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Emergency room patients can face steep bills even when treatment is declined

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Re: Emergency room patients can face steep bills even when treatment is declined

#71

Post by kalleboo »

a-saleh wrote: post #32
ishansharma wrote: post #3

Earlier quoted context omitted.

I guess the point of the article is exhorbitant fees. An ice pack and a bandage in ER don’t have to cost $5k plus.

As far as I know, point of the exorbitant fees is the weird process of collective bargaining between the care-providers and insurers. I.e. you, as the hospital, inflate your price, by X00% margin over what you actually plan to charge the insurance. Then you let the insurance negotiators negotiate, and you negotiate down to the reasonable price. This looks really good on the paper. Unfortunately, you as a patient, if…

> that you didn't really have the chance of negotiating

Not American, but from what I've read in these types of news articles, you often CAN negotiate it down a lot, but when you get a huge bill in the mail, the first thing you think isn't "I'm going to try to haggle down my $5000 bill with this huge hospital" you think "I'm so screwed. Time to google 'personal bankruptcy', was it 7 years?". Pharmaceutical companies are also always saying that they will subsidize prescription medications for those who can't afford it, but I dunno how much that is BS or not.

Re: Emergency room patients can face steep bills even when treatment is declined

#72

Post by paulsutter »

I paid $5500 last year for an unnecessary emergency room visit (doctor sent me down to get a scan).

They wired me up to machines and made me wait 5 hours for the scan, then 3 hours to get discharged. They wouldn’t let me leave until the doctor on duty wrote up her treatment recommendation. Even though I was just there for a scan.

No insurance last year so after my “35% cash payer discount” it came out to $5500 after the many parties in the ER sent me separate bills. Scan was $2000 of that, but I could have paid $600 across town.

Don’t go to the ER unless you’re unconscious. It’s that rare case where you are paying AND you are the product.

Re: Emergency room patients can face steep bills even when treatment is declined

#73

Post by falsedan »

chapium wrote: post #49
toomanybeersies wrote: post #9

How can people read and hear about stories like this, and even possibly think it's OK or even normal? How do lawmakers in the USA convince people that this is acceptable? I have never directly paid a single cent for healthcare, and neither has anyone I know. When I had to get 6 stitches in my forehead at 2 AM on a Sunday morning, it cost me nothing. When my friend needed to get the tip of his finger reattached, it co…

Why should stitches be free? Of course they arent, its being paid for under your country’s healthcare model. The cost is harder to see to the individual but its there. I’m all for universal healthcare but comparisons like this are deceiving.

The advantage of the single-payer model is this: if some clinic decides to mark-up one patient's treatment by 4,453%, the single payer can not only refuse to pay for that treatment, but also refuse to pay all other treatments performed at that clinic. This keeps the cost for treatment in a much more reasonable range, since the health care budget is debated and scrutinised as part of government spending.

The Australian model is that health care providers can charge what they like, but Medicare only pays a predetermined amount for every kind of treatment. Providers are free to charge more, but have to capture the difference as a 'copay' or by billing the patient's private health insurance.

Re: Emergency room patients can face steep bills even when treatment is declined

#74

Post by code_duck »

charlesdm wrote: post #16
toomanybeersies wrote: post #9

How can people read and hear about stories like this, and even possibly think it's OK or even normal? How do lawmakers in the USA convince people that this is acceptable? I have never directly paid a single cent for healthcare, and neither has anyone I know. When I had to get 6 stitches in my forehead at 2 AM on a Sunday morning, it cost me nothing. When my friend needed to get the tip of his finger reattached, it co…

I will bring up one point. The wages medical practitioners make are generally higher in the US. So the cost of medical care is higher. I live in Belgium, mostly good and free healthcare (barring payment of a few euros here and there). I have 3 cousins who are (or are studying to become) doctors and while specialised doctors can make decent money (€75 -> 450k), they don't come anywhere close to what a US based doctor…

If you were to break down the charges from a surgery, the portion that goes to the surgeons salary is rather small, and particularly the portion that might be the difference between EU and US salaries. I think differences in charges for things like prescription drugs make a much higher impact.

Re: Emergency room patients can face steep bills even when treatment is declined

#75

Post by saalweachter »

swarnie_ wrote: post #67
saalweachter wrote: post #59

Earlier quoted context omitted.

Important note on ER care. The job of the ER is to prevent you from dying, not fix you. If you are injured in a way that requires an expensive surgery and therapy to fix but won't actually kill you if left untreated, even if it cripples you, they are not obligated to fix you under the law.

How did your healthcare system get messed up to such a level? This is criminal in western Europe.

The short answer is racism and greed.

Re: Emergency room patients can face steep bills even when treatment is declined

#76

Post by beguiledfoil »

travoc wrote: post #53
titzer wrote: post #21

Earlier quoted context omitted.

That's a good point, but not the only reason. The insurance industry extracts a big profit margin by just moving money from one risk pool to another, and that profit has to come from somewhere, so, costs go up. It's inevitable.

U.S. health insurers have an average profit rate of 3.1%. Does that sound massive to you?

The whole healthcare providerinsurer interface is hugely expensive.

http://www.commonwealthfund.org/publications/in-the-literatu...

Re: Emergency room patients can face steep bills even when treatment is declined

#77

Post by mfoy_ »

andruby wrote: post #46
c0nfused wrote: post #31

Earlier quoted context omitted.

Typically, the rates negotiated with the various insurance companies are basically secret. No one wants to share the data and there is great incentive not to. If you are in the insurer side, you think you have a competitive advantage compared to company Y. Sharing what you are paying per procedure is bad business If you are on the Hospital side, you want to make sure the insurers keep paying more, and publishing mean…

My personal opinion is that this should be illegal. Prices for the same treatment should be equal regardless of patient or insurer. The insurance repayment policies could differ, but at least the base pay won't seem completely made up. Disclaimer: I only lived in the US for a year.

Isn't it anti-competitive? How can consumers make an informed decision as to which care provider to visit?

Isn't this in the same boat as price-fixing?

Re: Emergency room patients can face steep bills even when treatment is declined

#78

Post by emodendroket »

toomanybeersies wrote: post #9

How can people read and hear about stories like this, and even possibly think it's OK or even normal? How do lawmakers in the USA convince people that this is acceptable? I have never directly paid a single cent for healthcare, and neither has anyone I know. When I had to get 6 stitches in my forehead at 2 AM on a Sunday morning, it cost me nothing. When my friend needed to get the tip of his finger reattached, it co…

People who have insurance good enough for all the medical care they've ever had are afraid of being denied care, basically.

Re: Emergency room patients can face steep bills even when treatment is declined

#79

Post by falsedan »

travoc wrote: post #53
titzer wrote: post #21

Earlier quoted context omitted.

That's a good point, but not the only reason. The insurance industry extracts a big profit margin by just moving money from one risk pool to another, and that profit has to come from somewhere, so, costs go up. It's inevitable.

U.S. health insurers have an average profit rate of 3.1%. Does that sound massive to you?

That's the same as Amazon's!

Re: Emergency room patients can face steep bills even when treatment is declined

#80

Post by a-saleh »

kalleboo wrote: post #71
a-saleh wrote: post #32

Earlier quoted context omitted.

As far as I know, point of the exorbitant fees is the weird process of collective bargaining between the care-providers and insurers. I.e. you, as the hospital, inflate your price, by X00% margin over what you actually plan to charge the insurance. Then you let the insurance negotiators negotiate, and you negotiate down to the reasonable price. This looks really good on the paper. Unfortunately, you as a patient, if…

> that you didn't really have the chance of negotiating Not American, but from what I've read in these types of news articles, you often CAN negotiate it down a lot, but when you get a huge bill in the mail, the first thing you think isn't "I'm going to try to haggle down my $5000 bill with this huge hospital" you think "I'm so screwed. Time to google 'personal bankruptcy', was it 7 years?". Pharmaceutical companies…

Oh, good to know. From the horror stories you usually read in the news it seemed that "try to haggle down my $5000 bill with this huge hospital" is something you just don't get to do, if you are a patient, I will remember that if that ever comes up (even though I hope it doesn't :)
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