S01.E18: Five Miles West

[txhorns79]

Quote

Reynolds struggles to help a young cystic fibrosis patient with curious symptoms, while Kapoor finally comes face-to-face with Ella after their awkward encounter. Meanwhile, Sharpe takes a major step in her personal life.

[auntiemel]

Nice to see Judith Ivey finally kicking Max's ass about his cancer! Like...it's called "the big picture," dude. Look into it.

I'm not a lawyer, but the surrogacy storyline (the kid not being given to the father) seemed off, because he WAS the biological father. So, it really seems like a custody dispute wouldn't have touched on the surrogacy at all. It would have been a more understandable story if he'd had bad swimmers and used a sperm donor AND a surrogate.

As it was, he had clear paternal rights. It was his DNA. They never made it clear why that didn't matter?

[Kleav]

14 minutes ago, auntiemel said:

As it was, he had clear paternal rights. It was his DNA. They never made it clear why that didn't matter?

Apparently the surrogacy's illegality (in New York State) meant that the judge couldn't rubber-stamp his claim. I think the DNA matters, but the legal process is more complicated.

[ams1001]

23 minutes ago, auntiemel said:

I'm not a lawyer, but the surrogacy storyline (the kid not being given to the father) seemed off, because he WAS the biological father. So, it really seems like a custody dispute wouldn't have touched on the surrogacy at all. It would have been a more understandable story if he'd had bad swimmers and used a sperm donor AND a surrogate.

As it was, he had clear paternal rights. It was his DNA. They never made it clear why that didn't matter?

Yeah, I didn't get that, either. They clearly said he was the genetic father, so why was there even a question? Do a paternity test, sure, but I don't see why he wouldn't get to keep the baby regardless of the relationship to the surrogate. (Though I knew as soon as he said he wouldn't fight for him so he wouldn't end up in foster care the parents would change their minds.)

Who played the CF patient's mother? IMDB doesn't list the full cast (although googling found me an article about the actor who played the patient, who apparently actually has CF in real life). And I get wanting to give your kid some control/responsibility for her health condition as she gets older, but making a 12 year old fully responsible for her meds to the point that you don't even realize she stopped taking them seems like a bad idea.

Edited April 18, 2019 by ams1001

[txhorns79]

Quote

Apparently the surrogacy's illegality (in New York State) meant that the judge couldn't rubber-stamp his claim. I think the DNA matters, but the legal process is more complicated.

The whole storyline was weird and poorly explained.  My understanding is that if the surrogacy contract was void, the baby goes to the custody of the birth mother and/or the biological father.  I did not understand why the situation appeared to be that in the absence of the surrogacy agreement, the birth mother's next of kin had to give permission before the biological father could take custody. 

And seriously, does Max not understand how money works?  His whole bartering system was interesting, but completely impractical.  

[ams1001]

4 minutes ago, txhorns79 said:

And seriously, does Max not understand how money works?  His whole bartering system was interesting, but completely impractical.  

Well, he also seems to think that his running everything in the hospital is more important than treating his cancer and maybe staying alive to be able to do his job in the future. 

[LittleIggy]

1 hour ago, txhorns79 said:

The whole storyline was weird and poorly explained.  My understanding is that if the surrogacy contract was void, the baby goes to the custody of the birth mother and/or the biological father.  I did not understand why the situation appeared to be that in the absence of the surrogacy agreement, the birth mother's next of kin had to give permission before the biological father could take custody. 

I’m surprised Dr. Free Spirit Rule Bender Max was such a stickler about the unenforceablity of the surrogacy contract in NY to start with. Doesn’t seem like something he would give a bleep about.

[Kelda Feegle]

Did I get something wrong? The baby wasn't even the surrogate's egg to start with? Which would make her parents completely irrelevant, plus if the biodad gave them custody he'd still be on the hook for child support?

Glad someone has finally slapped some sense into Max - shame it was only metaphorically.

[Dowel Jones]

I think the IRS rules require that barterers report the value of the work done as income also, but the enforcement of that would be difficult at best. 

Interesting production error (I think) occurred at about 40 minutes in, while Max is leaving Dr. Staunton's office.  He went in to get his keys, got the lecture, and then started to leave.  She tossed him his keys, and he held them in his right hand while looking over his right shoulder at her.  As he is leaving, the door shuts behind him.  His right hand is visible, his left hand is too far away; who closed the door?  It wasn't an automatic door, either.

[bros402]

I don't understand the barter storyline - was the board person saying Max paid the electrician $4800 for her work on top of her working off her dead, or that in tax terms, it was like they paid her $4800?

According to this site, even if she is not biologically related to the kid, she is considered the birth mother by the state of NY - https://www.creativefamilyconnections.com/us-surrogacy-law-map/new-york/

The contract is also just considered a statement of intent in NY - and apparently there is no case where a single parent used their own egg or sperm and used a surrogate - I am guessing the guy got an egg somewhere, had it fertilized, then implanted into the surrogate?

[alexvillage]

Sadly reminder of the terrible "health" system in the U.S. - you cannot pay the bills than someone suggests that you work for free to "pay" for said bills. Nobody should be forced to work for free in order to get what is a human right - in most of the rest of the rich world at least.

Also staggering that a collection agency would drive someone's life to ruins while paying the hospital only .5 cents on the dollar. Wouldn't it be more humane, or at least not so shitty, if the hospital tried to make a payment plan and get some of the money without allowing financial vultures to harass people? Oh, wait, capitalism doesn't not allow for humanity in full display. Sorry for the silly thought.

The girl who played the CF patient has Cystic Fibrosis. I don't know much about her, only that her name is Lily. Way for representation, even tough there wasn't much about CF as far as education goes. Maybe it got lost in the editing room but she seemed happy to be part of the episode.

[Dowel Jones]

9 hours ago, bros402 said:

I don't understand the barter storyline - was the board person saying Max paid the electrician $4800 for her work on top of her working off her dead, or that in tax terms, it was like they paid her $4800?

I'm pretty sure it was a straight swap.  There's no way (okay, Max would find a way) that the board would approve that kind of expense without a bid process.  I know what you meant to say (the bolded part), but now I have this image of Max wandering the halls, ringing a large bell and calling out "Bring out your dead" and the poor patient replying "I'm not dead yet".

[Flyin.Bryan]

14 hours ago, auntiemel said:

I'm not a lawyer, but the surrogacy storyline (the kid not being given to the father) seemed off, because he WAS the biological father.

My wife IS a lawyer, and I thought her head was going to explode. A lot of the same questions everybody had, plus the observation that you should get a real lawyer instead of letting the hospital shrink play lawyer.

[ams1001]

2 minutes ago, Flyin.Bryan said:

My wife IS a lawyer, and I thought her head was going to explode. A lot of the same questions everybody had, plus the observation that you should get a real lawyer instead of letting the hospital shrink play lawyer.

Yeah, I was thinking when he started to tell the parents they could have the baby, "you really should consult an actual lawyer before you do this." Why the hell is the psychiatrist involved in all this stuff, anyway?

[suzyq8017]

They waved it away by saying he was working in his role as a ‘child advocate.’ I am a hospital psychologist and my head was about to explode too!! I HATED this storyline!! For all the same reasons y’all did, but more than anything, this this specific thing. Get a lawyer!! And the idea that a dad would just say, fine, y’all take him, see ya never? This was clearly meant to be some kind of King Solomon story, but it was very poorly done. 

[tvrox]

That bartering system was insane and not practical. Seriously, every single person who owes the hospital money has a skill the hospital needs they can barter? Yeah, right.

Did they say if the dad was gay or straight and doing surrogacy because he was single? I thought they would have brought up the gay angle because the psychiatrist is.

I'm surprised they didn't check the blood levels of the CF patient's meds right away. My first guess was that she hadn't been taking her meds.

[ams1001]

5 minutes ago, suzyq8017 said:

They waved it away by saying he was working in his role as a ‘child advocate.’ I am a hospital psychologist and my head was about to explode too!! I HATED this storyline!! For all the same reasons y’all did, but more than anything, this this specific thing. Get a lawyer!! And the idea that a dad would just say, fine, y’all take him, see ya never? This was clearly meant to be some kind of King Solomon story, but it was very poorly done. 

And it didn't seem to occur to anyone that whoever ended up raising the kid, they could arrange to allow the other to still see him. I mean, they're not his biological grandparents, but nothing is stopping the guy from letting them see him as he grows up, if they wanted to work something out. And since he is the biological father he should at the very least be able to get visitation rights. 

(I also thought it odd that they referred to the father as a stranger. He said the surrogate was his best friend. Did she not have a relationship with her parents [if they mentioned an estrangement or something, I missed it]? Never mentioned her best friend for whom she's carrying a child?)

[LittleIggy]

I thought maybe I had missed something and the dad was a friend of Iggy’s until he asked Iggy if he had kids. Don’t know why he was talking to Iggy.

[bros402]

19 hours ago, alexvillage said:

Sadly reminder of the terrible "health" system in the U.S. - you cannot pay the bills than someone suggests that you work for free to "pay" for said bills. Nobody should be forced to work for free in order to get what is a human right - in most of the rest of the rich world at least.

Also staggering that a collection agency would drive someone's life to ruins while paying the hospital only .5 cents on the dollar. Wouldn't it be more humane, or at least not so shitty, if the hospital tried to make a payment plan and get some of the money without allowing financial vultures to harass people? Oh, wait, capitalism doesn't not allow for humanity in full display. Sorry for the silly thought.

The girl who played the CF patient has Cystic Fibrosis. I don't know much about her, only that her name is Lily. Way for representation, even tough there wasn't much about CF as far as education goes. Maybe it got lost in the editing room but she seemed happy to be part of the episode.

Every other country in the first world has UHC.

It's the same thing with all kinds of debt - I think John Oliver bought a bunch of student loan debt a few years back, then forgave it, to show how ridiculous the whole debt process is.

Some hospitals are much better than others about paying bills. The hospital I spent the first 2 1/2 months of my life at - they were happy to get whatever they could ($25 a month in my parents case), then the debt was forgiven when I was like 13.

Some hospitals won't do payment plans, or rather, won't do reasonable ones.

14 hours ago, Dowel Jones said:

I'm pretty sure it was a straight swap.  There's no way (okay, Max would find a way) that the board would approve that kind of expense without a bid process.  I know what you meant to say (the bolded part), but now I have this image of Max wandering the halls, ringing a large bell and calling out "Bring out your dead" and the poor patient replying "I'm not dead yet".

Hahahaha

6 hours ago, tvrox said:

That bartering system was insane and not practical. Seriously, every single person who owes the hospital money has a skill the hospital needs they can barter? Yeah, right.

Did they say if the dad was gay or straight and doing surrogacy because he was single? I thought they would have brought up the gay angle because the psychiatrist is.

I'm surprised they didn't check the blood levels of the CF patient's meds right away. My first guess was that she hadn't been taking her meds.

tbh I was expecting one of the people to not have a skill, then him going "Hey, can you pay 6% of what your total bill is?"

[Brookside]

I agree with what everyone has said about the ridiculousness of the bartering and surrogacy plot lines.

I've never particularly liked Max, but he has become totally insufferable, delusional, and with a God complex the size of  Alaska.  He totally needs to be fired.

Can someone remind me of what happened between Dr Kapoor, his son, and the coffee lady and how she ended up with the bracelet and ring? 

Another totally unrealistic newborn.  If you're gong to use a twelve pound, one month old, at least give it a more realistic birth weight than 7lb 6oz, and don't have it smiling.

[Lunula]

On 4/18/2019 at 1:45 AM, Kelda Feegle said:

Did I get something wrong? The baby wasn't even the surrogate's egg to start with? Which would make her parents completely irrelevant, plus if the biodad gave them custody he'd still be on the hook for child support?

Exactly! They made it very clear the surrogate was not the biological mother, so how could her next of kin have any claim to the child at all? I understand the legal system is complex and sometimes pretty stupid, but that seemed incredibly dumb. It would've made a lot more sense if she had been surrogate and egg donor, but signed the agreement with bio-dad. 

The entire story of the kid not taking her medication was simply stupid and made no sense. And the explanation after she woke up? Are you joking? She was jealous, at 12 years old, of the new baby and stopped taking her medication in an effort to see if mom would notice - and then it was all neatly tied up and we hugged and kissed after mom says she loves her? Ugh. 

Bartering system I thought was silly, but okay. 

The only stories I really connected with were the wife's bracelet - though I'm a bit shocked at how quickly the relationship between the son and the cashier lady is progressing - and Max's new doctor finally getting through to him (though it didn't make much sense that he was ignoring his health to run the hospital when he could die and miss everything). Oh. And what the hell is happening with his wife? He goes through a blizzard and prioritizes the hospital above his pregnant wife and also prioritizes the hospital above his very life, again ignoring the pregnant wife. Starting to think he's kind of an ass. 

This show seems to have a good following/ratings and I can only cross my fingers that the stories & writing get much better next season. Bordering on ridiculous every episode is wearing thin.

[Biggie B]

1 hour ago, Brookside said:

Can someone remind me of what happened between Dr Kapoor, his son, and the coffee lady and how she ended up with the bracelet and ring? 

Dr. Kapoor approached Ella (the coffee lady) at the coffee place, ostensibly to buy a cup of coffee, but also to again apologize to her (for previously saying a few episodes ago that the only reason his son was interested in Ella was to anger him). He spotted Ella wearing the bracelet (no ring was involved) and had a very visceral reaction, which Ella picked up on. She later went to his office to return it, correctly surmising that it belonged to Dr. Kapoor's wife. She said that whatever was going on between him and his son, she wasn't getting in the middle of it, and that even though she and Kapoor weren't in a good place, she'd never hurt him by keeping the bracelet. He took back the bracelet. Later on, he went back to Ella with a jewelry box that contained a full set of matching jewelry, including the bracelet. He explained that the set was an heirloom, meant to passed down from one generation to the next. When the bracelet went missing after Kapoor's wife died, Kapoor accused his son of stealing it and probably hocking it to get money to buy drugs, never imagining that his son kept it as a cherished reminder of his mother. Kapoor told Ella how very wrong he'd been about his son, and asked her to give his son the full set of jewelry. 

[Dowel Jones]

The other thing about the barter system at the hospital is, what happens if one of them is injured while performing the work?  The artist falls off the scaffold, the electrician gets a shock, etc.  Are they covered by the hospital insurance? Are they contractors?  Where is the paperwork?  Methinks that Dr. Max would find himself in legal deep water in a big hurry.

[doodlebug]

44 minutes ago, Lunula said:

Exactly! They made it very clear the surrogate was not the biological mother, so how could her next of kin have any claim to the child at all? I understand the legal system is complex and sometimes pretty stupid, but that seemed incredibly dumb. It would've made a lot more sense if she had been surrogate and egg donor, but signed the agreement with bio-dad. 

The newest innovations in reproductive technology have made for a lot of legal confusion.  Here's what generally happens:  the woman who carries the child and gives birth is the legal mother.  This is because many, many infertile women use donor eggs and and it would be a nightmare to have to find the actual egg donor, initially put her name on the birth certificate and get her to relinquish her parental rights to any children that come from her eggs.  When a woman donates eggs, she has to sign a release forfeiting her rights to any child that might be born using them.   In the case of a gestational surrogacy (donor egg carried by a woman who is not planning to parent the child), the woman who gives birth to the baby is initially listed as the parent on the birth certificate.  She has to legally renounce her rights to the child who will then be legally adopted by the mother who hired the surrogate. 

Then, there is the sperm donor issue.  Insemination using donor sperm has been around a lot longer than egg donation.  The law generally states that, if a couple is legally married, the male partner is the legal father.  His name goes on the birth certificate and he gets parental rights and responsibilities.  The donor, just like an egg donor, signs away all rights to any children that come from their donation at the time it is made.  This prevents people from trying to go back and sue a sperm donor for child support, etc. and also gets the government out of its citizens' personal lives.

There have been some legal cases where the surrogate tried to keep a baby, you can google Mary Beth Whitehead and Baby M if you want to look at the most famous case. Mary Beth was hired by a couple to be inseminated with the husband's sperm and then carry a child for them.  The baby was conceived using her egg, so it was genetically hers.  The wife in the case had MS and was worried about the effects of pregnancy on her health as well as wanting to avoid passing any genetic tendency to the child which is why they used donor eggs.  After the baby was born, Mary Beth kidnapped it, claiming that she realized that the adoptive couple were not  good parents and she needed to protect the baby from them.  It ended up in court where it was essentially treated as a custody dispute and the sperm donor/father ended up winning custody and Whitehead getting some visitation.  Eventually, the baby grew up, went to court and terminated Whitehead's parental rights and a formal adoption by her adoptive mother took place.

Edited April 19, 2019 by doodlebug

[Brookside]

On ‎4‎/‎19‎/‎2019 at 9:00 AM, Biggie B said:

Dr. Kapoor approached Ella (the coffee lady) at the coffee place, ostensibly to buy a cup of coffee, but also to again apologize to her (for previously saying a few episodes ago that the only reason his son was interested in Ella was to anger him). He spotted Ella wearing the bracelet (no ring was involved) and had a very visceral reaction, which Ella picked up on. She later went to his office to return it, correctly surmising that it belonged to Dr. Kapoor's wife. She said that whatever was going on between him and his son, she wasn't getting in the middle of it, and that even though she and Kapoor weren't in a good place, she'd never hurt him by keeping the bracelet. He took back the bracelet. Later on, he went back to Ella with a jewelry box that contained a full set of matching jewelry, including the bracelet. He explained that the set was an heirloom, meant to passed down from one generation to the next. When the bracelet went missing after Kapoor's wife died, Kapoor accused his son of stealing it and probably hocking it to get money to buy drugs, never imagining that his son kept it as a cherished reminder of his mother. Kapoor told Ella how very wrong he'd been about his son, and asked her to give his son the full set of jewelry. 

Thank you.  I said ring because I thought she put two things down on Dr Kapoor's desk, and he said later that two things were missing from his wife's jewelry box.

I'm still confused about how she knows his son.  And isn't he gay (or am I confusing another Indian doctor and son from another show)? Not that they couldn't be friends of course but it would be odd to give anyone other than a long time partner jewelry of such significance.

Edited April 20, 2019 by Brookside
Grammar

[Biggie B]

Brookside, you're right, Ella did put two things down on Dr. Kapoor's desk - I didn't recall that until you mentioned it.

I, too, initially thought the son was gay, and that that was one of the things that was causing problems between him and his father. Guess not! As for how the son and Ella met - I can't recall the specifics (even though I've seen all the episodes). Wasn't there a time when the son came to the hospital to meet up with Dr. Kapoor or something to that effect? If so - perhaps that's when he was introduced to Ella. I agree, it does seem a bit odd that the son would give Ella the jewelry, as they're so emotionally significant, and their relationship is still pretty new, no matter how close they are.

[ams1001]

Yeah, they met when he came to see his dad at the hospital and became friendly. I thought they were just supposed to be friends, though. Seems unlikely he'd give anyone but a serious long term partner something so meaningful to him that was his mother's.

[Lunula]

1 hour ago, doodlebug said:

The newest innovations in reproductive technology have made for a lot of legal confusion.  Here's what generally happens:  the woman who carries the child and gives birth is the legal mother.  This is because many, many infertile women use donor eggs and and it would be a nightmare to have to find the actual egg donor, initially put her name on the birth certificate and get her to relinquish her parental rights to any children that come from her eggs.  When a woman donates eggs, she has to sign a release forfeiting her rights to any child that might be born using them.   In the case of a gestational surrogacy (donor egg carried by a woman who is not planning to parent the child), the woman who gives birth to the baby is initially listed as the parent on the birth certificate.  She has to legally renounce her rights to the child who will then be legally adopted by the mother who hired the surrogate. 

Then, there is the sperm donor issue.  Insemination using donor sperm has been around a lot longer than egg donation.  The law generally states that, if a couple is legally married, the male partner is the legal father.  His name goes on the birth certificate and he gets parental rights and responsibilities.  The donor, just like an egg donor, signs away all rights to any children that come from their donation at the time it is made.  This prevents people from trying to go back and sue a sperm donor for child support, etc. and also gets the government out of its citizens' personal lives.

There have been some legal cases where the surrogate tried to keep a baby, you can google Mary Beth Whitehead and Baby M if you want to look at the most famous case. Mary Beth was hired by a couple to be inseminated with the husband's sperm and then carry a child for them.  The baby was conceived using her egg, so it was genetically hers.  The wife in the case had MS and was worried about the effects of pregnancy on her health as well as wanting to avoid passing any genetic tendency to the child which is why they used donor eggs.  After the baby was born, Mary Beth kidnapped it, claiming that she realized that the adoptive couple were not  good parents and she needed to protect the baby from them.  It ended up in court where it was essentially treated as a custody dispute and the sperm donor/father ended up winning custody and Whitehead getting some visitation.  Eventually, the baby grew up, went to court and terminated Whitehead's parental rights and a formal adoption by her adoptive mother took place.

I think you should apply to write for the show. Seriously, had bio-dad called a lawyer (which he should’ve done immediately) and gotten that explanation- or if the judge had explained it in such a fashion, I wouldn’t have been thinking it was so stupid the entire time I was watching!

[izabella]

3 hours ago, ams1001 said:

Yeah, they met when he came to see his dad at the hospital and became friendly. I thought they were just supposed to be friends, though. Seems unlikely he'd give anyone but a serious long term partner something so meaningful to him that was his mother's.

That whole relationship is suspect in my mind, and I think the son really did want to get back at his dad by giving her his mom's bracelet knowing that his dad would see it and be hurt.  I also believe Kapoor's son is dating coffee lady to hurt his dad. 

[LittleIggy]

The dad would have had a lawyer since he had a surrogacy contract. Why didn’t he call him? 🙄

[bros402]

13 hours ago, Brookside said:

Thank you.  I said ring because I thought she put two things down on Dr Kapoor's desk, and he said later that two things were missing from his wife's jewelry box.

Still confused about she knows his son?  And isn't he gay (or am I confusing another Indian doctor and son from another show?).  Not that they couldn't be friends of course but it would be odd to give anyone other than a long time partner jewelry of such significance.

13 hours ago, Biggie B said:

Brookside, you're right, Ella did put two things down on Dr. Kapoor's desk - I didn't recall that until you mentioned it.

I, too, initially thought the son was gay, and that that was one of the things that was causing problems between him and his father. Guess not! As for how the son and Ella met - I can't recall the specifics (even though I've seen all the episodes). Wasn't there a time when the son came to the hospital to meet up with Dr. Kapoor or something to that effect? If so - perhaps that's when he was introduced to Ella. I agree, it does seem a bit odd that the son would give Ella the jewelry, as they're so emotionally significant, and their relationship is still pretty new, no matter how close they are.

I believe she put down a little bar - the camera showed a little part of the bracelets where two circles lined up on the siide - maybe it was secured with the little bar?

[ams1001]

x

Edited April 20, 2019 by ams1001
wrong tab

[tinderbox]

On ‎4‎/‎18‎/‎2019 at 1:51 AM, bros402 said:

I don't understand the barter storyline - was the board person saying Max paid the electrician $4800 for her work on top of her working off her dead, or that in tax terms, it was like they paid her $4800?

According to this site, even if she is not biologically related to the kid, she is considered the birth mother by the state of NY - https://www.creativefamilyconnections.com/us-surrogacy-law-map/new-york/

The contract is also just considered a statement of intent in NY - and apparently there is no case where a single parent used their own egg or sperm and used a surrogate - I am guessing the guy got an egg somewhere, had it fertilized, then implanted into the surrogate?

I think this is an instance where the laws of New York haven't caught up to what's actually happening in the real world.

Edited April 20, 2019 by tinderbox
Typo

[alexvillage]

On 4/19/2019 at 10:06 AM, Brookside said:

I've never particularly liked Max, but he has become totally insufferable, delusional, and with a God complex the size of  Alaska.  He totally needs to be fired.

But he has cancer! And he is making the biggest hospital in the country better! And he is saving people from bankrupting! His ego has no limits.

Many shows - probably written by men - do this kind of crap: they pick an actor they believe will attract viewers - female because I guess I saw somewhere that women are the biggest audience for hospital dramas - and make the character adorably flawed, impulsive but with a big heart, extremely resourceful and a whole checklist of "ideal men" that they imagine every woman wants. Add the hunkiness and hotness (I guess the actor is what is considered "hot" - not to me, though) to that, the writers don't care about coherent developments or nothing needs to make sense.

Max will always save the world, at least the the New Amsterdam world. Then he will get some slapping but recover nicely, just to start getting his ego on the way of reason all over again.

[bros402]

12 hours ago, tinderbox said:

I think this is an instance where the laws of New York haven't caught up to what's actually happening in the real world.

Yeah, it's a bit odd. I mean I could understand if they had paid surrogacy be illegal to be conducted in the state - but a case like this, where they cannot even honor the contract?

12 hours ago, alexvillage said:

But he has cancer! And he is making the biggest hospital in the country better! And he is saving people from bankrupting! His ego has no limits.

Many shows - probably written by men - do this kind of crap: they pick an actor they believe will attract viewers - female because I guess I saw somewhere that women are the biggest audience for hospital dramas - and make the character adorably flawed, impulsive but with a big heart, extremely resourceful and a whole checklist of "ideal men" that they imagine every woman wants. Add the hunkiness and hotness (I guess the actor is what is considered "hot" - not to me, though) to that, the writers don't care about coherent developments or nothing needs to make sense.

Max will always save the world, at least the the New Amsterdam world. Then he will get some slapping but recover nicely, just to start getting his ego on the way of reason all over again.

The only thing I like about the shows portrayal of cancer: they had a young adult with cancer - representation! Woohoo!

[namelesscommenter]

On 4/18/2019 at 12:12 PM, Dowel Jones said:

I'm pretty sure it was a straight swap.  There's no way (okay, Max would find a way) that the board would approve that kind of expense without a bid process.  I know what you meant to say (the bolded part), but now I have this image of Max wandering the halls, ringing a large bell and calling out "Bring out your dead" and the poor patient replying "I'm not dead yet".

My understanding is that there was outstanding medical debt of $4800. The hospital planned to sell that debt for 5 cents on the dollar ($240) to collectors who would hope to collect more than 5 cents on the dollar.

Max committed to getting 6 cents on the dollar, so the hospital got a "$288 value" (lightbulbs being changed) and then forgave $4800 in debt rather than taking $240 in cash from the debt collectors. It wasn't a $4800 lightbulb change, but a $288 one.

Max really should have just called patients and offered a 6% buy out. Because LOL to a public hospital having random people change lightbulbs. The insurance issues alone are making me shudder. This show really weighs down some potentially great storylines with stupidity. 

[bros402]

3 hours ago, namelesscommenter said:

Max really should have just called patients and offered a 6% buy out. Because LOL to a public hospital having random people change lightbulbs. The insurance issues alone are making me shudder. This show really weighs down some potentially great storylines with stupidity. 

That's what I was expecting him to do - with a generous payment plan with 0% interest because he is Saint Max.

[alexvillage]

3 hours ago, bros402 said:

That's what I was expecting him to do - with a generous payment plan with 0% interest because he is Saint Max.

I don't know if public hospitals have constraints on how to work out patients debts but some "non-profit" hospitals (I quote the description because there is a lot of fishy dealings being it) will forgive part of a big debt and try to set up a payment plan based on income.

The idea was silly, as if it would give the episode some lightness. Writers treating the audience as if we are all children.

[starri]

41 minutes ago, alexvillage said:

I don't know if public hospitals have constraints on how to work out patients debts but some "non-profit" hospitals (I quote the description because there is a lot of fishy dealings being it) will forgive part of a big debt and try to set up a payment plan based on income.

My public hospital usually forgives insurance denials, at least for inpatient services.  Granted, I work in mental health, which requires huge fights with insurance companies to get more than about five days approved.  If insurance cuts off, the remainder is forgiven, particularly for the most indigent patients, of which, at a county hospital, we have a lot.

We also have a really, really good department that helps people who don't have insurance--for whatever reason--get emergency Medicaid.

[bros402]

20 hours ago, alexvillage said:

I don't know if public hospitals have constraints on how to work out patients debts but some "non-profit" hospitals (I quote the description because there is a lot of fishy dealings being it) will forgive part of a big debt and try to set up a payment plan based on income.

The idea was silly, as if it would give the episode some lightness. Writers treating the audience as if we are all children.

With the hospital I was at for 2 1/2 months after my birth, they -- wait I already mentioned this above didn't I?
 

I imagine NYC would be willing to get money however they could - here's an article I found from 2014 about Bellevue's debt crisis - https://www.cityandstateny.com/articles/policy/healthcare/new-york-city’s-public-hospitals-face-funding-crisis.html

 

[Sake614]

When I had a tumor removed, my doctor/hospital bill was six figures. If I worked five lifetimes I couldn't possibly have paid that kind of money. The insurance covered about one third of the bill and I called the surgeon's office to ask if they'd accept what they got and forgive the rest. Thankfully the surgeon had already told me not to worry if I couldn't pay the remainder. But it was still incredibly stressful until the accounting dept agreed.

[alexvillage]

9 minutes ago, Sake614 said:

When I had a tumor removed, my doctor/hospital bill was six figures. If I worked five lifetimes I couldn't possibly have paid that kind of money. The insurance covered about one third of the bill and I called the surgeon's office to ask if they'd accept what they got and forgive the rest. Thankfully the surgeon had already told me not to worry if I couldn't pay the remainder. But it was still incredibly stressful until the accounting dept agreed.

Wow, it is the first time I hear of a doctor forgiving a bill. All the doctors I have to deal with in hospital settings don't bill patients directly, they have these companies that do this, I am sure for a hefty fee. But the doctors get paid some, so they accept this relationship, which in turn puts the burden on the patients. It's a fucked up system.

Hope you are ok and that you don't have to experience that again.

[Aliconehead]

I broke my foot and then changed insurances and my doctor was no longer covered, he skipped a lot of charges and reduced others to help me out. It does happen with kind doctors, when they can. 

Edited April 24, 2019 by Aliconehead

[Sake614]

thanks @alexvillage. I suspect he was well aware he charged phone bill rates and didn't expect to be paid the full amount. At least that's what I tell myself lol! And the tumor has not grown back so all's good 🙂

[bros402]

10 hours ago, alexvillage said:

Wow, it is the first time I hear of a doctor forgiving a bill. All the doctors I have to deal with in hospital settings don't bill patients directly, they have these companies that do this, I am sure for a hefty fee. But the doctors get paid some, so they accept this relationship, which in turn puts the burden on the patients. It's a fucked up system.

Hope you are ok and that you don't have to experience that again.

My therapist takes whatever insurance pays him at the out of network rate + a $10 co-pay from me (well, my parents), so he forgives whatever the remainder is, since sometimes insurance is wacky.

[doodlebug]

Sometimes a doctor cannot write off a medical bill because he/she works for a corporation and doesn't have any clout.  I work for a huge midwestern hospital that employs all of its physicians (#2 in the US according to US News and World Report) and I don't even know what I charge for stuff and, if a patient has a problem paying out of pocket, all I can do is contact the billing office and ask that someone discount the care or write it off.  I don't even know whether that works unless a patient tells me later, my employer considers it private info.

When I was in private practice I wrote off stuff and discounted all the time.  I was also queen of the free samples even though the AMA says that it's not ethical.  I delivered a baby for a couple who paid me $20 a month on the couple thousand they owed me.  After maybe a year, I sent them a Christmas card telling them the debt was gone.  My staff and I would sit down annually at the holidays and write off a certain amount of bills in the spirit of the season, we would keep track of people who owed us who needed a break and give it to them.

BTW, most insurance companies have 'favored nation' clauses in their contracts with doctors and hospitals.  What that means is that nobody can ever pay less for a service than the insurance company does.  That's why the bills sent to uninsured people are so high compared to what insurance pays.  Say I charge $1000 to take out your appendix.  You have insurance and I have a contract with that plan; so they pay me maybe $600 and I have to write off the rest or bill you for the remainder depending on what the insurance contract says.  Now, if you don't have insurance, I have to bill you $1000 and, I have to try to collect that from you,  If you tell me you can't afford to pay it; I can then work out a plan and maybe give you a discount and you only have to pay me $500.  The problem is, that, if an insurance company finds out that I gave someone a better price than they got, they can terminate my contract or, more likely adjust their payments.  They can also come after me for past 'overpayments' for that service.  Now, if I took $500 from you; the insurance company can say that that is my new billable rate.  They have that 'favored nation' clause where they have to pay 60% of the going rate, so, from now on, I get $300 for an appendectomy from them rather than $600.  

Yes, it is all a great big racket.