Viewpoints: Surgery surprise: Out-of-network doctors' bills; consequences of making Medicaid enrollees pay premiums

Los Angeles Times: The Ugly Surprise Of Out-Of-Network Doctors And 'Balance Billing'
The New York Times' Elisabeth Rosenthal offered an important lesson in healthcare economics over the weekend that's a must-read for anyone about to undergo a major medical procedure. Rosenthal's piece explored how charges from out-of-network providers can magically show up on a hospital bill. She focused on one particularly nasty practice, called "drive-by doctoring," in which physicians call in colleagues not in a patient's network to consult or assist on a procedure. The out-of-network provider charges the retail rate -- in some cases, hundreds of times what the government would pay them for the same work, and invariably far more than what the patient's insurer will cover. The provider then tries to collect the remainder directly from the patient, a process known as "balance billing" (Jon Healey, 9/22).

The New York Times' The Upshot: Medicaid Gives The Poor A Reason To Say No Thanks
While Medicaid, our safety net program for the poor, has used cost-sharing mechanisms for some time, it has been prohibited from asking people to pay premiums. In the last couple of years, federal regulators have started lifting that prohibition, which is likely to lead to some negative consequences (Aaron E. Carroll, 9/22).

The Washington Examiner: Jindal Says Hospitals Are Shortsighted On Medicaid Expansion
Hospitals have been pushing the issue hard, because they were counting on an expanded Medicaid program to reduce their uncompensated care costs. ... But [Louisiana Gov. Bobby] Jindal, who once served as Secretary of the Louisiana Department of Health and Hospitals, said that if Medicaid were expanded in Louisiana, the number of people who would move to Medicaid from private insurance would exceed the number of uninsured residents who would gain coverage. "I told my hospitals I thought that [supporting Medicaid expansion] was a foolish, shortsighted, short-term position," he said (Philip Klein, 9/22).

The New Republic: How To Save Obamacare: Make It A Women's Issue
The challenge for the next Democratic presidential nominee is thus to break the psychic link-;to reshape the way the public thinks about health reform as something more than just a proxy for Obama. And whether she realizes it or not, Hillary Clinton has made a strong case that a female candidate will be better suited to the task than a male candidate. Last Thursday, Clinton joined a Center for American Progress panel about women's economic security, focused mainly on gendered issues like equal pay and child care. But Obamacare fits neatly into the same framework (Brian Beutler, 9/22).

The New York Times' The Upshot: Why Senate Control Matters
Regardless of which party controls it, Republicans will almost certainly control the House, and Democrats will hold the White House. Given how far apart the two parties are on almost every major issue -; climate, health care, inequality, the long-term deficit, immigration and same-sex marriage, for starters -; the odds of major legislation becoming law in the next two years are scant. … And yet control of the Senate still very much matters, just not for the most obvious reasons. It matters for climate policy and the Affordable Care Act, among other big issues (David Leonhardt, 9/23). 

The Wall Street Journal's Political Diary: Kentucky's Desperate Democrat
One motif that's been largely missing from Democratic campaigns this year is the Republican war on Medicare. Lo, Kentucky Democrat Alison Lundergran Grimes has disinterred the trope in a new ad that implicates Mitch McConnell in her grandfather's incapacitation. Really classy (Allysia Finley, 9/22). 

The New York Times' Room For Debate: Hiring A Woman For Her Womb
People unable to bear children have increasingly turned to women who bear children for them, often by transferring an embryo created by in-vitro fertilization. Because legal and social views on surrogacy vary from nation to nation (and even state to state), prospective parents often engage surrogates in the United States and in developing countries. Controversy has clouded this issue (9/22). 

Los Angeles Times: Dad Pleads: Don't Let Health Insurance Offer My Daughters Birth Control!
Remember the prediction that the Supreme Court's decision to let Hobby Lobby opt out of Obamacare contraception coverage would open the floodgates for more of the same? Well, it's not a flood, but it is a one-man trickle. A Missouri Republican legislator is suing in federal court for a personal opt-out for his family (Patt Morrison, 9/22). 

The Washington Post: Has The Department Of Health And Human Services Politicized FOIA Requests?
The Department of Health and Human Services (HHS) is denying an allegation by a top Associated Press journalist that the agency has politicized the handling of requests under the Freedom of Information Act (FOIA). "FOIA requests are handled by career staff," Kevin Griffis, an HHS spokesman, told the Erik Wemple Blog in a brief interview on Friday. Griffis was responding to a much-shared AP post summarizing "8 ways the Obama administration is blocking information," an inventory of press restrictions compiled by AP Washington Bureau Chief Sally Buzbee and presented at a meeting of the American Society of News Editors, the Associated Press Media Editors and the Associated Press Photo Managers. Under obstruction No. 7, Buzbee alleged, "The administration uses FOIAs as a tip service to uncover what news organizations are pursuing. Requests are now routinely forwarded to political appointees" (Eric Wemple, 9/22).

http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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