Is there anyone doing work on analyzing current legislation and providing alternate wording to fix the issue?
The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
81–90 of 175 posts
Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
#82We decided (slash "made the mistake") of going to the emergency room last summer. Spent less than two hours in an exam room before being dismissed with no conclusion and referral to another doctor. Got a $9500 bill about six months later and have been billed a 10% copay on that (insurance paid $5500 already at their negotiated rate). Still fighting it as absolutely absurd, but there's really no hope. This country is…
As someone not from the EU, this is something totally insane and crazy. Once, after my country got out of the Soviet Union, the US was seen as the dreamland of everyone. Now.. I don't think so, when getting sick with something easily treatable will ruin your whole life. That's just not a place I'd like to live in.
Once I was on a date with a younger girl and she was going on about how she'd like to live in the US, and I, being kind of a nerd had a Sheldon type of moment told her how awful it is, and she said "thanks, you ruined my dream". And she was talking about how she spent a summer as a barmaid there, got tonsilitis, visited a doctor who made her take a test for tonsilitis and got billed for it. Here where I live.. you can see that when someone has 1) a high fever 2) inflammation in their tonsils 3) has a swollen throat and white stuff there because of it then they have tonsilitis and you don't need to make additional lab tests, because it's 100% obvious, you don't need to waste time and money on useless stuff.
Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
#83Earlier quoted context omitted.
Gonna go out on a limb and assume you have good health insurance. Many (most?) Americans do not. I'm on an HDHP for example, so the first several thousand dollars in medical expenses per year come directly out of my pocket before insurance starts helping at all.
i work for a tech company in the fortune 500 top 25... i would assume the best insurance possible, still killing us (paid nearly $7000 out of pocket last year + the actual premium costs of several thousand more). i've got three small kids including one with a heart condition, so it's particularly bad right now.
> i would assume the best insurance possible
That's usually not a good assumption to make, not even among the FANG. There is extreme variability even with the same insurance company, depending on the negotiation between the company and the provider. And very few companies actually have any incentive to even provide the best 'possible' coverage.
Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
#84This story is total fake news. The patient is a teacher with a Cadillac health insurance plan. She paid $75 co-pay. The $10,000 bill is an illusion printed by the insurance company to make her think that her insurance is actually valuable. No one was paid $10,000. The hospital was paid a secret negotiated rate much much much much lower than $10,000.
The provider was paid 3,000 by the payor - that's how insurance billing works. It absolutely is a rats nest when it comes to finding out pricing information but the number on the bill is what ended up changing hands (less, possibly, any amount not covered and defaulted on by the patient).
I believe you're thinking of the provider's chargemaster and the pricing discrepancies there - this procedure was billable as 10,000 to a patient without insurance with the 7,000 discount being the payor's preferred rate - that 10k is the BS number that (mostly[1]) no one ever pays, while this 3k is the actual amount changing hands - for the patient the out of pocket cost is the most visible portion, but that bill was fully paid.
1. Mostly everyone except for the uninsured or out of network - those folks will get stuck with that BS price 7k price, which is there since payors always want to feel like they're paying discount prices.
(edit - corrected numbers to be in line with the actual bill)
Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
#85Side note: if you suspect a COVID-19 infection, DO NOT GO TO THE ER. Contact a physician by phone, get instructions. By going to the ER you put a lot of people at risk.
This is the most important thing here. The testing should be done at home.
Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
#86We decided (slash "made the mistake") of going to the emergency room last summer. Spent less than two hours in an exam room before being dismissed with no conclusion and referral to another doctor. Got a $9500 bill about six months later and have been billed a 10% copay on that (insurance paid $5500 already at their negotiated rate). Still fighting it as absolutely absurd, but there's really no hope. This country is…
An opposite example, went to the ER last year and spent a couple hours there. Paid a $100 copay. Haven’t seen any other bills.
Went to the ER last year with fever because the insurance told me to go to an ER. Saw the doctor for five minutes and was sent home. Still calling the insurance and the hospital over a $500 bill that was supposed to be covered but somehow they keep sending it. My girlfriend once got a $300000 after a surgery that required a five hour stay at the hospital. It took her two years to clear that up.
Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
#87Earlier quoted context omitted.
My daughter had an allergic reaction to food last year, which required us to give an epipen. We were told when this happened that we needed to call 911 and have her taken to the emergency room for observation and potentially for further treatment. We did, the ambulance came and took her to the hospital, which is under a mile away. We then had a similar experience to yours - spent about 2 hours in the hospital being o…
That ambulance bill is insane. Up here in Canada ambulance charges are paid out of pocket but my wife had a low blood pressure emergency and got an ambulance called and was only out 300$ for a three mile drive (through dense city streets even). I'm even of the opinion that that bill was a bit excessive.
$300 seems low.
'The distance' is basically irrelevant.
You're paying for a highly available, rapid response team to be prepared for almost any medical emergency, 24/7, literally almost at the press of a button.
'Preparedness' is expensive. What happened if the Ambulance broke down? Or a medic decided to say f-it and skipped a day. Or the phone didn't work. Or the critical piece of gear didn't work. Or ooops ran out of gas (hey doesn't happen often, but it happens!)
To get all of those things to 99.999% is quite a bit expensive. Constant vehicle checks/repairs/updates. Backups. Process, procedure.
The amount of training required for Medics should be quite a lot, considering the first few minutes of any problem are usually the most critical, and it can be 'anything'.
My unscientific 'instinct' is that $1K per call seems to be more or less in the right ballpark.
There should be some kind of insurance for this, one way to make it more palatable would be to have it subsidized. People who call more often I think can be expected to pay a little more but we can't be breaking the bank on folks.
Given that healthcare is a skyrocketing part of the economy, I wonder if we're going to end up with a kind of triage in Ambulances as well - i.e. ambulances for crazy life-threatening things, and ambulances for more common things which mostly require 'getting to a doctor quite soon, please' i.e. this is important, I need to go to the front-of-the-line'.
Edit: actually, $300 is definitely 'too low', there probably is some kind of subsidy.
Very crudely suppose an average call may last 1 hour. Suppose due to scheduling, that an ambulance may be idle for 1 hour in between calls. So the 'average call' would be 1 driver, 2x medics, for 2 'man-hours' each. Of course, there's other labor overhead: for each ambulance, there might be 0.3 mechanics, 0.3 dispatchers, this before we get into all the other unit an ancillary costs. $100K/year for any kind of professional in the medical field is ballpark reasonable, that's $50/hour - so we're looking at roughly $300 just for the immediate staffing - not including the mechanic, dispatch, op staff, gas, insurance, training, facilities, advanced equipment etc.. So very crudely ... ambulances are expensive.
Edit 2: yes, I'm talking costs here, obviously this is different than what people end up paying as a commenter has indicated.
Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
#88Earlier quoted context omitted.
Yeah. A lot of people focus on the insured vs uninsured gap - if you're uninsured you're fucked. But the reality is that, even with insurance, medical care is a disaster. Finding a doctor in your network, waiting months to see them, completely unpredictable costs that, to me, borders on fraud, etc. I've recently started a company, and at the same time a friend was laid off, and over the last 6 or so months I've gotte…
The whole waiting months thing is so shameful, since it is a major talking point from people arguing in favor of the status quo. They point to wait times in Canada, which are entirely misinterpreted and never point to the fact that it can take months to see a specialist in your network in the US. Heck, the number of times I've been told "this Dr. is not taking any new patients" or some version of that, is astronomica…
I'm up here in Canada - my wife's uncle had to wait three months for cataracts surgery, cataracts surgery is good in the long run and extremely non-urgent. He also had to have a rotoplasty in his heart to clear out plaque, he was booked into surgery within a week - my wife's aunt fell off a cliff (a small one) and got a concussion, she had excellent care.
In Canada non-urgent procedures have moderate wait lists, and urgent procedures get immediate attention. In the US monied patients get immediate attention and poor patients get long wait lines.
Honestly, this rationing BS needs to stop, the people spreading it are either maliciously disingenuous or misinformed and I'd bet quite a few are acting maliciously.
Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
#89This story is total fake news. The patient is a teacher with a Cadillac health insurance plan. She paid $75 co-pay. The $10,000 bill is an illusion printed by the insurance company to make her think that her insurance is actually valuable. No one was paid $10,000. The hospital was paid a secret negotiated rate much much much much lower than $10,000.
The insurer paid about $3000 according to the screenshot. The $10,000 is an illusion but I believe it's for tax purposes. If someone gets a $10k bill and the hospital eventually writes it off, they can write off the whole 10k.
Re: The Cost of Not Getting Tested for Coronavirus: A $10K ER Bill
#90This story is total fake news. The patient is a teacher with a Cadillac health insurance plan. She paid $75 co-pay. The $10,000 bill is an illusion printed by the insurance company to make her think that her insurance is actually valuable. No one was paid $10,000. The hospital was paid a secret negotiated rate much much much much lower than $10,000.
The provider was paid 3,000 by the payor - that's how insurance billing works. It absolutely is a rats nest when it comes to finding out pricing information but the number on the bill is what ended up changing hands (less, possibly, any amount not covered and defaulted on by the patient). I believe you're thinking of the provider's chargemaster and the pricing discrepancies there - this procedure was billable as 10,0…
Insurance _never_ pays as much as they bill. This is one of the reasons to have it in the first place: each insurance company has negotiated rates with the hospitals. Even if you have high deductible, you'll still be getting negotiated rates, not the bullshit they (try to) charge people with no insurance at all. IMO, this is one thing that should be made totally illegal, no matter where one lands on the political spectrum: cash customers should be "favored", meaning cash price must match or be lower than the lowest insurance negotiated rate for each procedure. Anything else is just stupid and unfair. That way if the insurance pays five cents for the paper cup the pills come in, you can't charge fucking 13 dollars for the same thing if I pay cash.