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What I learned from reading a thousand emergency room bills

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Re: What I learned from reading a thousand emergency room bills

#291

Post by stcredzero »

vec wrote: post #14

Exhibit A for why "free market healthcare" is an oxymoron. I have yet to hear a coherent explanation for how anyone can reasonably expect for price discovery to even pretend to function in a market where the consumers can't even guess the prices until after they've already purchased and frequently couldn't reasonably be expected to refuse service even if they did believe it was overpriced.

frequently couldn't reasonably be expected to refuse service even if they did believe it was overpriced

I wonder if private urgent care businesses could offer free rides from emergency rooms to other facilities? There might well be laws against this. However, the existence of such services might give people a degree of choice they don't currently have.

A few years back, I was in the position of seeking emergency room/urgent care services for my girlfriend at the time in North San Jose. It was not a pleasant experience, to the point where we just decided to simply give up. On the other hand, I did the same for my girlfriend at the time in Houston, and found the whole experience to be relatively smooth.

Re: What I learned from reading a thousand emergency room bills

#292

Post by wizzard »

briandear wrote: post #143
rootusrootus wrote: post #80

Earlier quoted context omitted.

I find myself in the same boat. I've spent more from my HSA this year than I put into it (and I put in $6900) while I'm nowhere near hitting my deductible ($6K) because for whatever reason the insurance only thinks I've spent $2.7K. During this time I've tried to shop around, find the least expensive option (none of my medical needs this year have been urgent) and it's been impossible. Nobody can tell me. "You'd have…

The problem with single payer is that it results in shortages. Look at waiting lists for the NHS, especially for mental health or routine surgery. That is a direct consequence of single payer. An unpopular view, but it is a fact.

Do you think a single-payer system creates more sick people?

If not, what do you think is currently happening to those people who need mental health care or routine surgery in a non-single-payer system?

Re: What I learned from reading a thousand emergency room bills

#293

Post by arethuza »

jessaustin wrote: post #228
ddebernardy wrote: post #139

Earlier quoted context omitted.

I'm at a loss as to why the US is still dead set to have no meaningful health coverage. I got burned by this in California a decade ago. A dentist charged me $4,500 to fix a broken tooth (panic!) and fill in a cavity on a Sunday. Had I known then what it might have cost I'd have simply flown back to Europe in the next flight ($600-800 at the time) and get the same thing done for under $100-200 with a full refund from…

USA dentists don't work on Sunday. If you had waited until Monday you would have had many more options. Besides what could she have possibly done to "fix a broken tooth" in one day? Nobody was milling crowns in the office a decade ago. If it was really just a filling, wow. Do dentists in Europe work on Sunday? In my experience the grocery stores aren't even open...

I've had emergency dental treatment in an NHS hospital in the UK for an extremely painful dental abscess - was treated first thing on a Sunday morning.

Re: What I learned from reading a thousand emergency room bills

#294

Post by ip26 »

vec wrote: post #14

Exhibit A for why "free market healthcare" is an oxymoron. I have yet to hear a coherent explanation for how anyone can reasonably expect for price discovery to even pretend to function in a market where the consumers can't even guess the prices until after they've already purchased and frequently couldn't reasonably be expected to refuse service even if they did believe it was overpriced.

Forget about obtuse billing, how is anyone expected to perform price discovery while unconscious (& being rushed to the hospital)?

Re: What I learned from reading a thousand emergency room bills

#295

Post by asdff »

edoo wrote: post #94
merpnderp wrote: post #53

Earlier quoted context omitted.

And yet it is by far the most regulated industry in the US. Almost as if the more invasive the regulations the more invasive the corruption.

It takes a while to realize nearly every law is anti-competition protectionism. I didn't realize it until I was working for a multinational food company and the managers were bragging about how the company lobbied for a safety bill that exactly regulated their own industry in a way that cost their competitors billions in compliance fees. They were proud of it. I was disgusted.

Disgusting, but know that there are good regulations—like environmental protections—that are frequently combatted by industry groups and tend to get weakened by the Republicans before they pass into law. Regulation can be abused by industry and corrupt politicians for anticompetitive reasons, but most of the time, it's to force companies from doing highly profitable things that aren't good for people or the planet; its much cheaper to just dump all your hazardous waste into the river, after all.

Re: What I learned from reading a thousand emergency room bills

#296

Post by maxxxxx »

ip26 wrote: post #289
heavyset_go wrote: post #66

Earlier quoted context omitted.

The history of private firefighting is a particularly dirty one. In the past, fire companies would show up and demand payment before putting out fires. If a payment couldn't be made, the company might negotiate the purchase of the burning property at a steep discount. Later, insurance companies hired brigades to only put out fires on insured properties. Fire companies might have fought or sabotaged one another in ord…

Why is this dirty? If you don't pay for fire protection, not even through taxes, why does anyone owe you incredibly hard & extremely dangerous labor saving your house? Firefighting is not a safe profession. (I certainly prefer publicly funded fire service)

" the company might negotiate the purchase of the burning property at a steep discount."

This creates the perverse incentive to demand an outrageous price so they can get an property for cheap. Next step would be setting fires to buy even more property.

Re: What I learned from reading a thousand emergency room bills

#297

Post by Filligree »

ip26 wrote: post #289
heavyset_go wrote: post #66

Earlier quoted context omitted.

The history of private firefighting is a particularly dirty one. In the past, fire companies would show up and demand payment before putting out fires. If a payment couldn't be made, the company might negotiate the purchase of the burning property at a steep discount. Later, insurance companies hired brigades to only put out fires on insured properties. Fire companies might have fought or sabotaged one another in ord…

Why is this dirty? If you don't pay for fire protection, not even through taxes, why does anyone owe you incredibly hard & extremely dangerous labor saving your house? Firefighting is not a safe profession. (I certainly prefer publicly funded fire service)

Simply because it's the best that can be expected, doesn't make it not an awful experience for everyone involved.

Re: What I learned from reading a thousand emergency room bills

#298

Post by maxxxxx »

krupan wrote: post #190

Let's be careful to not look at one type of health care, emergency care, and generalize to all types of health care. Right now we all (Americans at least) don't really have insurance. We are part of pre-paid health clubs and we try to use the health club membership to pay for everything. For true time-sensitive emergencies we should all have traditional insurance, and yes, the services should probably be supplied, li…

Vision and dental are areas where the market is halfways working. If you get a planned surgery the hospital will still try to rip you off left and right. It's not only emergency.

Re: What I learned from reading a thousand emergency room bills

#299

Post by chimeracoder »

josho wrote: post #163
wmil wrote: post #109

Earlier quoted context omitted.

Hospitals are required to treat the uninsured, but the government doesn't actually compensate them for that. So they jack up everyone else's bills in the hopes that enough people will pay that they'll make a profit. Insurance companies will usually push back, so (sometimes partially) uninsured people with decent credit hit with huge charges.

> So they jack up everyone else’s bills No. That’s the justification given so that people get angry at the wrong thing. Hospitals charge this because they CAN. They are doing what businesses do and that is maximizing their profit. Don’t get angry at the uninsured get angry at the politicians for enabling a broken system.

> No. That’s the justification given so that people get angry at the wrong thing. Hospitals charge this because they CAN. They are doing what businesses do and that is maximizing their profit.

Hospitals make very low profit margins; hospitals have been hemorrhaging money and either being bought out by hospital systems or insurers, or even shutting their doors entirely.

In any case, it's not uninsured patients that cost the hospital money; there aren't enough of them to make a difference at most hospitals. The patients that cost hospitals money are Medicare patients, because Medicare reimburses rates that are below COGS, and private insurers are required by law to reimburse more.

In other words, yes, it's the politicians that enable a broken system, but no, it's not the uninsured patients who are at fault, and it's not "profit-maximizing businesses" that are at fault either. Hospitals don't want this convoluted billing system any more than patients do, but it's literally forced on them as a result of accepting Medicare patients.

Re: What I learned from reading a thousand emergency room bills

#300

Post by AvocadoPanic »

josho wrote: post #147
ademup wrote: post #103

Earlier quoted context omitted.

Although most humans are perfectly ambulatory, there are innumerable reasons why they don't get to "choose where to live". Income levels, employment availability, schooling, racial pressure, and many more factors come in to play. Not everyone can physically fit into the best areas. The best areas for emergency services don't necessarily align with the best education (although very high income levels tends to align wi…

Mixing a public option with a private option isn’t that ideal either. The wealthy with their ability to influence politics will lobby to undermine/weaken the public system to save their tax dollars. You are better off with one system so that everyone is entitled to the same level of care. We do this with fire/police, same applies to health.

Why shouldn't someone with means be able to buy a better level of care?
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