Ambulance Rip Off

I'm telling you.... the health care industry is plagued by corruption, confusion, and greed.  I have a front row seat to this circus and it makes me ill. No pun intended.

Today I had to hear an appeal for a health plan.  The appeal was what the participant was charged directly for ambulance service here in Sonoma County and wanted us to cover 100% of the charges incurred by the ambulance company.  


We knew what the UCR (usual and customary rates) are for ground ambulance charges are and paid 85% of that rate -- the plan maximum.  What I heard today was that the ambulance service charged the participant 3x what the UCR rate is -- as the participant got a bill from the ambulance service company looking for payment on the difference that our plan did not cover.

Question:  Why is the ambulance service billing customers for exorbitant fees waaaaaaaaay above the 'usual and customary rates'?  Because people don't realize what the FAIR rate is for an ambulance ride and they are ripping people off by sending out inflated invoices.  People don't think to question what the UCR even is or that it actually exists. 

Scrutinize EVERY BILL you ever get from a hospital -- they are the worst.  Add to the confusion the implementation of Obama Care (ACA) and nobody knows what's really going on.  Nothing is working like it's supposed to.  It's an administrative nightmare.  The greedy are still trying to capitalize on human illness, suffering, and needs.  That's part of the reason why it's such a mess.  A for-monetary-gain-health system is evil.  Even Kaiser, who pats themselves on the back proclaiming "not for profit," is really for profit.  Don't be fooled for one second.  There is no limit in reserves for a non-profit organization.  Kaiser has more money in "reserves" than they can count while jacking up your premiums in double digit increments.  

And.... medical providers, pharma, dental providers, etc., are ALWAYS the first ones to sponsor and appear at our glitzy industry golf tournaments bearing raffle prizes for the drawing at dinner.  They seem to have plenty of money for that.

The Signature

Today something hit me emotionally at a meeting that I was not quite expecting.  I sit on a multi-employer trust fund in a supervisory capacity for health benefits.  Today the absurdity of our system hit home.

I arrived at the meeting shortly prior to the adjournment time - of course running late as so many things are demanding my perceived immediate attention these days.  I sat down at the meeting table with a cup of coffee nodding my 'hello' greeting to other attendees. 

As I mindlessly started signing forms and applications that needed my approval, one stood out.  I paused.  The form I was signing was to approve a 'temporary disability' application from a young man who was diagnosed with cancer.  I gazed at his shaky signature at the bottom of the form that obviously took quite a bit of effort.

I held up the application to the fund administrator and asked what was going on.  She sheepishly told me that the young man had died prior to needing any 'temporary disability' benefits as the cancer took his life. 

I became saddened and enraged.  Why should anybody who is on their death bed have ******g forms shoved in front of their face to sign?  Is this is what the health care industry has become?  Mind you, I get paid ZERO to sit on this trust fund, but that is not the point.  The point is that the system is what it is because so many people have tried to SCAM it to pad their own pockets.  Now we have to have people dying on their death beds signing forms trying to keep fraud under control.  Pathetic. 

I hope you're happy, disability scammers.