers and iron wills of Americans, or to our collective cowardice that our country has reached this point without more widespread violence. Both, maybe. But given the number of free-floating guns we have, I'm actually a touch surprised that people aren't starting to get shot.
With that consideration, it's either brave or foolhardy of the Accretive CEO to put her name and picture on the frontpage of their website.
posted by MartinWisse at 10:58 PM on April 24, 2012 [1 favorite]
With that consideration, it's either brave or foolhardy of the Accretive CEO to put her name and picture on the frontpage of their website.
posted by MartinWisse at 10:58 PM on April 24, 2012 [1 favorite]
Last year I took my wife to the ER when she had a horrible fever. After one hour and a few Aspirin we went home. We later received a bill for $4,500. We are lucky. That was after our modest insurance had covered a much larger part of the bill; it was over $10,000 for that one hour. How?!
Reading through the above comments I get the feeling that several of you feel as if you are 'sticking it' to the Man when you avoid paying medical bills. Like you, I am not part of America's 1%. But, like you and the other 300 million Americans, I am part of the world's 1%. So I do my best to pay for the services I request and require from my fellow human beings and prioritize and try and save so I can do this. I don't suffer famine or need clean water. I definitely don't mind paying a little more to help people who really can't afford to save for a rainy day after food and shelter are covered (that was me too for a good part of my protracted American youth so I get it).
What does bother me is this sense of self-entitlement I hear echoing in many of the above comments. I can't help thinking that you probably own a nice computer, an Xbox, a TV, perhaps a car and perhaps even went on a cool vacation recently. I don't know what portion of that $10k per hour in the ER went to feeding an over-fat medical-insurance-complex or how much went to financing your Right to Free Medical Care... But I do know if you sound off like it's your right that other people pay for your neglect to prepare when you can for life's inevitable emergencies... you are farting on the interweb in my and a lot of other people's general direction. I suspect you are at least part of the problem and not doing much for the solution.
Anyways, if you opted to let me pay for your Xbox and vacation in that one hour visit, please don't flaunt your pride that you screwed me out of my own vacation or Xbox. I don't mind you treating me and the medical establishment as your slave if you put down the video game and use your FREE time constructively. Perhaps you can work to abolish nation states so we can harvest a massive peace dividend that frees us slaves so we too can afford Xboxes, vacations and medical care? At the very least, please be careful and don't assume a morally self righteous tone of outrage as you brag about how you are screwing the Man the next time you don't pay your medical bills.
I would save your 'outrage' for when hospitals hire hit men to take back their services rendered from those who refuse to pay for them.
posted by astrobiophysican at 11:07 PM on April 24, 2012
Reading through the above comments I get the feeling that several of you feel as if you are 'sticking it' to the Man when you avoid paying medical bills. Like you, I am not part of America's 1%. But, like you and the other 300 million Americans, I am part of the world's 1%. So I do my best to pay for the services I request and require from my fellow human beings and prioritize and try and save so I can do this. I don't suffer famine or need clean water. I definitely don't mind paying a little more to help people who really can't afford to save for a rainy day after food and shelter are covered (that was me too for a good part of my protracted American youth so I get it).
What does bother me is this sense of self-entitlement I hear echoing in many of the above comments. I can't help thinking that you probably own a nice computer, an Xbox, a TV, perhaps a car and perhaps even went on a cool vacation recently. I don't know what portion of that $10k per hour in the ER went to feeding an over-fat medical-insurance-complex or how much went to financing your Right to Free Medical Care... But I do know if you sound off like it's your right that other people pay for your neglect to prepare when you can for life's inevitable emergencies... you are farting on the interweb in my and a lot of other people's general direction. I suspect you are at least part of the problem and not doing much for the solution.
Anyways, if you opted to let me pay for your Xbox and vacation in that one hour visit, please don't flaunt your pride that you screwed me out of my own vacation or Xbox. I don't mind you treating me and the medical establishment as your slave if you put down the video game and use your FREE time constructively. Perhaps you can work to abolish nation states so we can harvest a massive peace dividend that frees us slaves so we too can afford Xboxes, vacations and medical care? At the very least, please be careful and don't assume a morally self righteous tone of outrage as you brag about how you are screwing the Man the next time you don't pay your medical bills.
I would save your 'outrage' for when hospitals hire hit men to take back their services rendered from those who refuse to pay for them.
posted by astrobiophysican at 11:07 PM on April 24, 2012
Don't hate the player, hate the game.
posted by feloniousmonk at 11:12 PM on April 24, 2012 [2 favorites]
posted by feloniousmonk at 11:12 PM on April 24, 2012 [2 favorites]
I get the feeling that several of you feel as if you are 'sticking it' to the Man when you avoid paying medical bills.
i am horrified by this for populations that i was once a part of. i remember shaking under covers, watching my parents in hushed tones discuss if they could afford to take me to the doctor for what turned out to be life saving care. i'm damn lucky these days. i pay my medical bills when they come in. i have insurance. i get preventative care. this doesn't describe a large portion of the population, and that's the portion of the population that will be the most hurt by thugs like this.
i don't want free medical care. i want to help pay for everyone's medical care. i think it's a duty of mine as a citizen just barely scraping into the middle class. i haven't taken any lavish vacations, but i do own an xbox. i also am childless and will remain so, but i am happy to pay for public education. creating a system that helps the lowest rung is the sort of civilization i want to be a part of and i don't think that should be a radical idea.
posted by nadawi at 11:32 PM on April 24, 2012 [12 favorites]
i am horrified by this for populations that i was once a part of. i remember shaking under covers, watching my parents in hushed tones discuss if they could afford to take me to the doctor for what turned out to be life saving care. i'm damn lucky these days. i pay my medical bills when they come in. i have insurance. i get preventative care. this doesn't describe a large portion of the population, and that's the portion of the population that will be the most hurt by thugs like this.
i don't want free medical care. i want to help pay for everyone's medical care. i think it's a duty of mine as a citizen just barely scraping into the middle class. i haven't taken any lavish vacations, but i do own an xbox. i also am childless and will remain so, but i am happy to pay for public education. creating a system that helps the lowest rung is the sort of civilization i want to be a part of and i don't think that should be a radical idea.
posted by nadawi at 11:32 PM on April 24, 2012 [12 favorites]
These will be looked upon as the dark ages of health care. Our grandchildren will look upon us with pity. "They actually took your house away if you got a major illness???"
For the last fucking time -
Affordable heath care is a basic human right.
posted by Bighappyfunhouse at 11:42 PM on April 24, 2012 [8 favorites]
For the last fucking time -
Affordable heath care is a basic human right.
posted by Bighappyfunhouse at 11:42 PM on April 24, 2012 [8 favorites]
The whole concept of American healthcare as it currently stands continues to horrify me.
Imagine how it feels to those of us who live here. I live with a constant dread of the insane attitudes held by my fellow citizens, which promote these kinds of practices. Calvin Coolidge appears to have been correct after all.
The hospital broke the law. It's getting sued by the state. That's what's supposed to happen.
No, what's supposed to happen is that the hospitals obey the law, and do not hire others to break it for them.
I would save your 'outrage' for when hospitals hire hit men to take back their services rendered from those who refuse to pay for them.
If you are not attempting to troll us, I suggest that you've completely misdiagnosed the problem, and prescribe daily applications of mirror.
posted by Kirth Gerson at 1:00 AM on April 25, 2012 [2 favorites]
Imagine how it feels to those of us who live here. I live with a constant dread of the insane attitudes held by my fellow citizens, which promote these kinds of practices. Calvin Coolidge appears to have been correct after all.
The hospital broke the law. It's getting sued by the state. That's what's supposed to happen.
No, what's supposed to happen is that the hospitals obey the law, and do not hire others to break it for them.
I would save your 'outrage' for when hospitals hire hit men to take back their services rendered from those who refuse to pay for them.
If you are not attempting to troll us, I suggest that you've completely misdiagnosed the problem, and prescribe daily applications of mirror.
posted by Kirth Gerson at 1:00 AM on April 25, 2012 [2 favorites]
Did you know that a lot of poor people have cell phones?
Cell phones! Do you know how many appendectomies that could pay for?!
posted by dirigibleman at 1:36 AM on April 25, 2012 [9 favorites]
Cell phones! Do you know how many appendectomies that could pay for?!
posted by dirigibleman at 1:36 AM on April 25, 2012 [9 favorites]
This is what our government wants for the NHS.
Jesus h. christ.
posted by marienbad at 2:28 AM on April 25, 2012 [1 favorite]
Jesus h. christ.
posted by marienbad at 2:28 AM on April 25, 2012 [1 favorite]
At the very least, please be careful and don't assume a morally self righteous tone of outrage as you brag about how you are screwing the Man the next time you don't pay your medical bills.
Just adopt that tone when you're making outrageous assumptions about poor people then?
From where I'm sitting, the system in the US seems so appalling as to border on the criminal. You're damn right I expect someone to pay for my care when I can't afford it, and I sure as hell shouldn't have to sell all my possessions and live a monastic life (or on the street) to do so. Here's how, take the money from income tax contributions or a national insurance payment system organised around ability to pay.
It's a fucking systemic problem, stop blaming the damn individuals.
I can't get over what a tremendous load of utter bullshit you managed to spew here, and it pisses me off that I felt I had to respond. Fuck.
posted by knapah at 2:39 AM on April 25, 2012 [14 favorites]
Just adopt that tone when you're making outrageous assumptions about poor people then?
From where I'm sitting, the system in the US seems so appalling as to border on the criminal. You're damn right I expect someone to pay for my care when I can't afford it, and I sure as hell shouldn't have to sell all my possessions and live a monastic life (or on the street) to do so. Here's how, take the money from income tax contributions or a national insurance payment system organised around ability to pay.
It's a fucking systemic problem, stop blaming the damn individuals.
I can't get over what a tremendous load of utter bullshit you managed to spew here, and it pisses me off that I felt I had to respond. Fuck.
posted by knapah at 2:39 AM on April 25, 2012 [14 favorites]
This is what our government wants for the NHS.
If they did this in the NHS there would be medical strikes the like of which have not been seen in decades. If they dressed debt collection people up in medical uniforms? Eh. I would not be surprised if UNISON paid people to stand next to the entrance pointing out they aren't medical and that people shouldn't talk to them on principle. I'd give out leaflets to them for free.
posted by jaduncan at 2:44 AM on April 25, 2012 [3 favorites]
If they did this in the NHS there would be medical strikes the like of which have not been seen in decades. If they dressed debt collection people up in medical uniforms? Eh. I would not be surprised if UNISON paid people to stand next to the entrance pointing out they aren't medical and that people shouldn't talk to them on principle. I'd give out leaflets to them for free.
posted by jaduncan at 2:44 AM on April 25, 2012 [3 favorites]
After one hour and a few Aspirin we went home...it was over $10,000 for that one hour.
Cell phones! Do you know how many appendectomies that could pay for?!
That's ~20 phones just for one hour of emerg time, let alone minor surgery.
posted by justsomebodythatyouusedtoknow at 3:07 AM on April 25, 2012
Cell phones! Do you know how many appendectomies that could pay for?!
That's ~20 phones just for one hour of emerg time, let alone minor surgery.
posted by justsomebodythatyouusedtoknow at 3:07 AM on April 25, 2012
Last year I took my wife to the ER when she had a horrible fever. After one hour and a few Aspirin we went home. We later received a bill for $4,500. We are lucky. That was after our modest insurance had covered a much larger part of the bill; it was over $10,000 for that one hour. How?!
Reading through the above comments I get the feeling that several of you feel as if you are 'sticking it' to the Man when you avoid paying medical bills. Like you, I am not part of America's 1%. But, like you and the other 300 million Americans, I am part of the world's 1%. So I do my best to pay for the services I request and require from my fellow human beings and prioritize and try and save so I can do this. I don't suffer famine or need clean water. I definitely don't mind paying a little more to help people who really can't afford to save for a rainy day after food and shelter are covered (that was me too for a good part of my protracted American youth so I get it).
It's exactly this. You go to ER and get stuck with a $4500 bill by the hospital and your insurance company and you blame the undeserving (not) poor. This and this is alone is why the US doesn't have a health care system which works for everyone.
The "welfare queen" is a powerful strawman. If you remember, this post was about a woman who didn't go to ER until the tumor in her breast strangled the remaining living tissue and her breast fell off. This is what emergency medicine in this country is about, not a bunch of "xbox queens" who are buying video games instead of saving up for their tithe to the health care industry.
posted by ennui.bz at 4:25 AM on April 25, 2012 [15 favorites]
Anyways, if you opted to let me pay for your Xbox and vacation in that one hour visit, please don't flaunt your pride that you screwed me out of my own vacation or Xbox.
How about a house? The most common source of personal bankruptcy are medical bills. So, they can have a house, or you can have a house, but not both of you, as the Hospital needs its money from one of you.
Or you can have some kind of system, where everyone is required to pay into it every year, such that the payments are automatic and you go to jail if you don't pay, and since everyone is part of the system, efficiencies of scale make it even cheaper, so you wind up paying less and getting more. Let's call this marvelous collection system, where even poor people with X-Boxes pay into it, "Taxes," and the payment system "Single Payer Health Care." Those who are most opposed to it are the ones making obscene profits from your $4500 aspirin... not the pill itself, but the system that demands the hospital charge it.
Poor people aren't stealing your vacation. Rich people are.
posted by Slap*Happy at 4:34 AM on April 25, 2012 [28 favorites]
How about a house? The most common source of personal bankruptcy are medical bills. So, they can have a house, or you can have a house, but not both of you, as the Hospital needs its money from one of you.
Or you can have some kind of system, where everyone is required to pay into it every year, such that the payments are automatic and you go to jail if you don't pay, and since everyone is part of the system, efficiencies of scale make it even cheaper, so you wind up paying less and getting more. Let's call this marvelous collection system, where even poor people with X-Boxes pay into it, "Taxes," and the payment system "Single Payer Health Care." Those who are most opposed to it are the ones making obscene profits from your $4500 aspirin... not the pill itself, but the system that demands the hospital charge it.
Poor people aren't stealing your vacation. Rich people are.
posted by Slap*Happy at 4:34 AM on April 25, 2012 [28 favorites]
The hospital broke the law. It's getting sued by the state. That's what's supposed to happen. The headlines should be about the other states that chose not to act.
That's a good point, and the states that are doing nothing do indeed deserve worse. But it's still inconceivable to me, because no hospital where I live would even try that shit. If they did, the press would destroy them and the AG would then salt the earth.
posted by Mayor Curley at 4:34 AM on April 25, 2012
That's a good point, and the states that are doing nothing do indeed deserve worse. But it's still inconceivable to me, because no hospital where I live would even try that shit. If they did, the press would destroy them and the AG would then salt the earth.
posted by Mayor Curley at 4:34 AM on April 25, 2012
posted by Thorzdad at 5:01 AM on April 25, 2012 [1 favorite]
Metafilter: Tomorrow's tide of blood and phlegm and bile and tears to wade through until they find the wallets
posted by Renoroc at 5:28 AM on April 25, 2012
posted by Renoroc at 5:28 AM on April 25, 2012
The Corporatists and the GOP have made it clear that, in their world, being poor should literally, physically hurt.
posted by Legomancer at 5:48 AM on April 25, 2012 [1 favorite]
posted by Legomancer at 5:48 AM on April 25, 2012 [1 favorite]
Those who are most opposed to it are the ones making obscene profits from your $4500 aspirin
I'm not sure, Slap*Happy. And at least those people, I can understand, even if I loathe them. But the most virulent about opposing single-payer care seem to me to be those who are just obsessed with the concern that someone else may get some unearned benefit at their expense. The attitude that it's better for ten babies to die than for one slacker (is that still a word?) to get one single dime of my hard-earned money. And it's not just in medical care, it's in everything -- better the bridge fall down than for me to pay a dollar more on my tax bill. It's not the rich people turning a blind eye to suffering so they can get piles of wealth. It's bitter little people fighting over scraps.
posted by tyllwin at 6:08 AM on April 25, 2012 [4 favorites]
I'm not sure, Slap*Happy. And at least those people, I can understand, even if I loathe them. But the most virulent about opposing single-payer care seem to me to be those who are just obsessed with the concern that someone else may get some unearned benefit at their expense. The attitude that it's better for ten babies to die than for one slacker (is that still a word?) to get one single dime of my hard-earned money. And it's not just in medical care, it's in everything -- better the bridge fall down than for me to pay a dollar more on my tax bill. It's not the rich people turning a blind eye to suffering so they can get piles of wealth. It's bitter little people fighting over scraps.
posted by tyllwin at 6:08 AM on April 25, 2012 [4 favorites]
But the most virulent about opposing single-payer care seem to me to be those who are just obsessed with the concern that someone else may get some unearned benefit at their expense.
This is due to an amazing webwork of lies, half-truths and sloganeering, injected into mainstream media by paid spokespeople. It requires money, and lots of it, from very wealthy interests - and not because they believe in some higher notion of capitalism, but because it's an investment. Their fortunes depend on people losing their homes and retirement accounts because of illness or injury.
posted by Slap*Happy at 7:13 AM on April 25, 2012
This is due to an amazing webwork of lies, half-truths and sloganeering, injected into mainstream media by paid spokespeople. It requires money, and lots of it, from very wealthy interests - and not because they believe in some higher notion of capitalism, but because it's an investment. Their fortunes depend on people losing their homes and retirement accounts because of illness or injury.
posted by Slap*Happy at 7:13 AM on April 25, 2012
I know! Let's make up facts about how Canadian and European health care sucks! And then go back to being smug! About! Being! The Best! Country in the World!
posted by clvrmnky at 8:29 AM on April 25, 2012 [1 favorite]
posted by clvrmnky at 8:29 AM on April 25, 2012 [1 favorite]
On the subject of people obsessed with the concern that someone else may get some unearned benefit at their expense, a recent episode of This American Life looked at the privatization of city services in Colorado Springs.
A councilwoman got a note from a guy saying he had paid the city $300 to get his street lights turned back on. She said for $200 (what citizens would have paid if a tax increase had been approved), he could have had public swimming pools and parks open too.
The man just shrugged and left.
This is the attitude we're dealing with.
posted by reenum at 8:54 AM on April 25, 2012 [4 favorites]
A councilwoman got a note from a guy saying he had paid the city $300 to get his street lights turned back on. She said for $200 (what citizens would have paid if a tax increase had been approved), he could have had public swimming pools and parks open too.
The man just shrugged and left.
This is the attitude we're dealing with.
posted by reenum at 8:54 AM on April 25, 2012 [4 favorites]
no hospital where I live would even try that shit
If they did this in the NHS there would be medical strikes the like of which have not been seen in decades
We all have experiences with our local health care systems, and they're probably mostly positive. Then when we hear a really awful anecdote from somewhere else the impulse is to say that "This could only be a problem for those people." That's why basing opinions on anecdotes is a bad idea -- you have to look at overall results and outcomes. And you'll see that while the US health care system on average pretty much sucks, things work reasonably well in a handful of states including MA and MN. The crisis is in the south and southwest states, which have collectively decided that poor people's lives aren't worth anything.
posted by miyabo at 9:03 AM on April 25, 2012
If they did this in the NHS there would be medical strikes the like of which have not been seen in decades
We all have experiences with our local health care systems, and they're probably mostly positive. Then when we hear a really awful anecdote from somewhere else the impulse is to say that "This could only be a problem for those people." That's why basing opinions on anecdotes is a bad idea -- you have to look at overall results and outcomes. And you'll see that while the US health care system on average pretty much sucks, things work reasonably well in a handful of states including MA and MN. The crisis is in the south and southwest states, which have collectively decided that poor people's lives aren't worth anything.
posted by miyabo at 9:03 AM on April 25, 2012
What does bother me is this sense of self-entitlement I hear echoing in many of the above comments.
posted by astrobiophysican at 1:07 AM on April 25
I didn't mention it in my little anecdote, but the hospital got their money - the guy who rear-ended me had insurance, and even if he didn't, my car insurance would have covered me. However. You bet I'm self-entitled. I'm Canadian, and accustomed to getting basic medical care in exchange for paying my taxes, and the American system horrifies me every bit as much as if I'd moved to a country where police services were privately contracted. If you lived in such a place, and somebody called you self-entitled for expecting the police to find the guy who just mugged you instead of spending their time investigating whether your police insurance was paid up, how would you respond to them?
posted by joannemerriam at 9:16 AM on April 25, 2012 [2 favorites]
posted by astrobiophysican at 1:07 AM on April 25
I didn't mention it in my little anecdote, but the hospital got their money - the guy who rear-ended me had insurance, and even if he didn't, my car insurance would have covered me. However. You bet I'm self-entitled. I'm Canadian, and accustomed to getting basic medical care in exchange for paying my taxes, and the American system horrifies me every bit as much as if I'd moved to a country where police services were privately contracted. If you lived in such a place, and somebody called you self-entitled for expecting the police to find the guy who just mugged you instead of spending their time investigating whether your police insurance was paid up, how would you respond to them?
posted by joannemerriam at 9:16 AM on April 25, 2012 [2 favorites]
I get the feeling that several of you feel as if you are 'sticking it' to the Man when you avoid paying medical bills.
I don't see any such comment in this thread save one, by someone who had the temerity to demand documentation justifying a $600 charge and refused to pay until said documentation was forthcoming. Which it wasn't, though the charge remained. (This person also made inability to pay clear upfront and went so far as to refuse treatment that would later be billed.)
That person was, in every respect, absolutely right to do so. In my job I get reimbursed for expenses, and the company I work for expects a receipt for every cent, or it isn't paid. Refusing to pay an unjustified several-hundred-dollar charge isn't "sticking it to the man;" it's keeping the man from sticking you.
That aside, given the prevalence of inability to pay ernormous medical bills, I'm really not seeing anyone who could pay but refuses just to "stick it to the man." Can you give examples?
posted by Gelatin at 9:36 AM on April 25, 2012 [5 favorites]
I don't see any such comment in this thread save one, by someone who had the temerity to demand documentation justifying a $600 charge and refused to pay until said documentation was forthcoming. Which it wasn't, though the charge remained. (This person also made inability to pay clear upfront and went so far as to refuse treatment that would later be billed.)
That person was, in every respect, absolutely right to do so. In my job I get reimbursed for expenses, and the company I work for expects a receipt for every cent, or it isn't paid. Refusing to pay an unjustified several-hundred-dollar charge isn't "sticking it to the man;" it's keeping the man from sticking you.
That aside, given the prevalence of inability to pay ernormous medical bills, I'm really not seeing anyone who could pay but refuses just to "stick it to the man." Can you give examples?
posted by Gelatin at 9:36 AM on April 25, 2012 [5 favorites]
dirigibleman writes "Cell phones! Do you know how many appendectomies that could pay for?!"
justsomebodythatyouusedtoknow writes "That's ~20 phones just for one hour of emerg time, let alone minor surgery."
A prepaid disposable, even up here in the celluar waste land of Canada is $40 with $20 of air time. So you'd have to for go a couple hundred cell phones to pay for an hour of ER time. You could probably buy a new phone every month for life and still not spend a US appendectomy with the funds.
posted by Mitheral at 7:32 PM on April 25, 2012
justsomebodythatyouusedtoknow writes "That's ~20 phones just for one hour of emerg time, let alone minor surgery."
A prepaid disposable, even up here in the celluar waste land of Canada is $40 with $20 of air time. So you'd have to for go a couple hundred cell phones to pay for an hour of ER time. You could probably buy a new phone every month for life and still not spend a US appendectomy with the funds.
posted by Mitheral at 7:32 PM on April 25, 2012
It's not the rich people turning a blind eye to suffering so they can get piles of wealth. It's bitter little people fighting over scraps.
It's not just the rich people doing that, no. They are definitely doing it, though. The "bitter little people," as you call them, are desperately trying to stay afloat, and are constantly told (by those rich people) that it's cheaters - people even poorer than they are - who are causing it. Since they spend so much of their energy struggling to make ends meet, they don't have the time or resources to investigate and discover the truth. Slap*Happy's statement is accurate.
posted by Kirth Gerson at 4:54 AM on April 26, 2012
It's not just the rich people doing that, no. They are definitely doing it, though. The "bitter little people," as you call them, are desperately trying to stay afloat, and are constantly told (by those rich people) that it's cheaters - people even poorer than they are - who are causing it. Since they spend so much of their energy struggling to make ends meet, they don't have the time or resources to investigate and discover the truth. Slap*Happy's statement is accurate.
posted by Kirth Gerson at 4:54 AM on April 26, 2012
COLUMBUS, OHIO -- Even before the hospital bills started coming, Lori Duff and her family were living paycheck to paycheck. So when the debt collector called and demanded $1,800 for the prenatal visits she’d had while pregnant with her third son, she panicked.
The collector said the local Catholic hospital Duff had gone to could garnish 25 percent of each of her paychecks to pay off the bill. She offered to make a $20 payment—all she could afford at the time—but the collector told her the minimum was $400 down. "I was like, 'I don’t have that. You can have everything in my account right now. It's $1.25,'" Duff recalls.
Duff was likely eligible for free care under the Mount Carmel Health System’s financial assistance policy, which offers medical care at no charge for patients earning less than 200 percent of the federal poverty level. But the debt collector kept calling and soon informed her that the hospital was planning to sue her for the money.
Duff is one of nearly 1,600 people Mount Carmel sued in county court between 2009 and 2011. Most of them were patients like her who did not pay their medical bills.
More, if you can stand it.
posted by rtha at 1:38 PM on April 27, 2012
The collector said the local Catholic hospital Duff had gone to could garnish 25 percent of each of her paychecks to pay off the bill. She offered to make a $20 payment—all she could afford at the time—but the collector told her the minimum was $400 down. "I was like, 'I don’t have that. You can have everything in my account right now. It's $1.25,'" Duff recalls.
Duff was likely eligible for free care under the Mount Carmel Health System’s financial assistance policy, which offers medical care at no charge for patients earning less than 200 percent of the federal poverty level. But the debt collector kept calling and soon informed her that the hospital was planning to sue her for the money.
Duff is one of nearly 1,600 people Mount Carmel sued in county court between 2009 and 2011. Most of them were patients like her who did not pay their medical bills.
More, if you can stand it.
posted by rtha at 1:38 PM on April 27, 2012
« Older Father tapes teachers berating autistic son | We are the tiny house people Newer »
This thread has been archived and is closed to new comments
posted by nadawi at 5:47 PM on April 24, 2012 [3 favorites]