5 Big Healthcare Problems That Aren't Getting Enough Press

5 Ambulances Will Hit You With Surprise Billing

The Good News:

We've finally done something to save you from surprise billing!

Surprise billing is the worst kind of billing, much like surprise parties are the worst kind of party. You've protected yourself with health insurance, acting as responsibly as you can, but then you receive an enormous bill anyway because someone dragged your unconscious ass to a hospital out of your network. Well, tucked into a relief package late last year came some new protections against surprise billing. Get one of those extra charges, and your insurance company and the hospital will have to hash it out through complicated means you don't want to think about, but you yourself will now be off the hook. Hooray!

The Bad News:

The bill exempts ambulances. Ambulances can still surprise bill you as hard as they please.

This matters because surprise ambulance bills are the most common type of surprise bills. More ambulance trips than not result in a surprise bill -- in Texas, which handed out its own ambulance-exempted protection against surprise bills even before the recent national one, 85 percent of ambulance trips take the patient out of network. The average bill is $450, which isn't jaw-dropping by the standards of American medical prices, but it's a big enough out-of-pocket expense to make some people consider hitchhiking to the hospital instead, and you do get the occasional patient laden with ten times that in ambulance bills and resultantly homeless.

If you're wondering why an ambulance ride, even separate from any paramedic expenses, costs so much, the answer requires a complex analysis of the way municipalities fund ambulances -- an analysis so complicated that the people writing the surprise billing protections said, "This is too complicated, let's leave ambulances out of it."

Our Prescription:

When you need to go to the hospital, make sure you travel by helicopter. Because air ambulances, unlike ground ambulances, somehow are covered by the surprise billing protections. "But Doctor Cracked," you might say, "isn't a helicopter going to be even more expensive than a ground ambulance?" Maybe, but not as expensive as an out-of-network helicopter.

4 COVID Outreach Only Works On English Speakers

The Good News:

Vaccines are here, and they're multiplying fast! The US is set to have 90 percent of its population immunized by summer at the current rate, and everything points toward the speed quickly climbing, thanks to additional vaccinations from not only Johnson, but also from Johnson as well! Soon, we'll be back to rubbing our eyes on elevator buttons and getting high with strangers as the good Lord intended.

The Bad News:

Unless you speak Icelandic.

Or speak anything other than English. If you are reading this, we assume you do speak English, but millions in America don't, and they find themselves completely lost about how and where to get their vaccine. Health authorities realize this is an issue and provide vaccine registration sites in a bunch of different languages. But to read in those languages, you need to know how to switch to them, or at least how to scroll. Both of which can be a challenge if, in addition to not speaking English, you also happen to be elderly, like many non-English speakers. Public health experts are concerned because some of these communities that don't speak English are the same ones disproportionately dying in high numbers due to COVID. The elderly could ask help from English-speaking, tech-savvy younger relatives, but geez, have you ever had to walk an old relative through using a website?

Our Prescription:

We need to move beyond registering people for vaccines. Two words: vaccination bees.

3 Nobody’s Gone To The Doctor In A Year

The Good News:

Spending a year covering our mouths and spitting on one another hardly at all, we experienced disease a little differently in 2020. You know early on in the pandemic, people would compare tiny COVID numbers to normal flu numbers, and COVID later eclipsed most years' normal flu? Well, did you hear how the normal flu stacked up last year compared to most years' normal flu? On a regular year, the CDC says 140,000 to 960,000 Americans get hospitalized with the flu, or about 150 per 100,000 people. Last year? We don't have the final count, but looking at six months, including the height of the flu season, we saw just 0.7 hospitalizations per 100,000 people.

That really is good news. But if you look at all of American medicine, those aren't the only numbers that plummeted. There were fewer cases of breast cancer, colon cancer, and cervical cancer. We saw like a third as many new cases as usual. Wow! Did we discover some kind of magical elixir of good health?

The Bad News:

Uh, we only spotted a lot less cancer because a lot fewer Americans got cancer screenings last year. As far as we know, just as many have cancer, but more are running around undiagnosed. Many people avoided going to the doctor last year. They skipped screenings, they skipped checkups, and plenty of people who knew they needed treatment delayed it because they figured that during a pandemic, the last place you want to be is a hospital. That's where all the sick people are. So, we've got a bit of a time bomb on our hands, of people quietly stewing in their own various COVID-negative sicknesses.

Our Prescription:

If you don't want to go all the way to a hospital to get checked out, at least ask eager questions about your aches and pains to your son, Doctor Bob. If you are not lucky enough to be Doctor Bob's parent, marry your child to Bob, so you'll get him as a son-in-law. Marry your daughter or your son; Bob isn't picky!

2 Antibiotic-Resistant Bacteria Increased During COVID

The Good News:

In the surreal early stages of the lockdown, when restrictions were at their most stringent, we delighted in seeing wildlife flourish, newly undisturbed by humans. Pink dolphins came to Hong Kong in huge numbers. New eels and colorful fish came to Rome. Turtles multiplied in Florida, and wildcats and otters found their ways into various urban areas. Plus, a fair number of deer and bear that otherwise would have become roadkill got to live another day.

As for how much those changes lasted, well, that's a harder question to answer. But scientists suspect that one type of organism did manage to thrive this last year!

The Bad News:

Uh, it was harmful bacteria. Harmful bacteria thrived last year.

For decades now, bacteria have become more resistant to antibiotics, and the pandemic only made the problem worse. Facing millions of sick patients and with no good treatment in sight, lots of doctors turned to antibiotics, stuff like teicoplanin and azithromycin. Even if these substances do ease respiratory symptoms, widely dispensing antibiotics is how bacteria grow resistant. Plus, there's the small matter that now that we've had a chance to step back and assess what everyone did, it looks like these antibiotics may not have helped at all, either in marshalling the body's defenses against COVID or in fighting secondary infections.

Our Prescription:

Given that the we are so out of our element given the microbiological implications of this solution, we're going to be holding a symposium on this problem. It's in the vaccination bees' hive. Everybody in.

1 Insurance Is Even A Mystery To The Experts

The Good News:

The idea that your employer provides an insurance plan for you makes very little sense to anyone. Capitalists, socialists ... no one's worldview has a place for this system, but we somehow blundered into it. Your company doesn't assign you a house or give you clothes or food. It gives you money, and then you use that money to buy whatever you want.

So, people should just be free to choose their own insurance plans, and things can only get better once they do. Actually, they should be able to choose their own plan even if their employer pays for it. Hooray for health care exchanges and the Obamacare marketplace!

The Bad News:

That's if you can figure out which plan to pick. And apparently, no one can.

If you can even properly define what "deductible" and "coinsurance" mean, you're in better shape than most consumers, and you're still far from understanding exactly how each plan differs and which would cover the most stuff for the least money. There are just too many factors for anyone to be able to weigh them all. Even economists who design software to help people choose health care plans, when the time comes to choose one themselves, discover they can't do it.  

One especially revealing study came out of the Netherlands (despite what you might have heard, other countries have health insurance too -- people don't just walk into every hospital outside the US and get treated without getting billed). You'd think that, given the chance to choose a plan that best fits their needs, people would wind up with better plans than if someone chose their plan for them. That was not what the study aimed to test. The study tested whether people, given the chance to choose a plan that best fits their needs, wound up with a better plan than one chosen for them randomly. Only 5 percent did.

Our Prescription:

Just never get sick, and live forever. This solution is so obvious, we're surprised more people haven't thought of it before.

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Top image: Valeri Potapova, Temp-64GTX/Shutterstock