Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

vox.com

Post reply on HN
Print view View original

201–210 of 249 posts

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

#201

Post by assblaster »

gm-conspiracy wrote: post #197
assblaster wrote: post #184

Earlier quoted context omitted.

That's the contract you enter into. You pay a premium for coverage of unexpected medical costs and you agree to pay a copay and pay up to a deductible amount. If you don't like the contract, enter into a different contract with a different company, or start your own private insurance companyn or self insure.

I was actually doing something similar with my ISP.

Exactly. In a country where regulations allow you to start your own insurance company or your own ISP, it works well as an alternative.

With heavy regulation (Obamacare, net neutrality), it is much harder for the small time players to start their own businesses to address shortcomings of the existing companies.

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

#203

Post by assblaster »

ceejayoz wrote: post #179
refurb wrote: post #174

Earlier quoted context omitted.

60% of the US budget is spent on the military. No, it's 16%.[1] [1] https://www.nationalpriorities.org/budget-basics/federal-bud...

53% of discretionary spending, though.

And the rest is non-discretionary, most of which is welfare: Medicare, Medicaid, social security.

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

#204

Post by uberduber »

assblaster wrote: post #146
clarkmoody wrote: post #82

Plenty of anecdotes in this thread, predictably. Let's talk about why things are so messed up. The thing to realize here is that total government provision of healthcare is probably cheaper than the way the US does it, but that doesn't mean the market has failed. Healthcare in the United States is anything but a free market. It's the worst of all worlds: special interests extract rents through government regulations…

This poster gets it right 100%. In an ideal hospital, you should only have doctors, nurses, nurse assistants, nurse manager, accounting, pharmacy. Think of all the unnecessary healthcare MBAs that siphon off enormous amounts of resources to generate as much profit as possible to be shared with other healthcare MBAs. Think of all the suppliers of healthcare goods that try to patent and profit off of unnecessary medica…

You do need some administrators, like the receptionist, someone to manage the janitorial staff, etc. There's now something like 18 administrators for every doctor in a hospital. I think it was barely 5-6 years ago I was complaining because the ratio was 10 to 1. Their salaries are also pretty high, typically in the $250k range.

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

#205

Post by assblaster »

jahvo wrote: post #98
gambiting wrote: post #92

Earlier quoted context omitted.

I've literally had someone on reddit tell me that (and I quote) "the only reason why you have free healthcare is that we[USA] subsidize it by protecting your country so that you are free to spend your budget on healthcare". And I mean....maybe there is a little bit of truth to that, but what sort of attitude is this? It was almost pride as in "yeah we're paying through the nose so you don't have to"?

It's funny that guy would say that because, because of the wars the USA and its greatest ally begin, we have to deal with millions of economic immigrants now, which are seriously hamstringing our system. So I'd say it's kinda the opposite

Trump had made it pretty clear he was against the Iraq war, and plans on closing military bases overseas to reduce military costs.

Keeping our military in European bases certainly does cost the United States significant resources to counter the Russian threat to Europe. While NATO countries don't pay their fair share of costs of maintaining their security, the United States has to pay the balance.

If European countries actually spent what they ought to, they absolutely would have less money to spend on their welfare systems.

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

#206

Post by gm-conspiracy »

maxerickson wrote: post #155
kalleboo wrote: post #71

Earlier quoted context omitted.

> 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…

If you use insurance they are less willing to negotiate. (but you are getting the negotiated price anyway; the paranoid part of my brain thinks they run a scam here by recoding bills that come after the deductible has been met, which is a different sort of negotiation than agreeing on prices for services)

The urgent care clinic near me will charge $200 for a visit if you show insurance.

If you claim to not have insurance, the same visit is $80.

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

#207

Post by assblaster »

ThrustVectoring wrote: post #182
assblaster wrote: post #175

Earlier quoted context omitted.

The insurer only pays part of the bill because you entered into a contract with the insurer that specified that as such. No insurer pays 100% of every medical bill, no matter what, with no expectation of copay or deductible. Even if you had that sweet deal, you would be paying premiums that nobody could afford. Do you have a right to receive services from another human without appropriate payment?

They're not talking about the copay or deductible. They're talking about "Hospital believes that the services provided should cost $X, insurance company believes that a reasonable price is $Y, you now owe the hospital $X - $Y".

That's the problem! Hospital overcharges because government pays less than the cost of delivering care, so costs have to be recouped from other sources: privately insured, and uninsured.

The one caught in the middle is the individual who gets screwed by both the hospital and insurer/government.

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

#208

Post by waisbrot »

nickjj wrote: post #134
ajross wrote: post #104

Earlier quoted context omitted.

> 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…

> 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. Yes but the govt already takes a bit over 40% of my income (I run my own business). I'm certainly paying my share. It's not my fault that the govt would rather use those funds on non-healthcare related things. I'm all for a true universal health care for everyone, but if you're already…

> I'm certainly paying my share.

That seems very hard to determine, especially as a business owner. What's the value to you of safe shipping lanes to get raw materials to you? What's the value of employees not worrying about being executed by warlords? What's the value of having US customers who can afford your products?

I don't think you can say what your "fair share" is as some limit for what you pay. Rather, the amount the businesses are taxed has to be a matter of pragmatism.

> I would bet anything the amount I paid in penalties is more than what most people pay to be insured

One would hope so. That is the point of penalties, after all.

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

#209

Post by assblaster »

uberduber wrote: post #204
assblaster wrote: post #146

Earlier quoted context omitted.

This poster gets it right 100%. In an ideal hospital, you should only have doctors, nurses, nurse assistants, nurse manager, accounting, pharmacy. Think of all the unnecessary healthcare MBAs that siphon off enormous amounts of resources to generate as much profit as possible to be shared with other healthcare MBAs. Think of all the suppliers of healthcare goods that try to patent and profit off of unnecessary medica…

You do need some administrators, like the receptionist, someone to manage the janitorial staff, etc. There's now something like 18 administrators for every doctor in a hospital. I think it was barely 5-6 years ago I was complaining because the ratio was 10 to 1. Their salaries are also pretty high, typically in the $250k range.

Those are all relatively low level though.

I think the boom has been in pay and employment of hospital CEO, CFO, CTO, nurse directors, nurse compliance officers, legal, billing departments and supervisors of supervisors.

The people who actually deliver care, ie doctors and nurses, are being perpetually marginalized.

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

#210

Post by falsedan »

assblaster wrote: post #170
piyush_soni wrote: post #20

Ok, mine is way less than her, but at one of the ER in Wisconsin, they sent me a bill of $400 for literally telling me that I have no disease and sending me back. Out of that, the insurance paid $300, and I paid 100 out of my pocket. I had gone to ER only because it was at an odd time and no other hospital was open.

Why didn't you just wait to see your primary physician?

Lay people don't have the training to determine if an ailment is life-threatening or not; that's why they pay for insurance, so they can see a medical professional who is qualified to say if you could die or not.
Post reply on HN