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I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

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Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#61
post #45
post #17

Earlier quoted context omitted.

Greetings from Australia. My brother has MS and gets a monthly infusion of Tysabri. All he does is show his Medicare card and it doesn't cost him anything.

My brother lives over the ditch in Australia. He developed very serious metastasised melanoma. He was prescribed a very new drug which has worked brilliantly and saved his life. The first time he left the pharmacy with his monthly prescription, the pharmacist told him to take care, because the pills he'd given him cost more than $20k. For a months supply. The cost to him - absolutely nothing.

I had to pay for parking once at a hospital in Canada, I thought that was outrageous and parked down the street at free parking in protest.

Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#62
post #14

Earlier quoted context omitted.

This +1000. The whole billing / insurance system is intended to wear you down in a cascading swarm of bullshit. You want to know if a doctor is in network? Good luck, because the insurance company clearly states that they only provide that information on a best effort basis. The doctor can’t answer, as they refer you back to your insurance company. You want an outpatient surgery? Great! Make sure your doctor and faci…

There was legislation that changed this a couple years ago. https://www.cms.gov/nosurprises/ending-surprise-medical-bill...

All well and good until you sign away those rights in one of the many forms you fill out- see for example this excerpt from one of my local hospital websites (emphasis mine)

It’s trivial to be coerced into signing one of these agreements when you’re in a high stress high stakes environment.

> If you get other types of services at these in-network facilities, out-of-network providers can't balance bill you, _unless you give written consent and give up your protections._

Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#63
post #21

Another "fun way to lose money" is for example to get bitten by a wild animal. I am originally from a country where rabies shots are free. But here in an ER they could easily charge you $15k for that, which I was truly shocked about. ...or even $100k: https://abc7news.com/rabies-shot-hospital-bill-vacaville-ca-...

Related article quote about a bear attack: "Literally, as I was being eaten by a wild beast, I wasn't thinking about Jesus or my family or my son. I was thinking my insurance was not going to pay for this," she told The Independent. "I had to make this calculus as I was being eaten, 'Do I want to survive this?' Not, 'Can I survive this?' Not, 'What am I going to look like?'" [0]

In an AMA, she said that the worst part of the bear attack wasn't the bear attack, but dealing with her health insurance. [1]

[0] https://www.independent.co.uk/news/world/americas/us-electio...

[1] https://old.reddit.com/r/IAmA/comments/1byn1l/i_was_mauled_b...

Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#64
post #37

I'm generally a fan of HDHPs, but I echo some of the same complaints made in the article. For example, just a few months ago, my toddler was complaining about horrible pain in his stomach. Now, being 5, it's awfully hard to determine exactly how much he's hurting, and of course, the strong recommendation from every nurse, doctor, and UC clinic we talked to was to bring him to the ER. A UC clinic or PCP won't take the…

My mom was an RN and almost never took me or my brother and sister to the doctor when we got sick. Vomiting? Sip some 7-Up and rest. 24-48 hrs later I'm back outside playing at 100%. Same with practically every other malady.

I've adopted a similar mindset with my kid, now 18yrs old. Unless he'd broken a bone, is clearly in need of stitches, needs a vaccine or is otherwise laid low for more than a few days we'd try to stay out of the healthcare system.

Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#65
post #8

There are some good points in here. However, it feels disingenuous with the author being a former surgeon general. "the onus of the entire amount still fell on me due to my high-deductible health plan (HDHP)." I mean, yeah, that's how HDHP works. Anyone in healthcare should understand that.

A physician of mine has said that he thinks HDHPs are predatory and (in his opinion) should be illegal. They sound attractive until the moment you actually need to get medical care.

I like my HDHP. It's honestly not that much different than the other plans my employer offers. They all have large deductibles in my opinion. It's great because my premiums are lower and I contribute to an HSA. The deductible is only about $2k higher than the other plans. And yes, I have used it. I've hit my maximum out of pocket cap multiple years with it. I would have hit that cap under the other plans as well.

Now, that might change as I get older and I need care for chronic conditions that wouldn't hit the out of pocket max but would be above the deductible. And they aren't right for everyone - you need to be making enough to max out your HSA. Companies pushing low wage earners into them are probably predatory.

Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#66

We spend $14K per person, or $4.5T on healthcare in the US. The typical cost for healthcare in comparable countries is 1/2 of that per person. There is $2.25T per year of savings to be had. We can eliminate our national debt in 15 years, and with that also eliminate the $1T going to $1.5T of interest payments we pay each year on the debt, so a total savings down the road of about $3.5T per year. To put that in perspe…

The problem is that the solution is subtractive not additive. Its, at the very least, a lot harder to make a business where people stop doing stuff.

What do we need to stop doing? All of the billing shenanigans with insurance. We need to stop insuring regular healthcare, and go back to insuring catestrophic healthcare.

What we do now with healthcare is like buying car insurance that pays for oil changes.

Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#67
post #37

I'm generally a fan of HDHPs, but I echo some of the same complaints made in the article. For example, just a few months ago, my toddler was complaining about horrible pain in his stomach. Now, being 5, it's awfully hard to determine exactly how much he's hurting, and of course, the strong recommendation from every nurse, doctor, and UC clinic we talked to was to bring him to the ER. A UC clinic or PCP won't take the…

My mom was an RN and almost never took me or my brother and sister to the doctor when we got sick. Vomiting? Sip some 7-Up and rest. 24-48 hrs later I'm back outside playing at 100%. Same with practically every other malady. I've adopted a similar mindset with my kid, now 18yrs old. Unless he'd broken a bone, is clearly in need of stitches, needs a vaccine or is otherwise laid low for more than a few days we'd try to…

That may be fine as practical advice, but it’s horrible from a national policy perspective. The best way for people to avoid being bankrupted is to avoid the doctor? It stinks.

Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#68
post #57
post #18

Earlier quoted context omitted.

The premiums go to subsidize other people's even more expensive care, like $80k helicopter rides, or $100k heart surgeries.

Helicopter rides are pretty much never covered. > The average cost of life flight within the U.S. ranges between $12,000 and $25,000, according to NAIC (National Association of Insurance Commissioners). This is based on a 52-mile trip, which is also the average distance. This figure represents an out-of-pocket cost when not covered by insurance or calculated before an insurance company steps in. International flights…

I wouldn't say never covered. The stuff in that article doesn't give any data on how often they're covered. But I'm sure they play the same games as regular ground ambulances.

The one I have experience with involved transportation between hospitals and it was covered. I've had experiences where other ground ambulance services were not covered.

Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#69

We spend $14K per person, or $4.5T on healthcare in the US. The typical cost for healthcare in comparable countries is 1/2 of that per person. There is $2.25T per year of savings to be had. We can eliminate our national debt in 15 years, and with that also eliminate the $1T going to $1.5T of interest payments we pay each year on the debt, so a total savings down the road of about $3.5T per year. To put that in perspe…

The problem is that the solution is subtractive not additive. Its, at the very least, a lot harder to make a business where people stop doing stuff. What do we need to stop doing? All of the billing shenanigans with insurance. We need to stop insuring regular healthcare, and go back to insuring catestrophic healthcare. What we do now with healthcare is like buying car insurance that pays for oil changes.

> We need to stop insuring regular healthcare, and go back to insuring catestrophic healthcare.

Good point. In NZ we are covered for accidents, infections, heart attacks, etc.

But get lung cancer from smoking and you are paying yourself. It's not perfect, but sets priorities to live healthy.

Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

#70

The US needs to adopt the healthcare model of Singapore. Universal coverage for everyone along with a strong private insurance market as well. The problem is the current system is basically a giant jobs program. Healthcare spending is approximately 17% of US GDP. Politicians are terrified of rocking the boat on this, so the system will always remain broken.

There were proposals for Medicare for all, but unfortunately one of America’s scars from the Cold War is that any government program meant to help people is branded “socialism” which at that point you might as well have a Karl Marx tramp stamp.
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