Balance Billing and Means Testing

Health Business Consultant David E. Williams looks at Medicare.

What’s to be done? I don’t have a comprehensive solution, but here are a couple of ideas that are too radical even to be considered right now, never mind put into place:

These “radical” ideas might put you to sleep because they are pretty tame compared to what I’d like to do. In fact, they seem anything but radical:

Means Testing:
Make sure the person getting Medicare isn’t sitting on money they should be using to pay for their own health care. (This would be a great job for me… a few more weeks at the Physicians Neck and Back Clinic, and I’ll be able to hold old people upside down by their ankles and shake coins out)

Balance Billing: This means that hospitals charge what they wish with the stipulation that they must charge all patients the same. They are allowed to bill for the balance. That is, they can charge Medicare patients more than what Medicare will reimburse and bill them for it. I didn’t realize this, but THIS IS A HUGE CONTROVERSY…. because what a terrible thing to present someone with a bill for a service provided.
In some states, “balance billing” is synonymous with fraud:

The Medicare Balance Billing Program works to protect Medicare beneficiaries from being billed by health care practitioners for amounts beyond those approved by Medicare. The program investigates complaints and takes action against those practitioners who violate the law.

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About Tim

Minneapolis Blogger
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6 Responses to Balance Billing and Means Testing

  1. Kate says:

    under your radical health care plan, what would determine whether your trips to physicians neck and back are paid for? Your age? Your IQ? Other proofs of your ability to “contribute to society”?

  2. Tim says:

    Because of my High IQ, I actually anticipated this question.

    1) PNBC is preventative. It saves the system money in the long run because I will presumably cost the system less in terms of missed work and medical intervention.
    2) My costs aren’t being paid by taxpayers. So, the government doesn’t decide if I should get this care.
    3) If this wasn’t paid for by insurance, I would pay out of my own pocket, because this is the most valuable treatment I’ve ever received. This is the most controversial of all the reasons: I get to decide. Not my insurance company. Not the government. Me.
    4)If it were the government paying, I’d follow these rules: I can remember my name, what year it is, breathe by myself and wipe my own ass. If you can’t do all four of those things: No $$ for U. These would be my filters, but others could be taken into consideration.

    if radical means getting at the root, then lets look at the root causes of the unfolding Medicare disaster:

    unlimited demand / open ended promises / limited resources

    attitudes stuck in 1964 (we can fix it, there are no limits, every blob of flesh deserves to live because we don’t understand life, people usually die 2 years after they retire anyways)

    political power in the hands of those receiving most of the benefits.

    broken political system

    ignorance about the scope of the problem

    runaway technology

    greed (docs, patients, patients’ families, lawyers)

    We lack the language tools to talk about the end of life. It is forbidden to discuss such things, and as long as we can’t talk about it, the problem will grow.

  3. Kate says:

    Are you a blob of flesh with a high IQ? Am I a blob of flesh with a higher Word Twist score than you?

  4. Kate says:

    I love talking about death, btw. I get lots of practice at this, answering Frank’s questions.

  5. Rob R. says:

    I long for the feel of the Grim Reaper’s bony fingers on my shoulder.

  6. Kate says:

    will he be riding a bike?