Telehealth – Freakonomics

Thanks to the pandemic, the telehealth revolution we’ve been promised for decades has finally arrived. Will it stick? Will it cut costs — and improve outcomes? We ring up two doctors and, of course, an economist to find out.

ELLIMOOTTIL: Up until March 2020, less than 1 percent of Medicare patients have ever used a telehealth service.

ELLIMOOTTIL: We’re seeing patients from all over the state who sometimes travel four hours just to have a 15-minute consultation about their kidney stone. And to be honest, I probably knew the answer about how I was going to manage that patient when I looked at their C.T. scan.

CUTLER: It is amazing. We went from essentially no visits for medical care being telehealth to now between 10 and 15 percent of visits for medical care are telehealth. And we did it virtually overnight.

The Doctor Will Zoom You Now (Ep. 423)

2 Covid Tests, Same Place, Same Result – One cost X, One Cost Y

The two got drive-through tests at Austin Emergency Center in Austin. …

The emergency room charged Mr. Harvey $199 in cash. Ms. LeBlanc, who paid with insurance, was charged $6,408.

“I assumed, like an idiot, it would be cheaper to use my insurance than pay cash right there,” Ms. LeBlanc said. “This is 32 times the cost of what my friend paid for the exact same thing.”

Ms. LeBlanc’s health insurer negotiated the total bill down to $1,128. The plan said she was responsible for $928 of that.

Two Friends in Texas Were Tested for Coronavirus. One Bill Was $199. The Other? $6,408.
It’s an example of the unpredictable way health prices can vary for patients who receive identical care.
Sarah Kliff
https://www.nytimes.com/2020/06/29/upshot/coronavirus-tests-unpredictable-prices.html

He Got Tested for Coronavirus. Then Came the Flood of Medical Bills.

In an isolation room, the doctors put him on an IV drip, did a chest X-ray and took the swabs.

Now back at work remotely, he faces a mounting array of bills. His patient responsibility, according to his insurer, is now close to $2,000, and he fears there may be more bills to come.

By Elisabeth Rosenthal and Emmarie Huetteman
Ms. Rosenthal is editor in chief of Kaiser Health News, where Ms. Huetteman is a correspondent.
https://www.nytimes.com/2020/03/30/opinion/coronavirus-test-cost-bill.html

Fighting the Insurance Company – Example of

After My Son Suffered a Traumatic Brain Injury, I Was Told Insurance Would Cover His Medical Bills. I Was Dead Wrong.

When RJ was discharged from the ICU after three weeks, he was transferred to a rehab facility. After he got there, they called me on the phone and said, “Your insurance company called and said RJ’s rehab benefits are up on Friday.”

I said, “No, no, no, no. That’s covered. I was told by my insurance company that this facility is covered for at least 60 days and possibly more. We have more time.”

But all I had was a voice on the phone. Without written proof, without the summary plan description, I couldn’t prove it. So when the rehab facility got another call from my insurance telling them these benefits had lapsed and I couldn’t prove otherwise, I went to the facility and I asked, “Where am I supposed to take him? He’s in a coma.” I remember a social worker telling me I could look into foster care.

Months passed, and I still couldn’t get the summary plan description. I kept calling my insurance company, and they’d be telling me my benefits, and I’d say, “You’re giving me information that you’re looking at. Give me, like, a screen grab of your computer screen.” But they wouldn’t do it. They kept telling me it was being “revised.”

I did some research, and I found out that under a law called ERISA—the Employee Retirement Income Security Act of 1974—I was entitled to the details of my insurance policy.

So I called an ERISA lawyer and told him the situation, and he said, “I can help you, but you’re going to have to give me a retainer of $30,000.”

Stephanie Peirolo
First told at a show by the Moth, the live storytelling group, at the Neptune Theatre in Seattle

Readers digest: https://www.rd.com/true-stories/survival/when-insurance-stops-paying/

Stephanie Peirolo is executive director of the board of the Health Care Rights Initiative, a nonprofit providing advocacy and navigation services for patients and caregivers. This story was excerpted from All These Wonders.