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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

#111

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…

>In Moscow, treatment is world-class.

Is this true in the public system as well?

I'm asking since in Romania the public hospitals are still more miss than hit, even in big cities.

Hospital managers are politically appointed leading to terrible corruption and inefficiencies, meaning waiting times can be pretty long so the doctors who work there refer you to their private practices, and while conditions on the surface look good and everything is covered by the public insurance in theory, sometimes hospitals are short on supplies, asking you or your relatives to bring stuff from home, the food can be terrible, and you never know what corners some staff might have cut and you end up picking some dangerous hospital transmitted bacteria leaving you worse off than when you came in. And sometimes, if you're unlucky, you can end up in healthcare hell where you get bounced around between different hospitals if each judges you're not their problem to deal with.

Outside of big cities, you don't even want to go near any public hospital unless your situation is serious.

When my mom was admitted to the local hospital for infectious diseases around 2008ish, there were roaches and rats everywhere and this was in a big medical university city of the country. Pretty sure the roaches and rats are gone nowadays, but still that was unacceptable.

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

#112

Why is the discussion in America always private VS nationalised healthcare instead of just making private healthcare value for money / less insane. Here in the UK we have the NHS which is great. But we ALSO have private insurance / hospitals / healthcare that is reasonably priced.

For one thing, healthcare is such a mess in the US that it actually might be easier to just nationalize it rather than trying to fix the private insurance system.

Also, in a country with both, the private system can't be any worse than the public system because it has to compete with it, so the fact that the UK has good private healthcare doesn't necessarily mean that it will be easy to fix the private system in the US without the existence of a nationalized system as well.

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

#113
post #27

I'm in my mid 30s and have left fixing up some damaged teeth and my large wisdom teeth impacted for 17 years too long, this Monday I'm going to get them removed under general anaesthetic at a private hospital. The Australian government covers hardly any dental unless your teeth have completely rotted through and are chasing other issues. So far my costs are: - $4500 in fillings and general dental. - $1800 for a crown…

For those prices, odds are one could save money by traveling to Brazil and getting dental care in a top clinic in São Paulo or Rio de Janeiro.

There must be other countries with cheap care.

Someone should make a startup for that.

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

#114
How does the hospital arrive at the cost?

From what I can see there is a cost breakdown in the article, but a deeper breakdown would help make sense of these things.

If the hospital has to pay for administrative staff, nurses, doctors, maintenance, electricity, etc. and then deliver a profit to the owner. Is this profiteering or just costs that are passed on to the patient? If it's the latter, then why are those costs high, and so on until something looks disproportionately expensive.

Is it that hospitals are pricing treatment because of having to comply with some expensive regulatory requirement? Or is it that doctors are paid an incredibly high wage compared to doctors in other parts of the world? Or is it that insurance paperwork requires a large administrative staff?

I suspect there is no single answer to these questions, and that there is some complex set of reasons why costs are high.

If it's just profiteering, then the solution is to get stitches from elsewhere. A vet or a nurse or EMT can probably do it freelance too.

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

#115
post #98
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.

The costs are more diffuse than this. First, the U.S. system costs twice as much as other systems because we have more people employed delivering care and they make higher salaries. Doctors, nurses, they all make more in the U.S. than in Europe. So more people, getting paid higher wage, results in double the costs.

But wait, the financing in the U.S. is quite predatory, so a lot of people pay nothing, and a few people are stuck with outrageous bills. It's like the infamous SF General Hospital that offered loads of free care to the poor and to immigrants and then refused to take any insurance so that normal people were regularly driven to bankruptcy if the ambulence took them there. The U.S. healthcare is one in which a half a million is spent on emergency care for an indigent person and 10 middle class families lose their life savings of 50K treating snakebites and broken arms.

Once you wrap your head around this, you'll understand we have a very similar problem in higher education, and for very similar reasons.

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

#116

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…

Free market works fine, unfortunately like tuition prices the government got involved and prevented what the free market is good at and driving down prices. Fortunately now there a new price transparency laws which the full the effects haven’t been felt yet and are a step in the right direction.

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

#117

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?

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

#118
post #92
post #48

Earlier quoted context omitted.

Who are these people? Where are they? Not really convinced they exist.

Owners, private equity firms, VC's ... whoever is the ultimate lever in this arena. It's not hard.

Yep, wallstreet is heavily invested in this space. People fail to connect the dots.

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

#119
At what point will we start talking about breaking up the cartels?

The American Medical Association is an Anti Consumer lobbying group that literally 400M on bribes. Physicians should be punished. The other various medical cartels should be punished too.

The easy solution is to legalize science based medicine. But the Authority based medicine establishment would never let that happen.

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

#120
post #113
post #27

I'm in my mid 30s and have left fixing up some damaged teeth and my large wisdom teeth impacted for 17 years too long, this Monday I'm going to get them removed under general anaesthetic at a private hospital. The Australian government covers hardly any dental unless your teeth have completely rotted through and are chasing other issues. So far my costs are: - $4500 in fillings and general dental. - $1800 for a crown…

For those prices, odds are one could save money by traveling to Brazil and getting dental care in a top clinic in São Paulo or Rio de Janeiro. There must be other countries with cheap care. Someone should make a startup for that.

Travel during a global pandemic where we've had almost two years where we can't leave our houses for more than an hour I doubt that'd fly (no pun intended).
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