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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

#91

Post by wizofaus »

JohnFen wrote: post #55
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…

My mother got cancer (she survived it, fortunately). She had a fantastic insurance policy, made good money (well above the average income), and had money in the bank. Her medical costs ended up bankrupting her. That was where the scales fell from my eyes and I learned that what we're taught about the purpose of insurance (to protect us in the case of a catastrophic expense) is just pure BS.

I assume you're using the word "fantastic" as in "imaginative or fanciful; remote from reality"?

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

#92

Post by s_m_t »

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…

Sure the plumber is free to only offer outrageous rates but I'm not sure they would be able to markup a roll of teflon tape they used in the repairs as 50k and say that is covered by "plus unexpected expenses up to 50k".

To me it just seems like fraud. Forget about patient choice because in this situation the patients conceivably could have shopped around for rabies shots, AFAIK you aren't going to die because you got your rabies shot a few hours later the you needed to. The problem seems to be that even if they were able to shop around and find the lowest price apparently the hospital can just charge whatever they want regardless of the expected or quoted cost.

Going back to the example of the plumber; Imagine if my house is flooding and I get into contact with two plumbers, one tries to price gouge me and quotes me $5k/hr and one is seemingly honest and quotes me $80/hr. I go with the plumber that quotes me less but then he ends up charging me $50k for the teflon tape he used anyways. We can see this isn't a breakdown in being able to shop the market and the normal competitive dynamics that arise from that, the breakdown occurs because of the fraud.

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

#94

Post by fxd123 »

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.

Hospitals are required, under federal law, to list all their prices publicly.

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

#95

Post by theGnuMe »

dheera wrote: post #38
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…

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…

Why didn't the insurer pay? Was it not covered? And what setting was it in, outpatient or ER? If ER then you should be able to dispute with your insurer to get it covered. If outpatient you might be able to negotiate with the Financial Services folks that they (the doctor) did not submit for pre-authorization appropriately per industry standards.

That's where you build your argument that they acted inappropriately and did not disclose prices (did they?). The next question is are you on a State plan or a corporate EIRSA plan? If State they you can file a complaint with the California department of insurance. If you have a corporate plan, which is likely self funded, then I would ask your HR to talk to your insurance rep. You might find things get retroactively covered at that point. Or you can talk to the news. They love to report on these things.

Stanford has pattern of inflated charges. Hearing tests in audiology for example are ridiculously overpriced without insurance and they don't pre-authorize. And most insurers don't cover hearing tests anyway. Stanford could fix this by not being greedy.

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

#96

Post by maxerickson »

etrautmann wrote: post #89
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 infuria…

Doctors could, to some approximation anyway, go on strike. They endorse the system we have by working in it (and have not been silent participants in building either).

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

#97

Post by theGnuMe »

merek wrote: post #82

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.

People go to Mexico all the time for medical and dental procedures.

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

#98

Post by seanmcdirmid »

JohnFen wrote: post #55
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…

My mother got cancer (she survived it, fortunately). She had a fantastic insurance policy, made good money (well above the average income), and had money in the bank. Her medical costs ended up bankrupting her. That was where the scales fell from my eyes and I learned that what we're taught about the purpose of insurance (to protect us in the case of a catastrophic expense) is just pure BS.

Was this before or after the ACA? As far as I understand it, the ACA got rid of ceilings on benefits and added a max pay per year.

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

#99

Post by nradov »

justin_oaks wrote: post #60
nradov wrote: post #30

Earlier quoted context omitted.

Hospitals have been required to post price lists for several years. https://www.cms.gov/hospital-price-transparency

This won't be effective unless the hospital is required to provide prices whenever people ask, such as requesting an estimate from your car mechanic. And not only providing the prices but being required to honor the price they give you, with some reasonable threshold of variance. These hospitals posting their prices reminds me of this classic section of "The Hitchhikers Guide to the Galaxy": "But the plans were on di…

Due to the No Surprises Act, healthcare providers are now legally required to give patients a good faith cost estimate in certain circumstances.

https://www.cms.gov/nosurprises/consumers/understanding-cost...

https://www.cms.gov/nosurprises

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

#100

Post by etrautmann »

maxerickson wrote: post #96
etrautmann wrote: post #89

Earlier quoted context omitted.

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 infuria…

Doctors could, to some approximation anyway, go on strike. They endorse the system we have by working in it (and have not been silent participants in building either).

It seems uncommon for one group to strike on behalf of another group. Pragmatically that seems very unlikely to happen even if theoretically possible. Policy level changes seem more likely to me.
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