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The cost of two weeks in an pediatric/infant ICU

kingsley.sh

211–220 of 294 posts

Re: The cost of two weeks in an pediatric/infant ICU

#211

In 2011 I had major surgery. The hospital first billed the insurance company for $100,000. The insurance company then paid $20,000. Of course, the insurance rate was negotiated in advance. There was no reason to bill for 5x the negotiated rate. IMO: We need to start fining hospitals for billing errors like this.

I'm sure they play tons of games so it's not considered an error. That said, the government needs to step in and set prices for health care. The free market has failed, in this case. Nobody can afford to shop around for a cheaper health care provider in an emergency, and even then there's no real competition.

"That said, the government needs to step in and set prices for health care."

I don't see this working without other substantial changes. They do this with Medicaid and Medicare already. The reimbursement rate is pretty low and the actual costs of some services actually exceed the payment. Without fully going to a government run system, I don't think setting standard prices will work well due to the quality and cost differences from location to location.

A better solution might be some sort of truth in advertising/billing that changes how the providers and insurance companies run that process, like presenting actual cost of care, actual payment by insurance, and protecting individuals from any charge that exceeds the cost of care plus some profit limit like 2%. I'm sure there are a lot of details to prevent loopholes, but that's my general view.

Re: The cost of two weeks in an pediatric/infant ICU

#212
post #56

Earlier quoted context omitted.

> I don't understand how people can be so anti-universal healthcare in the US. Because I have zero faith that it will end up costing me less, and have a similar level of quality. I’m in tech. Combined HHI is something in the $200s. I pay about $300 per month for the entire family, $5K out of pocket max. So in a worst case scenario, let’s say healthcare costs me $9K per year. That’s what, 4% of my HHI? Will a universa…

> Because I have zero faith that it will end up costing me less, and have a similar level of quality. The US spends 2-3x per capita (counting both public and private spending; https://data.oecd.org/healthres/health-spending.htm ) than the rest of the OECD, with remarkably similar health outcomes. > I pay about $300 per month for the entire family, $5K out of pocket max. You're just paying your healthcare tax to your…

Just to make this point explicit: Your health care does not cost $300 a month. Your employer is paying for it as well, and as ceejayoz suggested it might be $1-2k a month. Add that in to your calculations.

Re: The cost of two weeks in an pediatric/infant ICU

#213
post #202

Earlier quoted context omitted.

The countries I have direct experience with, France and Germany, don't have any issues with people dying while waiting for procedures. Experts are usually readily available, so there are exceptions. I don't know of any public health care system in developed countries that have really these issues. I do know so, that a lot of that comes from a PR campaign run by US insurances against the Canadian system.

When you say they don't have any issues, do you mean it doesn't happen? I'm more familiar with the Spanish, Irish and UK systems. I tried to find a nice document giving numbers for what I was describing, but most of what I can find is anecdotal, and the official reports are weren't quantitative. Here's an article from an Irish newspaper last year that gives a rough guess (though of course there are other factors): ht…

Waiting times do happen, usually end of quarters when the quarterly budget runs out. No issues in so far as these waiting times don't affect emergency procedures.

And no, I don't see a direct link between public health care and wait times. The German issues are mostly caused by a bloated bureaucracy.

Re: The cost of two weeks in an pediatric/infant ICU

#214
post #159

Earlier quoted context omitted.

People can quit their job, and then meet their needs using their savings (if they have any), or welfare. The same is not true for health insurance.

They can't get health insurance on healthcare.gov?

There are two options after losing your job. Cobra or healthcare.gov.

Cobra will allow you to keep your current plan, for my family that would have been ~$800 per month.

Healthcare.gov rates are based on your income, or what it was, or what you expect it to be. Which for me was ~$700.

So there is no way to get affordable insurance to cover the gap in employment in a way that preserves cash reserves.

Re: The cost of two weeks in an pediatric/infant ICU

#215
post #71

>sodium chloride 3 % nebu soln - qty 33@$104 total $3,432 Ouch. $104 for 3ml of saline that goes in a nebulizer. These are $0.16 if you buy them yourself ($16 for a pack of 100).

Maybe, just maybe it also includes the cost of actually administering it by a professional and? Scotty aint gonna beam it into ya… So once it’s negotiated down to $800 - it’s mostly labor of people involved in the process of taking it from pharmacy all the way inside you

>Maybe, just maybe it also includes the cost of actually administering it by a professional

Nope. That's a separate line item. Appreciate the weird sarcasm though, as if I thought it would be magically administered for free?

>resp tx initial or subsequent qty 33@$318 total $ 10,494 (note: "tx" == therapy)

Also, 3ml takes 5 to 15 minutes to administer. So, even if I'm generous, that respiratory therapist costs $1272/hour.

Re: The cost of two weeks in an pediatric/infant ICU

#216

Earlier quoted context omitted.

Everything was not free, you just didn't pay directly for it while you were at the hospital. I don't understand why the word free always gets thrown around for country's with socialized medicine. You are paying for it.

This American fixation with the word "free" always makes me chuckle. Aa when a bus driver in Las Vegas got angry when I asked them if thag was the "free" bus, and he angrily replied "it's not free, its complimentary " .

Is this a copy pasta? I see this exact story repeated in several sites/comment threads.

Re: The cost of two weeks in an pediatric/infant ICU

#217
post #190

Earlier quoted context omitted.

Do you plan to retire? What will happen then? Do your family and friends have the same insurance plan? What will happen to them if they don’t? Seems short-sighted, yet telling, to talk only about the present time, and only about yourself.

> Do you plan to retire? What will happen then? When people retire, they are automatically covered by the socialized Medicare insurance program. Medicare is extremely popular among its recipients, many of whom nonetheless oppose socialized medicine for the general populace.

I wasn’t aware of that. Is there a minimum age to qualify?

I remember hearing some stories coming out of the 2016 election similar to what you mentioned, the hypocrisy/irony is palpable.

Re: The cost of two weeks in an pediatric/infant ICU

#218

Earlier quoted context omitted.

Probably because it’s not a real bill? These numbers bear no relation to money and nobody cares about them. The actual bill will be sent to insurance company, it will be 25-35% of this number, which is realistic given the cost of ultra modern equipment and high salaries for doctors. You will pay up to your maximum out of pocket, which is the real number you look at when shopping for a plan. Insurance for people who k…

Do you happen to know how one would be billed for this if they didn't have insurance?

Just noting that ~60% of all US hospitals are non-profit hospitals (although you wouldn't know it from the bills). What this means is that people who have no insurance pay significantly reduced prices via payment plans, or pay nothing at all.

To be clear, it's not like the hospital won't attempt to collect payment from them; they will. And some are downright assholes about it and will resort to scare tactics (usually farming the work out to a 3rd party). But, to maintain their tax breaks as a non-profit, etc. they are required to work with - and even forgive - patients who cannot pay.

Note: some hospitals are also assholes with the services they provide. They can't let someone die because they can't pay, but once "stable", then can boot you out.

Below this point is possible misinformation. It's my current understanding, but if someone with more direct knowledge can weigh in, I'd be very appreciative.

The above is where a large chunk of the costs for everyone else comes from. Basically, those who can pay are expected to pay for those who can't.

Where it really hurts is for those people who are - what I'll call - barely middle class. They probably make ~$50k / year and if they have health insurance, it's probably not a great plan: very high deductible and/or max out of pocket. Since they are insured, they will get a much higher bill (initially sent to the insurance company) designed to compensate for everyone else who is getting cheap/free treatment. And, because they insured, legally the hospital doesn't have to reduce the cost or forgive the debt.

Re: The cost of two weeks in an pediatric/infant ICU

#219
post #76

Earlier quoted context omitted.

Because in the US, if you're reasonably healthy, employed, live in a city with good hospitals and have private insurance, it "feels" better. It's easier to get better care. I'm Canadian, now living in the US, and I'll be honest: for the first couple of years, where I had some medium sized health issues, the US system felt so much better. The hospital I was treated at was leagues better than anything I saw in Canada.…

What if you want to start a business and have no significant other? Do American entrepreneurs bet that they won't fall sick before they strike gold?

You go to the emergency room and let the bill go to collections. Just make sure you have a different phone number for medical stuff so bill collectors don't bother you while you are working.

Re: The cost of two weeks in an pediatric/infant ICU

#220
post #2

I don't understand how people can be so anti-universal healthcare in the US. When you have an $8k deductible, your insurance is basically a gift to the CEO's yacht fund.

$8k deductible might be reasonable if $250k bills are the norm. It is not spoken out loud a lot (more during COVID), but the people who are against universal healthcare are likely pro high birth rate and survival of the fittest (unless they have money, of course).

You need a high birthrate to continue to suppress wages, don't forget about that! Once to population curve starts to flatten out, I do not see private insure prices going down as they will not be able to let go of the profit hence driving prices up higher.
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