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Insured, but Still Owing $109K for a Heart Attack

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Re: Insured, but Still Owing $109K for a Heart Attack

#161

There are midterms coming up. Vote for change and don’t vote for anyone who took one cent from the insurers.

Seriously? Find me the politicians who haven't accepted campaign donations(bribes) from insurance or healthcare companies. Good Luck.

These guys don't take corporate money. https://now.justicedemocrats.com/candidates

Re: Insured, but Still Owing $109K for a Heart Attack

#163
post #53
post #7

> UPDATE: Monday, shortly after publication and broadcast of this story by Kaiser Health News and NPR, St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.” Sounds all fine and dandy until you realize that these charges will just be made up for by people that aren't able to get NPR to publish a story about them.

There is a whole industry of "medical billing advocates" you can pay to find what is likely thousands if not tens of thousands of dollars of completely made up charges on any given US hospital bill and "negotiate" them away. You don't necessarily need press coverage though it obviously helps. Hell one time I got a $15k bill for something insurance should have covered. Called the hospital, turns out insurance had cove…

I had a hernia surgery shortly after a plan change. The hospital believed insurance wouldn't cover, so they discussed cash pricing with me of around 7k. The insurance ended up covering their portion with me paying about 2k out of pocket.

But then I almost had a hard attack when the statement arrived. The first number I saw was 24k, WTF!! Well, reading on there was a very large "discount" applied and the final bill to the insurance company was about right. I could only imagine though, that under some circumstance, the hospital would have tried to stick me with that totally bogus 24k bill had the insurance not covered it or the pricing not been negotiated in advance..

Re: Insured, but Still Owing $109K for a Heart Attack

#164
post #123
post #85

Earlier quoted context omitted.

Not always. My mom had a quadruple bypass about 6 years ago during a gap year where she stopped working but didn't have Medicare yet. Unlucky. I think she was billed for around $180k. She told them "I'm on Social Security for $1000/mo, I'll pay you $50/mo". It was basically that or sending it to collections and never getting a dime from a retiree. So they accepted and told her a "non-profit" paid for the doctor's por…

> Medical debt is the least concerning type of debt for most lenders. Just another data point, a large property management company I used to work for specifically exempted bankruptcies due to medical debt when calculating applicant credit scores.

I have a friend who sells debtor data for a living. He literally sells Excel spreadsheets of debtor data (name, address, SSN, amount owed, etc) to collections agencies for $5k-$25k a pop. He makes mid-six figures doing it. The quality of the data is what commands the price. He said the least desirable debt are debts older than a year and medical debt. He can't even give that crap away.

Also, if you're ever called by a collections agency, you should ask them to provide proof that they actually hold the debt you're obligated to pay. In some cases they've just bought the data, usually from another collections agency who couldn't collect, and they're trying to shake you down. Once you use the magic phrase "provide proof" they give up and stop hassling you, because they have no proof.

Re: Insured, but Still Owing $109K for a Heart Attack

#165
post #7

> UPDATE: Monday, shortly after publication and broadcast of this story by Kaiser Health News and NPR, St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.” Sounds all fine and dandy until you realize that these charges will just be made up for by people that aren't able to get NPR to publish a story about them.

When you realize that the hospital was charging $19,000 for a stent that cost $1,500, you realize that painting Calver as someone who is going to cost us all money is misdirected anger. And, to be clear, they charged $19,000 for the stent, not "stent plus theater time to place it plus surgeon, anesthesiology, OR nurses", of course not. Those are all absolutely billed separately.

Hospitals should be legally mandated to accept replacement of materials in lieu of payment.

If I can source the same stents for cheaper than the hospital bills me, they should be required to erase them from the bill and accept them as material replacement.

It's not as if medical supplies are unavailable to the end consumer.

https://www.esutures.com/product/0-in-date/41-boston-scienti... Here are the stents available for under $1000.

When I had a broken finger and was uninsured, I was charged ~$40 for a finger splint that costs $7 at Walgreens (yeah, the very basic one made out of aluminum and blue foam).

Also, a word of advice - never ever pay what you were sent from the hospital right away. I personally throw most medical bills in the trash and wait until they call me, then negotiate it down to a fraction of what was billed, offering to pay in cash.

Re: Insured, but Still Owing $109K for a Heart Attack

#166

I curious to know the details of his health. He just did an IRONMAN 5 months before. Why was he unaware of the status of his clogged “widow-maker” artery? Why was his artery clogged? high cholesterol? What does his diet consist of? Use of ultrasound imaging to measure the thickness of the inner walls of the carotid arteries that supply blood to the brain. Increasing carotid artery intima-media thickness, or CIMT, ind…

Please quit literally blaming the victim.

When did you last have an ultrasound of scan of your LVA? Have you had imaging done of your bile duct to rule out pancreatic cancer? Why don't you know your health status?

The answer is, of course, because there was no good reason to do the invasive testing needed to determine that status. There is an entire medical field dedicated to measuring the benefit vs cost (including testing-induced problems) of such things. No one recommends that ironman competitors do heart scans or arteriograms.

Re: Insured, but Still Owing $109K for a Heart Attack

#167
post #131

Earlier quoted context omitted.

Health insurance companies' profit margins are restricted by law, whereas Robert Wood Johnson and its executives and doctors profit margins are not restricted. If anyone is on the patient's side from a cost perspective, it's insurance, and the ones benefiting from higher pricing and unnecessary procedures are the providers.

I've suddenly started seeing this take all over the place and I have no idea where it comes from because it doesn't make sense. That the insurance companies profit margins are restricted means rather little because executive pay isn't capped: if they earn too much money, they can simply pay bonuses to raise their expenses. Or cut shareholders a check. Or. Or. Or. Tangentially, this is why "non-profit" doesn't mean wh…

If they pay bonuses to themselves, then their premiums will be higher than other insurance companies so they would lose customers, the same that stops any other business from doing the same.

And since taxpayer funded healthcare is off the table in the US, we have to work with what we can. The biggest problem with health insurance right now is everyone is not forced to use healthcare.gov so the risk pools don't have the correct distribution of healthy and unhealthy people.

Re: Insured, but Still Owing $109K for a Heart Attack

#168
Another easy solution, file for bankruptcy. No sane judge will kick a family out of their house over a medical bill. That would be counter productive to their recovery and cause undue hardship. If you don't see the utility in bankruptcy, just remember our President has used it several times over decades.

Edit: it's also known as unsecured-debt, which means the worst thing anyone can try to do to you is ruin your credit score. This isn't worth dying over and America is designed to bear the cost.

Re: Insured, but Still Owing $109K for a Heart Attack

#169
post #85
post #7

> UPDATE: Monday, shortly after publication and broadcast of this story by Kaiser Health News and NPR, St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.” Sounds all fine and dandy until you realize that these charges will just be made up for by people that aren't able to get NPR to publish a story about them.

Not always. My mom had a quadruple bypass about 6 years ago during a gap year where she stopped working but didn't have Medicare yet. Unlucky. I think she was billed for around $180k. She told them "I'm on Social Security for $1000/mo, I'll pay you $50/mo". It was basically that or sending it to collections and never getting a dime from a retiree. So they accepted and told her a "non-profit" paid for the doctor's por…

I worked with somebody who at 23 was bitten by a cat and it got infected. She didn't want to seek medical treatment even though her hand swelled up like crazy--"I don't have insurance, I will get better". I basically forced her to go to the hospital and she ended up spending a couple of days in the ICU. They told her if she waited another day, she might not have made it.

Total cost, something around $23,000 I think. This is somebody who was making maybe $10/hr. They took a payment plan of around $15/month, so she will be paying it back for the next 128 years.

Re: Insured, but Still Owing $109K for a Heart Attack

#170
post #160

Earlier quoted context omitted.

That's because the government allowed tax exempt employer funded health insurance to stick around. If everyone was forced onto healthcare.gov then it could be possible. Employers would have one less thing to deal with that has nothing to do with their product and taxpayers wouldn't have to worry about being tied to their employers, and can more accurately compare differences in pay and whatnot.

I strongly agree with everything you said except forcing everyone to healthcare.gov. A free market for insurance can and should exist without the need for a government run website/market

A free market also requires knowledgeable purchasers to make informed decisions. In the case of health insurance, it's so complicated that it makes sense to simplify it to protect consumers and offer easy to compare options (bronze/silver/gold). I guess it doesn't have to be government run, but it's already built and does a pretty good job.
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