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'This is classic whac-a-mole,' writes Walker. 'As soon as one specific problem is banned the industry quickly moves to find a slightly different new loophole to exploit.' (Photo: Medscape.com)

US For-Profit Health Care Industry is Always Innovating New Ways to Steal Your Money

Jon Walker

 by FireDogLake

The New York Times offers yet another example of the ongoing problem of consumer protection whac-a-mole. While the Affordable Care Act was meant to offer at least some limits on what people pay for preventive care and out-of-pocket spending, the health care industry is finding clever new fees that might not be cover. From the NYT:

As insurers ratchet down payments to physicians and hospitals, these providers are pushing back with a host of new charges: Ophthalmologists are increasingly levying separate “refraction fees” to assess vision acuity. Orthopedic clinics impose fees to put an arm in a cast or provide a splint, in addition to the usual bill for the office visit. On maternity wards, new mothers pay for a lactation consultant. An emergency room charges an “activation fee” in addition to its facility charges. Psychologists who have agreed to an insurer’s negotiated rate for neuropsychological testing bill patients an additional $2,000 for an “administration charge.”

Some of these fees may or may not end up being covered by your insurance, may or may not count as part of the in-network care, and may or may not apply to your out-of-pocket limit. This means individuals on the exchanges who often face huge deductibles can see their total spending on an unexpected illness exceed what they calculated even if they tried to be diligent health care consumers.

This is classic whac-a-mole. As soon as one specific problem is banned the industry quickly moves to find a slightly different new loophole to exploit. What is really needed is a broad solution, not a series of popular mallet whacks. There is no way our political system is set up to whack these problems as quickly as they are created.


© 2014 FireDogLake

Jon Walker

Jon Walker is political writer and blogger for FireDogLake. He is an expert on health care policy and the politics of health care reform.

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