America's medical system is so unnecessarily complex and confusing that you can get a master's degree in medical billing. One of the major problems with this Frankenstein's monster of a system is that patients often have no idea what they're paying for services.
You'd think that one of the advantages to having a private healthcare system would be the ability to make decisions based on price, as we do with everything else. But it never really seems to work that way.
In fact, about one in five visits to an in-network emergency room results in a "surprise" out-of-network bill that can drive up the cost by thousands. These bills happen when an out-of-network provider is unexpectedly involved in a patient's care.
(It's unexpected for the patient, but as you'll see, not for the hospital in many cases.)
These out-of-network doctors then ask for large fees that aren't covered by insurance.
This happened to me about ten years ago when I went into surgery to have a procedure on my foot. I was told the cost would be around $1200 after insurance. But a few weeks later, I got a bill for $2200. Evidently, the anesthesiologist was out of network.
Funny thing is that no one told me that at the time. Wouldn't it have been fair for someone to let me know the bill was about to double? As a patient, shouldn't I have the right to refuse service if it's going to cost me $1,000 more than I was quoted? If you went to get your car fixed and they quoted you one price, then billed you for double, you can sue them.
What's worse is that a lot of companies practice this type of billing on purpose. According to The New York Times, "Some private-equity firms have turned this kind of billing into a robust business model, buying emergency room doctor groups and moving the providers out of network so they could bill larger fees."
Surprisingly, Congress actually stepped up to the healthcare industry on Monday by passing the massive $900 billion, 5,600-page coronavirus relief package. Included in the bill was a law that makes "surprise" billing illegal for doctors, hospitals, and air ambulances, though not ground ambulances.
It's believed that President Trump will sign the bill into law sometime this week.
More than a dozen states, including texas and California, have passed similar bills banning this practice in one form or another.
Congress tried to pass this legislation in December, but a last-minute influx of money from private-equity forms and healthcare lobbyists scuttled the deal.
Even though it was a bipartisan issue with the support of 80% of Americans, lobbyists still made it tough to pass.
"There were a lot of things working in the legislation's favor — it's a relatively targeted problem, it resonates very well with voters, and it's not a hyperpartisan issue among voters or Congress — and it was still tough," said Benedic Ippolito, a resident scholar at the American Enterprise Institute, told the New York Times.
"It has almost everything going for it, and yet it was still this complete slog," he added.
"This was a real victory for American people against moneyed interests," said Frederick Isasi, executive director of Families USA. "This really was about Congress recognizing in a bipartisan way the obscenity of families who were paying insurance still having financial bombs going off."
Now, after the legislation passes, insurers and medical providers will have to agree on a payment rate for out-of-network services that is a fair amount based on what other hospitals and doctors normally charge. If they don't agree, they'll be sent to arbitration.
The legislation is a big win for consumers who will now be able to visit the emergency room without unknowingly being caught in a billing trap. However, we shouldn't celebrate the fact we're now protected from predatory practices that shouldn't have been legal in the first place.
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Will your current friends still be with you after seven years?
Professor shares how many years a friendship must last before it'll become lifelong
Think of your best friend. How long have you known them? Growing up, children make friends and say they’ll be best friends forever. That’s where “BFF” came from, for crying out loud. But is the concept of the lifelong friend real? If so, how many years of friendship will have to bloom before a friendship goes the distance? Well, a Dutch study may have the answer to that last question.
Sociologist Gerald Mollenhorst and his team in the Netherlands did extensive research on friendships and made some interesting findings in his surveys and studies. Mollenhorst found that over half of your friendships will “shed” within seven years. However, the relationships that go past the seven-year mark tend to last. This led to the prevailing theory that most friendships lasting more than seven years would endure throughout a person’s lifetime.
In Mollenhorst’s findings, lifelong friendships seem to come down to one thing: reciprocal effort. The primary reason so many friendships form and fade within seven-year cycles has much to do with a person’s ages and life stages. A lot of people lose touch with elementary and high school friends because so many leave home to attend college. Work friends change when someone gets promoted or finds a better job in a different state. Some friends get married and have children, reducing one-on-one time together, and thus a friendship fades. It’s easy to lose friends, but naturally harder to keep them when you’re no longer in proximity.
Some people on Reddit even wonder if lifelong friendships are actually real or just a romanticized thought nowadays. However, older commenters showed that lifelong friendship is still possible:
“I met my friend on the first day of kindergarten. Maybe not the very first day, but within the first week. We were texting each other stupid memes just yesterday. This year we’ll both celebrate our 58th birthdays.”
“My oldest friend and I met when she was just 5 and I was 9. Next-door neighbors. We're now both over 60 and still talk weekly and visit at least twice a year.”
“I’m 55. I’ve just spent a weekend with friends I met 24 and 32 years ago respectively. I’m also still in touch with my penpal in the States. I was 15 when we started writing to each other.”
“My friends (3 of them) go back to my college days in my 20’s that I still talk to a minimum of once a week. I'm in my early 60s now.”
“We ebb and flow. Sometimes many years will pass as we go through different things and phases. Nobody gets buttsore if we aren’t in touch all the time. In our 50s we don’t try and argue or be petty like we did before. But I love them. I don’t need a weekly lunch to know that. I could make a call right now if I needed something. Same with them.”
Maintaining a friendship for life is never guaranteed, but there are ways, psychotherapists say, that can make a friendship last. It’s not easy, but for a friendship to last, both participants need to make room for patience and place greater weight on their similarities than on the differences that may develop over time. Along with that, it’s helpful to be tolerant of large distances and gaps of time between visits, too. It’s not easy, and it requires both people involved to be equally invested to keep the friendship alive and from becoming stagnant.
As tough as it sounds, it is still possible. You may be a fortunate person who can name several friends you’ve kept for over seven years or over seventy years. But if you’re not, every new friendship you make has the same chance and potential of being lifelong.