Good grief. Alito and Thomas are already on the record:
The Act before us here exceeds federal power both in mandating the purchase of health insurance and in denying nonconsenting States all Medicaid funding. These parts of the Act are central to its design and operation, and all the Actâs other provisions would not have been enacted without them. In our view it must follow that the entire statute is inoperative.
Now, given that Alito and Thomas have already decided that 1) the individual mandate is unconstitutional, and 2) that part of the law canât be separated from the rest, why on earth would anyone suppose that they are such serious business jurists that when, presented with a lower court ruling which says exactly the same thing, they would change their minds?
More asshole providers - Zuckerberg General, so called because facebook dude gave them $75 million recently is out of network with every single private insurer.
This means they bill massively inflated out-of-network fees to pad up income. In the case of the biker above, the insurer already paid twice what medicare would have paid for the service. The hospitalâs billed price (the infamous supercharge) was 12 times the medicare payable amount.
Out-of-network balance billing for emergencies is one of the most bullshitty things out there.
Thatâs not the way it works. Our system is really insane: when you get admitted, you sign forms agreeing to pay the charges, but the hospital doesnât have to specify the charges. You are giving them a blank check. And if you are unconscious/unable to sign, in most cases that still doesnât matter.
Thatâs not entirely true. Most hospitals will continue to attempt to bill you for the full amount for months, and if you ignore that they may then try enrolling you in their âpayment planâ where they send you bills with much lower âmonthly paymentâ amounts. If you ignore everything, they WILL turn the bill over to a collections agency eventually. The collections agencies usually try to settle with you for a portion of the bill, offering anything from a 10% discount to as much as 50% depending on the total amount owed and the length of time itâs been due and the amount already collected.
If you ignore every single attempt to contact you and collect anything, they can report it as an unpaid debt to the credit agencies after 180 days (6 months). It will affect your credit rating, though most credit agencies do not factor medical debt as heavily as they do standard debt when compiling your credit report.
TL;DR - Donât completely ignore medical debt. Try to negotiate at every step. Even if it ends up going to collections, you can often negotiate a much lower amount with the collections agency, and it wonât end up on your credit report.
Our current healthcare system sucks for everyone who is not a member of Congress. It needs to change.
Presented just as a single data point and definitively not financial advice, when I worked in a credit department of a finance company we didnât care too much about medical debt. It was basically used as a tie-breaker: when we were trying to classify a file as a B or a B-, if you had outstanding medical debt you might get pushed down a partial grade. Otherwise it didnât factor in much.
SFGH is a state-run hospital. Its mission is to serve as the safety-net hospital for the city of San Francisco. 8% of the patients are homeless, and a majority are on Medicaid or uninsured. Its operating expenses are mostly funded either by the government or by soaking the few patients who can actually afford to pay. And guess what, the government has other priorities.
You want single-payer? SFGH is the closest youâll find in San Francisco outside the VA. But just like the VA, itâs explicitly not meant for everyone.
While this is true. Medical bills are probably the easiest bills to have taken care of.
Like, for instance, I had an issue with my leg last year, and they wanted to run some sort of circulation test on it, prior to referring me to the neurologist. Even though this hospital system is my âin networkâ provider, the test they ordered was not covered by my insurance for the diagnosis. My claim was denied by my insurer, and I basically told them, I am not paying for this, you ordered the test for me, and it wasnât covered. Figure it out. And after a very lengthy chain of phone calls, letters etc. They finally agreed to pay my insurer for the full amount of the test. It wasnât worth arguing over 500$ (of course not 20k like the story) It all worked out.
TLDR; Maybe you canât get out of 20k in medical charges, but you certainly can fight medical bills a lot, and most hospital systems will lower charges or work with you to get them paid. Certainly donât ignore them, just dispute them (publicly if you have to)