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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

#61

Post by iso1210 »

I had a gout flareup while in Washington DC for work. It's happened before, last time (in the UK) I phoned up the freephone national number for advice, my wife drove me to the local hospital, I walked (hobbled) in, had a couple of tests, was given some tablets and a presecription, and left in 15 minutes. That cost about $1.50 in gas parking would have cost another $5, but it was the weekend and parking was free. The prescription was $12 (standard price in the UK for any prescription drug or drugs, no matter what it is)

In the US I phoned my insurance company, got an Uber down the road to the hospital, and walked in passed the (armed?) guards to sit in a crowded waiting room. Receptionists took my blood pressure twice, was unimpressed with my (international) insurance. 2 hours later I went into some form of casualty area and sat in a chair, had blood pressure taken a couple more times. Eventually someone came and gave me a tablet, then they wheeled in some computer trolley to take my credit card (about $900), and gave me a prescription. There was no informing me of prices up front, no choices (not that you have much of a choice when you're in hospital - for me it was a really minor thing so I actually would have had the choice to either pay or not pay).

A few weeks later at home I received another bill for $2k from the hospital. I believe the bill charged for each of the times they took my blood pressure, I was never asked "would you like your blood pressure taken for $200", I wasn't asked if I wanted to sit in the comfy chair rather than the plastic chair for an extra two slips of latinum, the price wasn't up for negotiation, it just was.

The difference between the two cases is night and day, the UK treatment is fast and free, the US will make you wait for hours and then charge you a fortune.

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

#62

Post by bottled_poe »

helloguillecl wrote: post #58
refurb wrote: post #46

Earlier quoted context omitted.

The plastic surgery and vision correction industries work pretty well in the US. You see price competition and patients have the ability to shop around and make choices that are important to them (references from other patients, doctor personality, etc). Now contrast that with going to a hospital for a procedure where you have time to shop around. Can you get a price? No. Can you easily get appointments with doctors…

The United States leads the way in treatments and medical tech, but this gives me the impression that the US society is not benefiting as it could from that.

This seems poignant. The cost/benefit analysis does not seem to be aligned with the market. I suspect it’s driven purely by lack of qualified practitioners.

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

#63

Post by donatj »

garmaine wrote: post #19
helloguillecl wrote: post #8

This is absurd. Even in a country with liberal economics and "free choice" health system (however with universal care, and state regulation), the same stitches in a world-class private clinic in Santiago, Chile would cost 400 USD, before insurance . The clinics there are not the ones Americans imagine from a middle-income country, most of them have better infrastructure and doctors than the ones I know in Europe. And…

$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.

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

#64

Post by lelandfe »

aerodog wrote: post #22

Washington Hospital in the Bay Area charged me $2,010 for a COVID test when I went to their ER. Later I was told I was stupid for having gone to the ER to do the test there. I just never suspected they would charge that much.

That the CARES Act put no restrictions on pricing for tests is, in hindsight, pretty shameful.

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

#65

Post by knubie »

refurb wrote: post #46
helloguillecl wrote: post #8

This is absurd. Even in a country with liberal economics and "free choice" health system (however with universal care, and state regulation), the same stitches in a world-class private clinic in Santiago, Chile would cost 400 USD, before insurance . The clinics there are not the ones Americans imagine from a middle-income country, most of them have better infrastructure and doctors than the ones I know in Europe. And…

The plastic surgery and vision correction industries work pretty well in the US. You see price competition and patients have the ability to shop around and make choices that are important to them (references from other patients, doctor personality, etc). Now contrast that with going to a hospital for a procedure where you have time to shop around. Can you get a price? No. Can you easily get appointments with doctors…

Really any healthcare procedure that is not typically covered by insurance has seen costs go down over time. Things like lasik eye surgery, or orthodontics are great examples in addition to the ones you've already mention. The service and technology gets better while the price continues to go down.

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

#66

Post by chongli »

Lifelarper wrote: post #50
throwaway09223 wrote: post #16

Earlier quoted context omitted.

My understanding is that the ER system is especially expensive because paying customers are subsidizing non-paying customers (homeless) who use the ER as primary care. That said, I don't think this excludes the possibility that the insurance companies and the hospitals are also not telling the full truth.

I find it hard to believe the small non-paying contingent is unique to the US or even a significant % of daily patients, plenty of other countries have homeless who end up in ED's. America somehow spends far more than any other country on healthcare and yet patients still have some of the highest out of pocket costs even when they have expensive private insurance schemes, something is clearly broken to anyone looking…

The US's non-paying contingent doesn't need to be any different from any other countries in order to cause the problem. The issue is that the uninsured subsidize the non-payers alone. This is radically different from countries with universal health care where the costs are spread among the entire tax-paying population.

As for why the US spends more than any other country: it's due to an overabundance of caution among the comfortably insured. It's much easier to get a variety of expensive (and often unnecessary) tests and scans (such as MRI scans) in the US. In countries with universal health care these tests and scans are restricted only to those with demonstrable need and they may be subject to long waiting lists.

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

#67

Post by helloguillecl »

nisa wrote: post #49
helloguillecl wrote: post #26

Earlier quoted context omitted.

Yes, and it would be even more expensive in Germany. But in both countries the insurance covers normally 50% of it, wherever you go. If not all. (Other sickness are covered normally 80% if not entirely whatever insurance you have)

What are you talking about? As long as you are not private insured - which is not difficult to do usally - if you have a job you are insured (a percentage of your pay is used for insurance, if you study you are insured (90 eur) or you can join on your own for 200eur/month depending on your income if you are working on your own. You pay nothing for ER, 10eur/day for the hospital and a few eur for medication - but noth…

Did you actually read my comments in this conversation? Are you aware that in Germany clinics have different prices than the ones you pay after insurance? I have always talked about prices before insurance, which is what I'm arguing looks completely out of place.

I'm public insured in Germany and no, dental is not really covered, I had to pay my routine treatment last time at the praxis, and it was not cheap.

Do you know that if you don't have insurance (which is however mandatory in Germany) you get an actual bill for the medical services?

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

#68

Post by edgyquant »

aerodog wrote: post #22

Washington Hospital in the Bay Area charged me $2,010 for a COVID test when I went to their ER. Later I was told I was stupid for having gone to the ER to do the test there. I just never suspected they would charge that much.

In this case it seems like the steep price is to prevent frivolously using the emergency room. You can get covid tests dirt cheap (or free) if you schedule and appointment at a hospital or one of the testing sites. Emergency room has to have capacity to take on actual life threatening emergencies.

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

#69

Post by throwthere »

causi wrote: post #2

Somehow everybody in this system claims they're not the ones making bank on this swindling. The doctors say they're underpaid. The hospital admin says they're underpaid. The insurance companies say they're barely covering their payouts. So who is lying?

Lol what? Insurers are hugely profitable— many are public companies and don’t hide that. And you can underpay plenty of people if you give them difficult to do bullshit jobs that don’t provide value. That doesn’t make “administrators” liars. Doctor salaries have declined over time with inflation— is hard to blame them for higher healthcare expenditures. My main point is outright calling people liars and playing a blame game isn’t going to get anywhere. The system is fubard.

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

#70

Post by drdec »

sorokod wrote: post #30

Can someone make a coherent case for public healthcare to be a for-profit endeavour?

That is not the problem, IMHO. I would suggest that the problem is that the consumer, i.e. the patient, is doubly removed from price considerations.

Firstly, insurance shields the patient from the direct cost of healthcare. Second, many people are shielded from the cost of their insurance as it is chosen and paid for by their employer.

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