Tuesday, 30 September 2014, NEW YORK, NEW YORK - The New York Times in the first of a series of articles on the shameful state of the United States healthcare system to which interested readers may follow the below link reports that fully insured patients who are careful to use "in-network" hospitals still are increasingly completely ambushed by later surprise huge bills particularly for "contract" Emergency Room (ER) physicians by whom they have no choice but to be seen having been made to sign mountains of forms when usually waiting in distress in the ER which they are in no condition to read nor understand but are given to believe they must sign or die which means they essentially are signing under duress incomprehensible to them pre-prepared documents with no opportunity and in no condition to understand nor give meaningful agreement.
This effectively means these piles of documents are worse even than for example the printed insurance company "adhesion contracts" which courts invalidated as unenforceable non-contracts almost a century ago as not fulfilling fundamental requirements of contract law such as a meeting of the minds and moreover being completely invalidated by the fact that attempts to bind people to such documents merely by having them sign them in such circumstances is
per se unconscionable. As by the way are the fees often charged by the ER "contract" doctors as documented in the Times article which gives examples of even physicians bringing family members in for care and objecting to "contract" ER doctor bills as absolutely outrageous. Also when being gouged for such simple things as putting in eight stitches later followed by a surprise out-of-network surgeon's bill for $4,878.
Apparently many ER doctors often just gouge completely uninformed patients for relatively simple procedures because being an "ER doctor" was not even a specialty until the 1980's meaning that if any complicated medical work has to be done it still needs to be done by an actual medical specialist and not just someone who is merely a specialist at overbilling unknowing patients in distress and protecting their precious medical licenses by undermedicating patients in serious pain and distress because they are too scared of the DEA, the FDA and/or the state medical board so whenever possible they leave that risky problem to the actual treating physician they tell patients they must see as soon as possible anyway.
The Ninth Amendment wishes this could be said to be the exception and not the rule but the hard numbers prove otherwise. There have to be a great many ER doctors seriously overcharging to have in a period of just the past four years driven the average ER doctor's annual income up from $247,000 to $311,000 during an era of near zero and even negative inflation and when the average American's real income has not even yet risen back to previous levels. The Times horror stories include an ER physician charging $2,000 for having a patient hooked up to a heart monitor for a few hours before being released. In the stitching case mentioned above an out-of-network surgeon (not ER doctor) saved the day in the ER by putting eight stitches in a girl's chin and later charging $4,878 creatively coding his valiant work as "open wound, jaw, complicated". The Times did not detail if "complicated" referred to the procedure of putting in eight stitches or for thinking up a word that could possibly justify charging that amount for putting in just eight stitches and not getting sued (good thing it was not Medicare).
Likewise ER physicians' overcharging now has driven up their average annual incomes to more than that of all the previously most notoriously expensive out-of-network specialists being anesthesiologists, radiologists and pathologists (who best we recall often used to be want-to-be surgeons with challenges like alcohol problems who were directed away to a specialty where the patients were already dead) for basically looking at bloodwork, ordering x-rays, oh yes having nurses glance at heart monitors, and interrogating any patient who believes they need medicine that the physician possibly believes might be abused with any subsequent doctor then
de rigeur giving an inconsistent explanation of why it cannot be prescribed.
It has been the experience of the Ninth Amendment that most but not all such physicians lie to patients on such matters more creatively than many law enforcement officers sworn on a witness stand and that is pretty bad. Even the ER physicians' spokesman Dr. Jeffrey Bettinger, chairman of the reimbursement committee of the American College of Emergency Physicians, apparently could not help himself from lying to the New York Times when he "said that out-of-network emergency room doctors were an unusual phenomenon and expressed doubt that the practice was widespread". Actually the Times reported that the occurrence of out-or-network emergency room doctors indeed was "widespread" having now risen to an overwhelming 65% in the Nation's emergency rooms.
In fact the Ninth Amendment actually has been informed by emergency physicians for example in a Florida hospital that it is the policy of the State of Florida that because of the high level of abuse of pain medication that patients no longer can be treated at the hospital for previously existing pain conditions. We suggest the license plate slogan be changed from "Florida The Sunshine State" to "Florida It Is Going To Hurt A Little" superimposed over a five thousand dollar invoice rather than an orange. When the Ninth Amendment asked nurses if they had had many cases of deaths by prescription pain medicine overdoses coming in to the hospital they were able to remember none other than ones in which hospital anesthesiologists had accidentally given patients additional doses of pain medicine on the operating table after they forgot they already had given patients pain medicine which then overdosed them. Anyway pain apparently is now one less worry for ER "specialists" at least in Florida since they can let the State and the DEA practice medicine without a license and just follow orders and not treat it.
THE NINTH AMENDMENT IS IN NO WAY QUALIFIED TO PROVIDE MEDICAL NOR LEGAL ADVICE. READERS SEEKING LEGAL OR MEDICAL ADVICE OR CARE MUST CONSULT A PROPERLY QUALIFIED LICENSED LEGAL OR MEDICAL PROFESSIONAL.
The Ninth Amendment sympathizes that the situation exposed by the New York Times in the article with link below describes an impossibly frustrating situation for even readers who take every possible reasonable step to see that they are not shocked by what would seem to be a blatantly unfair circumstance that may arise especially in the case of a medical emergency for which they rightfully believe they have taken all apparent possible prudent precautions to avoid surprise unscrupulous catastrophic costs and expenses for which they have purchased and/or arranged insurance or other health cost coverage to the best of their ability.
It is apparent that the Times describes a healthcare system that is broken and completely unworthy of a country blessed with the great God-given resources of our Nation. How can President Obama repeatedly say in good conscience that the United States has "the best military the world has ever known" fully aware that he can say no such thing about the United States healthcare system? Although the Ninth Amendment can offer no suggestion at this time of a considered workable long-term solution it is our lay opinion in the meantime that given our understanding that all hospitals are obligated to provide emergency medical care to all patients who enter in need of it until such time as they have been stabilized properly with appropriate arrangements made for their continued care that the signing of prepared documentation in conditions such as those as set forth above is arguably unconscionable and cannot be a requirement of necessary medical treatment.
Rather than argue the point based on past experience we would be inclined to refrain from signing documents which we are in no condition to understand nor able to meaningfully signify agreement but rather simply scribble "I willl not pay" and hand them back as if they had been signed. But then that may just be us.
http://www.nytimes.com/2014/09/29/us/costs-can-go-up-fast-when-er-is-in-network-but-the-doctors-are-not.html?src=me&module=Ribbon&version=origin®ion=Header&action=click&contentCollection=Most%20Emailed&pgtype=article
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