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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

#171

Post by FearlessNebula »

Hakashiro wrote: post #126

I always find interesting to read these stories because nowhere else but the US can you make over 300k USD a year as a senior engineer of some kind. In Europe, 200k EUR is already ridiculous, and most countries take away half your salary in taxes anyway so... Would you rather make 300k and pay 4k for the occasional ER visit or make 50k after tax and pay 100 for the occasional ER visit? I suppose this comment will get…

$300k salaries are top tier engineers, not the norm. The vast majority of people regardless of job are making closer to $50k.

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

#172

Post by mdp2021 »

superfunny wrote: post #117
hamilyon2 wrote: post #76

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?

"Mutual assistance" I believe is the concept.

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

#173

Post by 300bps »

donatj wrote: post #63
garmaine wrote: post #19

Earlier quoted context omitted.

$400 still sounds high, to be honest.

I paid $400 for a plumber to do 30 minutes of work this week. A doctor has more training and a lot higher infrastructure costs and overhead, and thus a higher hourly fee.

Same thing happened to me with a plumber 12 years ago.

I spent a couple hours on YouTube and now I can solder my own copper pipes, install a new toilet and anything else I need.

Even being a software engineer I couldn’t compete with the hourly rate of a plumber so it makes financial sense for me to do the work myself.

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

#174

Post by ryannevius »

nyamada wrote: post #18

My daughter here in France had a bike accident two months ago which requires 14 stitches in her foot. We received 3 follow-up visits from nurses to clean and redress her wounds -- We pay about 100€ a month for supplemental private insurance on top of the public health insurance here -- Total cost for us? about 40€. We would have had to pay about 100€ more for the nurses' visits, but the mutuelle covered it. These are…

Exorbitant health insurance premiums and healthcare bills was the primary reason our family of 3 (now 4) left the USA (we're all American citizens). It's such a relief knowing that we all have the option to go to the ER without emptying our bank accounts. My tax rate is higher here in Europe, but I'm actually saving significant money compared to the USA, when factoring in healthcare costs.

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

#175

Post by zahllos »

jonplackett wrote: post #53

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.

In Switzerland the insurance system has various deductibles you can choose from per year, and then a monthly premium that varies per deductible. If you can't afford to pay this for genuine reasons, then the cantons will step in as part of the social insurance system. Once you have paid out of your deductible, insurance covers 90% up to a certain value and then everything.

Costs for treatments are standardized and agreed on nationally: you can go and look them up. Your bill has codes on it that match this list. It is called TARMED: https://www.bag.admin.ch/bag/fr/home/versicherungen/krankenv...

Insurers under the LAMal system are restricted in what they charge for premiums too, and must negotiate this with the confederation.

There's still a lot of scope for private companies to make money here. LAMal covers what are deemed essential treatments, which is most things you need a doctor for. If you want 'alternative' medicine there are insurers you can pay more money to for that. Likewise, if when you go to hospital you want a guaranteed private room every time, then you can pay extra for that. And so on.

Even on the basic system, you have a choice between telephone doctor for all appointments except emergencies, family doctor for the same or the unrestricted system where you can ring up a specialist yourself without referral. Needless to say, the one where you ring the insurer first is cheaper, followed by the family doctor (similar to the UK: referrals are controlled via your GP).

I don't see any poor doctors here, or poor insurers either (insurance, behind banking, is a massive business here). So it is entirely possible to design a system that includes a large amount of private insurance that also doesn't randomly try to bankrupt people for getting stitches.

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

#176

Post by wffurr »

Hakashiro wrote: post #126

I always find interesting to read these stories because nowhere else but the US can you make over 300k USD a year as a senior engineer of some kind. In Europe, 200k EUR is already ridiculous, and most countries take away half your salary in taxes anyway so... Would you rather make 300k and pay 4k for the occasional ER visit or make 50k after tax and pay 100 for the occasional ER visit? I suppose this comment will get…

That's a great deal for the programmers. Not so much everyone else. Median household income for 2021* in the United States is $80k; which is a far cry from $300k.

Even the $300k doesn't go as far as you'd think given the costs of housing in the areas that pay that kind of salary.

*https://www.huduser.gov/portal/datasets/il/il21/Medians2021....

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

#177

Post by legutierr »

learc83 wrote: post #144
legutierr wrote: post #23

Earlier quoted context omitted.

I've had doctors in the ER bill directly out of their own practice several times. Out of network, but I've had no choice in the matter except to receive treatment or refuse treatment for life-threatening conditions. The law here has changed since then to prohibit this kind of thing, though.

In the case where an ER doctor isn’t employed by the hospital, they are likely employed by a physicians’s group. These used to be ran by physicians, but now many of them have been bought up and consolidated by private equity. The doctors likely have very little say in the pricing.

Perhaps, but in these specific cases I was billed by offices owned by individual doctors.

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

#178

Post by docinabox »

code4tee wrote: post #164
donatj wrote: post #63

Earlier quoted context omitted.

I paid $400 for a plumber to do 30 minutes of work this week. A doctor has more training and a lot higher infrastructure costs and overhead, and thus a higher hourly fee.

And yet ironically, in the US at least, there’s a decent chance that plumber actually makes more than a physician.

I want whatever you’re smoking!

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

#179

Post by detaro »

akvadrako wrote: post #133
88840-8855 wrote: post #43

Earlier quoted context omitted.

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…

You think that's all it costs? According to wikipedia, German health care is 77% government-funded.

I'm fairly certain the indicator they cite there is Current expenditure on health by general government and compulsory schemes, i.e. includes the public health insurances, but it appears it's not in the current WHO database anymore and thus can't 100% verify that.

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

#180

Post by JshWright »

willcipriano wrote: post #152
JshWright wrote: post #94

Earlier quoted context omitted.

That was still a FFS model. The difference is whether the procedure is typically covered by insurance.

I don't see how it's fee for service if nobody can tell you what it's going to cost upfront.

The uncertainty comes from not knowing exactly what services will be performed, who will be performing them, and how much the insurance company will cover (which has a ton of variables, many of which aren't known until everything is settled).

In my opinion, getting away from the fee for service model is one of the routes we ought to be taking to address healthcare spending in the US (if you're charging per service, you're incentivized to perform as many services as possible in a given encounter).

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