But isn't the California law requiring the insurance company to act as a sin-eater here? They seem to be the only people you were frustrated with, even though they are not the ones who charged you $1000.
But isn't the California law requiring the insurance company to act as a sin-eater here? They seem to be the only people you were frustrated with, even though they are not the ones who charged you $1000.
They had the duty to pay and they try to trick every one of their customers into not realizing that, so that's why I'm only mad at them.
I acknowledge that the CA law is forcing them to, in the mechanism the article covers, causing them to subsidize other people's care, and this is happening in many areas of healthcare too.
Though those costs are surely accounted for when they set their premiums, which for 2025 amounted to just over $32,000 for my family.
The insurer is being forced to act as an insurer, by paying the $1000 they're supposed to cover.
Did they know they were supposed to cover it, or did the provider make a billing error? Even if there's no error, why is a government-run ambulance service making this the patient's problem, if the law says that they definitely have to pay? Why did it cost $1000 anyway, is that a reasonable price?
- The "why $1000" part is the subject of the article (I assume COVID-era inflation has brought that up to about $1700 similar to everything else)
> why is a government-run ambulance service making this the patient's problem
Whether government or private, they just want their money, and the insurance companies shrewdly avoid conversations where they might have to actually pay money. Plus, the ambulance guys probably have barely any documentation they could submit to prove that it was a "real" emergency, without which the $1000 would be the correct bill for me.
Insurance company's "genius" here is just remaining quiet and saying nothing, guaranteeing the average person will either get sent to collections by the ambulance, cut a deal with the ambulance, sell their plasma and subsist on ramen to afford it, or charge it on a credit card. And none of those involve the insurance sociopaths at all.
The article really proves that a "network" doesn't even make sense for this particular service. The insane part to me is that the insurance companies are allowed to pretend it does, and that they even have any "network" and impose the in/out of network distinction at all.
It's like if your Internet service came with "unlimited data" but when you read the fine print everything is pay-per-MB besides one single unpopular website.
> isn't the California law requiring the insurance company to act as a sin-eater here?
American healthcare providers have done a pretty good job at transferring PR liability to insurers. Cost inflation, in America, is mostly a problem at the provider level.