The anatomy of a ripoff

The countries in the EU all have pretty different ways of paying for health care. In the UK if you went to a NHS hospital (which you would do if it was an emergency) you would pay nothing - there would never be any charges for the hospital treatment and drugs administered in a hospital aren't charged.

NB: Note that NHS is based on treatment being "free at the point of delivery" - everyone knows that it's not "free" and we pay for it through NI and other taxes and people who can't (or even won't) still get the same treatment.

As far as I know in EU public insurance is mandatory, so you would never pay such ammount.

My wife recently had some tests done. Hospital's receptionist forgot to add insurance information to wife's profile, so accordingly to hospital's records she was uninsured.

Month later we receive bill for ~$1,400. After quick googling we find that if she would go to any local hospital and pay up front with cash, it would cost her maximum ~$400. Obviously, she went back to hospital to find out what's wrong with them (hospital owned by insurance company, so it is very wrong). There they found they did not record her insurance info, excused and said they will send corrected bill.

Month later we received her new, corrected bill. $74.68

You guys in USA have something very-very-very wrong with health care industry =)

I have spent a week in a hospital twice, once in the late 90s, once in the lates 00s. Different hospitals, different health plans.

Here's the thing: in the 90s experience, I received a complete itemized bill, organized by time and day, for everything that was done to me. I didn't have to pay, my insurance did, but I received copies of the bill. In the 00s, I received virtually nothing. Again, my insurance paid, and I was just given the very briefest of letters explaining that I was covered, and how to handle short term disability, and the like.

I found receiving the complete itemized bill truly enlightening. What I learned was:

    + exactly what was done to me in the hospital and when
      (I was not in a position to understand when I was admitted)
    + exactly what was being charged
    + exactly how expensive everything was
    + some charges did seem erroneous, perhaps for treatments that did not take place

The sum of the bill was staggering. But it was truly a good thing to see the bill. It helped me understand exactly what had happened. It served as a reference for googling my illness and treatment. It helped me understand the costs.

It helped me appreciate the efforts by others to get me that coverage. And it let me return some of that by giving me a way to check for mistakes in the billing.

I hope everyone has the coverage they need when they need it.

I do think that part of every medical service should be a completely itemized bill. I think it's a useful reference for the patient, I think it's a simple way to inform everyone on the complexities and costs of healthcare, and it's a simple way to encourage informed use, and correct mistakes.

If everyone had these bills, there would be websites developed to explain, compare, manage them, and it would help eliminate many of the games that hospitals seem forced to play.

So it would also encourage better accounting and put better incentives in place to have that better accounting.

There are many objections to universal healthcare, but not healthcare reform (Healthcare Reform != Universal Healthcare). The government has broken healthcare in the US through all sorts scams and tax incentives (why is employment tied to healthcare, wage controls in the 1940s), the solution is not to give the government more control. We can already see this with the medicare "doctor fix" and other broken government programs that actually encourage spending.

A better solution would be to allow nonprofits to hold large amounts of money, i.e. save during the good times, and to allow them to operate across state lines.