Thursday, September 25, 2014

Questionable Ethics in the Operating Room


For John, BLUFMoney is the root of all evil.  Nothing to see here; just move along.



Sunday, front page, top of the fold, The New York Times was an article on pop-up surgery charges.  The headline is "After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know".  The author is Ms Elisabeth Rosenthal.  The dateline is 20 September, notwithstanding the article showing up in my Sunday edition.

This sort of reminds me of the "Fee Splitting" imbroglio of the 1950s, when Physician A would refer you to Physician B, who would then kick back money to Physician A for the referral.  This was considered ethically dubious.

Today it is mystery doctors showing up and doing (or not doing) something to you and you may not even be aware that they were coming or that they showed up.  It is a case of hidden charges.  It is being looked into by some state agencies across the fruited plain.  Here is an example:

A New York State law that will take effect in March — one of a few nationally — will offer some protection against many surprise charges and require more advance disclosure from doctors and hospitals on whether their services are covered by insurance.  It states, for example, that patients are not responsible for unforeseen out-of-network charges beyond what they would have paid in-network.  It directs insurers and hospitals to negotiate any further payment or enter mediation.
The article suggests that other nations deal with this issue differently:
In many other countries, such as Australia — where, as in the United States, people often rely on private insurance — it is seen as a patient’s right to be informed of out-of-pocket costs before hospitalization, said Mark Hall, a law professor at Wake Forest University.
Regards  —  Cliff

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