As a German, this whole thread reads entirely bizarre. The US health system is the blind spot of the nation. The kind of fuckery you people have to endure every day and the kind of thought processes it requires, is astonishing. As a German, you don’t have to spend any brain cycles on health insurance or medical costs. If you’re self-employed, you maybe need to think about getting private insurance. Besides that: heal…
and I bet it's all completely untied from 'employment', right? this is the other huge blindspot we have here (US) - we've got generations of people who all have some odd belief this is somehow morally 'better' than employers provide this (because... that means you're 'working' and you need to be 'working' for the right/ability to have access to medical care).
Federal law means your insurance has to pay for emergency room care. They do like to try to weasel out of it by saying you actually have a true emergency though. You can push back and get your state insurance regulator involved.
Isn't this why the costs are so outrageous? The guaranteed insurance coverage means hospitals know they can charge whatever they want. This is why I'm not psyched about single payer healthcare solutions: It's not solving the problem, and may just mean huge government waste. It'd be far more effective to aggressively regulate hospital billing, wouldn't it?
ERs are mandated to provide emergency care to anyone regardless of insurance status. They get sweet tax deductions to do so and they get reimbursed by medicare as well. Also they have to take every insurance. There's a limit though, usually they will do enough to stabilize you out of immediate danger. So if you go to the ER with cancer and no insurance they may help you stabilize but they won't necessarily treat your cancer.
We had a call with someone who works on the pricelist/chargemaster for a major metro hospital recently, they set their prices by taking the Medicare reimbursement rate, and multiplying by 8.
This is pretty common. Uninsured patients are such a small percentage of revenue (and many aren't going to pay anyway) that hospitals don't put much effort into setting prices. Negotiating with insurers and navigating billing them is a big operation as it is.
Yeah, and there’s the Lesser Of clause in their insurance contracts - they’ll be reimbursed at the lesser of their retail rate and their negotiated rate. So they make their retail rate ridiculously high to make sure it’s never the limiter for insurance payments.
Adding insult to the injury. Im sorry for your loss... We lost our first, and er visit costed us much less. Few thousands... Didnt have the energy to fight that time...
:( sorry - it sucks We had insurance so we didn’t pay that crazy amount but it’s just absurd what these places charge.
I was assuming that. Even still, 148k bill, and an unimaginable situation is still a shocker.
I am willing to fight, even though my out of pocket is also very small.
There's an ideal world we want (that might never happen) and there's the real world. We live in the latter. Voting for the 3rd party is effectively voting one of the big 2. Also, I find it curious that while our community has generally settled on "incremental improvement" approach, we expect different from our governments and want the "big bang" changes. Then we are surprised when things get worse.
“We live in the latter. Voting for the 3rd party is effectively voting one of the big 2.” It’s not. It sends a signal that there is a desire for something else.
A signal to whom? Is that signal strong enough to persist in memory until the next election cycle?
> These people are all acting in violation of tons of existing laws - I don't understand why this isn't prosecuted. $$$$$$. The Medical system is being used to transfer wealth from the working and middle classes to the capital class under the guise of "free market". That money is being used to shape legislation, buy politicians, influence elections and kill threats to the system, allowing for even greater wealth tran…
I don’t think you could find even one person who thinks our healthcare system is a free market system. If only we could make it a free market system I think most of the problems would solve themselves. Unfortunately, I don’t think it’s feasible to untangle the decades of junk laws. Instead, it honestly might just be a better idea to implement single-payer. At least the incentives mostly line up unlike 3rd party payer…
How can you have a free market system where the most expensive items are heart attacks, organ replacements, brain operations and other situations where you often don't have a chance to "shop around"? Unless we have price controls and socialized medicine like other more modern nations, our system will remain a failure.
>I don't understand why this isn't prosecuted. Simply examine the way the issue was presented by frontrunners in the supposedly liberal party of the United States on the debate stage yesterday. Two candidates call for true universal coverage, a few call for a public option but brand it as universal coverage to confuse viewers, and several (with moderator and broadcast sponsor support) outright mislead by stating that…
I strongly support the Warren/Sanders universal healthcare plan, but in terms of optics, I don't actually see what the point is to making “duplicate coverage” private insurance illegal. It invites FUD and provides a convenient bogeyman while being entirely irrelevant in practical terms. If the government is providing comprehensive free healthcare to all, why would anyone need duplicate private health insurance? There…
M4A just won't work when half the country is completely against it. A public option as a stepping stone is much more feasible. We also need to stop limiting the number of doctors and nurses artificially.
I am not a lawyer or financial advisor. But I’ve heard that you can’t be sent to collections if you make a good faith attempt to pay your (medical) bill. Which in practice might mean you just pay $5 while you wait for the itemization
Our first born came with a $42k bill. Hospital and doctor said we were covered by our insurance pre-auth, but come bill time apparently pre-auth was null and void b/c it was requisite on a negotiation that fell through. Each side had a different story and their representatives acted absolutely helpless. We were broke at the time we found out about the pregnancy and memories of the first two years of my boy's life are…
You'll probably get a bill in a few years for 10% of the original amount from a bill collector the debt got sold to. Don't pay that either. They should have made sure your insurance covered it, so the onus is on them.
Our first born came with a $42k bill. Hospital and doctor said we were covered by our insurance pre-auth, but come bill time apparently pre-auth was null and void b/c it was requisite on a negotiation that fell through. Each side had a different story and their representatives acted absolutely helpless. We were broke at the time we found out about the pregnancy and memories of the first two years of my boy's life are…
Why aren’t US citizens queuing up to emigrate? At this stage, it seems like the US is the “land of the free”, whereby “freedom” is defined as the ability to freely exploit everyone.
Because most of these stories are extremes. All my friends' pregnancies and major surgeries came with some hefty "residual" bills, but all got negotiated down or tossed. If you stand up to them they'll back off. About 80-90% of America has insurance that is "ok" and will keep you from going bankrupt. It's not as bad overall (big picture) as the anecdotes portray. Don't forget there are 340 million people in the USA (1% is still 3.4 million people, plenty of room there for stories to arise). It still really sucks and we need price controls and public option for insurance though. Also fear of the unknown, leaving your family behind, other countries in general don't like Americans unless you bring a few million dollars with you, other countries seem to have a very high barrier to foreigners working there, etc get in the way.
As a German, this whole thread reads entirely bizarre. The US health system is the blind spot of the nation. The kind of fuckery you people have to endure every day and the kind of thought processes it requires, is astonishing. As a German, you don’t have to spend any brain cycles on health insurance or medical costs. If you’re self-employed, you maybe need to think about getting private insurance. Besides that: heal…
Why is insurance tied to "employers" in Germany? That seems antithetical to the "healthcare for all" that I keep hearing about Germany and other European countries. Why would a private contractor be on their own for health care? Taxes? I mean even as a contractor I still have to pay taxes like everyone else.