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Bay Area couple shocked by $200K hospital bill for rabies shots

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Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#81

Post by myth2018 »

1letterunixname wrote: post #68
dheera wrote: post #38

Earlier quoted context omitted.

I got charged $5000 for a 30-minute preventative echocardiogram (basically an ultrasound) that insurance was supposed to pay 100%. 20 emails later it's now at debt collectors, and I've contested the debt twice. I'm ready to appear in court if I have to. I'm ready to pay $8K in lawyer fees to get rid of this $5K bill because it's wrong. I just don't want this to impact my credit score because it's not my debt. I hate…

Oh my word. 2018, I was on Medi-Cal (Medic-aid) and had a stress ECG, right heart catheterization, and 12-lead EKG when admitted to their cardiac unit for 3 days. Cost $0. Like a third-world country: in America, you're better off being either totally penniless or a billionaire. If you don't have a balance sheet of $5 megabucks, your life will be miserable. The advantage most European and other countries have under so…

> Like a third-world country: in America, you're better off being either totally penniless or a billionaire. If you don't have a balance sheet of $5 megabucks, your life will be miserable.

I live in a "third-world" country. My family and I have insurance and only use private hospitals -- the capitalist portion of the system. Never had as bad an incident as the ones you guys are reporting here. Just some minor annoyances.

Not even the crappiest insurance companies do stuff like that, and they get terminated by the regulatory body if they start to mess up consistently.

Although I don't use it directly, I'm overall well-informed about the realities of the public health system. It's bad, but not even close to what I've seen posted here. One can even obtain overly expensive meds for rare diseases -- it requires some legal effort, but it eventually works.

Then I'd say that, when it comes to health systems, the USA is definitely way worse than some third-world countries -- and one of the main reasons I declined an invitation to work and live in there.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#82

Post by merek »

I'm not in the US, is medical tourism common amongst US citizens? For non-urgent cases, why not travel to a country that offers cheap, quality health care? Financially seems justifiable, given that in the US, simple treatments and medical procedures can cost many 000s without any transparency ahead of time.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#83

Post by andrewinardeer »

nitwit005 wrote: post #23
1letterunixname wrote: post #15

That's a shitty bill. It's also insane that US doctors and hospitals aren't required to post prices, keep prices reasonably within an allowed range, and are allowed to price gouge customers for however much they want without limit. In Redding CA, I ran across a woman with a nasal infusion pump tube taped to her face in a coffee shop. She was hurriedly collecting paperwork for a hearing across the street. It turns out…

> The hospital is required to make its charges public. NorthBay Health's online listing shows $547.65 for a rabies vaccine.

Does this price include administration of the vaccine as well or just the cost for the vaccine with syringe and professional services additional?

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#84

Post by 1letterunixname »

Louis Pasteur is rolling in his grave. The 3 shot rabies PEP vaccine costs $108 while in the US it costs $1000. Same shit, American patients just receive the privilege of paying more.

https://www.who.int/news-room/fact-sheets/detail/rabies

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#85

Post by 1letterunixname »

akomtu wrote: post #67
s_m_t wrote: post #27

How is that legal? What is stopping the hospital from charging 200 million dollars for the rabies shots? If I hired someone to fix my plumbing and they wouldn't give me an estimate and then decided to charge me $20k/hr I don't think a court would honor that contract.

I'm not sure about that. Hospitals use the fact that patients have no choice. Amoral business is the most profitable. A pipe in your house has burst, you called a plumber and he arrived in 1 hour (other plumbers were even further). He looks at your situation and says "sign here, my rate is 5k/hr plus unexpected expenses up to 50k" and when you try to negotiate, he calmly looks at water flooding the second floor in yo…

It's the gambit of brinkmanship + Vito Corleone.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#86

Post by AdamJacobMuller »

HPsquared wrote: post #46
AdamJacobMuller wrote: post #28

Earlier quoted context omitted.

What's their incentive to reduce the cost? They make money as a % of care paid out (max profit is capped). More costs == more profits and the costs are just passed onto the people paying for insurance (both employees and employers)

In a normal competitive market a series of new entrants would come in and undercut the incumbents by charging 10% less than the competition, one after the other until a sensible price is reached. Why doesn't this happen? Also where does all that money even go? It's so insane.

This is not a competitive market. It is a completely regulatory-captured market.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#87

Post by AdamJacobMuller »

1letterunixname wrote: post #59
AdamJacobMuller wrote: post #17

Earlier quoted context omitted.

Dispute the debt. They can't put a lien on property without a court case and I want to see someone stand in front of a judge and justify an un-itemized 100k bill when their own public charge sheet shows that the service should cost <1000.

That doesn't work in the real world. Their army of lawyers can and will outspend you at every turn. They will force you into bankruptcy when you should've declared bankruptcy to begin with.

There's no spending involved on your part. Don't spend a dime until you show up in court to defend yourself.

"I've been asking for 2 years for a breakdown to explain how what is listed on their website as a $600 charge became a 120k charge."

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#88

Post by schemescape »

jlmorton wrote: post #48
schemescape wrote: post #16

Earlier quoted context omitted.

Where does it say it's a billing mistake?

The article does not say it's a billing mistake, but it notes that NorthBay Healthcare lists a price online of $547.65 for a rabies vaccine. Surely human rabies immunoglobulin would be another $1,000, maybe more, but there is no chance on Earth that it is $100,000 each. NorthBay Healthcare is a non-profit hospital. This is a very, very obvious billing mistake. And while I have zero evidence for what I am about to say…

Thanks for pointing out that this article is not brand new. I’m curious to see if there is an eventual follow-up. If not, then that would be extremely disappointing.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#89

Post by etrautmann »

1letterunixname wrote: post #15

That's a shitty bill. It's also insane that US doctors and hospitals aren't required to post prices, keep prices reasonably within an allowed range, and are allowed to price gouge customers for however much they want without limit. In Redding CA, I ran across a woman with a nasal infusion pump tube taped to her face in a coffee shop. She was hurriedly collecting paperwork for a hearing across the street. It turns out…

Doctors are NOT to blame here. It's almost as inscrutable and impossible for them to understand the process as the patients. Doctors often times have to battle insurance companies on behalf of the patients to get them the drugs they need with coverage. My wife is a cancer physician and spends hours on the phone convincing insurance companies that patients actually need the treatments she's proscribed. It's an infuriating waste of time.

She also has little to no visibility into cost incurred by the patient, and often times there isn't a menu of options to pick from. She's not incentivized to perform extra testing/etc, and keeps patients costs in mind while providing care. I don't think that's rare among doctors. The whole system is frustrating, but yes mostly so for the patient.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#90

Post by falcolas »

p1esk wrote: post #74
1letterunixname wrote: post #59

Earlier quoted context omitted.

That doesn't work in the real world. Their army of lawyers can and will outspend you at every turn. They will force you into bankruptcy when you should've declared bankruptcy to begin with.

But do they want to outspend you? Especially if the case is not a sure win for them.

If they’re paying the lawyers regardless (as in paying them a salary), might as well give them some work.
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