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

#221

Post by ddingus » Wed, May 02, 2018, 4:24 PM UTC

psychometry wrote: post #140

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…

Tens of millions of Americans thought it was smart to elect Donald Fucking Trump president. We're paying the price for decades of underfunding and ignoring our educational system with an astoundingly ignorant electorate.

Universal Health Care / Medicare For All --> "That will never happen." Candidate for President Hilary Clinton

Trump being elected is not actually germane to this discussion.

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

#222

Post by gambiting » Wed, May 02, 2018, 4:33 PM UTC

assblaster wrote: post #205

jahvo wrote: post #98

Earlier quoted context omitted.

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 countri…

>>While NATO countries don't pay their fair share of costs of maintaining their security, the United States has to pay the balance.

The counterpoint here is that US keeps American bases in Europe because US wants to keep their bases here and it serves their interests first and foremost, any defensive goals are secondary, if not tertiary. All Nato nations could contribute exactly ZERO to the budget and US would still be getting the best deal out of everyone here.

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

#223

Post by jrs235 » Wed, May 02, 2018, 4:46 PM UTC

maxerickson wrote: post #123

ceejayoz wrote: post #116

Earlier quoted context omitted.

> 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.

Will publishing prices just cause more price inflation though? Similar to what happened with CEO compensation when companies became more transparent about their compensation?

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

#224

Post by assblaster » Wed, May 02, 2018, 4:53 PM UTC

falsedan wrote: post #213

assblaster wrote: post #195

Earlier quoted context omitted.

Hospital administrators are the problem. They don't contribute to medical care, and their job is to increase profit that goes to higher salaries of themselves and other administrators. Regarding balance billing: If Medicaid pays $100 for a $500 procedure, and private insurance pays $400 with the expectation of a 20% coinsurance from the patient but patient refuses to pay, who is going to pay the other $100? Is the ex…

> If Medicaid pays $100 for a $500 procedure On what planet would the special interest groups responsible for setting reimbursements make it less than the cost of delivery? Let's try again: > If a medical provider overcharges $100 for a $400 procedure Ok now your position makes more sense. Debt recovery is a well-known problem and yes, providers write it off or sell the debt on. > What other business exists where it'…

>On what planet would the special interest groups responsible for setting reimbursements make it less than the cost of delivery?

Take a guess what Medicaid pays for a labor epidural for a pregnant mother, which involves putting a very large needle next to a woman's spinal cord, with possible complications of paralysis, death, headache, back pain, infection, failure of epidural, etc?

If you run a hospital where 100% of patients are on Medicaid, the hospital will shut down immediately.

Medicaid simply pays less than the cost of delivery, and it does so because government knows it can get away with it. The government can impose its will with regulation and certification.

You have no idea how ridiculously underpaying Medicaid is. Can you imagine what would happen if government mandated that Facebook employees could only be paid a maximum of 10/hour?

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

#225

Post by assblaster » Wed, May 02, 2018, 4:56 PM UTC

gambiting wrote: post #222

assblaster wrote: post #205

Earlier quoted context omitted.

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 countri…

>>While NATO countries don't pay their fair share of costs of maintaining their security, the United States has to pay the balance. The counterpoint here is that US keeps American bases in Europe because US wants to keep their bases here and it serves their interests first and foremost, any defensive goals are secondary, if not tertiary. All Nato nations could contribute exactly ZERO to the budget and US would still…

Their interests are to prevent Russia from invading Europe. Clearly every non Russian European country has an interest in that as well.

The US could clearly exit NATO to save some (a lot) money.

How is paying for someone else's defense a good deal for America?

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

#226

Post by nickjj » Wed, May 02, 2018, 5:14 PM UTC

waisbrot wrote: post #208

nickjj wrote: post #134

Earlier quoted context omitted.

> 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 a…

> 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 am a freelance web developer and online teacher. I have no employees or physical goods.

About half of my customers are from the US and I am in a hyper competitive world wide market.

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

#227

Post by gambiting » Wed, May 02, 2018, 5:15 PM UTC

assblaster wrote: post #225

gambiting wrote: post #222

Earlier quoted context omitted.

>>While NATO countries don't pay their fair share of costs of maintaining their security, the United States has to pay the balance. The counterpoint here is that US keeps American bases in Europe because US wants to keep their bases here and it serves their interests first and foremost, any defensive goals are secondary, if not tertiary. All Nato nations could contribute exactly ZERO to the budget and US would still…

Their interests are to prevent Russia from invading Europe. Clearly every non Russian European country has an interest in that as well. The US could clearly exit NATO to save some (a lot) money. How is paying for someone else's defense a good deal for America?

I mean, if US wants to tell itself that it's protecting Europe from Russia, then sure, whatever they need to sleep well at night. I, as a European citizen, don't believe that for one second.

>>How is paying for someone else's defense a good deal for America?

Just get rid of the notion that America is "paying for someone else's defense" and it should become clearer - US currently has a complete military hegemony worldwide, and you can't maintain it without having forward bases all over the globe - countries inr Europe provide space for these bases, sometimes willingly, mostly over promises of things that have never materialized. In a lot of cases I think it's clear that the presence and actions of American forces around those bases are antagonizing Russia - at which point I'm not asking myself "why is Russia upset" but "wtf are the Americans doing". I have zero faith that in case of any conflict with Russia, US would come to our help or even prioritise us on the list of locations to defend - I'd much rather rely on our neighbours for help than a country literally on the other side of the planet whose interests don't necessarily align with ours.

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

#228

Post by seymour333 » Wed, May 02, 2018, 5:17 PM UTC

mfoy_ wrote: post #220

seymour333 wrote: post #137

Earlier quoted context omitted.

You forgot: 3. This is actually a good thing, because we get health care when we need it and aren't exposed to crippling debt? (your system entirely indefensible from every possible view point)

The list was "common argument by American's against the Canadian system", so why would they argue what you are saying?

Gonna go ahead and chalk that up to reading comprehension fails. Good times

I guess I'm just overly eager to tell Americans how crazy the system they accept is

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

#229

Post by chapium » Wed, May 02, 2018, 5:27 PM UTC

falsedan wrote: post #73

chapium wrote: post #49

Earlier quoted context omitted.

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 Australia…

That makes sense. Medicare works in a similar way in the US.

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

#230

Post by tialaramex » Wed, May 02, 2018, 5:53 PM UTC

DanBC wrote: post #156

gnode wrote: post #138

Earlier quoted context omitted.

> my green OHIP card was all I needed In the UK, the entitlement is even more ubiquitous and fluid. I was diagnosed by my GP, referred to hospital and undergoing surgery under general anaesthetic, in half a day, without showing any form of ID.

> without showing any form of ID. That's changing a bit under the hostile environment. https://www.gov.uk/government/publications/guidance-on-overs...

Only if you don't look like you belong. Classic hidden privilege.

As a tall middle-aged white guy, I go wherever I want, nobody asks to see any ID, nobody checks why I'm there. If they need to interact with me they start by apologising "I'm sorry sir".

Hospitals, government departments, everywhere I go I look like I'm supposed to be there.

But behave the exact same way as a 5'6" black teenager and you'll get stopped and questioned constantly.