Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Insured, but Still Owing $109K for a Heart Attack

khn.org

Post reply on HN
Print view View original

341–350 of 377 posts

Re: Insured, but Still Owing $109K for a Heart Attack

#341

Post by zaarn »

sturgill wrote: post #254
rdtsc wrote: post #52

> St. David’s HealthCare defended its handling of Calver’s bill and sought to blame the school district and Aetna for offering such a narrow network. So while dying of a heart attack he should have been negotiating with the ambulance driver, the paramedics, the nurses, each intern and doctor to make sure they are "in-network". > St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance bec…

I once got cut by a skate playing hockey. Showed up at the hospital pulsing blood from my leg. My first question to them, “Do you take X insurance?” Only after they assured me that my insurance would be accepted did I drag my bloody leg into the care room. Turns out the doctor that the hospital assigned to me did _not_ take my insurance. I got billed the full amount, yelled very loudly at lots of people, and when I “…

Medical emergencies are sadly not a free market.

You have a need that the customer (patient) needs to fill with a product (medical care).

The problem is, if the customer doesn't get the need fullfilled within the next 10 minutes they die of cardiac arrest. Or worse, the customer is already in cardiac arrest and requires resuscitation.

An unconsicous customer can't make market decisions.

So now we get to the next stage, a hospital revives/saves the patient but they are unconscious for a few days in the ICU.

The patient can hardly walk away while being non-responsive or later when drugged up on painkillers so they don't scream all the time.

By the time a patient can leave a hospital without dying the hospital has likely already spent 90% of the money that would be spent if the patient stayed for a few days more to recover.

But is it free market to bill the patient for actions taken while they were non-responsive or not even consented too (because they were non-responsive and/or dying)?

IMO the answer is simple; free markets don't exist. They are an ideal construct similar to how a bouncy ball should mathematically bounce forever but doesn't. And especially in healthcare there are too many interfering patterns for a free market to actually exist. In other markets, you could make a free market because people could pick and choose and compare and consent (ie, buying logs of wood for your fireplace). But dying people can't participate in the market to not die freely.

I also advice against superglue for wounds, the stuff can be toxic and/or nasty and will likely lead to an infection. There are some natural glues that your body produces to stitch wounds and you can obtain them in your supermarket, though they aren't clean enough that I would consider them fit for that use either.

Re: Insured, but Still Owing $109K for a Heart Attack

#342

Post by tluyben2 »

MrFantastic wrote: post #162
mabbo wrote: post #63

If you owe a 6-figure amount of money because of a health issue, you don't actually have health insurance.

Or Health Insurance means some of your bills will be paid, not "full coverage" as most people assume.

It should be though: people do not understand healthcare, the insurance they are getting, what is included and what is not, and, very important, at times of illness you really do not have the time or bandwidth to think about it. To me it always sounds rather inhumane what happens over there. But then again, I only get my info from comments and articles like this.

Re: Insured, but Still Owing $109K for a Heart Attack

#343

Post by tluyben2 »

megamindbrian2 wrote: post #308
chatmasta wrote: post #202

Earlier quoted context omitted.

Bankruptcy really is the ultimate medical insurance. In fact, when so many people don't even have $2k in liquid assets, it almost makes more sense to skip paying actual medical insurance, and just declare bankruptcy in the event of massive medical bills. What that doesn't help with, though, is something like being diagnosed with a chronic condition where pills cost $800 a pop.

I've read that it can only be done once every 7 years.

What happens when you do it more often? You have no money so...

Re: Insured, but Still Owing $109K for a Heart Attack

#344

Post by zaarn »

krupan wrote: post #242
burkaman wrote: post #226

Earlier quoted context omitted.

Ok, here's one list, I'm sure it isn't comprehensive: http://ourmed.org/wiki/List_of_medical_emergencies So for each item on this list you'll need to find out every possible treatment and drug and what they cost at every hospital within ~50 miles. Make sure you look up allergies and any side effects when combined with medication you regularly take, you don't want to be in a situation where you listed Hospital X for m…

Your google skills are strong. How many things on that list need treatment within minutes? "Is there anything else in your life that you shop around for in case of emergency?" Have you never heard of Preppers? But seriously, yes, I shopped around a little for a fire extinguisher in my home, I shopped around a bit for a good first aid class so I'd have some skills. I have spare batteries around the house in case the p…

>How many things on that list need treatment within minutes?

Let's go down the list for things that don't need treatment in minutes:

- Malaria

- Rabies

- Salmonella

- Lyme disease

- Malnutrition and starvation (though you'd rather have this taken care of fast if possible, in severe cases minutes would count)

- Attempted suicide, non fatal (though only if you aren't up for anything else as a result of said attempted suicide, you'll be fine if you don't get immediate treatment)

- Psychotic episode (under supervision)

- Suicidal ideation (if you're under supervision)

- Smoke inhalation (in very very minor cases)

- HELPP syndrome (doesn't seem to be very dangerous in the minute range though you'll want treatment either way)

- Priapism (although it is very painful)

- Sexual assault (before you downvote consider that sexual assault is generally not fatal itself and you don't need urgent medical attention, though urgent psychological attention is, in general you'll survive if you need more than a few minutes to the hospital)

Most of these come with a few ifs, notably that no other medical emergency coincides and some depend on severity, the rest of the list is to my knowledge pretty deadly if you don't get it taken care of as quickly as possible and for half the list it is likely you'd be either in extremely severe pain, unconscious, non-responsive, dying or a combination of the previous in any order.

Re: Insured, but Still Owing $109K for a Heart Attack

#345

Post by Scarblac »

int_19h wrote: post #282
Scarblac wrote: post #61

Earlier quoted context omitted.

You're right, that's unrealistic. In fact this sort of thing is why government was invented.

You need a government that is responsible to its citizens. We don't have that - we have a government that is responsible to its biggest donors. The more some company or some industry can abuse the market to extract insane profits, the more they can lobby the legislatures to cover their ass and secure their business model. And it's not just health insurance. Case in point: we have companies writing tax accounting soft…

I know, at least at federal level the US isn't a democracy anymore, it's been taken over by corruption entirely. Until that is changed the problems for normal people like the one described in the post will only get worse.

Re: Insured, but Still Owing $109K for a Heart Attack

#348

Post by etiennemarcel »

h4b4n3r0 wrote: post #274
TomVDB wrote: post #241

Earlier quoted context omitted.

And how much of this additional cost goes toward medical cost? The US health care issue can only be solved by higher taxes and lower cost (it’s currently at 2x the cost of developed countries.)

Doesn't have to be higher taxes, that's my point. It can be solved by lowering the cost through technology and regulation, which Obama chose not to do, because that would eliminate a ton of jobs. Switzerland has essentially Obamacare, and does cutting edge pharma research (unlike the rest of the world, except for the US), and doctors get decent, albeit not exorbitant, wages (again, unlike in the rest of the world exc…

Yet the administrative costs of Medicare or the French healthcare system are much lower than private insurances. I'm not sure the government is that inefficient...

Re: Insured, but Still Owing $109K for a Heart Attack

#349

Post by _archon_ »

noelsusman wrote: post #304
lotsofpulp wrote: post #94

Earlier quoted context omitted.

Health insurance companies' profit margins are restricted by law, whereas Robert Wood Johnson and its executives and doctors profit margins are not restricted. If anyone is on the patient's side from a cost perspective, it's insurance, and the ones benefiting from higher pricing and unnecessary procedures are the providers.

RWJ is a non-profit.

What's your point? Nothing says a nonprofit can't overcharge. If the hospital wants a few doctors and a new MRI, it's looking at many megadollars. Nothing says a nonprofit hospital would bill less aggressively than a for-profit one.

Re: Insured, but Still Owing $109K for a Heart Attack

#350

Post by maxerickson »

jtokoph wrote: post #7

> UPDATE: Monday, shortly after publication and broadcast of this story by Kaiser Health News and NPR, St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.” Sounds all fine and dandy until you realize that these charges will just be made up for by people that aren't able to get NPR to publish a story about them.

Any unmet costs would likely be made up by other patients, but the charges have nothing to do with the costs, so who knows what impact this has.
Post reply on HN