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Thursday, October 5th 2006

No Billing For You!

One Of Arnold Schwarzeneger’s Many Television Cameos

A while back my brother was in an accident. Not terribly serious. However, unaware of the way in which his insurance works he let the paramedics take him to the nearest hospital, instead of the one in our insurance’s network.

The result, our insurance reimburses at a lower rate, and my brother gets billed for the remainder. Fair enough. Even if he argued against the necessity for some of the procedures and tests they performed, I never heard him (or any of my family) argue against the hospital’s right to collect on that bill.

Well, soon enough my brother may be wishing he had been injured in California. In what I think is a stunning move the Governator has instructed state regulators to look into ways to halt patient billing in emergency rooms. (H/T Kevin, MD)

The Sacramento Bee article Kevin links to is subscription only. Here’s an op/ed on the move from a magazine – Southern California Physician.

The decision to restrain physician billing for services rendered in emergency care is a barrier to free trade in an open market economy. The governor’s ban is definitely illegal and contrary to the opinion of the California judicial system–not “possibly illegal” as media spin about balance billing had suggested.

I’m absolutely stunned by this measure and am convinced it will reduce access to emergency services, which aren’t exactly the cash cows of private hospitals to begin with.

Our patients don’t want and don’t deserve reduced emergency room coverage or emergency facility closures. Healthcare insurance should adequately cover needed services rendered. True healthcare coverage should not be a form of cheap, inadequate and phony “underinsurance” that constantly modifies valid billings with payment downcodings, delays and deductions. When a patient is insured–through a self-pay, work benefit or governmental program–the patient assumes and expects that the insurance policy will cover all legitimate costs without excessive co-pays or out-of-pocket bills. That is not an unreasonable expectation.