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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

#371

Post by WalterBright »

UnpossibleJim wrote: post #26
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.

Exactly. It's the same reason we don't have free market police and fire services. You simply don't get to "shop around" for emergency services, which includes privatized ambulance services (which are outrageously expensive, on the order of $12,000 for the ride I took when I had to take one, and it was a relatively benign one... thank god I had insurance). EMS is covered, but that's the Fire Department. After that, it…

A free market police system cannot work, because the police use force against people, which is not allowed by the free market.

Worse, the police aren't going to arrest people who pay them.

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

#372

Post by gammateam »

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…

There is no political will to subsidize healthcare if the health costs themselves arent fixed

This second aspect has never been addressed on a national level, or barely at all.

At the state level, if you think of them as their own countries some do have very accessible programs. Some even having universal healthcare in that state.

So the US is complicated.

And then there is the distrust of how people of other cultures in our country would use a subsidy if it isnt clear that they have the same ethics and motives. This exacerbates many political issues.

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

#373

Post by randyrand »

ip26 wrote: post #294
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)?

you’re not. Emergency care requires regulation. Even free market folks know this.

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

#374

Post by eximius »

josho wrote: post #313
vonmoltke wrote: post #183

Earlier quoted context omitted.

> Hospitals charge this because they CAN. They are doing what businesses do and that is maximizing their profit. Including all the non-profit hospitals? What's their motivation?

People misunderstand non-profits. There is nothing stopping you or I from starting a non-profit and soliciting donors then paying yourself a $1M salary. Non-profit simply means any surplus of revenue is spent. So, the more revenue generated by a non-profit's paying customers means they get to funnel that to their core mission (likely research, possibly those that can't pay, or cynically more salary for those running…

http://lmgtfy.com/?q=nonprofit+reasonable+compensation

That is patently false. Basically every part of what you said is false. There are rules that prevent that and that is not what a non-profit means.

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

#375

Post by randyrand »

codemusings wrote: post #7

Despite the fact that in my opinion this could be fixed by Universal Healthcare I'm left wondering: how is it legal to be billed these insane amounts of money without even getting a quote beforehand? Like just waiting in the ER is worth more than buying a first class airplane ticket and getting treated in another country.

Doesnt UHC not solve any underlying problems and just pass the bill onto taxpayers?

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

#376

Post by randyrand »

jvln wrote: post #111

Last year my 1 year old baby had an accident in Germany. She fell off of a bed. I took her to an ER and after the examination I paid approx. 100€ = ~100usd. I assume in USA I would have paid 10kUSD or more..

But what is the per person cost of health care paid annually by the tax payer?

That seems like an important number to know.

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

#377

Post by bko »

cogman10 wrote: post #354
nordsieck wrote: post #319

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. 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…

"Don't let The Perfect be the enemy of The Good." We are overspending on the quality of health care we get today. Further there is a lot of fear mongering about socialized medicine. I've experienced medicine in both the UK and the US. I can tell you, there isn't a difference in quality. Further, when I got a cold and went in, wait time wasn't 6 hours or whatever other BS people claim. Wait time was ~10 minutes. In fa…

Why did you go to a doctor for a cold? That seems to be a problem. You send someone to school for 10 years and they spend their time talking to patients about a runny nose due to a common cold. And for what? To write a prescription?

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

#379

Post by noelsusman »

drak0n1c wrote: post #48
ams6110 wrote: post #5

I'm not an advocate of government paid health care, but hospitals and medical providers should see that this train is coming and if they don't become more transparent it's going to be forced upon them. I don't have a problem with ER care being more expensive -- that isn't necessarily unreasonable when you are getting care in an expensive facility open 24x7, fitted out with equipment to handle any possible medical eme…

For non-life-threatening ER visits an app that has your insurance info and lists the Doctor prescribed treatments with their itemized cost would be ideal to see before you consent or choose what to do. For those without smartphones, the software can also be in the hospital computers ready to give a print-out. Wouldn't presenting it beforehand drive down costs? I'd be in favor of legislation requiring up-front costs t…

That's not remotely how medicine works, but ignoring that, part of the problem is that consumers don't care about costs. Why would they? Insurance will cover it.

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

#380

Post by noelsusman »

dbt00 wrote: post #17
lolsal wrote: post #3

I know $60 Ibuprofen can seem like a lot, but is anyone arguing that you're literally paying for only the pill(s) with that $60? Aren't you paying for the instant availability, the insurance that it's not expired (do they even expire? I really don't know), and confidence that your healthcare provider has signed off that XXX mg of Ibuprofen is a.) OK to have with your current medications and conditions and b.) suffici…

> I know $60 Ibuprofen can seem like a lot, but is anyone arguing that you're literally paying for only the pill(s) with that $60? Aren't you paying for the instant availability, the insurance that it's not expired (do they even expire? I really don't know), and confidence that your healthcare provider has signed off that XXX mg of Ibuprofen is a.) OK to have with your current medications and conditions and b.) suffi…

You also have to cover uncompensated care, which is a significant chunk of change at any hospital in a major metro area. Besides, nobody actually pays the charges. Insurance companies don't, CMS doesn't, and even the uninsured can typically negotiate a bill down with a quick phone call. That's why the charges are all made up bullshit. It doesn't matter so why bother?

Most hospitals in the US are non-profits. You can go look at their financial statements yourself. They're not exactly raking in the dough. Running a hospital is enormously expensive, and if somebody comes in needing $1 million worth of care, then you're required by law to give it even if they can't pay.

That money has to come from somewhere. That's why Ibuprofen is $60.

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