Summary: And now for something completely different: We take cost headlines recently reported in KHN (Kaiser Health News) and imagine how they would look under single payer, or how they just wouldn’t make sense. Enjoy the vision. Let’s make it happen.
KHN Health Costs, December 2, 2021
BILL OF THE MONTH: The ER Charged Him $6,500 for Six Stitches
No Wonder His Critically Ill Wife Avoided the ER.
Single Payer: You’re all set. No charge.
Stranded by the Pandemic, He Had Only Travel Insurance. It Left Him With a $38,000 Bill.
Although it’s possible to buy travel insurance that provides some health coverage, the devil is in the fine print. Obama-era laws that prevent refusal of payment for preexisting conditions don’t apply to travel insurance.
Single Payer: Stranded by the pandemic, man received the care he needed, free.
Your Out-of-Pocket Health Care Costs Need Not Be a Mystery
A new California law requires health insurance companies to notify consumers how much remains on their deductibles and how close they are to their annual out-of-pocket spending limits.
Single Payer: You don’t have any out-of-pocket costs.
Patients Get Stranded Out of Network as Insurer-Hospital Contract Talks Fall Apart
As hospital systems and insurers adjust to the pandemic, their contract negotiations grow increasingly fraught. Contracts for in-network care are ending without a new deal, leaving patients suddenly with out-of-network bills or scrambling to find new in-network providers.
Single Payer: Networks?
Congressional Doctors Lead Bipartisan Revolt Over Policy on Surprise Medical Bills
Congress last year shielded consumers from unexpected out-of-network charges, but hospitals and doctors have decried the arbitration plan put forward by the Biden administration for negotiating these bills as favoring insurers. More than 150 members of the House agree.
Single Payer: What’s a medical bill? Sure would be surprised to receive one of those.
New Health Plans Offer Twists on Existing Options, With a Dose of ‘Buyer Beware’
Fueled by consumer frustration with high premiums and deductibles, two new insurance offerings promise a means for consumers to take control of health care costs. But experts say they pose risks.
Single Payer: What’s a health plan?
Why You Can’t Find Cheap At-Home Covid Tests
You probably won’t be testing everyone at your Thanksgiving table for covid because the tests are expensive and hard to find. Why? The federal government is partly to blame.
Single Payer: Covid tests – all medical tests – provided free.
As Big Pharma and Hospitals Battle Over Drug Discounts, Patients Miss Out on Millions in Benefits
The number of pharmacies dispensing 340B discounted drugs soared to more than 31,000 this year. Drugmakers struck back by halting some discounts. Hospitals say they are losing millions of dollars — and cutting back services to patients — as a result.
Single Payer: Latest update of drug prices released by government.
Medicare’s Open Enrollment Is Open Season for Scammers
Medicare officials say complaints are rising from seniors lured into private plans with misleading information or enrolled without their consent. In response, officials have threatened to penalize the private companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.
Single Payer: Everyone covered, cradle to grave. No transitions between coverage, ever.
Medicare Enrollment Blitz Doesn’t Include Options to Move Into Medigap
TV ads and mailings targeting seniors tout Medicare Advantage plans this time of year, but millions choosing traditional Medicare make a costly and difficult decision about Medigap coverage, which gets much less attention.
Single Payer: See above. Not a thing.
Researcher: Medicare Advantage Plans Costing Billions More Than They Should
Some insurers pocketed ‘eye-popping’ overpayments, billing records show.
Single Payer: Doctors and single payer commissioner agree on payment rates for next year.
Uninsured in South Would Win Big in Democrats’ Plan, but Hospitals Fear Funding Loss
The latest iteration of President Joe Biden’s social-spending package would close the health insurance gap for at least 2.2 million people, making a huge difference especially in the South, where political opposition has blocked Medicaid expansion.
Single Payer: Hospitals get new annual global budget amounts. (What’s “uninsured”?)
Missouri’s Thin Dental Safety Net Stretched Amid Medicaid Expansion
An estimated 275,000 Missouri adults can get dental insurance now as the state has expanded who is eligible for Medicaid. But with so few dentists participating in the program, the state’s already-backlogged dental clinics are facing a glut of new clients.
Single Payer: Dentists settle on payment rates for next year.
How Rural Communities Are Losing Their Pharmacies
More than 1,000 independent rural pharmacies have closed since 2003, leaving 630 communities with no retail drugstore. As 41 million people stuck in pharmacy deserts make do, the remaining drugstores struggle to survive.
Single Payer: Rural pharmacies receive subsidies to stay open.
California Law Aims to Strengthen Access to Mental Health Services
The law doesn’t take effect until July, but its passage should force insurers to expand their rosters of therapists. Here’s how you can challenge your health plan’s mental health services until then.
Single Payer: 90% of mental health providers in single payer system.
KHN’s ‘What the Health?’: Why Health Care Is So Expensive, Chapter $22K
A new survey finds the average cost of an employer-provided family plan has risen to more than $22,000.
Single Payer: Who remembers work-based health insurance?
‘An Arm and a Leg’: Need Surgery to Save Your Life? Tips for Getting Insurance to Pay
Laurie Todd calls herself the “Insurance Warrior” and is sharing her strategies for getting health insurance companies to bend to her will.
Single Payer: Surgery included in coverage!
By Jim Kahn, M.D., M.P.H.
This isn’t fantasy in any wealthy country except the US. Embrace this future.