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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

#251

Post by noonespecial »

jtokoph wrote: 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.

Sounds like the usual billing practice of "send him a bill for everything he'll ever have and then graciously negotiate it down merely everything he's got now".

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

#252

Post by NearAP »

ArchTypical wrote: post #194
FireBeyond wrote: post #96

Earlier quoted context omitted.

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.

Paying 300-500/mo for decades, as a chronic heart patient here. I've had multiple open heart surgeries and nothing sweeter than paying 6k for the recovery room and 0 for the surgery (along with sweet receipts for 1mil in aggregate surgery costs). The separate billing is a pointless red herring, in context of the article. $10,920 for room charges is absolutely ludicrous.

I'm curious - do you think the figures for room and board is generally high? Or do you just think it is high for the city?

I'm asking because a friend was in the hospital in the bay area for 7 days and his room and board was approximately $21,000

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

#253

Post by mikekij »

*Disclaimer: I'm not attempting to support HCA's billing practices here."

HCA has profit margins around 10%, which do not appear to me to be exorbitant. (https://investor.hcahealthcare.com/press-release/hca-reports...) While this patient's experience is clearly out of whack, and the $19k for a $1,500 stent thing is nuts, this points to a larger pricing / business model issue within US Healthcare. Typically, a few medical specialties (Surgery, Imaging, Rad Onc) have high profit margins, but are offset by losses in other departments (ER).

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

#254

Post by sturgill »

rdtsc wrote: post #52

> St. David’s HealthCare defended its handling of Calver’s bill and sought to blame the school district and Aetna for offering such a narrow network. So while dying of a heart attack he should have been negotiating with the ambulance driver, the paramedics, the nurses, each intern and doctor to make sure they are "in-network". > St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance bec…

I once got cut by a skate playing hockey. Showed up at the hospital pulsing blood from my leg. My first question to them, “Do you take X insurance?” Only after they assured me that my insurance would be accepted did I drag my bloody leg into the care room.

Turns out the doctor that the hospital assigned to me did _not_ take my insurance.

I got billed the full amount, yelled very loudly at lots of people, and when I “resubmitted” the claim ended up paying like $50 out of pocket. I’m pretty sure that every item in the hospital is purchased by a separate company and that the Venn diagram of approved insurance companies never intersects.

My dad is a nurse and I grew up hearing how insurance was destroying health care. As a free market libertarian, I have no idea what to do about it. But next time I need stitches I think I’ll just opt for the super glue in my workshop...

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

#255

Post by burkaman »

krupan wrote: post #242
burkaman wrote: post #226

Earlier quoted context omitted.

Ok, here's one list, I'm sure it isn't comprehensive: http://ourmed.org/wiki/List_of_medical_emergencies So for each item on this list you'll need to find out every possible treatment and drug and what they cost at every hospital within ~50 miles. Make sure you look up allergies and any side effects when combined with medication you regularly take, you don't want to be in a situation where you listed Hospital X for m…

Your google skills are strong. How many things on that list need treatment within minutes? "Is there anything else in your life that you shop around for in case of emergency?" Have you never heard of Preppers? But seriously, yes, I shopped around a little for a fire extinguisher in my home, I shopped around a bit for a good first aid class so I'd have some skills. I have spare batteries around the house in case the p…

> How many things on that list need treatment within minutes?

I don't know, I think most? I am not a medical expert, and as such am not qualified to answer that question. I think that means I'm also unqualified to draw up a living will detailing what to do if I exhibit symptoms of any of these.

> I shopped around a little for a fire extinguisher

And then bought it immediately, right? You're not gonna wait for a fire to buy one. Same with the first aid class, the batteries, the flashlight, and the food. You cannot buy medical care ahead of time, or take a class to train you to treat yourself.

In case you missed it in my other comments, how often would you update your living will in this world? How would you prepare for travel within the US?

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

#256

Post by krupan »

mikekij wrote: post #253

*Disclaimer: I'm not attempting to support HCA's billing practices here." HCA has profit margins around 10%, which do not appear to me to be exorbitant. ( https://investor.hcahealthcare.com/press-release/hca-reports... ) While this patient's experience is clearly out of whack, and the $19k for a $1,500 stent thing is nuts, this points to a larger pricing / business model issue within US Healthcare. Typically, a few m…

Thank you for pointing this out. How many medicaid patients paying below cost does it take to drag down profits from the occasional 1000% markup that the hospital gets away with?

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

#257

Post by ThrustVectoring »

robin_reala wrote: post #174
ThrustVectoring wrote: post #149

This is why I plan on moving to Texas: creditor protection. At any point in time I could require medical services and have medical service providers simply decide that I owe them a truly massive amount of money. The only route I have to mitigate that risk is through creditor protection laws. In Texas, wage garnishment is limited to child support, unpaid taxes, and some other limited categories that medical billing do…

You might be better moving to a country with a nationalised health system and avoiding this mess entirely.

It's significantly easier to move between US states than it is to emigrate.

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

#258

Post by mikekij »

krupan wrote: post #256
mikekij wrote: post #253

*Disclaimer: I'm not attempting to support HCA's billing practices here." HCA has profit margins around 10%, which do not appear to me to be exorbitant. ( https://investor.hcahealthcare.com/press-release/hca-reports... ) While this patient's experience is clearly out of whack, and the $19k for a $1,500 stent thing is nuts, this points to a larger pricing / business model issue within US Healthcare. Typically, a few m…

Thank you for pointing this out. How many medicaid patients paying below cost does it take to drag down profits from the occasional 1000% markup that the hospital gets away with?

Can't tell if you're being sarcastic or not, but yes, there are patients that pay (or are charged) a 1,000% markup, that in turn offsets patients not paying anything. I'm not saying the problem is the patients paying nothing; the problem is that the payment model is broken.

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

#259

Post by krupan »

krupan wrote: post #242
burkaman wrote: post #226

Earlier quoted context omitted.

Ok, here's one list, I'm sure it isn't comprehensive: http://ourmed.org/wiki/List_of_medical_emergencies So for each item on this list you'll need to find out every possible treatment and drug and what they cost at every hospital within ~50 miles. Make sure you look up allergies and any side effects when combined with medication you regularly take, you don't want to be in a situation where you listed Hospital X for m…

Your google skills are strong. How many things on that list need treatment within minutes? "Is there anything else in your life that you shop around for in case of emergency?" Have you never heard of Preppers? But seriously, yes, I shopped around a little for a fire extinguisher in my home, I shopped around a bit for a good first aid class so I'd have some skills. I have spare batteries around the house in case the p…

"You cannot buy medical care ahead of time"

Actually, that's pretty much what our current "insurance" system tries to look like, so maybe you do have a point there :-)

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

#260

Post by krupan »

mikekij wrote: post #258
krupan wrote: post #256

Earlier quoted context omitted.

Thank you for pointing this out. How many medicaid patients paying below cost does it take to drag down profits from the occasional 1000% markup that the hospital gets away with?

Can't tell if you're being sarcastic or not, but yes, there are patients that pay (or are charged) a 1,000% markup, that in turn offsets patients not paying anything. I'm not saying the problem is the patients paying nothing; the problem is that the payment model is broken.

I think you just said what I was trying to say. Thanks!
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