The way anesthesia costs get offloaded onto (American) patients is nuts enough as it is...
Like, I'll absolutely grant that it's not cheap to knock people out—my friend's father growing up was an anesthesiologist assistant and he made good money doing it, which is fair enough considering it's a job where you literally hold people's lives in your hands. I don't want the guy feeding me propofol to be an underpaid grunt.
But in addition to the already-too-high healthcare costs in this country (specifically the way that those costs get passed onto patients), it sucks getting a separate anesthesiologist bill on top of whatever you paid for the procedure that warranted going under in the first place. Especially when the cost of the initial procedure was insulting to begin with.
And I don't think it's solely a matter of outpatient surgery centers using third-party anesthesia techs. A few years back I was meant to get a bronchoscopy (basically a colonoscopy for your lungs) at a prestigious local hospital, but the anesthesiologist never showed up (and they weren't gonna put a tube down my trachea while I was awake, lol) so they had to send me home. Turns out there was a scheduling snafu and the anesthesiologist who was supposed to be there never got notified that they were on duty.
How does a hospital not have in-house anesthesiologists? Are they really cutting costs by scheduling medical technicians like they're picking up shifts at Taco Bell?
in practice, they just make you sign a notice and consent form in order to receive care. if all the local hospitals do this (and they do) then you no longer have any option but to sign the form.
we really need to eliminate this absolutely ludicrous distinction legislatively.
EDIT: i stand corrected with regard to anesthesiologists. I maintain that hospitals and providers are quickly learning how to maneuver patients into scenarios where they will be subjected to surprise billing anyway. I also maintain that the concept of out-of-network services is mostly ridiculous, since the median patient is very rarely in a position to make actual choices about most of the care they receive.
> in practice, they just make you sign a notice and consent form in order to receive care
Is there a concept of illegal agreement clauses in US? Where even after signing an agreement the signee can claim that such and such clause was illegal and if the court confirms it the whole agreement (or just the clause) is void?
An improvement, for sure. But how about getting rid of the laws that allow these healthcare providers to bill people without having formed any sort of definite contract? You'd never expect to go to the grocery store, pay for your items per the prices listed on the shelf, and then two months later receive another bill demanding you pay a fee to the person who bagged the items for you. Yet this is the type of post-facto nonsense that the medical industry has been allowed to get away with.
> How does a hospital not have in-house anesthesiologists? Are they really cutting costs by scheduling medical technicians like they're picking up shifts at Taco Bell?
Don’t work in healthcare, but if I were to venture a guess it’s around liability. If the patient is in a surgery and dies the anesthesiologist is probably one of the first to get blamed.
Anyone that's sat in on a surgery knows that the anesthesiologist literally does nothing. The assistant does the challenging work of turning the knob clockwise when heart rate increases and counterclockwise when it decreases, and I'd bet that if the heart stops someone else gives the epinephrine shot.
Another scheme these PE groups have concocted is using their regional monopolies to force hospitals and surgery centers to pay an outrageous annual “stipend” for the “privilege” of letting them provide anesthesia. This is in addition to the traditional insurance billings mentioned in the article. However, I think (hope) we’ve reached peak PE intrusion in medicine with increased scrutiny like this article creates, coupled with laws passed to outlaw “surprise out of network billing” (a big tool they were using to boost their bottom line), and physician disillusionment as they realize they ended up working as a cog in the wheels of Walmart medicine. Medical practice is a weird market, revenues are pretty much fixed to Medicare with marginal flexibility in insurance contracts (you can’t just double what you charge), so the main way these firms extract value is through cost cutting (using their market power to pay physicians and mid level providers less, skimp on support staff, etc). Doctors, while typically not great business men, aren’t dumb and can tell when they are getting screwed. With upcoming ftc regulations to curtail noncompetes, a lot these docs can actually bail out, so hopefully private equity has had its day.
American medical system is pure gotcha capitalism and extortion with an ostensible patina of restraint. Medical shouldn't be for-profit and shouldn't be a driver of bankruptcy, but those with legislative ability are on the take from big pharma and big medical to make it even more lopsided, anti-choice, expensive, and anti-consumer. There can be no reform from within a political system that refuses to restrain itself with campaign finance reform. There isn't much hope but large scale, grassroots, nonviolent rebellion to first remedy the political operating system that is a prerequisite for enduring change on any issue that cannot be bought and undone by crooked politicians.
I couldn't agree more. We pay top dollar for second-rate healthcare in the US, and the involvement of a wide array of for-profit corporations is a very large part of why that is.
It's more like third- or forth-rate. The US healthcare has worse outcomes than many other countries. Michael Moore's "Where to Invade Next?" and "Sicko" dive into this issue. The US ranks last in healthcare amongst top economies.
The whole point of this reporting is to uncover anticompetitive actions. Duh, it happens. But also we don't know where and when. This reporting helps pressure regulators to address these anticompteitive moves.
Like, I'll absolutely grant that it's not cheap to knock people out—my friend's father growing up was an anesthesiologist assistant and he made good money doing it, which is fair enough considering it's a job where you literally hold people's lives in your hands. I don't want the guy feeding me propofol to be an underpaid grunt.
But in addition to the already-too-high healthcare costs in this country (specifically the way that those costs get passed onto patients), it sucks getting a separate anesthesiologist bill on top of whatever you paid for the procedure that warranted going under in the first place. Especially when the cost of the initial procedure was insulting to begin with.
And I don't think it's solely a matter of outpatient surgery centers using third-party anesthesia techs. A few years back I was meant to get a bronchoscopy (basically a colonoscopy for your lungs) at a prestigious local hospital, but the anesthesiologist never showed up (and they weren't gonna put a tube down my trachea while I was awake, lol) so they had to send me home. Turns out there was a scheduling snafu and the anesthesiologist who was supposed to be there never got notified that they were on duty.
How does a hospital not have in-house anesthesiologists? Are they really cutting costs by scheduling medical technicians like they're picking up shifts at Taco Bell?