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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

#101

This is not that bad because he ended with a negotiated rate and paid 1,000 or so. I’ve seen much worse One cause is political. One place I worked govt would only pay a % of the billable rate - this was so politically they could say program was saving money. So the ‘rack’ rate went through the roof. The irony? We’d have preferred to charge less to cash payors (this was a nonprofit) because they were much less painful…

Yes you can negotiate the prices with insurance, but that means there's always a risk that insurance doesn't cover as much as you hoped for. This means every emergency becomes a risk assessment of estimated cost / probability of negotiation / network coverage / hassle. This is so broken.

When I'm headed to the ER, I'm looking for immediate medical attention. I don't want to be shopping around for hidden hospital price estimates, verifying network coverage and deciding if I should Uber, ambulance or drive while I'm half dead. After all that we still got slapped with a $30k bill for half an hour. Cleared the HDHP deductible real fast. Thanks WEC Hospital for the wonderful hours long wait to pay you jacked up prices.

When we had our first kid, we had to repeatedly call the hospital and insurance to make sure it's within network and that the midwives were going to be covered. Then we got slapped with a $15k bill because one of the nurses is outsourced and not within network. After 5 separate hour long conversations on the phone with Aetna we finally managed to get the clinic to lower the bill to $3000 which Aetna then covered. And then 10 days later I received a $15k bill payment reminder.

I think the whole healthcare discussion in the US seems way too distracted with figuring out how to refactor a code base written by clowns, instead of just building a new system ground up. With 50 different states to pander to, I guess that's the logical result.

Pretty glad I left the US, my mind is now cleared of lots of unnecessary baggage.

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

#102
post #46

Earlier quoted context omitted.

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…

The United States leads the way in treatments and medical tech, but this gives me the impression that the US society is not benefiting as it could from that.

As someone who used to work for a company trying to get insurance to pay for medical technology, the US was typically the easiest and fastest country to get coverage in for both private and public insurance.

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

#103

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…

Meanwhile, Congress passed a bill that's supposed to help with surprise billing. The Biden administration has started to implement it, but doctors and their representatives (Democrats and Republicans alike) claim the administration is not implementing the bill as intended and they are favoring insurance companies over medical providers by trying to keep costs down.

> “The Administration’s recently proposed regulation to begin implementing the law does not uphold Congressional intent and could incentivize insurance companies to set artificially low payment rates, which would narrow provider networks and potentially force small practices to close thus limiting patients access to care,” Rep. Larry Bucshon (R-Ind.), who is a doctor and helped spearhead a letter of complaint this month, said in a statement to KHN.

https://khn.org/news/article/surprise-medical-bills-policy-c...

This shit makes my blood boil. Various vested interests, but mostly doctors, have stymied virtually all legislation (the ACA, Medicare and Medicaid being the notable exceptions) for a century.

https://pnhp.org/a-brief-history-universal-health-care-effor...

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

#104
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…

It is listed / breaker out as such or is it a percentage coming from Total Tax?

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

#105

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 ER has all the pricing power when you need medical care and can’t go anywhere else. The customer has all the pricing power when the medical care has already been provided and the ER hasn’t been paid.

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

#106

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…

Same in the UK (except the hospital probably is understaffed!) - it's weird for me to think of a hospital as somewhere you might go to pay for a service, like Tight muscles? Go there, pay the masseuse; Bone sticking out? Go there, pay the doctor.

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

#107

Earlier quoted context omitted.

The United States leads the way in treatments and medical tech, but this gives me the impression that the US society is not benefiting as it could from that.

This seems poignant. The cost/benefit analysis does not seem to be aligned with the market. I suspect it’s driven purely by lack of qualified practitioners.

[deleted]

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

#108
post #66

Earlier quoted context omitted.

I find it hard to believe the small non-paying contingent is unique to the US or even a significant % of daily patients, plenty of other countries have homeless who end up in ED's. America somehow spends far more than any other country on healthcare and yet patients still have some of the highest out of pocket costs even when they have expensive private insurance schemes, something is clearly broken to anyone looking…

The US's non-paying contingent doesn't need to be any different from any other countries in order to cause the problem. The issue is that the uninsured subsidize the non-payers alone. This is radically different from countries with universal health care where the costs are spread among the entire tax-paying population. As for why the US spends more than any other country: it's due to an overabundance of caution among…

> As for why the US spends more than any other country: it's due to an overabundance of caution among the comfortably insured. It's much easier to get a variety of expensive (and often unnecessary) tests and scans (such as MRI scans) in the US.

Countries with universal healthcare also tend to have private health companies which can provide tests and scans at a higher speed, either on an insured or a pay-as-you use basis, typically at much lower costs than the US. Yet there doesn't seem to be the same "overabundance of caution" elsewhere. To the extent that precautionary procedures are responsible for high US spend, I don't think that can be decoupled from a system designed to ensure that primary healthcare providers are sales outlets for those procedures.

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

#110

Anecdata: I just had a very mild infection a month ago, but it went to my heart so I went to the ER (thinking they'd give me antibiotics and send me on my way). They wanted to monitor me for 2 days so admitted me. I know I have the right to refuse (and very nearly did), but wanted to make sure my heart was all right. Long story short, they gave me nothing more than aspirin for that stint, did an echo and an EKG, and…

This is absolutely ridiculous. Lots of people who would need to be monitored will simply refuse to do so, afraid of the astronomical bills. Even 5k would be a lot but 130k?
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