US Hospitals “Bait and Switch” Charity Care Patients and turn them over to debt collectors, and that time I got a court to strike down part of the Indiana Medicaid law.

US Hospitals “Bait and Switch” Charity Care Patients and turn them over to debt collectors. -The New York Times

In training materials obtained by The Times, members of the hospital staff were instructed how to approach patients and pressure them to pay.

“Ask every patient, every time,” the materials said. Instead of using “weak” phrases — like “Would you mind paying?” — employees were told to ask how patients wanted to pay. Soliciting money “is part of your role. It’s not an option.”

If patients did not pay, Providence sent debt collectors to pursue them.

The hospital in the article is also a hedge fund with over $10 billion in investments, which brags about breaking state laws about debt collection, and that less than 1% of its bills end up as charity care.

In many ways though, this is similar to my experience with Parkview Hospital in Indiana in 2009. I had two seizures and was uninsured, and was in their ER for about 5-6 hours.

They handed me a bill for over $12,500 ($17,200 in inflation adjusted dollars) then told me I would qualify for “Charity Care” since I was uninsured.

They told me I would have my bill forgiven if I applied for Indiana Medicaid and got denied. They’d even send a lawyer to help me appeal.

So I did everything I was supposed to, and when we lost the case, they turned me over to a debt collector for $12,500 instead of forgiving it.

When I talked to the same woman in the billing department, she said she never recalled saying it would be forgiven if I applied for Medicaid and lost.

I never did pay the bill. I told the lady from the debt collection agency that if they sued me, I had no assets for them to take and would probably either file bankruptcy or stay judgment-proof (too poor to take anything from).

When I ultimately declared bankruptcy in 2020 over something else, I shoved Parkview Hospital in it and they very charitably have to never bring it up again or else.

Charity Care.

The lawyer they sent to the appeal hearing was basically useless. He didn’t even say anything and he just let them deny me without arguing about it.

When I filed for Medicaid again, I did it on my own, got denied again, filed an appeal and went to a judge, and got the law that they used to deny my appeal with struck down in court.

I got my Medicaid approval letter in the mail two weeks later. But by that time it had been more than 90 days since I was in the ER and they didn’t pay for it.

But I did manage to change a law because I was good and pissed off.

The Republicans in the Indiana legislature ended up having to pass a new Medicaid law that complied with the court’s decision to expand Medicaid (which I’m sure is the last thing they wanted to be in there doing), and which made thousands of people in Indiana newly eligible for Medicaid.

Correction: Blue Cross Blue Shield of Illinois didn’t rip us off at the dentist. They “forgot” to send payment.

Correction: Blue Cross Blue Shield of Illinois didn’t rip us off at the dentist. They “forgot” to send payment.

A while back, I got a bill in the mail for ~$1,600 for some dental work we had already paid for.

At the time, Blue Cross Blue Shield of Illinois was making it very difficult to read the Explanation of Benefits and I posted in confusion about what was going on.

It seems that they did “approve” payment of my spouse’s dental bills, but then never actually deposited the approved payment amount into the dentist’s bank account, which triggered the bill which threatened to send us to collections.

I worked with the dentist’s office and BCBS of Illinois and was able to get BCBS of Illinois to send a paper check to the dentist in the mail, and now we have an account credit of $142 for his next visit, instead of an amount due. But I’m annoyed that whenever insurance makes an “error”, it’s never in your favor. Notice that? Notice how they made an “error” that would have kept $1,800 in the pockets of BCBS had I not pounced on it right away?

Insurance just makes everything confusing and impossible to figure out what’s really going on. And if they do something like this and you don’t really do anything about it, sure the dentist will be happy to take your money for something your insurance ought to have issued them a check for.

As the police interrogation tactics show, all you have to do is get mean with someone and start making threats, and most of the time they back down, even when they’re right. They start saying and doing things that are not in their interest, which they know are wrong. Because someone got mean with them. In this case, the insurance company stiffs you, the dentist threatens to send you to collections. Many people probably just send them the money.

I think that in the last 5 years, I must have filed appeals forms for health and dental claims at least 5 or 6 times, totaling several thousand dollars. And what usually happens is, yes they should have paid, but didn’t. And then they start blaming “the computer” or something.

Then by the time you get it sorted out, sometimes you’re already in collections and have to send proof your insurance finally did pay the claim to credit bureaus to repair damage to your credit reports.

I have no dental insurance at all. I get by on $15 cleanings, and have been lucky enough to have not needed a filling since 2007. Last time I was in for a cleaning, I let a student seal all of my teeth that the dentist said were most likely to develop cavities in the future, and they did like 9 of them, and hopefully that will forestall any serious repair work for at least another ten years.

Which is good, since my spouse is from the Philippines and has never had access to good dental care until he came here. And I’m spending beaucoup bucks even with his insurance, and fighting mishandled claims, to try to play damage control.

McDonald’s turns to child labor and then pays them less than the normal minimum wage.

McDonald’s turns to child labor and then pays them less than the normal minimum wage.

That way, McDonald’s can pay the children about half what they’d pay a worker over 18 (Several dollars an hour less and no benefits package.), while the adults/parents go unemployed.

It’s not that there is a labor shortage. It’s that companies don’t want to pay anything. McDonald’s isn’t happy that they have to hire anyone at all.

They’ve been trying to “solve the problem” for a while now with ordering kiosks, apps the spy on you, and now a deal for voice recognition, so no human has to take your drive through orders.

They even expect that customers will put RFID stickers on their windshield so it has their usual order on the screen when they pull up.

(Out of good taste, I’ve omitted these links to the spam farm called ZDNet which have been paid to talk this dystopian nightmare up.)

Eventually, it’ll just be robots in there flipping burgers and putting ten pounds of salt on each batch of fries and handing you super-gulp sized carbonated sugar water.

I’ve heard it said that Americans eat like we have free health care. Of course we don’t.

Thanks largely to Trump, we got outright junk insurance and Christian Health Care Sharing scams that don’t actually cover you when you get sick (and which appeal to millions and millions of rubes who buy it until they go to the hospital once and are left with 25 times their maximum annual out of pocket had they bought an Obamacare plan), but at least companies that served you garbage that makes you sick over time used to have to hire people.

One thing for sure is that they hate these new living wage laws and are working to undermine it while they get a system into place to get rid of the workers entirely.

If you see your employer offer you any benefits managed by Auxiant, run like hell.

There’s a super shady company called “Auxiant” that manages things like Flex Spending and Health Savings Accounts where my mom works.

Lately, it appears that they’re basically stealing from the employees by freezing them out of their accounts and threatening them with having the IRS called on them if they don’t pay back FSA money that the employees spent on eligible medical care.

It’s happening to many people my mom works with, including her. They froze her out of nearly $2,000 that was left in her account and then tried to blackmail her into paying back money that she used on HSA/FSA eligible dental care.

So if you see “Auxiant” on anything you can sign up for, don’t.

I went looking around the Web to see if anyone had good things to say about this company, and it turns out, doesn’t seem like it…. They have a 1 star rating on Google, and it turns out that they seem to deny people coverage, lose paperwork, and play other games with them.

“Urgent Care”: You’re sicker than Hell. If you’re alive when the labs come back, we might start you on antibiotics. But you’ll definitely get a bill. (What going to the doctor is like in America.)

This is my subjective opinion on the issue of the state of healthcare in America and my view of what has happened to me and some people that I know inside this system.

Yesterday, my spouse got sick at work. He has a really nasty cough, a headache, lost his sense of smell, etc. etc. so I took him to an urgent care clinic.

I hardly go to the doctor, myself, because I don’t understand how it would improve my health outcome.

If you have a sinus infection, walk-in clinics and most Federally Qualified Health Centers (Which see uninsured, Medicaid, and Medicare patients mostly) typically won’t give you antibiotics anymore.

I’ve literally ended up in the ER with “the worst sinus infection I’ve ever seen” (the physician’s words) on a CT scan, because it was giving me cluster headaches that felt like someone was stabbing me in the eye with an icepick.

They didn’t even do a CT scan the first time (reckoning that oxygen would clear it up), so I ended up in the ER again two days later, at Northwestern Memorial Hospital in Chicago. Which is rated as one of the best hospitals in the country.

Everyone goes “It’s probably viral! Go home and sleep it off!”. If you have the flu, they generally don’t give you Tamiflu, or even test for flu. “Go home and sleep it off.”.

It’s what happened to my ex at the Northwestern Medicine Urgent Care in Evanston, Illinois when he had the flu in 2019. They billed him $260 after insurance and didn’t even do anything.

It’s what’s happened to me several times at several facilities until I just gave up going to urgent cares completely. (I guess I would if I broke a bone or something, where they can’t play the “We refuse to shit out any medicine because we don’t know what it is!” game)

It’s what happens to mom, and my brother.

It’s what happens to everyone, it seems.

But even with insurance, and most Americans have high deductible health insurance under some sort of crummy and expensive “Obamacare” plan that’s not worth the paper it’s printed on, not “health care”, the out of pocket costs could be anything and you won’t know what it is for weeks. Usually at least a few hundred dollars at an Urgent Care.

I have high blood pressure. I went to the Lake County, IL health department because they have a FQHC that takes Medicare. The doctor told me to watch the salt and wouldn’t even consider putting me on blood pressure medication. Somehow nobody I know is told this. They just get medicine so that they won’t die of high blood pressure, but they can afford to go see a real doctor.

In fact, I now have to wait until September (which is when my next “Medicare Annual Wellness Visit” could be scheduled, and I won’t be out lots of money if the doctor does nothing…..just all day to get to Chicago and back) because I thought I would be savvy and try to contain costs by going to a FQHC instead of my family physician, and then I got Dr. “Watch the salt.” (which doesn’t even make any real difference to me, but hey, horseassed advice funtime), and a nurse that took my blood pressure a couple times, and then a bill.

So, the way I figure it is that if they don’t do anything for you anyway, why go? Why wait for a bill? Why not just save your money if they don’t care and won’t help?

The FQHC, I think, wouldn’t give me blood pressure medicine because I’m a Medicare patient and they just want me to go away and die cheaply. In fact, it’s an open secret that doctors in America despise Medicare patients. One in Huntington, Indiana (who was later arrested and convicted of groping women) told a friend of mine “You’re on Medicare. They’re not paying me anything, so I don’t care.” when she said she might die of COPD.

Given the fact that standard of care is this low in America, and the cost of going to the doctor and often leaving with nothing has never been higher, it’s amazing that some doctors and politicians wonder why many people don’t go at all until they’re in the middle of a medical emergency that could kill them, which could have been avoided with cheap and simple medicine that is on the World Health Organization’s List of Essential Medicines for a modern healthcare system.

Along with not doing a hell of a lot in general for my spouse other than a few swabs to see if it was COVID or strep, or a general culture to see if anything grew at a lab (which will be backlogged so long that my spouse will either be self-resolved or in the hospital by the time we know what’s going on), the doctor at PromptMed Urgent Care in Antioch, IL only took him off work for one day, even though his regular days off are coming up and if she had given him two days off he wouldn’t look like he was screwing around on a holiday weekend, when he’s really in bed running a high fever, coughing all over me, and in pain.

My mom’s ex-husband, who was not the greatest wordsmith in the world, had a point.

“Nobody does nothing for anybody anymore.”.

While he wasn’t the brightest bulb in the box, or a very nice man, he at least held down an honest profession.

He was an auto mechanic and a truck driver, and there’s nothing wrong with either one.

People come to you with car problems, you fix their car, you smile and thank them for their business.

Healthcare in America is nothing like that because it’s not customer-centered at all. It’s a monopoly, backed by Uncle Sugar’s evil subsidies and market manipulations, in which some bad actors will flourish because there’s really no competition based on market prices and good service.

People complain about auto mechanics all the time, but I actually know some very good ones, who remember my name and tell me ways I could solve problems in a cost-effective way, and fix things right the first time, and who build rapport. Doctors, on the other hand, often refuse to do what some would consider the bare minimum.

In the Science Fiction series Star Trek: Voyager, Robert Picardo played the Emergency Medical Hologram Mark I. It was notorious for “terrible bedside manner”, but it knew everything there was to know about medicine. It had ethical subroutines that required it to treat the patient to the best possible standard of care.

In other words, they wouldn’t have a lot to complain about if all they had him on was “bad attitude”.

I just got off the phone with PromptMed, and basically asked why they weren’t doing a lot to help my spouse, and their answer was come in for a chest x-ray, which would be another office visit for something they could have done yesterday (and god only knows what a chest x-ray would cost when they could just call in some $5 antibiotics over the phone right now) when they were sending us home with “allergy pills”.

We’re already living in a post-antibiotic age, and it’s because of the doctors, not the patients.

Doctors are, generally speaking, quite condescending in a paternalistic way. They don’t feel that their patients are rational human beings who can follow basic instructions, so they respond by not giving out medicine.

We’re often told that we’re heading into a new era of super-germs and it’s because people don’t use antibiotics responsibly, or because doctors are overprescribing them.

But the biggest cause of antibiotic resistance is, in fact, people who acquire sexually transmissible disease.

According to the CDC, the number of STDs in America is at record levels, because people today are just generally disgusting and bums, and wouldn’t you know it, limping into the urgent care with an STD is the most reliable way to leave with antibiotics.

Why is that? The government leans on doctors to keep STD levels down, thereby rewarding people for their own foolishness, while it urges them to not write too many prescriptions, so if you walk in there with a sinus infection, you’ll get sold a load of crap about how it’s probably just seasonal allergies, and here’s our bill.

It’s not just me who noticed. In fact, when I mentioned to an ex in 2003 that he could go to the walk-in clinic in the town I lived in back then for something, he said, “Oh it’s pretty well known that those doc in the box places are pretty bad and you’d only go there if you had an STD.”.

While doctors wring their hands and say that you can’t change undesirable sexual behavior of a patient, so you may as well treat the patient, they also tell you to take personal responsibility for what you eat.

In a world of supermarkets with junk, and give you referrals to nutritionists that you can’t afford to talk to. It’s also not that I’m not aware of what not to eat, it’s that I’m not going to change and I despise being manipulated.

We need to look into more options in America for healthcare. Not surprisingly, the American Medical Association is lobbying state governments and Congress against laws requiring them to post their fees on the wall so there won’t be any surprise bills. They know that they’ll trick even the smart people several times into going there out of desperation simply to leave empty-handed, but that there’s more born every minute.

But if they have to post what every service costs you, in cash, many people will limp right back on out.

My mother is a nurse who mentioned colloidal silver. I have no idea if it works, but at this point we’re out of options. We tried asking the doctor for help. Mom asked, “What’s the worst that could happen?”. I replied, “Nothing, but that’s basically what the doctor already did.”.

I would have gone to the PromptMed location in Waukegan, because I’ve gone there before and the doctor who tends to be working there seems like an okay guy. Now that I know that, I always call before I go in for anything and ask which doctor is in that day, because I don’t feel like risking that it will be anyone else and that I’ll just be out the money.

But it really is the luck of the draw. They make you go over to Antioch right now because it’s the only one seeing respiratory symptom patients due to COVID going around. That’s a real shame. It’s like being sold a pig-in-a-poke when you go to these places.

Trump actually scored a few wins for middle America.

I don’t like the guy. I didn’t vote for him, but Obamacare is one of the biggest scams ever pulled. The Democrats frequently applaud themselves for “containing the cost of healthcare”, but they really only falsely conflate the idea of insurance policies with “care” when the insurance companies provide no care, and really only exist to be paper pushers who negotiate what essentially amount to fake discounts.

Many people with Obamacare policies haven’t seen much, if any, improvement in health.

In fact, the American life expectancy now is lower, according to Google, than it was when the ACA went into effect. 78.54 vs 78.84. Google cites the World Bank.

While Trump failed to pull up this rotten, perverse, and expensive law out by the roots, his tax law set the IRS fine for not buying junk insurance to zero, meaning that people who can’t afford the insurance that does nothing for them, because the government isn’t helping them buy it, can at least opt out of it.

The Republicans have failed us on healthcare too. Bankruptcy court shouldn’t be the insurance policy against an expensive hospital bill, but whether you have no insurance or you have Obamacare, the result is that bankruptcy is healthcare.

Many news articles are screaming that Americans haven’t been in worse health than they’re in now in modern history, and much of the reduction in progress is the result of suicide, depression, and obesity-related disease that set in during the Democrat shutdowns.

While yet more articles are bragging that corporations will feed you beer, pizza, and krispy kreme donuts as a cheap bribe to get a vaccine.

Americans can’t afford to be antivaxxers.

Don’t let anyone say I’m against vaccines. I’m not. With all of the barely competent doctors and the ones who don’t want to do their jobs out there, combined with the fact that most operations and procedures cost 6-8 times the OECD average in America, you really don’t want to be sick with anything that a vaccine can prevent.

I’m not a politician, so I won’t tell you that I have all of the answers, but on healthcare, it’s clear that if the majority of Americans support “Obamacare”, it’s because they still don’t understand what it is, aren’t paying their premiums, and/or haven’t actually been to a doctor lately. Because it’s more expensive with insurance now than it was to pay cash before.

How much money are people wasting on doctors?

If you consider what your copays and deductibles are, it’s probably some serious scratch. Talking to the doctor and having a few simple tests done that might even be pointless can cost as much as a month’s worth of food or two weeks rent, and that’s if you’re insured. Over 12 million Americans aren’t even insured, to say nothing about undocumented immigrants.

In closing, and speaking in a generality, don’t bother with Urgent Care “doc in the box” centers. Some are okay, most are crap. They will charge you money. Probably more than your primary care doctor.

In fact, some health coverage even covers certain types of visits for free regardless of your deductible status. If you do want to go once a year, you could just schedule a Medicare Annual Wellness Visit, and let them kick the tires. At least that way if they don’t really do much, you’re not wasting money that could have been clothes, gasoline, a pair of boots, or any number of useful things.

I was shocked when I recently read an article suggesting that Millennials prefer urgent care to a regular physician. These centers almost never manage chronic health issues, and you’re lucky if you get them to do anything real over an acute problem, which is ostensibly what they exist for.

As a final point, the government apparently managed to screw up COVID testing. It’s supposed to either be “free” or mandated to be “covered by insurance”, but it seems that’s not always the case.

Some people have reviewed PromptMed in Antioch stating that they got huge surprise bills for COVID testing, and the responses from PromptMed seemed rather rude.

Nobody at PromptMed warned us about this issue, so I’m hoping that his insurance actually does cover THAT.