Alright, this is absolutely first world problems, but holy mother of healthcare, am I furious.
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@monstrodosrtiago Agreed. It was a tropey semantic shortcut for "Of all the things in the world that matter, this is not really one of them." But yes, it is absolutely a USA problem, and USA isn't even the first world any more, so notes taken, will be applied in future.
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Alright, this is absolutely first world problems, but holy mother of healthcare, am I furious.
So, I saw a doctor in the #Baylor system (who have purchased most medical practices in the area), a few weeks ago. I paid the doctor at the time of the visit. ($165 after insurance). I knew there was a facility fee, but refused to pay it, because it's egregious.
I got an email this morning from Baylor saying I owed another $300 for facility fees. (I was waiting for the bill, so I could talk to someone about it.)
So I called and said "Hey, this charge is unreasonable, and well outside usual and customary fees."
And their response, as Bob is my witless was, "Our fees are defensible." Which means they had lawyers sitting up figuring out to the last penny what they think they can get away with.
Those lawyers never met me.
@MissConstrue just wondering: aren't there no laws against usury in the USA?
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@MissConstrue just wondering: aren't there no laws against usury in the USA?
@GRA3432 There are, but they generally only apply to loans, and set statutory caps on interest rates.
The Application of Texas Usury Law: Insights from a Recent Supreme Court Ruling
Texas usury laws are designed to protect borrowers from excessive interest charges on loans, capping the maximum allowable rates to prevent predatory lending practices. Under the Texas Finance Code, "interest" is broadly defined as any compensation for the use, forbearance, or detention of money, and usurious interest exceeds the statutory limits—typically 10% per annum unless otherwise specified, with higher caps for commercial loans up to 28% in certain cases.
The Basile Law Firm (www.thebasilelawfirm.com)
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@GRA3432 There are, but they generally only apply to loans, and set statutory caps on interest rates.
The Application of Texas Usury Law: Insights from a Recent Supreme Court Ruling
Texas usury laws are designed to protect borrowers from excessive interest charges on loans, capping the maximum allowable rates to prevent predatory lending practices. Under the Texas Finance Code, "interest" is broadly defined as any compensation for the use, forbearance, or detention of money, and usurious interest exceeds the statutory limits—typically 10% per annum unless otherwise specified, with higher caps for commercial loans up to 28% in certain cases.
The Basile Law Firm (www.thebasilelawfirm.com)
@MissConstrue I see. But for me this looks like a form of usury - exploiting the sick.
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Alright, this is absolutely first world problems, but holy mother of healthcare, am I furious.
So, I saw a doctor in the #Baylor system (who have purchased most medical practices in the area), a few weeks ago. I paid the doctor at the time of the visit. ($165 after insurance). I knew there was a facility fee, but refused to pay it, because it's egregious.
I got an email this morning from Baylor saying I owed another $300 for facility fees. (I was waiting for the bill, so I could talk to someone about it.)
So I called and said "Hey, this charge is unreasonable, and well outside usual and customary fees."
And their response, as Bob is my witless was, "Our fees are defensible." Which means they had lawyers sitting up figuring out to the last penny what they think they can get away with.
Those lawyers never met me.
So, I'm going to the mat on this facilities fee thing with Baylor. $300 to see a doctor and $300 to see a building is obscene.
I've been doing research, which was not at all easy, because damn, they bury this stuff.
There was a Medicare change, and medical practices can now charge facility fees if they are part of a hospital.
How it was interpreted by money men was "buy every medical practice and put them under the hospital umbrella, and poof, double billing".
So, I tracked down the billing code and was able to drill down into the APC and CMS and find out what Medicare would pay U&C. (Usual and Customary)
I have to start with the national unadjusted APC payment: $134.00, Apply locality and wage index adjustments, which have to be looked up somewhere else, and the end result of 6 hours of research and math:
$133.47 Which is still absurd, but almost a third less absurd.
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@MissConstrue I see. But for me this looks like a form of usury - exploiting the sick.
@GRA3432 It's certainly immoral and unethical and should be outlawed.
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So, I'm going to the mat on this facilities fee thing with Baylor. $300 to see a doctor and $300 to see a building is obscene.
I've been doing research, which was not at all easy, because damn, they bury this stuff.
There was a Medicare change, and medical practices can now charge facility fees if they are part of a hospital.
How it was interpreted by money men was "buy every medical practice and put them under the hospital umbrella, and poof, double billing".
So, I tracked down the billing code and was able to drill down into the APC and CMS and find out what Medicare would pay U&C. (Usual and Customary)
I have to start with the national unadjusted APC payment: $134.00, Apply locality and wage index adjustments, which have to be looked up somewhere else, and the end result of 6 hours of research and math:
$133.47 Which is still absurd, but almost a third less absurd.
@MissConstrue Happened to us over a decade ago: child met with a pediatric psychiatry resident at OHSU, and we were billed separately for the resident's time and the tiny room (his regular office) they talked in. Infuriating.
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So, I'm going to the mat on this facilities fee thing with Baylor. $300 to see a doctor and $300 to see a building is obscene.
I've been doing research, which was not at all easy, because damn, they bury this stuff.
There was a Medicare change, and medical practices can now charge facility fees if they are part of a hospital.
How it was interpreted by money men was "buy every medical practice and put them under the hospital umbrella, and poof, double billing".
So, I tracked down the billing code and was able to drill down into the APC and CMS and find out what Medicare would pay U&C. (Usual and Customary)
I have to start with the national unadjusted APC payment: $134.00, Apply locality and wage index adjustments, which have to be looked up somewhere else, and the end result of 6 hours of research and math:
$133.47 Which is still absurd, but almost a third less absurd.
And I recognize that at some point fighting this is more expensive in time and effort than just paying it, but dammit, up with this I will not put.
I'm standing on principle here, and that principle is that medicine should not be an extractive force in society. People shouldn't be left sick or untreated because some board member needs a third yacht.
When I got my doctorate in bioethics, I naively believed that the field of medicine was filled with people who wanted to help people. And for a large percentage of actual caregivers that's true. But they have been vampire-squidded by the vulture capitalists, and I don't know how to rescue them. (For the record, I ended up in tech because at the time, it was more ethical than hospitals...oh the 80s...we were all so innocent.)
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@MissConstrue Happened to us over a decade ago: child met with a pediatric psychiatry resident at OHSU, and we were billed separately for the resident's time and the tiny room (his regular office) they talked in. Infuriating.
@msbellows Yeah, they've been able to do it for a long time if the "office" was in a hospital building. But now, it can be any practice "owned" by a hospital conglomerate. The doctor I saw was not in a hospital. There are no hospital facilities in that building. There are only medical practitioners, with easy access to a nearby er. There's no surgery, no intake, no billing office, just an office building filled with medical professionals in their own practices.
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And I recognize that at some point fighting this is more expensive in time and effort than just paying it, but dammit, up with this I will not put.
I'm standing on principle here, and that principle is that medicine should not be an extractive force in society. People shouldn't be left sick or untreated because some board member needs a third yacht.
When I got my doctorate in bioethics, I naively believed that the field of medicine was filled with people who wanted to help people. And for a large percentage of actual caregivers that's true. But they have been vampire-squidded by the vulture capitalists, and I don't know how to rescue them. (For the record, I ended up in tech because at the time, it was more ethical than hospitals...oh the 80s...we were all so innocent.)
fuck 'em up
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Alright, this is absolutely first world problems, but holy mother of healthcare, am I furious.
So, I saw a doctor in the #Baylor system (who have purchased most medical practices in the area), a few weeks ago. I paid the doctor at the time of the visit. ($165 after insurance). I knew there was a facility fee, but refused to pay it, because it's egregious.
I got an email this morning from Baylor saying I owed another $300 for facility fees. (I was waiting for the bill, so I could talk to someone about it.)
So I called and said "Hey, this charge is unreasonable, and well outside usual and customary fees."
And their response, as Bob is my witless was, "Our fees are defensible." Which means they had lawyers sitting up figuring out to the last penny what they think they can get away with.
Those lawyers never met me.
@MissConstrue So unless you’re seen in a tent at the farmers market (or similar) you now have to pay an extra ‘facilities fee’?
I see where this is going
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Alright, this is absolutely first world problems, but holy mother of healthcare, am I furious.
So, I saw a doctor in the #Baylor system (who have purchased most medical practices in the area), a few weeks ago. I paid the doctor at the time of the visit. ($165 after insurance). I knew there was a facility fee, but refused to pay it, because it's egregious.
I got an email this morning from Baylor saying I owed another $300 for facility fees. (I was waiting for the bill, so I could talk to someone about it.)
So I called and said "Hey, this charge is unreasonable, and well outside usual and customary fees."
And their response, as Bob is my witless was, "Our fees are defensible." Which means they had lawyers sitting up figuring out to the last penny what they think they can get away with.
Those lawyers never met me.
Only America, not first world.
My immediate family has had 5 heart attacks, liver cancer, open heart survey, multiple eye surgeries, broken spine, a dozen broken bones, a handful of diseases and not one hospital bill.
America throws half a million families into bankruptcy every year, from medical bills. Bankruptcy.
No one in Britain, France, Canada, Germany, Italy has had that fate.
Universal healthcare is a right.
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And I recognize that at some point fighting this is more expensive in time and effort than just paying it, but dammit, up with this I will not put.
I'm standing on principle here, and that principle is that medicine should not be an extractive force in society. People shouldn't be left sick or untreated because some board member needs a third yacht.
When I got my doctorate in bioethics, I naively believed that the field of medicine was filled with people who wanted to help people. And for a large percentage of actual caregivers that's true. But they have been vampire-squidded by the vulture capitalists, and I don't know how to rescue them. (For the record, I ended up in tech because at the time, it was more ethical than hospitals...oh the 80s...we were all so innocent.)
@MissConstrue
Kicking the medical Industrial complex in its privates is always the ethical thing to do. -
And I recognize that at some point fighting this is more expensive in time and effort than just paying it, but dammit, up with this I will not put.
I'm standing on principle here, and that principle is that medicine should not be an extractive force in society. People shouldn't be left sick or untreated because some board member needs a third yacht.
When I got my doctorate in bioethics, I naively believed that the field of medicine was filled with people who wanted to help people. And for a large percentage of actual caregivers that's true. But they have been vampire-squidded by the vulture capitalists, and I don't know how to rescue them. (For the record, I ended up in tech because at the time, it was more ethical than hospitals...oh the 80s...we were all so innocent.)
@MissConstrue Medicine is profit motivated now, even if there are still providers within an organization who actually want to help. My primary care physician is a good example. He pretty much ignores Medical Center restrictions to provide good medical care. But the guy I'm seeing this week for my trigger thumb follows medical center rules, which include a meet and greet appointment where I'm not allowed to get any actual treatment. That means a minimum of two visits for any problem.
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And I recognize that at some point fighting this is more expensive in time and effort than just paying it, but dammit, up with this I will not put.
I'm standing on principle here, and that principle is that medicine should not be an extractive force in society. People shouldn't be left sick or untreated because some board member needs a third yacht.
When I got my doctorate in bioethics, I naively believed that the field of medicine was filled with people who wanted to help people. And for a large percentage of actual caregivers that's true. But they have been vampire-squidded by the vulture capitalists, and I don't know how to rescue them. (For the record, I ended up in tech because at the time, it was more ethical than hospitals...oh the 80s...we were all so innocent.)
@MissConstrue Stay there, and do what you can. And here's a little pick you up. https://www.youtube.com/watch?v=QE-_3b7bqRM&list=RDQE-_3b7bqRM
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Alright, this is absolutely first world problems, but holy mother of healthcare, am I furious.
So, I saw a doctor in the #Baylor system (who have purchased most medical practices in the area), a few weeks ago. I paid the doctor at the time of the visit. ($165 after insurance). I knew there was a facility fee, but refused to pay it, because it's egregious.
I got an email this morning from Baylor saying I owed another $300 for facility fees. (I was waiting for the bill, so I could talk to someone about it.)
So I called and said "Hey, this charge is unreasonable, and well outside usual and customary fees."
And their response, as Bob is my witless was, "Our fees are defensible." Which means they had lawyers sitting up figuring out to the last penny what they think they can get away with.
Those lawyers never met me.
@MissConstrue
You are right to stand on principle, and if you want you can hire someone to negotiate your medical bills for you. The system is so effed up there's a cottage industry in medical billing advocates. Some charge by the hour, some a percentage of what they save you. -
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