Emergency room patients can face steep bills even when treatment is declined • Hacker News Board

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

#121

Post by Bjartr » Wed, May 02, 2018, 2:08 PM UTC

ajross wrote: post #104

nickjj wrote: post #33

Earlier quoted context omitted.

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 sim…

Health care has a cost, sure. But you haven't explained why that cost is so much higher in the US if outcomes aren't proportionally better.

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

#122

Post by toomuchtodo » Wed, May 02, 2018, 2:09 PM UTC

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.

American Exceptionalism combined with FUD.

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

#123

Post by maxerickson » Wed, May 02, 2018, 2:10 PM UTC

ceejayoz wrote: post #116

maxerickson wrote: post #37

Earlier quoted context omitted.

I doubt it, hospitals were already required to make those prices available, the change is that they have to make them available on the internet. While hospitals are already required under guidelines developed by CMS to either make publicly available a list of their standard charges, or their policies for allowing the public to view a list of those charges upon request, CMS is updating its guidelines to specifically r…

> While hospitals are already required under guidelines developed by CMS to either make publicly available a list of their standard charges... This requirement is useless, though. The "standard charges" don't reflect reality. My wife receives regular infusions in an infusion center. They bill $3k to insurance each time. Insurance pays about $400, which the hospital happily accepts. That $3k number is what an uninsure…

The new requirement is the same in that regard.

It's a good talking point though, several people in this thread are excited about the potential for it to bring about change.

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

#124

Post by Cthulhu_ » Wed, May 02, 2018, 2:10 PM UTC

OnMyPhone wrote: post #65

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 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…

A simple retort to that would be "Why should we pay any of our hard earned money to the government so it can send our children off to some fucking desert to fight in an unwinnable war that was started before they were even born?"

60% of the US budget is spent on the military. Reduce that to just 50 or 40% and suddenly, hundreds of billions would become available to spend on health care, education, infrastructure, etc.

Raising taxes is probably also something to do though, the US is racking up trillions in debts at the moment.

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

#125

Post by justherefortart » Wed, May 02, 2018, 2:10 PM UTC

jhall1468 wrote: post #115

justherefortart wrote: post #93

Just don't pay it. That's the solution. Hospitals have these bullshit inflated fees, once they accept the insurance payout that is all they're getting from me. They're all "non-profits" that scam the system by writing all this shit off as goodwill or bad debts.

Yeah, they write it off as a bad debt then you end up with it on your credit report for 7.5 years. Good call.

Most credit scores are ignoring medical collections or deemphasizing it.

I went to the ER a while back, my insurance paid roughly 1600 for the 8k+ they billed. I have a HSA that pays out as well, yet they have tried to bill me on top of that. They'll never see another cent.

Credit is overrated anyway. Causes more troubles than it's worth.

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

#126

Post by lr4444lr » Wed, May 02, 2018, 2:10 PM UTC

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.

It goes back to WWII when we had a strange price controls on labor. Health insurance was a way for employers to provide employ compensation circumventing that. Originally it was quite manageable, but as with any system where neither the consumer nor the producer of the good/service has any incentive to keep down costs, it spiraled out of control.

Also, president Richard Nixon effectively linked national health care with socialism as part of Cold War propaganda. (That said, he did offer comprehensive health reform too that in a number of ways was more dramatic than we achieved under president Obama, but the congress killed it.)

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

#127

Post by falsedan » Wed, May 02, 2018, 2:10 PM UTC

Arnt wrote: post #13

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.

What is it that does cost $5k? Keeping a mostly-unused tomography machine and crew ready in case someone at the ER needs it? Insurance premiums charged per patient who walks in the door? We get these complaints in Germany too (where I currently live) BTW. "A five-minute drive with an ambulance shouldn't cost €500!" someone complained to the newspaper here recently. It doesn't, what costs €500 is keeping enough ambula…

> a mostly-unused tomography machine and crew ready in case someone at the ER needs it

No hospital administration would allow this: they would refer you to a separate medical imaging clinic, or run one on hospital grounds that all departments would refer patients to.

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

#128

Post by HillaryBriss » Wed, May 02, 2018, 2:11 PM UTC

OnMyPhone wrote: post #65

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 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…

> They are however selfish as shit and don't care about anyone outside of their initial friends and family.

evidently people in Canada, the UK, Japan, Sweden, Singapore and other places where there is a comprehensive, well-managed health care system are not "selfish as shit."

so, we should probably ask: "why? why are people selfish as shit in America?"

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

#129

Post by wccrawford » Wed, May 02, 2018, 2:11 PM UTC

paulsutter wrote: post #72

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…

I recently had an appendectomy. The doctors said that if you are having abdomen problems, you absolutely should go to the ER as there's too high a chance it's life threatening. They said that limbs and such weren't as ER-necessary and urgent care might suffice, depending on severity. But for the stomach, just go to the ER.

I initially stopped at an urgent care facility, but they told me to sit and wait before even asking my symptoms. I'm not afraid of many medical things, but my appendix has always made me extra nervous. So we left and went to the ER, where they asked a few questions and rushed me into a room, and then a scan shortly after. We had caught it very early.

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

#130

Post by assblaster » Wed, May 02, 2018, 2:13 PM UTC

sjg007 wrote: post #38

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…

It’s predicated on the HMO model where you pay a copay and your insurance company negotiates the rates. Under the guise of consumer choice insurance companies have expanded copays and coinsurance to shift the burden to the insured. Out of network Hospitals and doctors balance billing needs to be outlawed. They should only be able to balance bill up to the Medicaid rate.

Medicaid is already at the lowest payment rate, so balance billing to that would be a net negative actually.

Why should hospitals and doctors be forced to accept contacts from insurers that underpay for services rendered for nothing in return (being part of limited network)?