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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

#261

Post by [deleted] »

jhayward wrote: post #148
csomar wrote: post #146

Looking at the bill, here is some ridiculous: NaCl (basically salted water) costing around $300/liter. That's outrageous. These guys are protected by your politicians and make use of mercenary tactics. Villains in doctors clothing. I'm for free markets but we are kinda going over the limit here. Maybe have fixed rates for emergency where you can't get the approval of the patient. Maybe give the patient the possibilit…

Retail cost for Lactated Ringer's solution, injectable (basic saline fluid for IV) was over $40/liter in qty 12 liters about 3 years ago. I can imagine it has gone up since then. The use of the health care system to extract every single excess dollar from the middle class extends to many, many layers of the supply and service chain. It may be that the saline was "merely" marked up by a factor of 2x.

[deleted]

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

#262

Post by GFischer »

wang_li wrote: post #135
PeekPoke wrote: post #48

Earlier quoted context omitted.

This is why it's good to be English - our national health service fixes you up and sends you on your way without providing you with a bill.

Unless the NHS has no approved treatment, in which case you die instead of being able to go abroad for care.

There are better systems... over here in Uruguay, you have basic tax-paid "free" healthcare but you are able to purchase better services on top (I have several layers of extra care on top of national basic service).

The richest usually purchase insurance to be operated in the U.S. by top doctors (ironically, probably cheaper than what U.S. nationals pay for the same service), but local doctors are very good (there ARE some services where U.S. expertise is preferable).

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

#263

Post by logfromblammo »

antisthenes wrote: post #165
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.

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…

Nope. No way. Have we learned nothing from "fulfilled by Amazon" counterfeits?

The supply chain has to be verifiable as genuine goods from the factory to the hospital floor. Trying to verify the authenticity of patient-supplied replacements would be a nightmare.

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

#264

Post by UncleEntity »

defen wrote: post #200
achoped wrote: 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…

> Just let it go to collections. You'll get harassed for a little over a year. Debt older than a year is almost never pursued by collections agencies. I don't understand. Is there no penalty to not paying other than a hit on your credit score? Can't you end up with wage garnishments or liens or something like that?

Where I live (Arizona) there's a statute of limitations on consumer debt, think it's 2 years for random bills and 3 years for recurring payments...or something similar.

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

#265

Post by GFischer »

NTDF9 wrote: post #218

Has anyone in the US considered flying overseas to get treatment done? Many hospitals in third world countries are cheaper and more humane. Sure, you lose out on the ability to sue them if things go awry but where is the tradeoff between six figure debt at an old age vs paying $10000 to get the whole thing done?

A lot of immigrants do that, but you have to know the local system of where you'll be treated (that's why it's mostly immigrants that do it).

For what I'm readying, for a lot of non-life-threatening care, it's way cheaper to fly here (Uruguay), have treatment, stay a month, and then fly back, than stay one DAY in the U.S. - a plus is that treatment will likely be better.

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

#266

Post by [deleted] »

csomar wrote: post #224
jhayward wrote: post #148

Earlier quoted context omitted.

Retail cost for Lactated Ringer's solution, injectable (basic saline fluid for IV) was over $40/liter in qty 12 liters about 3 years ago. I can imagine it has gone up since then. The use of the health care system to extract every single excess dollar from the middle class extends to many, many layers of the supply and service chain. It may be that the saline was "merely" marked up by a factor of 2x.

Seems like the problem is broadly in the medical sector (including pharmacological). There is 0 reasons why it would cost over $1. Maybe $2. $40 is still way ridiculous. I mean in a competitive market.

[deleted]

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

#267

Post by linker3000 »

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.

In the UK and paying a monthly National Insurance tax:

About 5 years ago, I had 6 weeks in hospital, a total of 3 angiograms, one MRI scan...and then 5 stents (should have been 4, but they tore something and had to put in a covered one!).

The wait was mainly down to an unfortunate series of events: One stent was needed in a 'tricky' place and so I was timetabled to be operated on by a specialist surgeon elsewhere, but his father fell seriously ill so he went on leave. My first op was rebooked for another hospital...and they had a 'flu outbreak so ops were postponed. Eventually I was booked in elsewhere had a one hour ambulance transport ride for 'third time lucky'.

The stents were fitted in two separate operations about two weeks apart. The most notable expense I incurred was for data top-ups on my cellphone because hospital wifi was still being setup and hadn't quite made it to my ward.

The NHS gets a lot of flak, and it's by no means perfect, but it's generally there for you when you really need it.

PS: I'm on a slew of meds for my heart condition and T2 diabetes - all free at the point of collection.

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

#268

Post by dawnerd »

JumpCrisscross wrote: post #207
antisthenes wrote: post #165

Earlier quoted context omitted.

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…

> never ever pay what you were sent from the hospital right away This is actually good advice. It shocked me when I realised it. But it’s good advice.

People are surprised when I tell them I simply refused the 3k dollar (after insurance) couple hour hospital bill for having the flu. They couldn't tell me why two tylenols, a saline drip, and a prescription cost that much. (I was vomiting blood which is why I was taken in).

They ended up dropping the bill altogether as insurance had already paid them.

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

#269

Post by hathathat »

antisthenes wrote: post #215
loeg wrote: post #211

Earlier quoted context omitted.

> 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. Meh. The only reason they inflate supply costs is because that's where insurance negotiations let them. Mandating supplies must be available at-cost to consume…

Trivially disproven by UK's health care system, which consistently ranks #1 in the world by outcomes and employs price caps for health care suppliers. https://www.commonwealthfund.org/press-release/2017/new-11-c... > Mandating supplies must be available at-cost to consumers is just a stupid cost-shifting game. That's not what I suggested in my post at all. Also, if it reduces costs for the end consumer, what's the ha…

> Trivially disproven by UK's health care system

Not trivially? [1]

[1] https://www.theguardian.com/society/2017/jul/18/uk-cancer-su...

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

#270

Post by senorjazz »

antisthenes wrote: post #215
loeg wrote: post #211

Earlier quoted context omitted.

> 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. Meh. The only reason they inflate supply costs is because that's where insurance negotiations let them. Mandating supplies must be available at-cost to consume…

Trivially disproven by UK's health care system, which consistently ranks #1 in the world by outcomes and employs price caps for health care suppliers. https://www.commonwealthfund.org/press-release/2017/new-11-c... > Mandating supplies must be available at-cost to consumers is just a stupid cost-shifting game. That's not what I suggested in my post at all. Also, if it reduces costs for the end consumer, what's the ha…

> Also, if it reduces costs for the end consumer, what's the harm?

Less profit for the company.

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