Feb 28 2014
08:33 am

Al Madrigal tackles the states that have not expanded Medicaid (just in case you missed it).

bizgrrl's picture

Ashley Landes, President,

Ashley Landes, President, South Carolina Policy Council says, "Doctors don't turn away patients in need."

Too funny. I've been to many a doctor's office where they ask for payment in advance.

No, I believe doctors do turn away patients without any method to pay. ERs don't turn away patients in need and then the federal and state governments pay the higher price for ER healthcare reimbursement.

B Harmon's picture

I believe that ERs will treat

I believe that ERs will treat a true emergency regardless of ability to pay. However, for a non life threatening symptom, they will 'counsel' them on payment options upfront.

So if you don't have the money to pay, come in with chest pain or shortness of breath, or have some serious injury. For all other concerns, go to the Walgreens/CVS walk-in and prepare to pay whatever their cost.

Pam Strickland's picture

I had an abdominal ultra

I had an abdominal ultra sound on Monday, an attempt to see what's causing a pesky pain that I've been having the last couple of months. It was at Tennova. When Interfaith called with the appointment, I was told that Tennova would call the day before to tell me how much that my payment would be and what payment arrangements could be made. I didn't get that call. When I arrived Monday, I was told that I needed $101 upfront. When I said I didn't have that much and no one had called at first I was told that I would have to reschedule. But have some haggling, afterall I had expected the call and had my phone with me all day on Friday plus I had fasted in preparation for the test, it was agreed that I could pay half and be billed for the rest.

So, yeah, they would have gladly turned me away. And my aunt had recently had an MRI there and she has insurance but was still required to pay the co-pay upfront. And there had been a problem with a gentleman who was there Monday who had insurance and was obviously in pain. I didn't catch all of it, but the admitting clerk was not kind.

When I received a follow-up call from KAPA about my appointment, I asked that in the future I not be sent there. I've had other tests at UT, and they were very nice. Oh, don't get me wrong, once I got back with the tech, everything was fine, but getting there was not pleasant.

traveler's picture

Sorry for your experience.

There are many reports lately to the effect that hospitals and doctors are worried patients won't be able to pay the ACA's deductibles and co-pays, so they're demanding cash up front.


(I'm not saying yours was related, naturally.)

To be fair, the practice predates PPACA, but PPACA has made the problem more acute--doctors and hospitals fear the flood of low-means individuals with 'Bronze' and 'Silver' plans. To provide all the mandates yet keep premiums lower, there's no coverage until you meet a substantial deductible. Many can't or won't pay, many people have never done this and don't know, and the providers(*) are afraid of getting gypped.

They have a point.

This is what I mean (in the other thread) when I suggest the solution lies in things that make the practice of medicine better and cheaper. The ACA is a set of shell-games (hidden costs / taxes / fees) meant to disguise the cost of over-priced insurance--that's unhelpful. And, the ACA increases costs, by a variety of mechanisms. That's unhelpful too.

(*) I dislike typing that word--it's depersonalizing. Yuck.

R. Neal's picture

What you really seem to be

What you really seem to be saying over and over is, poor sick people should just go away and die because you don't want to chip in for their health care.

OK, we got it.

Pam Strickland's picture

Yep, that's what he seems to

Yep, that's what he seems to be saying.

Nelle's picture

Talk about dehumanizing

You find the word "provider" dehumanizing, but you have no problem using the word "gypped"?

As our host would say, OK then.

jbr's picture

Now on your restaurant bill: Obamacare fee

From CNN …

Diners at eight Gator's Dockside casual eateries are finding a 1% Affordable Care Act surcharge on their tabs, which comes to 15 cents on a typical $15 lunch tab. Signs on the door and at tables alert diners to the fee, which is also listed separately on the bill.

Now on your restaurant bill: Obamacare fee

R. Neal's picture

I wouldn't dine there, then.

I wouldn't dine there, then. Not because of the 15 cents but because of their attitude. Merchants should generally leave their politics at the door.

Average Guy's picture

I don’t know

As a continuation of the debate in the other thread, I like the idea of truth in charges.

And I do think it cuts both ways. Where it turns you off, it may turn others on.

I think Papa John’s played politics. If he had just added the surcharge with an explanation, I think people would have found that more credible than the overt politics he played.

R. Neal's picture

Yes, it cuts both ways. I

Yes, it cuts both ways. I just think if they bring politics into it they aren't focused on whatever it is they do. Seems unprofessional to me. I'm sure I've made exceptions, and will again.

bizgrrl's picture

Dang, we've eaten at their

Dang, we've eaten at their Lake Mary location. Makes me kind of sad, but there are a lot more choices in Lake Mary than when they first opened. I recommend TooJay's if you are ever in the area.

reform4's picture

Small businesses

aren't under the act until 2015.

If they are billing diners for ACA, then that constitutes.. oh, what's that word... um... oh, yeah.


And if they are taking credit cards, that constitutes interstate wire fraud. Prison time for the owners.

cafkia's picture

Fraud concerns not

Fraud concerns not withstanding, if they are charging patrons but not contributing themselves, I have an issue with them. If they are contributing in some way, they probably ought to explain that adjacent to the surcharge explanation.

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