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The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

thecity.nyc

121–130 of 175 posts

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#121
post #19

The statement from the hospital management boggles my mind: "In addition, there are different parts to a patient bill. One part is what the hospital charges the insurance company, one part is what the insurance company eventually pays [...]" I can't think of any other business transaction where someone just puts a giant number on a bill and then is happy if someone pays ~25% of it. Such companies would be shunned by…

Here is an overview of the economics of healthcare from a textbook: https://scholar.harvard.edu/files/mankiw/files/economics_of_...

Awesome read.

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#122
post #66

Earlier quoted context omitted.

separate line items, typically

Do you really think current health care is giving accurate line items on your bill?

Accurate or not clinician time is typically billed separately, as are drugs, individual procedures, equipment, etc. Some stuff is rolled up but not that much; hospital accounting systems are quite comprehensive and structured in such a way to help them argue with insurance companies.

So the argument that the crutch is expensive because an MD handed it to you probably doesn't hold, the clinician files something, probably under a CPT code, and you were billed for that separately.

This depends on the service of course, you may see say a CT scan where the room time & tech etc. are rolled into one item, but the radiologist review is separate. So it isn't just people vs. equipment, etc.

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#123
post #31

Earlier quoted context omitted.

[flagged]

I work adjacent to the industry and can clearly see what a rotten pile of crap it is - I'm also actually a US/Canadian border straddler, I emigrated from the US to come up here in fact. Please don't take any of my statement above as any sort of excuse for the market's behavior, these companies hold profit over the well being of patients - otherwise they wouldn't be so willing to stick poor people with such high bills…

I literally knew you must’ve been part of the industry. You might want to think your word ‘unavoidable’. It caused me so much rage I literally couldn’t make it through the rest of your post until after I made mine.

I completely inteperet your post as an excuse - the word unavoidable alone gives that away.

Canada’s system isn’t perfect - but it also isn’t literally raping the lower class on purpose.

Just look up Martin Shkreli if you need to be educated. I have nothing but passionate hatred for the way the US enslaves it’s lower class through this. It’s utterly, incomprehensibly pathetic and lower than human.

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#124
post #2

As a Canadian who has also lived in America, I am consistently mortified by the costs of health care in the states. Are they intentionally designed to force the lower class into even more poverty (I’ve seen $50 being charged for a pill of Advil - first hand) - or is it just an unintended side effect? I find it harder to believe it’s accidental than intentional. EDIT: Due to jiveturkey’s pathetic and wholly inaccurate…

> I’ve seen $50 being charged for a pill of Advil - first hand

A paper plant was having a problem with their mill. They brought in a consulting engineer to help them with the problem. He took a look at the machine and after a few minutes, drew an X on it in chalk. "Hit it there with a hammer". It worked!

"How much do we owe you?"

"$10,000"

"That's absurd! I can't pay you that for literally 2 minutes of your time! I need a detailed invoice."

The engineer wrote up an invoice:

chalk mark $5 knowing where to put it $9995

=========

The patient in your example did not pay $50 for an Advil.

There is a lot wrong with US healthcare, but this isn't it. It's about misaligned incentives.

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#125

Earlier quoted context omitted.

[flagged]

A shill accusation never goes over well. The commenter just pointed out that this is an emergent property of the incentives with the insurance system and pricing laws. Nobody is doing it intentionally to “hurt the poor”.

Look up Martin Shkreli. You are patently wrong.

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#126

Earlier quoted context omitted.

Meanwhile, I went to the emergency room in a hospital with my girlfriend in London two years ago and it was free for her. We're Americans. Guess which country has better health outcomes.

>Guess which country has better health outcomes. The US, by all objective measures. https://en.wikipedia.org/wiki/List_of_countries_by_quality_o... It's actually not uncommon for Brits to travel to America to pay for treatments not available on the national health or to avoid the often years-long waiting lists.

40 million Americans don't have healthcare[1], and another 38 million have "inadequate" health care[2]. Together that's more than the entire population of the UK.

It's not so impressive that if you only treat the richest with the best jobs who can afford the best treatments, you get better outcomes than systems which treat everyone.

[1] https://www.cnbc.com/2018/01/16/americans-without-health-ins...

[2] https://www.pbs.org/healthcarecrisis/uninsured.html

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#127

Earlier quoted context omitted.

>Guess which country has better health outcomes. The US, by all objective measures. https://en.wikipedia.org/wiki/List_of_countries_by_quality_o... It's actually not uncommon for Brits to travel to America to pay for treatments not available on the national health or to avoid the often years-long waiting lists.

Mmm yeah I wonder. UK: someone dies of cancer or whatever. Enters the statistics as cancer death. Drags down outcome. USA: someone dies of cancer or whatever. Was poor. Gets buried. Cancer statistics unharmed.

You still have to report some cause of death.

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#128
post #51

Earlier quoted context omitted.

Meanwhile, I went to the emergency room in a hospital with my girlfriend in London two years ago and it was free for her. We're Americans. Guess which country has better health outcomes.

Yeah, here in the UK she could've been told that she wasn't going to get tested for coronavirus over the phone for free. It's a much more civilized system. (Though to be fair, we did a little better at adding Italy to the list of qualifying countries promptly than the USA.)

UK tests per million: 387

USA tests per million: 26

Not really the same.

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#129
post #99
post #2

As a Canadian who has also lived in America, I am consistently mortified by the costs of health care in the states. Are they intentionally designed to force the lower class into even more poverty (I’ve seen $50 being charged for a pill of Advil - first hand) - or is it just an unintended side effect? I find it harder to believe it’s accidental than intentional. EDIT: Due to jiveturkey’s pathetic and wholly inaccurate…

It isn't intentionally designed, just a side effect of the system as it exists today. There are two ways to bring healthcare costs down in America: 1. Insure everyone — no exceptions (by the government or through private insurance) 2. Let hospitals (and ERs) deny care to those that can't pay Since neither of them is happening anytime soon, Advil is going to keep costing $50.

I don't see how #1 solves anything. The biggest issue which leads to all the cascading effects is the hospitals can charge a ridiculous amount for goods and services, with some hospitals charging more than 1000% more than what the government thinks they should (https://www.theatlantic.com/health/archive/2015/06/hospitals...).

I had a colonoscopy done a year ago and the prices pre-insurance ranged anywhere from $7000-$16000 depending on the location, all within network. I ended up paying just $1300 because of my insurance with a couple hundred covered by my HSA account. Why is there such a drastic price difference between places? Why are hospitals and other care providers that have a monopoly over an area able to act like a monopoly and have complete control over pricing?

Everything else is just a 2nd order effect.

Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill

#130

Earlier quoted context omitted.

People take UBER to the hospital now instead of an ambulance. #Merica

IMHO, you're mis-stating the problem. One should take an uber/friend to the hospital if the ailment is not time-sensitive or in need of ongoing treatment so that the ambulances are freed up for more critical patients. Ambulances should have some level of cost associated with them to dissuade using them for minor ailments. Should that level of cost be thousands and thousands of dollars? Probably not.

For example, some years ago on holiday to Edinburgh I had terrible diarrhoea. Probably norovirus infection. Fine, holiday spoiled but I can sit in a hotel room, stay hydrated and watch Netflix in the calmer moments. Then I began shitting blood. OK, that definitely might /not/ be fine, need somebody to check.

So I call NHS Direct, they agree that unexpected blood is potentially urgent and I arrange a taxi in the middle of the night to go to the closest Urgent Care clinic. Taxi driver did completely fail to find the right entrance to the hospital, but I was just sick not stupid so I followed the signs he'd ignored and went to Urgent Care. I was the only adult, every other patient was a sick child whose parents were probably worrying too much. A doctor takes a look, goes yup, just what you'd expect, not serious but thanks for checking, disapproves of my "Crisps and full fat Coke = Salt + Sugar + Water = acceptable rehydration" approach and hands me nasty tasting rehydration powder. Boo but since I'm the one who just dyed a toilet bowl red with their own blood I vow to follow their instructions. Taxi back to the hotel. All better in time for the trip home. Still have the last sachet of rehydration powder somewhere actually, it's probably expired but can't taste worse now than it did then.

NHS Direct is really handy, because it's often tricky to judge the correct amount of urgency or know how best to access the service you need, especially when far from home. But I don't see how you could build a trustworthy service like that under the US system.

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