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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

#101

Post by jbb67 »

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…

Yes, prices in the USA seem totally out of control.

I pay a significant amount in the UK in tax towards the NHS ( I think about £7500 a year of my tax goes towards it) but that's nothing like what I'd pay in the USA.

It's not just the system there that is poor, it's how expensive it is in addition.

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

#102

Post by danmaz74 »

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.

Yes, the cost is there, but it's much lower per treatment. Mainly because the medical/insurance complex makes less money off healthcare.

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

#103

Post by malnourish »

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?

Should healthcare be a for-profit venture?

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

#104

Post by ajross »

nickjj wrote: post #33
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…

It's because most people in the US are brainwashed (note: I live in the US) into thinking paying ~$450 / month per adult for basic health insurance with high deductibles is a bargain because it "saves" them from $100,000+ hospital bills in an emergency scenario. Meanwhile they are still losing ~40% of their income to taxes if they own a small business with no insurance applied. The messed up thing is, the US also off…

> into thinking paying ~$450 / month per adult for basic health insurance with high deductibles is a bargain because it "saves" them from $100,000+ hospital bills in an emergency scenario

It is, though. Insurance is expensive, but it's not a scam. That money tends to go mostly for care, overall. Someone has to pay it.

It's true that on the whole, the US tends to overpay for care and that other systems tend to get similar results for less cost. But that's a constant factor on the insurance payment.

Obviously many of us think making this an individual burden is a bad idea: obviously it's regressive and burdensome for the bottom of the income distribution, and more subtly it's a moral hazard for the healthy, who are tempted to forego insurance figuring that they don't need it and thus pushing the cost of providing care disproportionately onto the sick and the elderly.

But again, someone has to pay it. There's no magic wand here that makes health care cheap or free. Health care is expensive, someone's got to write that check.

> In 2017 I had to spend thousands of dollars in tax penalties for not having insurance. Welcome to the US!

Because someone has to pay it, and you didn't!

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

#105

Post by lr4444lr »

spsrich wrote: post #22

Any parent has similar stories. Consumer law does not seem to apply to doctors and hospitals. Imagine if you took your car into the shop - there is no price list, they won't give you an estimate, and for weeks after they send you random bills without indicating what it's for? This affects everybody in the US, and I don't understand why it's allowed to continue, except the medical industry has bought off all the polit…

That may be changing soon: https://www.infectiousdiseaseadvisor.com/practice-management...

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

#106

Post by ceejayoz »

emodendroket wrote: post #86
OnMyPhone wrote: post #65

Earlier quoted context omitted.

I hate it all, and would rather pay much more taxes if we had universal healthcare. That aside, I had a few different people give me the following reason why this is acceptable to them. "Why should we pay any of our hard earned money to the government so some drug addict can get their fix?" "Why should I pay for single mothers who made bad decisions?" It is almost always other people making poor decisions or getting…

In addition to being cruel, this kind of penny-pinching is often penny-wise and pound-foolish. It's easy to lose more money verifying that people are not shiftless than you save by denying them benefits.

For example:

https://www.nytimes.com/2012/04/18/us/no-savings-found-in-fl...

> Because the Florida law requires that applicants who pass the test be reimbursed for the cost, an average of $30, the cost to the state was $118,140. This is more than would have been paid out in benefits to the people who failed the test, Mr. Newton said. As a result, the testing cost the government an extra $45,780, he said.

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

#107

Post by maxerickson »

humanrebar wrote: post #51
maxerickson wrote: post #19

Earlier quoted context omitted.

The individual mandate was repealed. With the explicit goal of causing the individual marketplaces to implode. In the meantime it's increased the cost to taxpayers of subsidizing marketplace plans!

The individual markets were already a mess.

That doesn't really excuse the political cowardice of undermining the system while leaving most of it in place.

I guess we are pretty screwed though, there's no willingness to prop up the buy side of the market and no willingness to make regulatory changes that would negatively impact incumbents on the sell side.

(the fair, "market based" approach to decreasing medical costs in the US is to dramatically increase the number of doctors and mid-level providers).

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

#108

Post by oldcynic »

humanrebar wrote: post #54
nicktelford wrote: post #41

Earlier quoted context omitted.

This isn't at all accurate. There was no treatment for his condition beyond palliative care. He was on life support for the rest of his life, no matter what anyone did. His doctors, whose duty is to the patient, determined that it was more harmful to artificially keep him "alive" (he was in a semi-vegetative state due to serious brain damage) than to disconnect his life support and allow him to die. The offer of "car…

> The court case was between his doctors and his parents. The UK government had absolutely nothing to do with it. Is there a difference in terminology here? The courts are part of the government in my mind. And they have the ability to overrule unjust law.

UK courts have had judicial independence since the Act of Settlement. Governments don't appoint judges - now via an independent panel since the Blair govt abolished the Lord Chancellor, but even then govts didn't have influence or appointing powers.

The courts quite often upset UK governments (of whichever party) when they strike down bad laws via judicial review, or by finding some aspect of government policy illegal.

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

#109

Post by jhall1468 »

Ensorceled wrote: post #45

I recently had a spot appear in my vision. Went to my GP same day, the receptionist called around to get me into a local optometrist who determined it was a detached retina, she called and got me into the local hospital as an emergency case. It was busy but I got my first treatment that evening. The entire journey, my green OHIP card was all I needed, no insurance forms, no pre-approvals, no extra charges. 5 hospital…

Dying while waiting is just a stupid argument based on a distant truth. You do wait considerably longer for non-life threatening procedures in Canada than you do in the US. That's the big sell of a medical system that cost 2 to 3 times yours. Hair transplants require less waiting.

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

#110

Post by dragonwriter »

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…

> How do lawmakers in the USA convince people that this is acceptable?

They don't; it's a lot easier to channel blame for the problem in the wrong direction than to sell the system as acceptable, so that's what they do.

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