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The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

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Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#131

Post by JshWright »

soneca wrote: post #28
ceejayoz wrote: post #6

Earlier quoted context omitted.

The doctors likely have nothing to do with how much procedures bill for. In private practice outside a hospital, they perhaps have more guilt here, but in an ER? They set the prices about as much as the janitors do.

The article mentions an accusation that doctors are “upcoding” procedures to be able to charge more.

The doctors likely aren't the ones coding the visit. That is often done by separate back-office staff (especially in case like this, where the physician is working for a medical staffing company).

Most medical practices employee (or outsource) medical "coders" whose job it is to take the notes written by the doctor and determine which procedure codes should be applied (which then determine what gets billed for)

Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#132

Post by kayxspre »

This reminds me of the ESS surgery I took last Sunday. The bill came at approximately $4,900, and approximately 60% goes to the physician. I didn't have insurance, so I have to pay them in full.

Although I enrolled in the universal healthcare scheme (which allowed me to pay up to $1 for treatment), my sinusitis is more serious such that I don't think UHS will properly cure me, causing me to pursue special clinic at public hospitals (where more experienced physicians are available).

Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#133

Post by akvadrako »

88840-8855 wrote: post #43
sorokod wrote: post #30

Can someone make a coherent case for public healthcare to be a for-profit endeavour?

Just my 2 cents. I live and work in Germany and am insured in one of the many public insurances. My monthly contribution is 350 Euro, my employer has to pay 350 Euro per month, too. Hence, I am paying approx. 7500 Euro for my insurance per year. Assuming I work 35 years plus some inflation, then I will pay over 300.000 Euro for my insurance. This excludes contribution before 25 (where my parents paid for me) and my c…

You think that's all it costs? According to wikipedia, German health care is 77% government-funded.

Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#134

Post by pietrovismara »

superfunny wrote: post #117
hamilyon2 wrote: post #76

Most of the time I restrict myself from this kind of comments, but here is what experience is typically like in Russia. You are sick or even probably sick, like biten by tick and worry about it is infectious. You go to the neatest hospital, local ER, register yourself (no documents needed). Any time of day. You get triaged immediately, if your situation is not life-threatening, there is a queue. Waiting times are any…

"The state-provided health care is free" Today I learned that doctors and nurses in Russia work for nothing. No? So where does the money to pay them come from?

Public money, that as you might know comes from a variety of sources, including taxes. But to say some taxpayer is paying your "free" treatments is a grotesque simplification.

Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#135

Post by scrose »

Even with my $0 deductible insurance that I paid several hundred a month for, I just got through a months long battle with my insurance over a $10,000 ER bill and additional $2,000 bill they deemed ‘not medically necessary’ — my partner was bleeding from their mouth and unable to eat or drink for more than 2 days after a surgery. It took multiple calls to the doctor and insurance and haggling with the billing department to get the final charges reduced to $0 and $100 respectively.

Even as a well paid software engineer, I’m strongly eying other countries where your life and death isn’t seen as a massive profit center for investors.

Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#136

Post by donatj »

LightG wrote: post #98
donatj wrote: post #75

Earlier quoted context omitted.

They don’t exist. They’re the imagined scapegoat for what is actually just a much harder to comprehend creeping bureaucracy cost. The human mind loves clear enemies but Hanlon’s Razor almost always applies. Almost no one ever actually has malicious intent, but our brain evolved to watch for enemies and loves seeing patterns where they aren’t.

Cool story. So what you're saying is there is an horrendous creeping bueaucracy cost here. Funny, because that's exactly what free market proponents argue is the cause of inefficiency in publicly managed healthcare systems, and the reason to move towards models based on the US system. Someone is lying.

> Someone is lying.

It’s you, to yourself. What we have is not by any stretch of the imagination a free market solution. It’s insane amounts of paper pushers created by the government. The whole insurance system we have is an impractical mess designed to fail. The free market would never have designed something so customer unfriendly, people would have gone elsewhere had competing solutions been allowed to exist. In a free market, you are free to go somewhere else.

Our health system is designed by the government, by way of outlawing everything else. If you want to talk free market, in the early 1900s it was common for large companies to keep a doctor on staff and offer their services to employees. That was essentially outlawed.

The rise of cash only flat rate doctors in current years is the closest thing we have to free market, and they’re great. Prices posted up front. No back and forth with insurance companies.

Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#137

Post by temac »

HPsquared wrote: post #13
helloguillecl wrote: post #8

This is absurd. Even in a country with liberal economics and "free choice" health system (however with universal care, and state regulation), the same stitches in a world-class private clinic in Santiago, Chile would cost 400 USD, before insurance . The clinics there are not the ones Americans imagine from a middle-income country, most of them have better infrastructure and doctors than the ones I know in Europe. And…

The stitches are expensive mostly because of many regulatory factors that restrict the supply of medical services and drive costs up, with the "free market" component being in how much they can charge the patients. It's the worst of both worlds in the US.

Not so sure for the impact of regulatory. Tons of other countries/areas have equivalent regulatories req, if not more strict, yet does not yield to absolutely insane prices.

Regulatory is there to prevent e.g. killing patients in a Therac-25 like events. When you have a too weak reg, you end up with things like 737-max situations.

Now maybe regulatory can also go too far in some niches, but the correct solution is not to blindly go in the other direction.

And anyway, absurd prices in cases of e.g. ER are most of the time explained not by the cost of medical supplies but by random attempts to purely extorts the patients: 6 stiches and a shot do not imply thousands of dollar of BOM, nor are physicians paid hundreds per minute. Look at the cost of covid vaccines if you want to know more realistic costs.

Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#138

Post by saiya-jin »

refurb wrote: post #46
helloguillecl wrote: post #8

This is absurd. Even in a country with liberal economics and "free choice" health system (however with universal care, and state regulation), the same stitches in a world-class private clinic in Santiago, Chile would cost 400 USD, before insurance . The clinics there are not the ones Americans imagine from a middle-income country, most of them have better infrastructure and doctors than the ones I know in Europe. And…

The plastic surgery and vision correction industries work pretty well in the US. You see price competition and patients have the ability to shop around and make choices that are important to them (references from other patients, doctor personality, etc). Now contrast that with going to a hospital for a procedure where you have time to shop around. Can you get a price? No. Can you easily get appointments with doctors…

Exactly the same situation is in rest of the world, no patient is shopping around. just goes usually to closest/biggest hospital. Yet we don't have this tragic mess US has. So its not about shopping around, rather some other reason like regulations, wrong dynamics between hospitals and insurances etc.

You don't have better equipment nor doctors in US compared to biggest hospitals in Switzerland for example. Yet we have fraction of the costs as patients, and its not due to low doctors/staff salaries. Equipment is also top notch everywhere, new machines in all departments.

Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#139

Post by [deleted] »

Aeolun wrote: post #74
refurb wrote: post #51

Earlier quoted context omitted.

Well UCSF charged my brother in law $20,000 for an MRI a private standalone MRI clinic charges $3,000 for. Insurance paid UCSF $16,000 after discount. So I’d say the hospitals definitely are a part of the problem. You can imagine what he did with a fund raising letter he got from UCSF asking for a donation so they could continue to help the community…

Meanwhile, the most expensive MRI I’ve ever gotten in Japan was $300 before insurance. Even the private clinic is making bank like there’s no tomorrow.

[deleted]

Re: The ER charged him $6,589.77 for 6 stitches, cost that led his wife to avoid ER

#140

Post by coldtea »

HPsquared wrote: post #13
helloguillecl wrote: post #8

This is absurd. Even in a country with liberal economics and "free choice" health system (however with universal care, and state regulation), the same stitches in a world-class private clinic in Santiago, Chile would cost 400 USD, before insurance . The clinics there are not the ones Americans imagine from a middle-income country, most of them have better infrastructure and doctors than the ones I know in Europe. And…

The stitches are expensive mostly because of many regulatory factors that restrict the supply of medical services and drive costs up, with the "free market" component being in how much they can charge the patients. It's the worst of both worlds in the US.

We have more "regulatory factors" in Europe, and much cheaper treatment... Like 1/40 or so as much in this case...
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