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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

#341

Post by Gibbon1 »

heavyset_go wrote: post #325
ip26 wrote: post #289

Earlier quoted context omitted.

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)

>Why is this dirty? Sabotage and physical fights broke out between fire companies while fires burned. That's a pretty gritty situation. Allowing fire sales gives way to perverse incentives, like the profitability of arson and predatory pricing of fire fighting fees such that certain portion of victims will always have to sell their property at a discount.

Also fire companies notoriously would collect insurance payments then go bankrupt.

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

#342

Post by spullara »

ams6110 wrote: post #229
ncallaway wrote: post #117

Earlier quoted context omitted.

But, as described in the article that system does not function . Acquiring insurance does nothing to ensure that the facility you visit will accept that insurance. Further, even if the facility you visit does accept the insurance, that's no guarantee that all doctors within that facility accept that insurance. Even further, there's no guarantee you'll be conscious to validate that you go to a facility that accepts yo…

Proper insurance pays you for insured losses you incur. When my car is damaged in an accident, I take it wherever I want to have it repaired. I don't have to think about whether the shop is "in network" or not. My insurance pays for the cost of the repair, up to the limits of my coverage. Simple.

I'm not sure if you have ever done this but there are a lot of caveats to that. Many car insurers will have you shop around for a good price, have you pick one of their preferred repair providers or may decide that damage you claim happened in the accident was preexisting. The job is called "claims adjuster" and I'd be surprised if no one from the insurance company visited you when you filed a claim.

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

#343

Post by jopsen »

bjelkeman-again wrote: post #226
ptaipale wrote: post #204

Earlier quoted context omitted.

Not everywhere, though. In Denmark, private operators have been handling emergency services since 1926; currently one company (Falck) is handling 65 percent of municipal fire brigades and 85 percent of ambulance services. No particular nastiness has been reported afaik.

I think this is because the culture is quite different in DK compared to the US. There is an expectation of how it will work which is very different by everyone involved.

No, it's because ambulance service in Denmark is a public contract. Private citizen don't pay out of pocket.

Essentially, the state (or region) contracts a company to deliver ambulance services. The contracts usually last a few years and are limited to a region.

Furthermore, the company that wins the contract (usually lowest bidder) is held accountable is too many responses are too slow, etc.. usually with hefty fines.

I guess you can call it privatization, but it's more of a regulated monopoly. Ultimately, these things outsources uncertainty from the state to the private sector. I'm not convinced it's always a good idea, since companies can just factor the cost of fines into the contract... Granted if there is competition, it can drive the prices down a LOT.

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

#344

Post by Wowfunhappy »

manfredo wrote: post #224
tangent128 wrote: post #189

Earlier quoted context omitted.

> With respect to financial responsibility, if the cost of the delivery is a concern... As the GP noted, if you don't even know the order of magnitude to expect, the cost will always be a concern. The upper bound on the price is in the trillions, after all. > If we start making hospitals list prices beforehand, then they're going to have to raise the base price for an uncomplicated birth in order to subsidize those t…

While the exact prices may not be exposed, estimates from past customers can be found online without much difficulty. If you seriously think that a hospital charging trillions of dollars is a possibility, I don't think you're writing comments in good faith. Prices negotiated with insurance companies are negotiated under conditions very different from an uninsured patient. For example, risk of non-payment is drastical…

> While the exact prices may not be exposed, estimates from past customers can be found online without much difficulty.

They can?

Vox's reporting over the past couple years has suggested quite the opposite—that past prices are not easy to find, and that even when they are, your price can drastically vary from someone else's even for the same service. That's why they started this "submit your emergency room bills" project.

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

#345

Post by debt »

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.

I’m reminded of airports which function very similarly to healthcare. There’s absolutely no choice of merchants I can be in an airport is decided by a very small group of people. It’s not like an open air market you’re finding some developing countries where people can just set up shop and start selling stuff. It is a tightly very tightly controlled market I have very very small number of entities and organizations.

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

#346

Post by jopsen »

ip26 wrote: post #302
maxxxxx wrote: post #296

Earlier quoted context omitted.

" 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.

Without their offer, the market value of the property is zero. Who is going to buy a house that has no fire insurance and is currently on fire ? Is a steeply discounted price really outrageous? They might perish in the fire, they might fail to save it. Firefighting back then was no sure thing. Now, if two crews showed up and bid against each other, things start to get interesting.

If two crews have to show up for a fire... That means higher prices because most of the time there is no fire, so they just sit around waiting -- more people higher cost.

It also means it might be that nobody shows up, because it's a holiday, so nobody was on duty.

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

#347

Post by modriano »

ddebernardy wrote: post #139
y-c-o-m-b wrote: post #28

I was a victim of the surprise out of network bill in the Portland, OR area. I did all my research before hand: hospital in network, surgeon in network, etc. but ONE person in that operating room was not in network and SURPRISE i'm out thousands of dollars. The worst part about this is my state passed a bill to stop this prior to my surgery, but the bill's effective date was roughly 3 months later. Talk about bad tim…

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…

>I'm at a loss as to why the US is still dead set to have no meaningful health coverage.

The US isn't a monolith. The majority of the population very much wants meaningful health coverage, but thanks to Supreme Court decisions like Citizens United, corporations are entitled to free political expression under the first Amendment, so they can give unlimited amounts of money to political candidates. This allows uberwealthy individuals to form corporations for the explicit purpose of installing anti-taxation cronies into legislatures at both the state and national level.

Our political process is very corrupt, and it's taken a national emergency (Trump's Presidency) to wake people up. The 2018 midterms demonstrated that far more citizens are paying attention and plan on voting, so hopefully the US goes single payer soon, but it's going to be a brutal political fight.

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

#348

Post by jopsen »

dsfyu404ed wrote: post #270
stdplaceholder wrote: post #37

Earlier quoted context omitted.

They have literally no limitations. The reason that an advil at the hospital costs $200 is because they were afraid if they made it cost $20000 people would burn down the hospital.

Considering how many people have had their lives ruined by absurd hospital bills I'm honestly surprised nobody's shot one up yet.

Really, the only surprise is that you didn't Google "hospital shooting", the following hit from Google lists 15 hospital shootings in 2018 alone:

https://www.campussafetymagazine.com/tag/hospital_shootings/

I guess you can go look for the motivation, most shootings probably isn't financially motivated thought.

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

#349

Post by minikites »

nordsieck wrote: post #319
xenadu02 wrote: post #318

Earlier quoted context omitted.

Price discovery requires pricing some people out of the market. Period. There is no "free market" healthcare system that can or ever will deliver required health services to everyone. Furthermore when the alternative is death or debilitation, the price a "consumer" is willing to pay is effectively everything they possess and can borrow. That is both a massive distortion and non-optimal for the economy as a whole. The…

> Price discovery requires pricing some people out of the market. Period. There is no "free market" healthcare system that can or ever will deliver required health services to everyone. There is no economic system that can deliver all of the health care to everyone who wants it. Fundamentally, health care resources are limited: doctors, beds, MRI machines, etc. Desire for health care is much less limited. The questio…

Are you saying that the richest country in the world can't accomplish something that already exists in plain view in some of the poorest countries in the world?

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

#350

Post by FireBeyond »

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...

Hah, there's not a dentist in my entire County that works on Friday either. I've been in the situation where I've called each and every one, all closed Fri-Mon.
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