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ACA Running Thread

RJKarl said:
They are participants in the fraud. They are knowingly creating bills that shouldn't exist.

I realize you must disagree with everything I post or burst into flame, but even industry insider CH agrees with me.
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Ive moved from shill to insider! Sweet!

I think its unethical, greedy and needs to be fixed but I do not think its actually fraud. Clearly putting $ in front of patients.
 
RJKarl said:
EVERY Dem candidate should make "surprise bills" the first law they would ask to be introduced. They are outrageous, immoral and should be considered bait and switch and thus illegal.

The penalties need to be extreme and after a certain number (as low as 3-5), executives at the facilities, the doctors and executives of the insurance company should be held criminally and personally, civilly accountable.

This should be a no brainer and should lessen fears about changing other aspects of healthcare.
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Gonna need a perp walk.
 
CHDeac said:
Ive moved from shill to insider! Sweet!

I think its unethical, greedy and needs to be fixed but I do not think its actually fraud. Clearly putting $ in front of patients.
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First of all, there shouldn't have to be laws to keep companies from acting immorally or unethically.

It's absolutely fraud. If you call an insurance company or hospital and they tell you they are in your network and go there only to find out part or all of the services rendered to you at that facility aren't covered, that's the definition of fraud.

From the doctors to the managers to the CEOs, people should be in jail and broke because of this. Doctors, etc. stealing from people who are sick, injured or even dying for profit should have more serious penalties than robbing banks and three strike laws should definitely apply.
 
RJKarl said:
First of all, there shouldn't have to be laws to keep companies from acting immorally or unethically.

It's absolutely fraud. If you call an insurance company or hospital and they tell you they are in your network and go there only to find out part or all of the services rendered to you at that facility aren't covered, that's the definition of fraud.

From the doctors to the managers to the CEOs, people should be in jail and broke because of this. Doctors, etc. stealing from people who are sick, injured or even dying for profit should have more serious penalties than robbing banks and three strike laws should definitely apply.
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Let's pretend you're an author. Should you be charged with fraud if you refuse to sign a contract with Amazon and then you sell your book for a higher price than Amazon charges for it?
 
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DistrictDeacon said:
Let's pretend you're an author. Should you be charged with fraud if you refuse to sign a contract with Amazon and then you sell your book for a higher price than Amazon charges for it?
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That's gibberish. No one was told the price of the book was X and then was charged Y when they got. Then, if they didn't pay they weren't sued and their credit ruined.

If a doctor who is independent or in Z Network goes to A Network hospital should be covered by A Network and not be able to charge the patient without PRIOR WRITTEN & ELECTRONIC approval by the patient. Without the doctor's participation, the fraud couldn't be enacted.
 
RJKarl said:
That's gibberish. No one was told the price of the book was X and then was charged Y when they got. Then, if they didn't pay they weren't sued and their credit ruined.

If a doctor who is independent or in Z Network goes to A Network hospital should be covered by A Network and not be able to charge the patient without PRIOR WRITTEN & ELECTRONIC approval by the patient. Without the doctor's participation, the fraud couldn't be enacted.
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You still haven’t shown any fraud on the doctors part. They show up, do their job, and charge their fee. Where’s the fraud?
 
it does seem like a scam that Dr X recommends Y procedure and the patient signs off on being charged whatever it will be without ever knowing and then is subject to $xxx,xxx bills.
 
They are participants in the fraud. Without them providing services, there is no fraud. Without them, it would like pointing your finger and going bang to shoot someone.

To say they don't know what's going on is preposterous and totally unbelievable.
 
RJKarl said:
They are participants in the fraud. Without them providing services, there is no fraud. Without them, it would like pointing your finger and going bang to shoot someone.

To say they don't know what's going on is preposterous and totally unbelievable.
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You keep using that word. I don’t think you know what it means.

And you certainly haven’t provided any examples of how doctors are committing fraud.
 
The doctors know why they are working under contract and not as employees to the facilities. Their purpose is to create large bills that are outside the coverage of the incoming patients. They are the backbone of the fraud of telling patients they covered in the ER or operating theater.

In reality, they are even more immoral than the corporations. They know why they signed the contract. They know many of the people don't know they will be getting billed for their services in an approved location.

Doctors are supposed to care about their patients. Doctors who participate in these contract don't give a flying fuck about anything other screwing their patients out of every penny they can steal. Their greed will cause the ruin of many families and create more illnesses due to the stress of the immoral actions of the doctors and the hospitals. They are intentionally breaking their Hippocratic Oath for the almighty dollar and should permanently lose their licenses.
 
RJKarl said:
The doctors know why they are working under contract and not as employees to the facilities. Their purpose is to create large bills that are outside the coverage of the incoming patients. They are the backbone of the fraud of telling patients they covered in the ER or operating theater.

In reality, they are even more immoral than the corporations. They know why they signed the contract. They know many of the people don't know they will be getting billed for their services in an approved location.

Doctors are supposed to care about their patients. Doctors who participate in these contract don't give a flying fuck about anything other screwing their patients out of every penny they can steal. Their greed will cause the ruin of many families and create more illnesses due to the stress of the immoral actions of the doctors and the hospitals. They are intentionally breaking their Hippocratic Oath for the almighty dollar and should permanently lose their licenses.
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So no fraud on the doctors part? Cool. Glad we could agree.

And if you find examples of hospitals promising that the whole medical care will be covered in-network and then bringing in out-of-network doctors, then we can start talking about fraud on their part. But I’m guessing you’ll have a really hard time doing that too.
 
ImTheCaptain said:
it's ridiculous that 'real prices' isn't on the top 5 things to do WRT to healthcare. you'd think republicans would be hammering that "market" drum in response to the Dem direction
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defs feels like the political will around real prices should not be a hurdle

gotta figure some lobbies are pretty closely involved in keeping that out of the debate
 
DistrictDeacon said:
So no fraud on the doctors part? Cool. Glad we could agree.

And if you find examples of hospitals promising that the whole medical care will be covered in-network and then bringing in out-of-network doctors, then we can start talking about fraud on their part. But I’m guessing you’ll have a really hard time doing that too.
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Just because the doctor doesn't talk to the patient directly doesn't mean they didn't participate in the fraud. Without the doctor, the fraud couldn't occur. They are, by definition, co-conspirators, by signing the contract, providing services and presenting the bills.

Sounds like this has hit close to home. Are you one of the scumbag doctors or administrators who are fucking innocent people?
 
RJKarl said:
Just because the doctor doesn't talk to the patient directly doesn't mean they didn't participate in the fraud. Without the doctor, the fraud couldn't occur. They are, by definition, co-conspirators, by signing the contract, providing services and presenting the bills.

Sounds like this has hit close to home. Are you one of the scumbag doctors or administrators who are fucking innocent people?
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What fraud?
 
If I said today is Thursday, you would have a seizure and say, "not in Australia".

Defending these actions is de facto supporting stealing from people, destroying families and ruining lives.

but you have to challenge RJ...that's more important being honest and moral.
 
RJKarl said:
If I said today is Thursday, you would have a seizure and say, "not in Australia".

Defending these actions is de facto supporting stealing from people, destroying families and ruining lives.

but you have to challenge RJ...that's more important being honest and moral.
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You can’t even define the fraud that you want to sentence people to life in prison for committing.

And then throw a fit when you get called out on it.
 
I like that RJ thinks that out of network doctors at hospitals are surprise billing frauds that just show up to a hospital and are like ill work here for awhile, Ohh I treated RJ that’s going to be, let’s see it was 9pm, a Friday, the third week of the month, hmm 3,700 sounds about right.
 
DistrictDeacon said:
You can’t even define the fraud that you want to sentence people to life in prison for committing.

And then throw a fit when you get called out on it.
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I figured anyone with a brain would understand such a simple word:

"wrongful or criminal deception intended to result in financial or personal gain"

You can't get a more perfect definition of what is being done to these patients.

But you will come up with an excuse while I'm away in a few minutes.
 
RJKarl said:
I figured anyone with a brain would understand such a simple word:

"wrongful or criminal deception intended to result in financial or personal gain"

You can't get a more perfect definition of what is being done to these patients.

But you will come up with an excuse while I'm away in a few minutes.
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What deception?
 
This is my last post to you on this subject.

When a patient calls in to ask if they are covered at X Hospital for the ER or an operation, you'd have to be high to think that they are told, "Yes, you are covered but the ER is contracted out to a private vendor and you will be receiving an additional bill." or "Your operation is covered, but you'll have to cover extra payments for the anesthesiologist because we don't pay him enough."

Not telling EVERYTHING entailed is 100% the textbook definition of deception.

Have to head out, but you'll come up some other BS to protect doctors, hospitals, insurance companies.
 
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