New law on recouping medical debt

The Friday Pulse Check

Dec 02, 2022

Good morning and happy Friday. Welcome to this week’s edition of the Friday Pulse Check.

In the news:

Human trials on brain implants may begin next year

Elon Musk has been busy. The founder of SpaceX, CEO of Tesla (TSLA 0.00%↑), and most recently owner of Twitter announced this week he is seeking FDA approval for human tests for his brain implant next year. The device is called Neuralink and would work to enhance the capabilities of the human brain by connecting it to a computer. Neuralink is not the only device currently in development; there are others including some that have grants from the federal government. Read more in the New York Times.

Should doctors be “nice” to their patients?

One statistician says yes. Layla Parast, PhD, is an associate professor in the Department of Statistics and Data Sciences at the University of Texas at Austin and former senior statistician at the RAND Corporation. She wrote in The Hill this week that surveys show that patients who had better experiences with the physician are more likely to fill their prescriptions, receive follow up care, and take their doctor’s advice. Read more in The Hill.

Online trackers might violate HIPPA

In our technological era, whenever you visit a website there are trackers that keep a tally on what links you click, how you got to the website, and what you do on a particular website. Substack does this on FLATLINING to give us analytical results of how many open and read this newsletter or listen to our podcast. Commercially, many websites use Google Analytics (GOOG 0.00%↑) or Meta Pixel (META 0.00%↑) as their tracker. The Department of Health and Human Services is warning that there are several “regulated entities” (those that are required to abide by HIPPA laws) which have commercial trackers and those trackers are receiving personal health information. It is important to remember that HIPPA does not apply when someone downloads or inputs their own health information into a third party app (like Apple Health (AAPL 0.00%↑) or Fitbit). Read the bulletin from HHS.

Money Money

This week on the FLATLINING Podcast, Ron and I spent a good deal of time talking about money and healthcare. We’ve talked at length before about our healthcare equation.

As a reminder that is that there are three desirable outcomes in healthcare: quality, access, and affordability; you can have two but not three of these in a healthcare system.

For example, we would argue that the United States has the quality and access part down. You can go to any hospital, you can see specialists in a timely manner, and (with the exception of very rural America) there are facilities everywhere. In Canada, however, we might say they have the quality and affordability but not the access. We spoke on a previous episode of the FLATLINING Podcast that average wait times in Canada to see a specialist after a referral were between twenty and fifty-six weeks (pre-COVID) depending on which province you lived in. (For those of you keeping score: Ontario had the shortest wait times, Prince Edward Island and New Brunswick had the longest).

On the podcast this week we discussed medical debt and a new anti-smoking grant. In New York, Governor Kathy Hochul just signed a new bill that forbids garnishing wages and taking liens out on homes to recoup medical debt. This ties the hands of collections agencies as these are some of the main ways debt can be recouped.

As Ron and I talked about, this is good for the people who incur medical debt, without a doubt. And it is very important to remember that those who go into medical do not chose to and we must be empathetic towards that.

On the other hand, the new law really hurts the hospitals and doctors who provided a service and are now unable to collect the payment they are owed.

This follows a decision from earlier this year from major credit companies saying they would no longer consider medical debt when determining credit scores.

As medical debt becomes less and less important, I think I can say confidently that the cost of healthcare is going to continue to go up, making an already affordably situation even more so.

We already know why one dose of acetaminophen at a hospital costs $8; it is to cover for the people that aren’t going to be paying for that care.

By asking physicians to write off more and more medical debt, we are footing our own selves with a higher and higher medical bill.

Medical debt is undoubtedly a problem that should be addressed. There are numerous other ways, however, to solve it than simply saying “you can’t recoup it.” The state and federal governments could create assistance programs to help people making under certain amounts (who do not qualify for Medicaid or possibly even exchange plans). Hospitals could be allowed to recoup certain percentages of debt for individuals who qualify for assistance programs.

There are compromise solutions out there that aren’t “you can’t recoup the debt.”

Let me know what you think in the comments below or by emailing me at flatlining@substack.com or sending me a Tweet (@radioHandley).

Ukraine

The British newspaper the Telegraph is reporting that surgeons are repeatedly having to conduct surgeries while someone holds up a flashlight as Russian bombing continues on civilian infrastructure. The United Nation is reporting that there have been more than 700 strikes on healthcare facilities throughout the country. Read more in the Telegraph via MSN.

Final thought

The 988 national mental health hotline is back up after a nearly day-long outage. HHS spokeswoman Sarah Lovenheim said in a Tweet on Thursday night, “While HHS and [Veterans Affairs] immediately acted to provide support to 988 callers via text, chat, and alternate numbers, the disruption of phone service was unacceptable, and HHS continues to investigate the root cause of the outage.”

988 is the new suicide prevention and mental health hotline set up in July of this year. During the outage, you could still text 988 or visit the website 988lifeline.org to chat.

Intrado, the Omaha, Nebraska based telecommunications company which provides the emergency response service, said in a statement that it is working to return to be fully operation. Read more from ABC News.

Have a good weekend,

Matthew