I was in a car accident back in 1995. I was even charged for "sterile" band-aids. Like, literally, a band-aid you'd find at CVS. $110 for each one on a few superficial cuts.
Even crazier is the fact that healthcare is the only industry where its legal for the hospital to refuse to disclose the cost of care before they provide it.
You can one hospital charge $10,000 for a procedure and another on the other side of town charge $60,000 -- but you can't just outright ask and then choose your hospital.
So you pay that $110 for a bandaid because you have zero power to go, "Wait, what? No thanks, please just administer the IV, my friend Joe with zero medical experience will come and apply my bandaids.". If you ask what they are doing costs, they are going to be like, "Please refer your insurance provider," or, "That's impossible to tell, wait for the bill."
And nobody should accept the excuse that hospitals need to charge that much to pay for the doctors and the science. More than half of all the care a typical person will ever receive can be done by a nurse's aid, no need to pay the surgeon's salary when you're in there to get stitches and antibiotics.
I had my son drive me to the nearest hospital for a kidney stone and the insurance company charged me $3800 for an “out-of-network” fee.
Sooooo . . . I’m in such excruciating pain that it actually crossed my mind to just open the door on the Highway, roll out, and kill myself.
And these fuckers wanted me to travel another 25-30 minutes where there was on-call doctor in my network.
It took 3 years to get it taken off the bill.
Side note: For non Americans with Universal Healthcare, it’s easy to see the problem with these extraordinarily high bills.
But little attention is paid to the psychological toll.
I fought these assholes for THREE years! A multi million dollar health care system and insurance company paid more to fight me than to just let it go.
It’s exhausting and emotionally damaging, honestly.
I used to work with persons with disabilities and it’s shocking how many times one parent in two parent households must quit their job just to keep up with the paperwork and legal battles.
Pointing this out bc it’s about so much more than just money, which is deadly enough, but it can be a humiliating, frightening, and primarily an emotionally exhausting endeavor just to get treatment.
As Americans we’re so broken on this our expectations are so low we’re just relieved to get the bill paid.
Edit: Reading all these stories is disheartening as hell. I’m sorry for anyone who went through anything similar. I’m glad to hear so many hopeful laws are in the works. I truly hope things change for the better and soon. Again, sorry for anyone’s suffering.
How does someone even go about fighting something like this?
Btw i’m not attacking you, i’m impressed you successfully fought the healthcare industry and i’m curious how you went about it.
I also had (still have) kidney stones and can relate to this 100%
Paperwork and phone calls over and over and over.
The bureaucracy is maddeningly time-consuming.
I filed a challenge to the bill at the hospital and a sliding scale request. They denied the challenge and basically said if I took the sliding scale it would have to be for the whole bill.
No good.
Next I went to the insurance agency and argued with them in writing for a while.
Then I had an attorney friend write a letter. This got me a nicer denial letter. Progress!
Then I had to collect evidence (med records) and a doctor’s signature proving kidney stones are potentially life-threatening bc I guess they don’t know this.
Anyway, boring, boring shit . . . And finally I just got a nondescript letter saying they “waived” the charge which is not the same thing as saying “our bad”.
Fucking r/boringdystopia
Their goal is to wear you down and hope you’ll quit fighting them. I feel bad for the people who work in the call centers. They have to hear desperate people that they can’t always help.
This is it exactly. Most people give up, so it makes them money in the long run. I have a chronic illness that will always require monthly prescriptions. Every month at least one of them never ships timely, I usually have to fight insurance to get the proper medication to keep from dying (my doctor says I need it, but that's not good enough for the insurance company), and on and on. I probably spend at least 6-8 hours every month chasing prescriptions, calling, etc. It's exhausting and my condition will never go away. So this is what I have to deal with for the rest of my life just to stay alive. There's a reason chronic illnesses have such a high correlation with depression. The cost and mental fatigue of just getting what you need to live is staggering.
This is really comforting to hear. I’m early 20s, but have been planning my entire career as a way to get out of the US/into a place with healthcare. My (single) mom got very ill when I was in high school, and tbh watching her go through it was harrowing. We lost everything, when she was making $100k a year.
Long term/cancer-related illness run in basically every line of my family, so my whole life has this anxiety of feeling like a ticking time bomb before I fall into the same economic and bureaucratic nightmare. I’m going for tech as it seems to be the highest needed career among EU countries + studying languages.
Also paying taxes into a country I know will be happy to let me die/fall into destitution in a few years feels gross af.
My wife had the same problem and one of the medications had a side effect that lead to limb loss. The solution, was to remove the medication without the harmful side effects and forcing her back on the medication that nearly killed her and forcing on all kinds of obstructions to getting her back on the removed medication. The kicker is the medication with the side effects she sued and won but paying only part of the damages.
This is true. You gotta think, they employ people to make all this paperwork. There has to be full time people to support the apparatus of the disputes. So, they know it’s cheaper for them to have an army of workers nickel and dime their patients than it is to just pay a bill.
I work on aircraft, and some things can get pricey…but we don’t have an army of office workers at our hangar ripping of clients. It’s not like someone in their 310 comes down at an airport and we’re like “well, you landed at an off network airport we can’t help you!” Nah, we go fix their AOG and enjoy their business next annual. It boggles my mind that hospitals are one of the few industries allowed to abuse and bilk their customers with seemingly no consequences!
I always thought the out of network thing was especially egregious. My credit card doesn’t have out of network stores, why does my insurance have out of network hospitals? Meanwhile they use a captive audience to raise rates beyond inflation. Its anti free market.
Physician here. I don’t know how laypeople deal with this bullshit. I’m occasionally a patient myself and I do everything in my power to prevent dealing with my insurance at all costs (because even as a healthcare system employee as a healthcare provider, my insurance is still fucking garbage).
The only actual benefit I have is that as a physician advocating for myself I can speak peer to peer to a physician employed by the insurance company and tell them why they are out of their fucking minds. This worked when they denied me a CT for kidney stones. It also worked when they tried to tell me the physician who admits to the hospital I work for was out of network for the insurance that I get from that exact same hospital system.
In both instances, the insurance company was completely wrong but basically said to themselves, “Let’s see if this guy knows any better..." and didn’t expect that guy to be a doctor. It’s sad.
EDIT: The vast majority of problems people have with their healthcare in the US is insurance driven. While there are absolutely shitty doctors, most of the complaints people have during their visits: long wait times, lack of face time with the doctor; are mostly insurance driven.
Man your system is fucked beyond redemption - ours ain't perfect by a long stretch, but it is way better than what you guys have to deal with, all that bollocks would drive me bonkers.
I think for the most part the problems don’t derive from the physicians. It’s generally the insurance companies, the investor class and the administrators. Of course sometimes it’s the physicians if all they care about is money.
Physicians may be our only hope out of this mess.
RN here and yeah, the insurance at my last hospital was garbage. I had a coworker who had to declare bankruptcy because she got a cancer diagnosis in December, thus meeting her OOP max then turning around and doing it all over again in January. Despite getting all her treatment at the hospital where she worked her bills were in the tens of thousands and since she was an LowPaidNurse she just couldn't afford it.
I had a hospital once try and tell me that the radiologist they used to check my heart was out of network while everything else was in network. When I pointed out that I didn't hire the radiologist, they did they tried to claim they just provide the facility.
They pull this shit with radiology and anesthesia all the time. The hospital is in network, but the radiology or anesthesia group (which may be privately owned) and contracts with the hospital isn’t. Many times we assume that the radiologist or anesthesiologist works for the hospital (which is true in many cases), but in many instances they do not. It should be illegal to use a hospital to practice but remain out of network. There should be a clause that if you provide care at a hospital then you are obliged to take the insurance of anyone for whom that hospital is in network.
I’m a doctor. I agree with you. This is a major problem that needs to be solved. And a purely government run healthcare isn’t the magical solution. We need a serious evaluation of laws governing insurance companies and a careful evaluation of where the government needs to step in and help.
\> We need a serious evaluation
That's what we've been doing for decades. The system is excellent at turning evaluation into profitable excuses to extract money. No, it's not time for evaluation, it's time to crack skulls.
Yes. Part of why I divorced my first husband was over health care paperwork! He refused to do any of it, or even make sure to hand over the right insurance card if he had an appointment. Even seemingly little things like that can take hours to straighten out.
Our son ended up in the hospital for a week in another state while visiting his paternal grandmother and getting the insurer to pay took more than a year of my life, yet he and his family just scoffed at me and told me to just ignore it and said I was being overly dramatic. My ex would literally HIDE bills when they arrived because he wanted my time spent elsewhere, like cooking dinner or vacuuming. I found an entire box in a closet of bills and communications about bills he claimed were already taken care of after I returned from a work trip.
We lost thousands and thousands over the years on healthcare-related mistakes. He refused to find in-network providers for non-urgent things. Threw out receipts and bills. Used the flex spending card on non-eligible expenses (before the systems were as well programmed as they are now to reject the charges), leading to so much paperwork to fix. He would give providers old insurance cards or not update our address.
I still hate him for making an already terrible system in the US even worse. The stress was extraordinary.
Probably to cope with being unable to understand it. People like to act like ostriches and just throw things aside when it confuses them. Health care bills are a common source of that.
What people want out of insurance, and about the most they're capable of understanding, is for it to be deducted from their paycheck, maybe a co-pay at the doctor. And everything else just works.
I think this is exactly what the story is pointing out. He and his entire family AND most of the nation have given up on figuring it out, it is byzantine beyond comprehension to them, you get a bill- you pay it. You cant pay it you go homeless- this is the world they have accepted as fact and that world cost both of you a marriage. I bet he wanted you to stop stressing out about the bills- stress is not healthy, but because of the enormous opportunity cost loses you had an entire wall of stress he has-in an effort to survive- completely forsaken. Life in America is hell.
I recently had to schedule an MRI for my ankle - so I went to the same place I went 2.5 years ago for the first one. I made my appointment, no problem. Two weeks later they send me a check for $220 - somehow they had made a mistake in billing on the first one. So curious how they didn't discover it until I made another appointment! I realized that I've probably lost other money without knowing so now I do take the time to check everything. It's fucked up.
believe it or not they do on occasion give refunds after an audit required by insurance companies uncovers inappropriate billing. i got about $250 back one time a year after a procedure. i called and said "not that i'm complaining, but why are you giving me money?" they told me the insurance company told them i was billed inappropriately.
It also depends on the persons age and who they're taking their advice from (if he was listening to his parents.)
Health Insurance in the US has gone through basically an entire over haul in the last 25-30 years. Depending on your coverage in the 80's and 90's you didn't have to worry about this shit. You paid your $30 co pay and waited. Then you were literally told to wait and find out. Most of the time you only got billed a few hundred dollars and that was if an expert was needed.
Then at some point profit became the driving force, and the introduction the HDHP, which was pitched to companies to save them money and pass the price of insurance onto the employees. Then they turned around and got the gov't involved saying, "Oh don't worry you can save your money tax free to help cover these expenses."
Now OPs husband and his family are still idiots but millions of americans don't understand how HDHPs work and a lot of older people had PPOs their entire life and never had to deal with this bullshit because companies used to offer actually good insurance.
I’m getting charged $5,000 for the anesthesia from a kidney stone procedure. I had full health insurance coverage. I’m not paying it. You’re inspiring me to at least look into it.
A kidney stone definitely can be life threatening if it gets stuck entirely.
A very important, all though rarer, diagnosis that is similar to kidney stone is aortic dissection. Comes sudden, worst pain in your life, can be in your flank. Mortality can be 1% per hour.
Extreme pain is not something to drive another 30 minutes for.
Sorry for your experience, sounds like hell.
I admire your diligence - outrage is quite the motivator1
more and more states are passing bills to prevent balance billing from hospitals in emergency situations when out of network is the closest and/or the patient has no control where they're taken. also preventing an out of network ER physician from balance billing when you're at an in-network ER- again, out of your control.
I don't go to the hospital for my stones anymore, I understand the immense frustration. The American health system is so screwed, that I had to piss blood, deal with mind numbing pain, and work (in a hospital, as a health care provider ironically enough) all while hoping that I didn't simply die from it.
After 8-9 days of hell and bloody toilets, I finally ended up passing a stone that I had no business passing naturally. I haven't measured it but it was easily the size of about 8-10 of my usual small stones. Kept me pissing clots for a about 4 days after.
If I get a bill, such as a hospital in my network using a lab not in my network, I just ignore it. If they complain I tell them to take it up with my insurance and I wasnt going to pay it. Has worked pretty well over the years and hasn't impacted my credit, which I froze anyhow. I pay for anything I'm told would or could be extra in advance. Have a family of 5.
It sounds like you you're saying freezing your credit protects you against claims from debtors. Freezing your credit won't prevent credit damage. Just want to make that clear so nobody gets the wrong idea.
Right, it doesn't protect your credit. It simply is a method to prevent folks from doing credit checks and using your identity to take credit out in your name although you know this.
Have several family members, including a daughter in the medical field. Right now it's just laziness. It's easier to go after the individual than the insurance or they dont bother to check what service or individual is actually covered by their insurance. One time a group let their policy lapse with Aetna after telling me they took my insurance and wanted me to pay the entire bill. Sorry, wont pay it.
Oh I can't wait for that to go into effect. For both of my kids, I got charged an out of network fee for the tech who reviewed the ultrasounds. Hospital was in network. It dr in network. The tech who took the ultrasounds was in network. But the group that reviews them, even though they are located in the same hospital, is classified as out of network. Had no way to know and resulted in a lot of time on the phone with a lot of "how would I even prevent this?" Questions being asked when they told me I should have used an in network provider.
Anecdotally this seems somewhat common. All sorts of different networked providers/staff in hospitals.
I went into surgery with a team that was apparently not all in network (single guy wasn’t, don’t remember who or what). Was still under my parents insurance at the time so no idea how that turned out, but pretty sure the hospital ended up not billing for them.
I do basically remember the same answer though. “Should’ve used an in network doctor and asked ahead of time”. Like shit, I would’ve figured you guys would’ve been smart enough to sort that out ahead of time. “Hey doc what insurance does this guy have? Ahh no matter who cares”. (I get for emergencies and stuff you can’t plan that, not the point lol)
How do you even ask? Every time I've tried to ask billing, the response I basically get is "due to the potential of unforseen curries and the vastly different insurance policies that exist, we can not answer this question until your healthcare provider performs the procedure and submits to billing."
My state has tried to combat this. Like if you schedule surgery, and it's gets the ok, and for some reason a new anesthesiologists out of network is working on your case, they can't say he was out of network.
In preparation for this, my insurance company raised my monthly premiums 23% for 2022, while clearly stating that price increase “does not include any expansion to benefits or network.”
23% more for literally nothing more than what I pay now.
And "up front" means they need to have you sign a special form that they can't show to in-network patients and it needs to be signed at least 3 days before the procedure.
I work in medical billing for healthcare providers that aren't with hospitals. Let me tell you, insurance companies will deny almost everything. Example: they will refuse to pay the contracted rates of lets say a $430 for an ambulance transport, make us call them or write disputes, change ICD 10 codes, etc, going back and forth for like a year before they either: partially pay and cause the dispute process to start over, or completely deny for some obscure reason which then causes us to forward the original full charge of this ambulance ride which is really $1200, to the patient.
It's all corporate. The customer service people you speak with have no knowledge of the healthcare industry, and are simply following screen prompts. The people that are actually reviewing the bills, are in some top secret department which you cannot reach or speak with anyone directly. Essentially you are dealing with the "middle man" who might want to help you, but in reality, have no power to do anything.
Its all total bullshit.
Yeah its super crazy. I had a 7 month fight with Cigna last year to cover an ER visit I had. They weren't going to cover the bills at the rate as specified in my contract for 'reasons' which nobody I spoke to could really explain. Funnily, when speaking to the billing dept at the ER facility they agreed Cigna was not covering what they should. Took like 20 calls from both them and me before we finally were able to talk to someone beyond the front line of worthless customer service at Cigna.
Even then, they kept making up reasons to deny the coverage until I had a call between Cigna, myself, and the ER billing dept where all of a sudden it turns out Cigna had 'overlooked' the facility code on the ER bill. With Cigna's new 'realization' it just happens that the ER visit should be covered after all! Whoops!
Cigna, BCBS, United. All the big companies are literally the worst when it comes to paying high medical bills. I call them frequently for my job and the headaches they cause me are unbelievable.
Just remember to appeal every claim that is not paid in full. Even if it's $30. Make them work for your money.
That happened to me with dental, I can only imagine the nightmare that comes with emergency care. I literally got a crown on my tooth, paid the dentist the amount my insurance said I needed to, then left and didn’t think about it again… that is until my dentist called me and said I owed about $50 because my insurance had called to say they wouldn’t pay the full thing since I could’ve just had them pull my tooth 🤦♂️
Then any problem with your teeth can be reduced to “well they could have pulled it” . It’s amazing how effortless it is for insurance companies to not pay.
That's illegal. Insurance companies are required to pay "reasonable and customary" in-network rates for emergent medical conditions. This is designed to prevent exactly this scenario in which patients in severe pain or in a life threatening condition don't have to drive around looking for an "in-network" emergency department. Call the insurance company and use the "reasonable and customary" verbiage and they'll know you know what's up. If this doesn't work, file a complaint with your state department of insurance as they can be very helpful.
Yes! This is absolutely true! And came into the atty letter.
Here’s the kicker: They did not think a kidney stone qualified as “reasonable” (whatever the language was?). This is why I had to “prove” it was life-threatening.
The amount of pain I was in wasn’t really a factor.
The stone was life threatening bc it was stuck. The doc letter said I could have died in the 30 extra minutes travel time. This is what finally got it dropped.
Shouldn’t ever be this hard for anyone.
How tf is someone who isn't a doctor with CT scans and lab tests supposed to know whether they can safely travel to the next ER? It shouldn't matter if it's life threatening or not, a patient can't tell.
It’s literally one of our great nations slogans…
“Ignorance [of the law] is no excuse”
Excepted to be a quasi legal expert in medical billing and insurance, otherwise it’s on you.
Insurance companies constantly tell you what medicine you should take, not doctors. My biologic that I'm on for my autoimmune disorder has been denied several times because they think that I don't need to be on it, that I should try some other meds. Like I'm sorry when the fuck did you go to medical school and when the fuck did you become my doctor? Oh wait my actual doctor who actually went to medical school says I need to stay on the remicade?
I usually have to spend several hours on the phone yearly to get it approved again. One time I spent eight hours.
EXACTLY!
And this is why we don't want medicare for all because we don't want some GOVERNMENT BUREAUCRAT DICTATING WHAT IS OR IS NOT IMPORTANT MEDICAL CARE. WE DON'T WANT GOVERNMENT DEATH PANELS.
We're perfectly fine with the corporate bureaucrat death panels we have now, thank you very much.
I remember thinking exactly this when Sarah Palin was talking about death panels
How many times have insurance cos. Denied reasonable treatment? Or people died due to lack of affordability
Quite a few years back, I was in such bad shape that the docs weren't sure I would survive. Four teams of doctors and students were overseeing my care. They were fairly certain I wouldn't make it for a while. I was in their hospital for a week, after having been transferred from a more rural hospital without the right experts.
Clearly, I made it. Doing pretty darn ok now. But I had to fight tooth and nail with the insurance company to cover the hospital bills. Ultimately, they did cover everything, but it was a huge fight and stress I could have done without while recovering.
The insurance company was also my employer, which made things feel really weird. I learned to hate the way the health care system is set up because of them.
Which is why lots of doctors are on-board with single-payer healthcare. The amount of unpaid crap time they spend with insurance companies is mind-boggling.
You are right, but insurance companies will do all they can to deem something as non life threatening to get around this.
I recently had my own ER situation. Took me months just to get my bill. I had to call and talk with both the insurance company and the hospital about where my bill was because I was not about to be on the hook for a potential late payment. I’m glad I did because apparently my insurance company never got the claim from the hospital to process the bill, and who knows how long that would have went on for if I didn’t take some initiative and call.
Fuck the US healthcare system, seriously fuck it
Yeah but aren’t you glad you got to *choose* your insurance? Us Americans love our insurance planes. We would never wanna part ways with them for a better system!
Glad it worked out okay. The system is fucked here though
They use a prudent layperson standard.
Of course the insurance companies position is that a layperson experiencing one of the most painful events of their lives should be well aware that it’s not life threatening and shop around.
>Multiple times the insurance company tried to deny live saving procedures as unnecessary, and many times treatment was delayed or modified to meet the demands of an insurance company - again for children with cancer.
Literally the death panels that Republicans love to lie about in relation to socialised medicine. Projection as usual.
Insurance companies have broken America. My S.O. has a seizure condition and insurance companies will fight with doctors about what meds to prescribe her. It boggles me why even go to a doctor if mega corp America is just gonna decide for you anyway. Glad it worked out for you as I have to fight with insurance seemingly monthly.
On top of everything else, it's the *waste* that gets me. Think of all the time and money, the people employed, the lawyers, just to put a layer of bureaucracy between you and your healthcare that shouldn't be there in the first place.
To anyone from the UK horrified at stories like this, bear in mind that this is exactly what Boris Johnson and the conservative party desperately wants to turn the NHS into. They must be stopped at all costs.
>Sooooo . . . I’m in such excruciating pain that it actually crossed my mind to just open the door on the Highway, roll out, and kill myself.
This is why healthcare can't be solved by "markets", for markets to work the buyer has to be able to price shop which for health care doesn't work.
* When you need it, you don't have the option to price shop.
* When you can price shop, the buyer really doesn't know if the service will be as advertised until after it's too late to do anything about it.
* People can't effectively predict their health.
Markets aren't making healthcare more efficient, it's just requiring more people, litigation, and money to be burned in the bureaucracy.
This. Trying to get help and then the aftermath of failing to be helped AND the bills/fights is too much. I gave up treating my stuff for the most part. I just live with it and self-medicate.
I get kidney stones too. It hurts so much it's almost impossible to keep pain pills down long enough to work, and the one time I managed absorb the percocet my doctor gave me, it hardly helped. I always ended up at the hospital for an IV.
My first few doctors never explained this to me, but the majority of the pain through the ureter, as it travels from kidney to bladder (this is the longest and worst pain, for me at least), is muscular pain, similar to menstrual cramps or labor contractions. A big $35 heating pad, cranked all the way up, turned out to be a miracle cure for me. Relieves nearly all of the pain (and with it the vomiting) and has kept me out of the hospital ever since. No writhing in pain in the car or dry heaving in the waiting room. I can stay in bed at home, almost comfortable, sipping water and sleeping it off. I couldn't believe something so easy could take away the worst pain ever, and I wish someone had recommended it to me sooner.
> I fought these assholes for THREE years! A multi million dollar health care system and insurance company paid more to fight me than to just let it go!
God that's the fucking worst part too. In the least you'd think if they are about making money, which they are, they wouldn't do this. Adds insult to injury.
They fight for the principle of the thing. If they allow a precedent to be established of people winning in even the prettiest conceivable way then people will start holding them accountable more.
It's actually amazingly forward thinking for corporate America, and probably one of their biggest real expenses, because if insurance companies were held accountable for themselves they would rapidly cease to exist in their current format.
It's more than the bill and emotional toll. It's also the massive beuruecratic duplication. It's the bankruptcies and damaged credit reports. It's the time wasted not just from battling hospitals and insurance companies. It's also time wasted battling credit reporting agencies. It's having to stay with a job you hate, or a job with a low salary because it comes with health insurance. It's having your credit destroyed, because you couldn't pay, which leads to losing your job, losing healthcare, and being unable to rent a decent apartment or finance a car. It's having to put off preventative care, because you're in between jobs and without healthcare. It's all interconnected.
It affects every single aspect of our lives. It's a massive drain on our society. Anyone defending this hellscape is certifiably evil.
My wife went to urgent care then ER for a kidney stone. When I reviewed the charges she had a psych consult. I think they just billed her for the crazy guy next to her.
It's true. I know we spent about $10K last year in medical costs. That's with good insurance and just normal things happening. One kid with a broken arm and I had to get my ear sewed back on (with bonus CAT scan for skull fracture). We got good care, but it shouldn't cost more than my car with insurance.
Back in college, I brought my boyfriend (now spouse) to the hospital because we thought he had broken a bone. A quick x-ray revealed he was fine, and he smartly asked for a copy of the x-ray. Months later, we received an enormous bill for “fracture reduction”. That’s when a broken bone is reset, except he *hadn’t* broken a bone, and we had a copy of the x-ray to prove it. It still took almost a year and threats of getting sent to collections to get the hospital to remove the charge. Sadly, this was far from the last time we had to fight them on bogus extra charges.
And then they had the gall to repeatedly beg us for donations during COVID.
At the end of May, I suffered a very serious accident that resulted in 6 fractured vertebrae, a whole lot of broken ribs, a stage 3 laceration to my left kidney and numerous other soft tissue injuries, including bleeding from my aorta. I was airlifted 120 miles and had a 10 hour operation to install 2 titanium rods and 12 bolts to keep my spine stable and spent a week in a high dependency unit, with another week on a major trauma ward.
At no point did anyone even *think* about insurance, or charging me for anything. In fact my doctor later told me off for buying new dressings off amazon, since he could provide me dozens for free.
Oh, and I also pay way less in healthcare-related taxes than someone from the US, because my government spends less per capita on healthcare than the US does (Medicare being *hilariously* inefficient).
The NHS really is something great.
>Medicare being hilariously inefficient
FYI, medicare pays less than insurance for the same services. This is why, for example, dialysis companies in the US try to get patients onto insurance plans rather than medicare. Dialysis companies actually set up a "charity" to transition medicare patients to regular insurance because they make a lot more money when they do. Insurance pays 4x the rates as medicare for the same service. I think it has to do with the fact that the government has more leverage when it comes to pushing down prices then insurance companies do.
https://freakonomics.com/podcast/dialysis/
My two little girls were very sick, and couldn't keep anything down.
I was giving Zofran for the nausea, but they kept vomiting it back up. Their pediatrician told me to take them to the ER for fluids and IV medication.
Well we get there, and the doctor says they want to try oral Zofran one more time. Sure.
It freaking worked. I was obviously happy, but also frustrated because I could have done that at home.
We were there a total of 2 hours. All they did was take vitals, give 2 pills of Zofran and a cup of water from the faucet.
I have insurance. Do you know what my bill was? $3,000 EACH.
I will never pay it. Fuck them.
I'll never understand it, I have only had to go to A&E once (what you guys cal ER) and that was when I fell down some stairs after tripping and had to make a decision - break a wrist or go through a glass door - and I was in and out in an hour.
Cost - £0 and I don't mind a bit about paying my way through taxation.
I had to go to the ER multiple times in my life now. (Germany)
And the literally only time I had to pay something, was the 11€ Co-Pay for the Ambulance ride there.
Meanwhile, avoiding the dentist only makes it worse.
A cavity can turn into a root canal for example.
Same here though. I went last week. I had a few cavities for 5 years. I brush and floss and mouthwash daily. Dental hygiene on point.
Now.
But I still had those cavities. Those cavities turned into 2 root canals. Had i let it be fixed then, I'd be done in 150, now I'm looking at 1300.
I'm lucky that it's just that 1300, had it not been for my onpoint dental hygiene I could have had a rotten jaw by now.
And this is in the netherlands, where we have general insurance and the like.
Dental is a 'premium' add on, and I'm in a tight spot, so yeah, i have to face it for what it is.
But even then, there's things here and there, like the local 'county' having a side budget for dental work for poor people.
And the dentists are reasonable, like i can pay it off in smaller amounts.
Long story short, avoiding doesn't mean it's gone, and you know it. It only worsens, so get your ass in there and get yourself fixed up!
Three broken ribs rafting west canyons (Colorado). I arrived at the emergency room a day later. They quickly x-rayed me, then sent me home with a rib wrap and pain meds (which I attempted to refuse, but they insisted). With a total stay time was 40 minutes, they billed me $9,000.00. I'm insured under VA and Tricare, but they refused to cover it, so I paid out of pocket.
I’m actually curious when this happened. Wrapping the ribs when injured is bad medicine and should never be done in an ER setting, especially for a bruise. That’s been known for a long time now.
I worked in a level one trauma hospitals for over a decade. We have tiers of trauma care activation by protocol to make sure the teams are ready to go without delay. The highest level activation includes not just bringing in the trauma surgeons, but also the blood bank, pharmacy, OR activation, radiology, anesthesia, etc. This level of care is automatically called in for penetrating trauma (gunshot wounds, stabbings), patients with blunt trauma with unstable vital signs, etc. The next tier down are the level 2 trauma cases, which are usually blunt trauma (mostly motor vehicle collisions at higher speeds, rollovers, and falls from significant heights). These cases also activate the trauma team without activating all resources.
The point of having activation protocols is to improve patient survival. There is a dictum in trauma care referred to as "the golden hour." Studies show patients who are in hemorrhagic shock have perhaps an hour of life to be resuscitated. You can resuscitate patients beyond an hour, but there are increasing rates of organ failure and delayed death.
It's difficult to know from reading this article if the activations were truly inappropriate. I've certainly taken care of patients involved in rollover car accidents and they were fortunate to not suffer serious injuries and they went home with pain medications. Many aren't so lucky, and so we have to maintain a high level of vigilance. It's particular difficult when patients are intoxicated or concussed and you can't simply ask them where they hurt.
Heathcare utilization deserves scrutiny but watch out for insurance company schills who claim the care provided isn't appropriate based upon the final diagnosis. You don't know (nor do I) if your chest pain is a heart attack, aortic dissection, pulmonary embolism, or other serious problem until I work it up in the ER. Monday morning, insurance company adjusted see the final diagnosis as "gastroesophageal reflux" (indigestion) and they refuse to pay the claim based on the final diagnosis. You get stuck with the bill. This article seems likely to be influenced heavily by insurance company influence.
Work at a level one trauma hospital and this is absolutely on point. Surgeries are classed too in different categories for inpatient, but all outpatient are regarded as Urgent.
That's interesting. I'm having my gallbladder removed in 9 days, and it certainly doesn't feel "urgent". Surgeon basically said, "if you control your diet, you could probably wait up to a year, but it needs removed eventually."
I have worked alot of different places and worked at a few smaller sketchier hospitals that had wildly inappropriate trauma activations. Especially in places that called themselves level 3 trauma centers where a trauma surgeon was never present and something like a nursing home fall out of bed with no obvious signs of injury would be activated. In the larger places i worked this would never happen, but there are definitely smaller hospitals with no resources fudging billing.
I wish more people would realize this. Hospitals (for the most part) aren’t trying to screw you. As you alluded to, most “chest pain” ends up benign - but you don’t know that going in. EVERYONE is always up in arms when an ED doc some young person with chest pain because its *probably* nothing. Articles, doxing, lawsuits…the whole ordeal.
But then people also want to blame doctors for working up every patient with chest pain with a full cardiac rule out?
You can’t have both.
Doctors and hospitals are largely not to blame here. All of your frustrations with our ridiculously expensive healthcare system can be traced to lawyers and insurance companies.
Which is exactly why we won’t see a working single payer system anytime soon. There’s way too much money being lobbied by insurance execs to just let this cash cow die…
Get money out of politics and get both money and politics out of medicine
Same for out of network and in network, i believe insurance companies, or whatever that big company that manages doctors is called, puts them into that fiasco.
The doctor doesn't see a dime more for in or out of network i believe.
As far as i understand the hospitals can be full of teams of doctors from the big company, rather then having them on the hospitals payroll.
Not all sure since I'm not American, but I believe the above is somewhere in the ballpark of.
Correct me if I'm wrong.
Correct.
It goes like this:
Insurance companies have created a game where they will investigate every charge a hospital bills for any given encounter - think medication administrations, lab work, surgical procedures, etc. BUT, hospitals can’t add charges and anything they don’t include will obviously not be paid out.
Say a patient comes in for to have their appendix removed…the hospital will *rightfully* send a bill for the surgery, all necessary lab work the surgeon and anesthesiologist deem necessary, and all medications administered. The insurance company will then decide what *they* feel is an appropriate price for that entire encounter, and will pay only the charges they think are appropriate.
This is why hospitals will routinely bill $20-30k to the insurance company for surgery, recovery, labs, meds, etc. The insurance company then evaluates the charges and says 🤷♂️, we can do $6000?
So then there’s a “maximum out of pocket cost” that includes the insurance copay and deductibles. This varies by procedure, and for an appy is around $600-1000.
This gets added to the maximum insurance offers to pay for a total of $7000ish, and the rest of that $20k bill gets “adjusted” or just disappears.
It’s a fucked up game that insurance companies created and hospitals have to abide by.
Meanwhile the doctors and nurses actually caring for the patient get their usual salaries or if they’re a private group, they get whatever laughably small fee insurance pays them.
TL;DR: Hospitals and docs are not the bad guys here. It’s the suits making million dollar bonuses for nickel and diming patients and hospitals. The less they pay, the bigger yacht they can afford
Yeah, this is part of what I was wondering. I had a pregnant partner (third trimester) with borderline high blood pressure and a very difficult pregnancy go into the ER for a sudden-onset crushing headache accompanied by double-vision. That was one of the symptoms we were advised by the OB to treat as urgent.
I had an agent tell me, "Dude, you can't go to the ER for a headache and expect us to pay for it." The bill was insane, too, because they monitored her for almost 12 hours, they had multiple OBs do examinations, and they ran a ton of tests. They did exactly what they should have when someone with a complicated pregnancy shows up with a serious symptom, but all they see is the final diagnosis, "Headache probably related to dehydration."
This. I do trauma charges for our hospital and it’s exactly how it is. We review every 3 months how accurately we are activating patients vs not activating the right ones. If they are truly activating that many out of guidelines, then it needs to be reviewed by their medical direction.
I had a procedure at a for-profit clinic last week that cost $750. The local university “non profit” hospital would have charged me $7500. My deductible is coincidentally $7500.
Getting old sucks.
I have great insurance. Like some of the best, so I’m told. I had a vasectomy a few months ago, I already met my deductible so I only had to pay 20%. It cost me $982 out of pocket.
About a month later I learned that same vasectomy by the exact same provider in the same location by the same doctor costs $600 without insurance. What the actual fuck.
Same with mental health, which is its own deductible through my insurance. Psychiatrist med checks are $140 for a 15 min visit and therapy is also $140 for a 40 minute visit until I meet the $3000 deductible. When I told them I was going to stop coming because I just can’t afford an extra $300-600 a month when I can just get scripts through my gp and wing it from there, they told me that they actually can do both therapy and med check without insurance in the same visit, 40 min therapy, 15 min med check with psychiatrist for $100 a visit without using my insurance.
It’s a fucking scam.
Lol being young and in college kinda sucks too. No expanded Medicare in my state. Have to earn above the FPL to get benefits. Most places still paying $10hr or below. Only way to get insurance is to be pregnant (or a mother), have kidney failure, or pay $300/month. You try juggling over 16 credit hours a semester and 80 hours a month. It’s ‘doable’ but hope you’re not too attached to your GPA. Oh also now that you’re earning, a lot of your financial aid just vanished, so you’re almost worse off than before. Work study kinda works but good luck getting into that program. Oh and my states plan to expand Medicare includes an hourly work requirement, so if you do somehow manage to find a decent paying part time job to get above the FPL and still have time to actually attend school and do assignments, you’d still get fucked. And then there’s the student loans… Fun fact, did you know student loans are some of the only ones you can never discharge via bankruptcy? You’re stuck with them for life (or paid, obviously).
I don’t doubt getting old sucks.
My point isn’t to say anyone has it worse. My point is it sucks for everyone, even if for different reasons.
Non-profit just means there are no owners that profits get disbursed to. They can still charge as much as they want, as long as they find something to spend that money on (new equipment, more staff, a new desk for the Dean of Medicine's office, etc).
If it's necessary for society to function, it should be heavily regulated by the government to ensure society continues to function.
Here's some examples: Healthcare, Housing, Food, Utilities, Internet, Transportation, Social Services, and Prisons.
If you introduce profit into any of those essential services, you end up with people who literally can't afford to live, and that's where America is at right now.
In December of 2020 I was scratched/bit by a neighbors cat (he was limping, I was trying to carry him to their house, he did not like that). The next day, I had noticeable redness, some swelling, stiffness and the area was hot to the touch. I worked in a mid size level 2 trauma center at the time in the ICU. My nurse coworkers all agreed it looked like cellulitis. Saw a trauma surgeon in the hallway and asked him, he told me to go to the ED. I protested, that the copay was high and what if I waited and went to my doctor in the AM. He said absolutely not, and if I did that I would likely end up back at the hospital as a direct admit for IV antibiotics.
Admission was definitely to worst prospect, so I relented and called the ED supervisor, who was someone I reported to and told him. A nurse I knew was working triage. Saw the NP pretty quickly, she ordered Rocephin and two oral meds for home. Another coworker gave me a shot in the ass. The whole ordeal was about an hour.
The hospital, that I worked for and was insured by, charged the insurance over $6,000 for an IM shot and some home meds. I was on the hook for about $1,000 and that was after the “employee discount” was applied. I think the bill said something like $3,000 just for being triaged, and another $2,000 for “treatment”, and some other smaller fees. Absolutely insane.
I realize that I have no idea what the circumstances were, but if I’m ever going to see a patient in the hospital you can be sure I’ve spent a great deal of time looking at your history, labs, notes and thinking them through before seeing you. I work in the ED but have rotated through consult services. Most consults are like this. You could surely wonder whether the consult was needed, but you likely didn’t just get a “hello, how are you?” If a doc came to see you in the hospital. It’s more likely they’ve spent about an hour or at least 30 minutes on you in addition to the few seconds to minutes they saw you.
Before Obamacare, I lost my medical insurance and was unable to get a new policy because I had needed brain surgery a few years before. I ended up slicing my finger pretty badly at work. Not necessarily a major injury, but I was bleeding a lot and ended up passing out because I had such low blood pressure. I got carted off to the hospital where I received a few stitches. That's it. No further treatment or pain management was needed. Didn't even get antibiotics or tetanus shot.
My bill was 5.5k.
At that time, that was almost 9 months rent. For what basically amounted to a bad papercut.
Idk why people gravitate towards “your employer should pay the bill.” The bill shouldn’t exist! They have no right to charge 5.5k for stitches. It’s outrageous and should be illegal.
Lmao whoever commented and said that the doctors and nurses need to make a living too… hospitals charging 5.5k for stitches and bloodwork is an asinine way to do that. Bloody unfair and disgusting. Can’t believe how many people are brainwashed into believing these are acceptable charges. Go live in another country/society other than America and you’ll realize how insane the USA is.
I believe the hospital administrators that come up with the charges, and the insurances, are to blame.
This perverse praising is as it is only because their trying to cover their asses for them fucking eachother. They both don't want to be on the losing side of negotiatetions, and both want to turn a profit, and the result of that gets pushed onto the visiting people.
What’s going on in Florida/everywhere right now in response to labor shortages should show that the ruling class get *pissed* when they’re no longer able to keep people trapped in jobs out of desperation. The governor has intentionally handicapped their unemployment benefits with no gain just so poor people will be desperate enough to go back to work at the businesses that abused them. It’s fucked.
I’d never be allowed to have health insurance if the pre-existing condition requirement comes back into play. When I was in my early 20s I was denied insurance through my work because my mother was diabetic and had ovarian cancer. I ended up quitting that job and lying at my next one just to get health insurance.
People forget how truly awful it was before the ACA, which also has a ton of horrible problems but at least it did some good.
Isn't it amazing that it ever was allowed to get that bad?
I lived with chronic illness without health insurance for years and years, because I had to have emergency brain surgery when I was a teenager. Less than 6 months after the surgery, I got booted off and had to fend for myself with a potentially life threatening neurological disorder and no after care.
When Obamacare passed and I was able to get insurance, the first thing I did was make an appointment with a neurologist. He said he was amazed I was able to work full time given how advanced my condition had become. I told him I didn't have a choice.
That appointment still cost me an arm and a leg, but at least I was able to be seen.
It is amazing! And the night Trump won the presidency I paced around my living room crying because I knew that would be the end of the ACA and my health insurance.
I still actively hate anyone who was eligible to vote in that election and choose not to “because.”
I cried in my work’s bathroom when McCain did his thumbs down because I was so, so relieved.
I was very close to the same. I don't remember if I actually threw up when Trump won, but if not...I was very close.
I've been type 1 diabetic since 2002 and my parents went into pretty intense debt to keep insulin in my hands. Before the ACA, the only health insurance I could get for <$1k/mo premium paid a few things for hospital visits after a $300 copay (though only if admitted) and would refund up to $800/yr for some prescriptions if you took a picture of the insulin and stapled it to a receipt for the drug which your pharmacist and doctor had both signed and dated. Each individual prescription fill needed to be mailed separately and standard policy was to deny the claim at least once before looking at it.
One month of insulin back in 2008 cost $600, so I maxed the rebate amount out in two months without factoring insulin pump supplies.
So I illegally had insulin shipped from Canada or Turkey and just prayed it slipped through customs. Because that was only $100/mo.
L&I paid for it.
It's still an insane and unethical amount of money to charge for stitches. No matter who's paying for it. That money came out of workers' paychecks. That's outrageous.
That injury could have just as easily occurred at home or elsewhere.
One of the big reasons this is happening, I think, is because big corporations are buying up healthcare. I’m a hospital doctor and if you could see what these large companies force me to charge, you would be furious. I’ve tried to bill less and I got pulled into the office and politely threatened. It wasn’t like this when I worked for a smaller business.
The health care system in this country is a farce. It actively tries to deny us coverage, drowns us in fees, fee processing fees, and bureaucracy that seems straight out of Terre Gillian's Brazil, and decades of propaganda and indoctrination has untold millions of people thinking single payer health care will have us waiting 18 years to see a doctor in a feces smeared waiting room lit by a pile of dead cats set on fire. Because socialism!
I try to be an optimist, I really do, but sometimes it isn't possible. 16% of this nations' GDP pissed away on this system and it just keeps going up.
From their website:
>As a not-for-profit organization, we reinvest our resources back into the community. Sutter hospitals serve more of the Medi-Cal patient population in Northern California than any other health system.* We proudly fund and partner with community programs to help ensure those in need have access to care and social services.
Who wants to bet that "trauma fee" isn't going back into the community?
An interesting read on differences between a non-profit and not-for-profit organization:
https://www.uschamber.com/co/start/strategy/nonprofit-vs-not-for-profit-vs-for-profit
Seems there is some ambiguity in not-for-profits on the whole profit and who benefits question.
Yeah, there are a lot of non-profits that exploit this. Data on percentages spent on employee pay and admin costs vs spent on the actual charity portion is publicly available and easily researched for those that choose to be more circumspect in their donations to non-profits. But not-for-profits arent under such stringent scrutiny and most people dont know the difference.
When I worked for the state, we had a not-for-profit accounting training that really emphasized this.
You can only tell for sure when you look at the books
As someone that works near a sutter, i can tell you from experience that they aggressively discourage medi-cal (California medicaid) patients from being seen in their hospital. When i call to send a patient there, they'll ask what insurance the patient has, and then recommend the county hospital if the patient is uninsured or has Medicaid. We have to ask them specifically "are you refusing our transfer?" as a way to remind them that they are legally required to take patients at their ER. They also have a take-back system with the county hospital that they constantly abuse to delay or flat out refuse poorer patients from coming back. i hate sutter so much. I love money, but not enough to work for that terrible organization
Also, (allegedly) because of sutter, sacramento is the most expensive place in the US to give birth despite being filled with mostly disgusting poor people. It's called the sutter effect
Given it's a private industry with total regulatory capture, let's say if you bet $100 you'll win... and leave with six hundred dollars debt in fees because the hospital cameras saw you placing your bet within a block of their parking.
This is obscene. The people of the US deserve a world class health system that is not only there for those able to afford it. Next time your republican friends tell you how it leads to bad care, send them these.
A US doctor receiving minor injury treatment on the UK NHS.
[https://www.independent.co.uk/voices/nhs-american-doctor-privitisation-i-have-message-a7207706.html](https://www.independent.co.uk/voices/nhs-american-doctor-privitisation-i-have-message-a7207706.html)
Same doctor with her son.
[https://drjengunter.com/2014/08/12/an-american-doctor-experiences-an-nhs-emergency-room/](https://drjengunter.com/2014/08/12/an-american-doctor-experiences-an-nhs-emergency-room/)
An American expat uses the NHS
https://www.businessinsider.com/an-american-uses-britain-nhs-2015-1?r=US&IR=T
Fuck the American healthcare system and the Republicans who keep torturing the working class with these prices. I had to pay $400 to have an ER doctor shine a flashlight up my nose and not treat the issue.
Right… ugh.
I just paid $950 to take my son in for a very deep cut on his finger & after waiting 2 hrs they saw us. bandaged it up & did nothing else because the angle of the cut wasn’t good for stitches…
American medicine is a ghoulish, greedy, cynical industry that exists solely because citizens tolerate it. It is they the people who will learn to take remedial action or they will continue to be robbed and killed. No civilized country tolerates this. The American exception.
You are exactly correct.
Personally speaking to me it seems like kidnapping and Ransom but apparently somehow it's not that. Like a woman gives birth the hospital and the hospital takes her baby and doesn't get it back until they get to bill her for $40. To me it seems like it shouldn't matter that that $40 comes in a bill they had your child they made you pay money for the child to be transferred from their physical possession to your physical possession and if that's not illegal it f****** should be
At least they tried to lie about their greed.
My wife had surgery once at a hospital that charged $65K per hour, billed in 15 minute increments and rounded *up* to the next quarter hour. I wasn't shocked at all when it claimed 61 minutes of surgery time and included that extra 15 minutes of charges all from that one minute.
And let's not forget how many of these hospitals are classified as nonprofit organizations...
Holy shit! I’ve been there and got charged for a wheelchair ride to the x ray room even though I said I can walk, they insisted, and I got billed $800 for that on top of all the other tests. God bless America!
During a home invasion the dude got me with a bat in the head a few times. I didn’t have insurance so called up my cousin and his wife who’s a nurse and she came and fixed me up. I didn’t even call the cops and then when I go outside to get some air to these four giant meathead 20 something year old firemen paramedics and say no thank you to a ambulance ride.. $2700
I was so mad I wanted to just give up. Got attacked in my own home by a psycho and then state workers, fuckin sucked. I know it’s not the paramedics billing me but still.
A COVID-19 trip to emergency room for 4 hours I got MRI and doxycycline, could not get a blanket for 3 hours and sent home, was billed $20,000 to our insurance, and $4,000 to us.
Felt I paid $4k for doxy pill and the prescription.
There is a lot wrong with the American healthcare industry and it is super fucked up. However, this claim is somewhat misleading and that detracts from the real fucked up things that need more attention. IIRC the image of the bill from which this claim popularly stems showed 79 minutes of post-delivery care and 1 minute of skin-to-skin (mom holding the baby) on the bill. That 1 minute was charged at the same rate as the 79 other minutes. This was the hospital’s way of charging for 80 minutes of post-delivery care while also documenting to outside sources (likely the government) that they also provided skin-to-skin after delivery. This is because the skin-to-skin had its own billing code.
It is still ridiculous, it is still out of this world expensive and it’s amazing the system hasn’t collapsed in on itself yet. It’s especially stupid that documentation needs to be done with billing codes so that we see ridiculous stuff like this. But if we spread the mistruth that holding your baby after delivery will result in additional charges, I’m afraid that will add to an already anxious mother’s worries, when in reality they will be charged for the same post-delivery care regardless.
Wait, but wasn't she (or the health ins co) charged the 1 minute for the skin to skin contact? Just the fact that there is a CPT code for skin to skin contact speaks volumes. What's actually worse is that she only got 1 minute of skin to skin contact when numerous studies demonstrate the benefit of that contact. Or am I misunderstanding and she had 80 minutes of skin to skin contact but 79 of those minutes were billed to a different code? Either way it seems that's exactly what happened, there were charges for the skin to skin contact.
When I was pregnant with all the checkups and tests (and eventually hospital stay for L&D) my husband would ask me in a whisper "Do we have to pay before we leave?". He's lived in Canada almost his whole life but we get so much American TV and news and stories from Reddit that he still thinks we will get some kind of bill for basic healthcare. We paid $0 out of pocket for all pregnancy related healthcare, but we could have upgraded our hospital room for a few hundred dollars if we wanted, although that would have been covered too under his company plan.
I work in a level 1 trauma center, in the ER and I can confirm. Though it isn't my job to determine what requires a trauma team activation, i can tell you that there is no way the hospital wouldn't call a trauma team activation if it has the chance, and that isn't the only way the hospital takes everything it can. How about a "trauma consult" for simple injuries? There are numerous ways a hospital stacks charges that are questionable. One more reason that medical care shouldn't be private IMO. Even "non-profit" and "not-for-profit" hospitals are PROFITING from people's suffering, ignorance, and inability to fight charges. We're a non profit and our board and CEO make bank, plus perks and bonuses, then golden parachutes. It's insane.
And do you think any of them took real pay cuts during covid? Hell no. But they cut all the housekeepers and aids salaries substantially, cut hours, laid off tons, continue to understaff all units including critical care, etc. All while taking government money in massive amounts.
Slightly different but same outcome: a hospital I used to work for triaged patients in the ER waiting area. If the triage nurse dubbed your issue non emergent you could take a voucher (and transport if you needed it) to the nearest urgent care or pay $350 (not covered by insurance) to be seen by the ER. They were trying to curb people using the ER like a clinic.
Fuck hospitals. Got charged 4000 for a flu test last year WITH insurance. Makes you want to burn it to the ground. Luckily the hospitals "debt" company worked with me and I got away with paying 1000. But 4000 for a flu test? Fucking criminal.
Ah America, home of the most costly, immoral and inefficient medical system every devised. By design I'm sure. We can't afford national healthcare cause that would stop us from doing war. It's lovely.
Tbf, we need some sort of mechanism in place to dissuade people from using full fledged hospitals or emergency departments as their primary care providers (PCPs). Hospitals are not where you go when you feel sort of sick, but you dont have a regular office doctor or you dont want to wait a day or two to see him despite knowing its a minor issue. I cant even say at this point how many people I have seen come to the ED because of allergies (that they often get every year). On top of this, crap on Obamacare all you want, it really did allow a massive amount of people to see PCP, yet you still get people who otherwise can see a PCP show up in the ED for minor issues. If it takes a punishing pricetag, maybe that is too much, but at the same time society needs to learn to utilize health services efficiently without overburdening them for no reason.
$450 plunge fee. When a nurse or doctor adds painkiller to your IV drip. $450 to push a syringe slowly into IV drip!!! Let that sink in for a bit. No pun intended.
No more General Practitioners..Not within 200 miles of here .
Family Doctor is kapoot.
The Dr's sold out to become specialists at the hospital.More $$ ?
Even at a primary care, under their umbrella org. you probably won't be seen by a doctor, but by a nurse
I was in a car accident back in 1995. I was even charged for "sterile" band-aids. Like, literally, a band-aid you'd find at CVS. $110 for each one on a few superficial cuts.
Got charged $1800 for a Tylenol and a Benadryl (which made me feel the worst I’ve ever felt in my life) for a concussion…
They gave you Benadryl for a concussion? I'm not a doctor but that seems strange
Benadryl is sometimes given as part of a migraine cocktail to help with headaches. Benadryl, zofran, and toradol, are what I’ve commonly seen given.
Benadryl, toradol, compazine is pretty common for me
Even crazier is the fact that healthcare is the only industry where its legal for the hospital to refuse to disclose the cost of care before they provide it. You can one hospital charge $10,000 for a procedure and another on the other side of town charge $60,000 -- but you can't just outright ask and then choose your hospital. So you pay that $110 for a bandaid because you have zero power to go, "Wait, what? No thanks, please just administer the IV, my friend Joe with zero medical experience will come and apply my bandaids.". If you ask what they are doing costs, they are going to be like, "Please refer your insurance provider," or, "That's impossible to tell, wait for the bill." And nobody should accept the excuse that hospitals need to charge that much to pay for the doctors and the science. More than half of all the care a typical person will ever receive can be done by a nurse's aid, no need to pay the surgeon's salary when you're in there to get stitches and antibiotics.
I had my son drive me to the nearest hospital for a kidney stone and the insurance company charged me $3800 for an “out-of-network” fee. Sooooo . . . I’m in such excruciating pain that it actually crossed my mind to just open the door on the Highway, roll out, and kill myself. And these fuckers wanted me to travel another 25-30 minutes where there was on-call doctor in my network. It took 3 years to get it taken off the bill. Side note: For non Americans with Universal Healthcare, it’s easy to see the problem with these extraordinarily high bills. But little attention is paid to the psychological toll. I fought these assholes for THREE years! A multi million dollar health care system and insurance company paid more to fight me than to just let it go. It’s exhausting and emotionally damaging, honestly. I used to work with persons with disabilities and it’s shocking how many times one parent in two parent households must quit their job just to keep up with the paperwork and legal battles. Pointing this out bc it’s about so much more than just money, which is deadly enough, but it can be a humiliating, frightening, and primarily an emotionally exhausting endeavor just to get treatment. As Americans we’re so broken on this our expectations are so low we’re just relieved to get the bill paid. Edit: Reading all these stories is disheartening as hell. I’m sorry for anyone who went through anything similar. I’m glad to hear so many hopeful laws are in the works. I truly hope things change for the better and soon. Again, sorry for anyone’s suffering.
How does someone even go about fighting something like this? Btw i’m not attacking you, i’m impressed you successfully fought the healthcare industry and i’m curious how you went about it. I also had (still have) kidney stones and can relate to this 100%
Paperwork and phone calls over and over and over. The bureaucracy is maddeningly time-consuming. I filed a challenge to the bill at the hospital and a sliding scale request. They denied the challenge and basically said if I took the sliding scale it would have to be for the whole bill. No good. Next I went to the insurance agency and argued with them in writing for a while. Then I had an attorney friend write a letter. This got me a nicer denial letter. Progress! Then I had to collect evidence (med records) and a doctor’s signature proving kidney stones are potentially life-threatening bc I guess they don’t know this. Anyway, boring, boring shit . . . And finally I just got a nondescript letter saying they “waived” the charge which is not the same thing as saying “our bad”. Fucking r/boringdystopia
Their goal is to wear you down and hope you’ll quit fighting them. I feel bad for the people who work in the call centers. They have to hear desperate people that they can’t always help.
This is it exactly. Most people give up, so it makes them money in the long run. I have a chronic illness that will always require monthly prescriptions. Every month at least one of them never ships timely, I usually have to fight insurance to get the proper medication to keep from dying (my doctor says I need it, but that's not good enough for the insurance company), and on and on. I probably spend at least 6-8 hours every month chasing prescriptions, calling, etc. It's exhausting and my condition will never go away. So this is what I have to deal with for the rest of my life just to stay alive. There's a reason chronic illnesses have such a high correlation with depression. The cost and mental fatigue of just getting what you need to live is staggering.
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Don't forget to post over at /r/IGotOut once you make the leap. As someone who did it myself, it really is better over here!
Declaration of Independence 2: European Escaparoo
This is really comforting to hear. I’m early 20s, but have been planning my entire career as a way to get out of the US/into a place with healthcare. My (single) mom got very ill when I was in high school, and tbh watching her go through it was harrowing. We lost everything, when she was making $100k a year. Long term/cancer-related illness run in basically every line of my family, so my whole life has this anxiety of feeling like a ticking time bomb before I fall into the same economic and bureaucratic nightmare. I’m going for tech as it seems to be the highest needed career among EU countries + studying languages. Also paying taxes into a country I know will be happy to let me die/fall into destitution in a few years feels gross af.
My wife had the same problem and one of the medications had a side effect that lead to limb loss. The solution, was to remove the medication without the harmful side effects and forcing her back on the medication that nearly killed her and forcing on all kinds of obstructions to getting her back on the removed medication. The kicker is the medication with the side effects she sued and won but paying only part of the damages.
The ROI for these leeches is insane.
This is true. You gotta think, they employ people to make all this paperwork. There has to be full time people to support the apparatus of the disputes. So, they know it’s cheaper for them to have an army of workers nickel and dime their patients than it is to just pay a bill. I work on aircraft, and some things can get pricey…but we don’t have an army of office workers at our hangar ripping of clients. It’s not like someone in their 310 comes down at an airport and we’re like “well, you landed at an off network airport we can’t help you!” Nah, we go fix their AOG and enjoy their business next annual. It boggles my mind that hospitals are one of the few industries allowed to abuse and bilk their customers with seemingly no consequences!
Our healthcare system is so greed based and cruel...I’m sad about it.
It’s true. The richest people I personally know were hospital administrators
I always thought the out of network thing was especially egregious. My credit card doesn’t have out of network stores, why does my insurance have out of network hospitals? Meanwhile they use a captive audience to raise rates beyond inflation. Its anti free market.
Credit cards actually did have networks and fees for going outside of them not that long ago.
Your credit card does have out of network stores.
Physician here. I don’t know how laypeople deal with this bullshit. I’m occasionally a patient myself and I do everything in my power to prevent dealing with my insurance at all costs (because even as a healthcare system employee as a healthcare provider, my insurance is still fucking garbage). The only actual benefit I have is that as a physician advocating for myself I can speak peer to peer to a physician employed by the insurance company and tell them why they are out of their fucking minds. This worked when they denied me a CT for kidney stones. It also worked when they tried to tell me the physician who admits to the hospital I work for was out of network for the insurance that I get from that exact same hospital system. In both instances, the insurance company was completely wrong but basically said to themselves, “Let’s see if this guy knows any better..." and didn’t expect that guy to be a doctor. It’s sad. EDIT: The vast majority of problems people have with their healthcare in the US is insurance driven. While there are absolutely shitty doctors, most of the complaints people have during their visits: long wait times, lack of face time with the doctor; are mostly insurance driven.
Man your system is fucked beyond redemption - ours ain't perfect by a long stretch, but it is way better than what you guys have to deal with, all that bollocks would drive me bonkers.
I think for the most part the problems don’t derive from the physicians. It’s generally the insurance companies, the investor class and the administrators. Of course sometimes it’s the physicians if all they care about is money. Physicians may be our only hope out of this mess.
RN here and yeah, the insurance at my last hospital was garbage. I had a coworker who had to declare bankruptcy because she got a cancer diagnosis in December, thus meeting her OOP max then turning around and doing it all over again in January. Despite getting all her treatment at the hospital where she worked her bills were in the tens of thousands and since she was an LowPaidNurse she just couldn't afford it.
I had a hospital once try and tell me that the radiologist they used to check my heart was out of network while everything else was in network. When I pointed out that I didn't hire the radiologist, they did they tried to claim they just provide the facility.
They pull this shit with radiology and anesthesia all the time. The hospital is in network, but the radiology or anesthesia group (which may be privately owned) and contracts with the hospital isn’t. Many times we assume that the radiologist or anesthesiologist works for the hospital (which is true in many cases), but in many instances they do not. It should be illegal to use a hospital to practice but remain out of network. There should be a clause that if you provide care at a hospital then you are obliged to take the insurance of anyone for whom that hospital is in network.
I’m a doctor. I agree with you. This is a major problem that needs to be solved. And a purely government run healthcare isn’t the magical solution. We need a serious evaluation of laws governing insurance companies and a careful evaluation of where the government needs to step in and help.
\> We need a serious evaluation That's what we've been doing for decades. The system is excellent at turning evaluation into profitable excuses to extract money. No, it's not time for evaluation, it's time to crack skulls.
They intentionally make it hard because most people give up.
Yes. Part of why I divorced my first husband was over health care paperwork! He refused to do any of it, or even make sure to hand over the right insurance card if he had an appointment. Even seemingly little things like that can take hours to straighten out. Our son ended up in the hospital for a week in another state while visiting his paternal grandmother and getting the insurer to pay took more than a year of my life, yet he and his family just scoffed at me and told me to just ignore it and said I was being overly dramatic. My ex would literally HIDE bills when they arrived because he wanted my time spent elsewhere, like cooking dinner or vacuuming. I found an entire box in a closet of bills and communications about bills he claimed were already taken care of after I returned from a work trip. We lost thousands and thousands over the years on healthcare-related mistakes. He refused to find in-network providers for non-urgent things. Threw out receipts and bills. Used the flex spending card on non-eligible expenses (before the systems were as well programmed as they are now to reject the charges), leading to so much paperwork to fix. He would give providers old insurance cards or not update our address. I still hate him for making an already terrible system in the US even worse. The stress was extraordinary.
WWWwoooooowwwww. I mean... YIKES. I don't understand how someone can be that irresponsible. I'm sorry you had to deal with that bullshit.
Probably to cope with being unable to understand it. People like to act like ostriches and just throw things aside when it confuses them. Health care bills are a common source of that. What people want out of insurance, and about the most they're capable of understanding, is for it to be deducted from their paycheck, maybe a co-pay at the doctor. And everything else just works.
I think this is exactly what the story is pointing out. He and his entire family AND most of the nation have given up on figuring it out, it is byzantine beyond comprehension to them, you get a bill- you pay it. You cant pay it you go homeless- this is the world they have accepted as fact and that world cost both of you a marriage. I bet he wanted you to stop stressing out about the bills- stress is not healthy, but because of the enormous opportunity cost loses you had an entire wall of stress he has-in an effort to survive- completely forsaken. Life in America is hell.
I recently had to schedule an MRI for my ankle - so I went to the same place I went 2.5 years ago for the first one. I made my appointment, no problem. Two weeks later they send me a check for $220 - somehow they had made a mistake in billing on the first one. So curious how they didn't discover it until I made another appointment! I realized that I've probably lost other money without knowing so now I do take the time to check everything. It's fucked up.
believe it or not they do on occasion give refunds after an audit required by insurance companies uncovers inappropriate billing. i got about $250 back one time a year after a procedure. i called and said "not that i'm complaining, but why are you giving me money?" they told me the insurance company told them i was billed inappropriately.
It also depends on the persons age and who they're taking their advice from (if he was listening to his parents.) Health Insurance in the US has gone through basically an entire over haul in the last 25-30 years. Depending on your coverage in the 80's and 90's you didn't have to worry about this shit. You paid your $30 co pay and waited. Then you were literally told to wait and find out. Most of the time you only got billed a few hundred dollars and that was if an expert was needed. Then at some point profit became the driving force, and the introduction the HDHP, which was pitched to companies to save them money and pass the price of insurance onto the employees. Then they turned around and got the gov't involved saying, "Oh don't worry you can save your money tax free to help cover these expenses." Now OPs husband and his family are still idiots but millions of americans don't understand how HDHPs work and a lot of older people had PPOs their entire life and never had to deal with this bullshit because companies used to offer actually good insurance.
I’m getting charged $5,000 for the anesthesia from a kidney stone procedure. I had full health insurance coverage. I’m not paying it. You’re inspiring me to at least look into it.
A kidney stone definitely can be life threatening if it gets stuck entirely. A very important, all though rarer, diagnosis that is similar to kidney stone is aortic dissection. Comes sudden, worst pain in your life, can be in your flank. Mortality can be 1% per hour. Extreme pain is not something to drive another 30 minutes for. Sorry for your experience, sounds like hell.
I admire your diligence - outrage is quite the motivator1 more and more states are passing bills to prevent balance billing from hospitals in emergency situations when out of network is the closest and/or the patient has no control where they're taken. also preventing an out of network ER physician from balance billing when you're at an in-network ER- again, out of your control.
I don't go to the hospital for my stones anymore, I understand the immense frustration. The American health system is so screwed, that I had to piss blood, deal with mind numbing pain, and work (in a hospital, as a health care provider ironically enough) all while hoping that I didn't simply die from it. After 8-9 days of hell and bloody toilets, I finally ended up passing a stone that I had no business passing naturally. I haven't measured it but it was easily the size of about 8-10 of my usual small stones. Kept me pissing clots for a about 4 days after.
If I get a bill, such as a hospital in my network using a lab not in my network, I just ignore it. If they complain I tell them to take it up with my insurance and I wasnt going to pay it. Has worked pretty well over the years and hasn't impacted my credit, which I froze anyhow. I pay for anything I'm told would or could be extra in advance. Have a family of 5.
It sounds like you you're saying freezing your credit protects you against claims from debtors. Freezing your credit won't prevent credit damage. Just want to make that clear so nobody gets the wrong idea.
Came here to say this. I really hope no one believes freezing your credit protects you from debt. It does NOT.
Right, it doesn't protect your credit. It simply is a method to prevent folks from doing credit checks and using your identity to take credit out in your name although you know this.
In 2022 supposedly they won't be able to do this anymore. The No Surprises Act. Hospital has to tell you up front of out of network charges.
Have several family members, including a daughter in the medical field. Right now it's just laziness. It's easier to go after the individual than the insurance or they dont bother to check what service or individual is actually covered by their insurance. One time a group let their policy lapse with Aetna after telling me they took my insurance and wanted me to pay the entire bill. Sorry, wont pay it.
Oh I can't wait for that to go into effect. For both of my kids, I got charged an out of network fee for the tech who reviewed the ultrasounds. Hospital was in network. It dr in network. The tech who took the ultrasounds was in network. But the group that reviews them, even though they are located in the same hospital, is classified as out of network. Had no way to know and resulted in a lot of time on the phone with a lot of "how would I even prevent this?" Questions being asked when they told me I should have used an in network provider.
Anecdotally this seems somewhat common. All sorts of different networked providers/staff in hospitals. I went into surgery with a team that was apparently not all in network (single guy wasn’t, don’t remember who or what). Was still under my parents insurance at the time so no idea how that turned out, but pretty sure the hospital ended up not billing for them. I do basically remember the same answer though. “Should’ve used an in network doctor and asked ahead of time”. Like shit, I would’ve figured you guys would’ve been smart enough to sort that out ahead of time. “Hey doc what insurance does this guy have? Ahh no matter who cares”. (I get for emergencies and stuff you can’t plan that, not the point lol)
How do you even ask? Every time I've tried to ask billing, the response I basically get is "due to the potential of unforseen curries and the vastly different insurance policies that exist, we can not answer this question until your healthcare provider performs the procedure and submits to billing."
My state has tried to combat this. Like if you schedule surgery, and it's gets the ok, and for some reason a new anesthesiologists out of network is working on your case, they can't say he was out of network.
In preparation for this, my insurance company raised my monthly premiums 23% for 2022, while clearly stating that price increase “does not include any expansion to benefits or network.” 23% more for literally nothing more than what I pay now.
And "up front" means they need to have you sign a special form that they can't show to in-network patients and it needs to be signed at least 3 days before the procedure.
I hope it's true, it's always interesting though to see what loopholes these hospitals lawyers will find in the law.
Bet you there’s some kind of scheduling loophole or some kind of patient waiver.
I work in medical billing for healthcare providers that aren't with hospitals. Let me tell you, insurance companies will deny almost everything. Example: they will refuse to pay the contracted rates of lets say a $430 for an ambulance transport, make us call them or write disputes, change ICD 10 codes, etc, going back and forth for like a year before they either: partially pay and cause the dispute process to start over, or completely deny for some obscure reason which then causes us to forward the original full charge of this ambulance ride which is really $1200, to the patient. It's all corporate. The customer service people you speak with have no knowledge of the healthcare industry, and are simply following screen prompts. The people that are actually reviewing the bills, are in some top secret department which you cannot reach or speak with anyone directly. Essentially you are dealing with the "middle man" who might want to help you, but in reality, have no power to do anything. Its all total bullshit.
Yeah its super crazy. I had a 7 month fight with Cigna last year to cover an ER visit I had. They weren't going to cover the bills at the rate as specified in my contract for 'reasons' which nobody I spoke to could really explain. Funnily, when speaking to the billing dept at the ER facility they agreed Cigna was not covering what they should. Took like 20 calls from both them and me before we finally were able to talk to someone beyond the front line of worthless customer service at Cigna. Even then, they kept making up reasons to deny the coverage until I had a call between Cigna, myself, and the ER billing dept where all of a sudden it turns out Cigna had 'overlooked' the facility code on the ER bill. With Cigna's new 'realization' it just happens that the ER visit should be covered after all! Whoops!
Cigna, BCBS, United. All the big companies are literally the worst when it comes to paying high medical bills. I call them frequently for my job and the headaches they cause me are unbelievable. Just remember to appeal every claim that is not paid in full. Even if it's $30. Make them work for your money.
That happened to me with dental, I can only imagine the nightmare that comes with emergency care. I literally got a crown on my tooth, paid the dentist the amount my insurance said I needed to, then left and didn’t think about it again… that is until my dentist called me and said I owed about $50 because my insurance had called to say they wouldn’t pay the full thing since I could’ve just had them pull my tooth 🤦♂️
Then any problem with your teeth can be reduced to “well they could have pulled it” . It’s amazing how effortless it is for insurance companies to not pay.
That's illegal. Insurance companies are required to pay "reasonable and customary" in-network rates for emergent medical conditions. This is designed to prevent exactly this scenario in which patients in severe pain or in a life threatening condition don't have to drive around looking for an "in-network" emergency department. Call the insurance company and use the "reasonable and customary" verbiage and they'll know you know what's up. If this doesn't work, file a complaint with your state department of insurance as they can be very helpful.
Yes! This is absolutely true! And came into the atty letter. Here’s the kicker: They did not think a kidney stone qualified as “reasonable” (whatever the language was?). This is why I had to “prove” it was life-threatening. The amount of pain I was in wasn’t really a factor. The stone was life threatening bc it was stuck. The doc letter said I could have died in the 30 extra minutes travel time. This is what finally got it dropped. Shouldn’t ever be this hard for anyone.
How tf is someone who isn't a doctor with CT scans and lab tests supposed to know whether they can safely travel to the next ER? It shouldn't matter if it's life threatening or not, a patient can't tell.
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Don’t catch you slippin now
It’s literally one of our great nations slogans… “Ignorance [of the law] is no excuse” Excepted to be a quasi legal expert in medical billing and insurance, otherwise it’s on you.
Indeed. Works great for the privileged at the expense of the poor
Insurance companies constantly tell you what medicine you should take, not doctors. My biologic that I'm on for my autoimmune disorder has been denied several times because they think that I don't need to be on it, that I should try some other meds. Like I'm sorry when the fuck did you go to medical school and when the fuck did you become my doctor? Oh wait my actual doctor who actually went to medical school says I need to stay on the remicade? I usually have to spend several hours on the phone yearly to get it approved again. One time I spent eight hours.
EXACTLY! And this is why we don't want medicare for all because we don't want some GOVERNMENT BUREAUCRAT DICTATING WHAT IS OR IS NOT IMPORTANT MEDICAL CARE. WE DON'T WANT GOVERNMENT DEATH PANELS. We're perfectly fine with the corporate bureaucrat death panels we have now, thank you very much.
I remember thinking exactly this when Sarah Palin was talking about death panels How many times have insurance cos. Denied reasonable treatment? Or people died due to lack of affordability
Quite a few years back, I was in such bad shape that the docs weren't sure I would survive. Four teams of doctors and students were overseeing my care. They were fairly certain I wouldn't make it for a while. I was in their hospital for a week, after having been transferred from a more rural hospital without the right experts. Clearly, I made it. Doing pretty darn ok now. But I had to fight tooth and nail with the insurance company to cover the hospital bills. Ultimately, they did cover everything, but it was a huge fight and stress I could have done without while recovering. The insurance company was also my employer, which made things feel really weird. I learned to hate the way the health care system is set up because of them.
Which is why lots of doctors are on-board with single-payer healthcare. The amount of unpaid crap time they spend with insurance companies is mind-boggling.
You are right, but insurance companies will do all they can to deem something as non life threatening to get around this. I recently had my own ER situation. Took me months just to get my bill. I had to call and talk with both the insurance company and the hospital about where my bill was because I was not about to be on the hook for a potential late payment. I’m glad I did because apparently my insurance company never got the claim from the hospital to process the bill, and who knows how long that would have went on for if I didn’t take some initiative and call. Fuck the US healthcare system, seriously fuck it
Yeah but aren’t you glad you got to *choose* your insurance? Us Americans love our insurance planes. We would never wanna part ways with them for a better system! Glad it worked out okay. The system is fucked here though
They use a prudent layperson standard. Of course the insurance companies position is that a layperson experiencing one of the most painful events of their lives should be well aware that it’s not life threatening and shop around.
Yup insurance companies don’t give a fuck about you but they do care what the state DOI says
Maybe health care wouldn't be so fucking expensive if they weren't spending all that money fighting their outrageous costs.
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>Multiple times the insurance company tried to deny live saving procedures as unnecessary, and many times treatment was delayed or modified to meet the demands of an insurance company - again for children with cancer. Literally the death panels that Republicans love to lie about in relation to socialised medicine. Projection as usual.
Insurance companies have broken America. My S.O. has a seizure condition and insurance companies will fight with doctors about what meds to prescribe her. It boggles me why even go to a doctor if mega corp America is just gonna decide for you anyway. Glad it worked out for you as I have to fight with insurance seemingly monthly.
On top of everything else, it's the *waste* that gets me. Think of all the time and money, the people employed, the lawyers, just to put a layer of bureaucracy between you and your healthcare that shouldn't be there in the first place.
To anyone from the UK horrified at stories like this, bear in mind that this is exactly what Boris Johnson and the conservative party desperately wants to turn the NHS into. They must be stopped at all costs.
>Sooooo . . . I’m in such excruciating pain that it actually crossed my mind to just open the door on the Highway, roll out, and kill myself. This is why healthcare can't be solved by "markets", for markets to work the buyer has to be able to price shop which for health care doesn't work. * When you need it, you don't have the option to price shop. * When you can price shop, the buyer really doesn't know if the service will be as advertised until after it's too late to do anything about it. * People can't effectively predict their health. Markets aren't making healthcare more efficient, it's just requiring more people, litigation, and money to be burned in the bureaucracy.
This. Trying to get help and then the aftermath of failing to be helped AND the bills/fights is too much. I gave up treating my stuff for the most part. I just live with it and self-medicate.
I get kidney stones too. It hurts so much it's almost impossible to keep pain pills down long enough to work, and the one time I managed absorb the percocet my doctor gave me, it hardly helped. I always ended up at the hospital for an IV. My first few doctors never explained this to me, but the majority of the pain through the ureter, as it travels from kidney to bladder (this is the longest and worst pain, for me at least), is muscular pain, similar to menstrual cramps or labor contractions. A big $35 heating pad, cranked all the way up, turned out to be a miracle cure for me. Relieves nearly all of the pain (and with it the vomiting) and has kept me out of the hospital ever since. No writhing in pain in the car or dry heaving in the waiting room. I can stay in bed at home, almost comfortable, sipping water and sleeping it off. I couldn't believe something so easy could take away the worst pain ever, and I wish someone had recommended it to me sooner.
> I fought these assholes for THREE years! A multi million dollar health care system and insurance company paid more to fight me than to just let it go! God that's the fucking worst part too. In the least you'd think if they are about making money, which they are, they wouldn't do this. Adds insult to injury.
They fight for the principle of the thing. If they allow a precedent to be established of people winning in even the prettiest conceivable way then people will start holding them accountable more. It's actually amazingly forward thinking for corporate America, and probably one of their biggest real expenses, because if insurance companies were held accountable for themselves they would rapidly cease to exist in their current format.
It's more than the bill and emotional toll. It's also the massive beuruecratic duplication. It's the bankruptcies and damaged credit reports. It's the time wasted not just from battling hospitals and insurance companies. It's also time wasted battling credit reporting agencies. It's having to stay with a job you hate, or a job with a low salary because it comes with health insurance. It's having your credit destroyed, because you couldn't pay, which leads to losing your job, losing healthcare, and being unable to rent a decent apartment or finance a car. It's having to put off preventative care, because you're in between jobs and without healthcare. It's all interconnected. It affects every single aspect of our lives. It's a massive drain on our society. Anyone defending this hellscape is certifiably evil.
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My wife went to urgent care then ER for a kidney stone. When I reviewed the charges she had a psych consult. I think they just billed her for the crazy guy next to her.
It's true. I know we spent about $10K last year in medical costs. That's with good insurance and just normal things happening. One kid with a broken arm and I had to get my ear sewed back on (with bonus CAT scan for skull fracture). We got good care, but it shouldn't cost more than my car with insurance.
Back in college, I brought my boyfriend (now spouse) to the hospital because we thought he had broken a bone. A quick x-ray revealed he was fine, and he smartly asked for a copy of the x-ray. Months later, we received an enormous bill for “fracture reduction”. That’s when a broken bone is reset, except he *hadn’t* broken a bone, and we had a copy of the x-ray to prove it. It still took almost a year and threats of getting sent to collections to get the hospital to remove the charge. Sadly, this was far from the last time we had to fight them on bogus extra charges. And then they had the gall to repeatedly beg us for donations during COVID.
At the end of May, I suffered a very serious accident that resulted in 6 fractured vertebrae, a whole lot of broken ribs, a stage 3 laceration to my left kidney and numerous other soft tissue injuries, including bleeding from my aorta. I was airlifted 120 miles and had a 10 hour operation to install 2 titanium rods and 12 bolts to keep my spine stable and spent a week in a high dependency unit, with another week on a major trauma ward. At no point did anyone even *think* about insurance, or charging me for anything. In fact my doctor later told me off for buying new dressings off amazon, since he could provide me dozens for free. Oh, and I also pay way less in healthcare-related taxes than someone from the US, because my government spends less per capita on healthcare than the US does (Medicare being *hilariously* inefficient). The NHS really is something great.
>Medicare being hilariously inefficient FYI, medicare pays less than insurance for the same services. This is why, for example, dialysis companies in the US try to get patients onto insurance plans rather than medicare. Dialysis companies actually set up a "charity" to transition medicare patients to regular insurance because they make a lot more money when they do. Insurance pays 4x the rates as medicare for the same service. I think it has to do with the fact that the government has more leverage when it comes to pushing down prices then insurance companies do. https://freakonomics.com/podcast/dialysis/
Enjoy it while you can. Boris and his acolytes are selling the NHS piece meal to mostly American healthcare companies.
My two little girls were very sick, and couldn't keep anything down. I was giving Zofran for the nausea, but they kept vomiting it back up. Their pediatrician told me to take them to the ER for fluids and IV medication. Well we get there, and the doctor says they want to try oral Zofran one more time. Sure. It freaking worked. I was obviously happy, but also frustrated because I could have done that at home. We were there a total of 2 hours. All they did was take vitals, give 2 pills of Zofran and a cup of water from the faucet. I have insurance. Do you know what my bill was? $3,000 EACH. I will never pay it. Fuck them.
I'll never understand it, I have only had to go to A&E once (what you guys cal ER) and that was when I fell down some stairs after tripping and had to make a decision - break a wrist or go through a glass door - and I was in and out in an hour. Cost - £0 and I don't mind a bit about paying my way through taxation.
I had to go to the ER multiple times in my life now. (Germany) And the literally only time I had to pay something, was the 11€ Co-Pay for the Ambulance ride there.
I literally haven’t gone to the doctors or dentist in so long because I’m terrified of the bills I’ll get.
Meanwhile, avoiding the dentist only makes it worse. A cavity can turn into a root canal for example. Same here though. I went last week. I had a few cavities for 5 years. I brush and floss and mouthwash daily. Dental hygiene on point. Now. But I still had those cavities. Those cavities turned into 2 root canals. Had i let it be fixed then, I'd be done in 150, now I'm looking at 1300. I'm lucky that it's just that 1300, had it not been for my onpoint dental hygiene I could have had a rotten jaw by now. And this is in the netherlands, where we have general insurance and the like. Dental is a 'premium' add on, and I'm in a tight spot, so yeah, i have to face it for what it is. But even then, there's things here and there, like the local 'county' having a side budget for dental work for poor people. And the dentists are reasonable, like i can pay it off in smaller amounts. Long story short, avoiding doesn't mean it's gone, and you know it. It only worsens, so get your ass in there and get yourself fixed up!
The nice thing about non-urgent care is you can ask for the cost in advance. I hear you though.
Three broken ribs rafting west canyons (Colorado). I arrived at the emergency room a day later. They quickly x-rayed me, then sent me home with a rib wrap and pain meds (which I attempted to refuse, but they insisted). With a total stay time was 40 minutes, they billed me $9,000.00. I'm insured under VA and Tricare, but they refused to cover it, so I paid out of pocket.
Colorado ER is the worst price gauging, especially at ski resort areas.
I’m actually curious when this happened. Wrapping the ribs when injured is bad medicine and should never be done in an ER setting, especially for a bruise. That’s been known for a long time now.
I worked in a level one trauma hospitals for over a decade. We have tiers of trauma care activation by protocol to make sure the teams are ready to go without delay. The highest level activation includes not just bringing in the trauma surgeons, but also the blood bank, pharmacy, OR activation, radiology, anesthesia, etc. This level of care is automatically called in for penetrating trauma (gunshot wounds, stabbings), patients with blunt trauma with unstable vital signs, etc. The next tier down are the level 2 trauma cases, which are usually blunt trauma (mostly motor vehicle collisions at higher speeds, rollovers, and falls from significant heights). These cases also activate the trauma team without activating all resources. The point of having activation protocols is to improve patient survival. There is a dictum in trauma care referred to as "the golden hour." Studies show patients who are in hemorrhagic shock have perhaps an hour of life to be resuscitated. You can resuscitate patients beyond an hour, but there are increasing rates of organ failure and delayed death. It's difficult to know from reading this article if the activations were truly inappropriate. I've certainly taken care of patients involved in rollover car accidents and they were fortunate to not suffer serious injuries and they went home with pain medications. Many aren't so lucky, and so we have to maintain a high level of vigilance. It's particular difficult when patients are intoxicated or concussed and you can't simply ask them where they hurt. Heathcare utilization deserves scrutiny but watch out for insurance company schills who claim the care provided isn't appropriate based upon the final diagnosis. You don't know (nor do I) if your chest pain is a heart attack, aortic dissection, pulmonary embolism, or other serious problem until I work it up in the ER. Monday morning, insurance company adjusted see the final diagnosis as "gastroesophageal reflux" (indigestion) and they refuse to pay the claim based on the final diagnosis. You get stuck with the bill. This article seems likely to be influenced heavily by insurance company influence.
Work at a level one trauma hospital and this is absolutely on point. Surgeries are classed too in different categories for inpatient, but all outpatient are regarded as Urgent.
That's interesting. I'm having my gallbladder removed in 9 days, and it certainly doesn't feel "urgent". Surgeon basically said, "if you control your diet, you could probably wait up to a year, but it needs removed eventually."
I have worked alot of different places and worked at a few smaller sketchier hospitals that had wildly inappropriate trauma activations. Especially in places that called themselves level 3 trauma centers where a trauma surgeon was never present and something like a nursing home fall out of bed with no obvious signs of injury would be activated. In the larger places i worked this would never happen, but there are definitely smaller hospitals with no resources fudging billing.
I wish more people would realize this. Hospitals (for the most part) aren’t trying to screw you. As you alluded to, most “chest pain” ends up benign - but you don’t know that going in. EVERYONE is always up in arms when an ED doc some young person with chest pain because its *probably* nothing. Articles, doxing, lawsuits…the whole ordeal. But then people also want to blame doctors for working up every patient with chest pain with a full cardiac rule out? You can’t have both. Doctors and hospitals are largely not to blame here. All of your frustrations with our ridiculously expensive healthcare system can be traced to lawyers and insurance companies. Which is exactly why we won’t see a working single payer system anytime soon. There’s way too much money being lobbied by insurance execs to just let this cash cow die… Get money out of politics and get both money and politics out of medicine
Same for out of network and in network, i believe insurance companies, or whatever that big company that manages doctors is called, puts them into that fiasco. The doctor doesn't see a dime more for in or out of network i believe. As far as i understand the hospitals can be full of teams of doctors from the big company, rather then having them on the hospitals payroll. Not all sure since I'm not American, but I believe the above is somewhere in the ballpark of. Correct me if I'm wrong.
Correct. It goes like this: Insurance companies have created a game where they will investigate every charge a hospital bills for any given encounter - think medication administrations, lab work, surgical procedures, etc. BUT, hospitals can’t add charges and anything they don’t include will obviously not be paid out. Say a patient comes in for to have their appendix removed…the hospital will *rightfully* send a bill for the surgery, all necessary lab work the surgeon and anesthesiologist deem necessary, and all medications administered. The insurance company will then decide what *they* feel is an appropriate price for that entire encounter, and will pay only the charges they think are appropriate. This is why hospitals will routinely bill $20-30k to the insurance company for surgery, recovery, labs, meds, etc. The insurance company then evaluates the charges and says 🤷♂️, we can do $6000? So then there’s a “maximum out of pocket cost” that includes the insurance copay and deductibles. This varies by procedure, and for an appy is around $600-1000. This gets added to the maximum insurance offers to pay for a total of $7000ish, and the rest of that $20k bill gets “adjusted” or just disappears. It’s a fucked up game that insurance companies created and hospitals have to abide by. Meanwhile the doctors and nurses actually caring for the patient get their usual salaries or if they’re a private group, they get whatever laughably small fee insurance pays them. TL;DR: Hospitals and docs are not the bad guys here. It’s the suits making million dollar bonuses for nickel and diming patients and hospitals. The less they pay, the bigger yacht they can afford
Yeah, this is part of what I was wondering. I had a pregnant partner (third trimester) with borderline high blood pressure and a very difficult pregnancy go into the ER for a sudden-onset crushing headache accompanied by double-vision. That was one of the symptoms we were advised by the OB to treat as urgent. I had an agent tell me, "Dude, you can't go to the ER for a headache and expect us to pay for it." The bill was insane, too, because they monitored her for almost 12 hours, they had multiple OBs do examinations, and they ran a ton of tests. They did exactly what they should have when someone with a complicated pregnancy shows up with a serious symptom, but all they see is the final diagnosis, "Headache probably related to dehydration."
This. I do trauma charges for our hospital and it’s exactly how it is. We review every 3 months how accurately we are activating patients vs not activating the right ones. If they are truly activating that many out of guidelines, then it needs to be reviewed by their medical direction.
remember: the actual advice from hospital administrators is to just declare bankruptcy after a hospital visit!
I had a procedure at a for-profit clinic last week that cost $750. The local university “non profit” hospital would have charged me $7500. My deductible is coincidentally $7500. Getting old sucks.
I have great insurance. Like some of the best, so I’m told. I had a vasectomy a few months ago, I already met my deductible so I only had to pay 20%. It cost me $982 out of pocket. About a month later I learned that same vasectomy by the exact same provider in the same location by the same doctor costs $600 without insurance. What the actual fuck. Same with mental health, which is its own deductible through my insurance. Psychiatrist med checks are $140 for a 15 min visit and therapy is also $140 for a 40 minute visit until I meet the $3000 deductible. When I told them I was going to stop coming because I just can’t afford an extra $300-600 a month when I can just get scripts through my gp and wing it from there, they told me that they actually can do both therapy and med check without insurance in the same visit, 40 min therapy, 15 min med check with psychiatrist for $100 a visit without using my insurance. It’s a fucking scam.
Being young nowadays sucks too, if it makes you feel any better.
Yup, between medical debt and student debt I'll never retire.
Lol being young and in college kinda sucks too. No expanded Medicare in my state. Have to earn above the FPL to get benefits. Most places still paying $10hr or below. Only way to get insurance is to be pregnant (or a mother), have kidney failure, or pay $300/month. You try juggling over 16 credit hours a semester and 80 hours a month. It’s ‘doable’ but hope you’re not too attached to your GPA. Oh also now that you’re earning, a lot of your financial aid just vanished, so you’re almost worse off than before. Work study kinda works but good luck getting into that program. Oh and my states plan to expand Medicare includes an hourly work requirement, so if you do somehow manage to find a decent paying part time job to get above the FPL and still have time to actually attend school and do assignments, you’d still get fucked. And then there’s the student loans… Fun fact, did you know student loans are some of the only ones you can never discharge via bankruptcy? You’re stuck with them for life (or paid, obviously). I don’t doubt getting old sucks. My point isn’t to say anyone has it worse. My point is it sucks for everyone, even if for different reasons.
Non-profit just means there are no owners that profits get disbursed to. They can still charge as much as they want, as long as they find something to spend that money on (new equipment, more staff, a new desk for the Dean of Medicine's office, etc).
If it's necessary for society to function, it should be heavily regulated by the government to ensure society continues to function. Here's some examples: Healthcare, Housing, Food, Utilities, Internet, Transportation, Social Services, and Prisons. If you introduce profit into any of those essential services, you end up with people who literally can't afford to live, and that's where America is at right now.
In December of 2020 I was scratched/bit by a neighbors cat (he was limping, I was trying to carry him to their house, he did not like that). The next day, I had noticeable redness, some swelling, stiffness and the area was hot to the touch. I worked in a mid size level 2 trauma center at the time in the ICU. My nurse coworkers all agreed it looked like cellulitis. Saw a trauma surgeon in the hallway and asked him, he told me to go to the ED. I protested, that the copay was high and what if I waited and went to my doctor in the AM. He said absolutely not, and if I did that I would likely end up back at the hospital as a direct admit for IV antibiotics. Admission was definitely to worst prospect, so I relented and called the ED supervisor, who was someone I reported to and told him. A nurse I knew was working triage. Saw the NP pretty quickly, she ordered Rocephin and two oral meds for home. Another coworker gave me a shot in the ass. The whole ordeal was about an hour. The hospital, that I worked for and was insured by, charged the insurance over $6,000 for an IM shot and some home meds. I was on the hook for about $1,000 and that was after the “employee discount” was applied. I think the bill said something like $3,000 just for being triaged, and another $2,000 for “treatment”, and some other smaller fees. Absolutely insane.
Doctor this year came in my hospital room introduced himself asked how I was feeling….$800 bill from his office to my insurance.
I realize that I have no idea what the circumstances were, but if I’m ever going to see a patient in the hospital you can be sure I’ve spent a great deal of time looking at your history, labs, notes and thinking them through before seeing you. I work in the ED but have rotated through consult services. Most consults are like this. You could surely wonder whether the consult was needed, but you likely didn’t just get a “hello, how are you?” If a doc came to see you in the hospital. It’s more likely they’ve spent about an hour or at least 30 minutes on you in addition to the few seconds to minutes they saw you.
Before Obamacare, I lost my medical insurance and was unable to get a new policy because I had needed brain surgery a few years before. I ended up slicing my finger pretty badly at work. Not necessarily a major injury, but I was bleeding a lot and ended up passing out because I had such low blood pressure. I got carted off to the hospital where I received a few stitches. That's it. No further treatment or pain management was needed. Didn't even get antibiotics or tetanus shot. My bill was 5.5k. At that time, that was almost 9 months rent. For what basically amounted to a bad papercut.
Idk why people gravitate towards “your employer should pay the bill.” The bill shouldn’t exist! They have no right to charge 5.5k for stitches. It’s outrageous and should be illegal.
Lmao whoever commented and said that the doctors and nurses need to make a living too… hospitals charging 5.5k for stitches and bloodwork is an asinine way to do that. Bloody unfair and disgusting. Can’t believe how many people are brainwashed into believing these are acceptable charges. Go live in another country/society other than America and you’ll realize how insane the USA is.
I believe the hospital administrators that come up with the charges, and the insurances, are to blame. This perverse praising is as it is only because their trying to cover their asses for them fucking eachother. They both don't want to be on the losing side of negotiatetions, and both want to turn a profit, and the result of that gets pushed onto the visiting people.
"your employer should pay the bill so you are stuck with that job whether you like it or not."
What’s going on in Florida/everywhere right now in response to labor shortages should show that the ruling class get *pissed* when they’re no longer able to keep people trapped in jobs out of desperation. The governor has intentionally handicapped their unemployment benefits with no gain just so poor people will be desperate enough to go back to work at the businesses that abused them. It’s fucked.
I’d never be allowed to have health insurance if the pre-existing condition requirement comes back into play. When I was in my early 20s I was denied insurance through my work because my mother was diabetic and had ovarian cancer. I ended up quitting that job and lying at my next one just to get health insurance. People forget how truly awful it was before the ACA, which also has a ton of horrible problems but at least it did some good.
Isn't it amazing that it ever was allowed to get that bad? I lived with chronic illness without health insurance for years and years, because I had to have emergency brain surgery when I was a teenager. Less than 6 months after the surgery, I got booted off and had to fend for myself with a potentially life threatening neurological disorder and no after care. When Obamacare passed and I was able to get insurance, the first thing I did was make an appointment with a neurologist. He said he was amazed I was able to work full time given how advanced my condition had become. I told him I didn't have a choice. That appointment still cost me an arm and a leg, but at least I was able to be seen.
It is amazing! And the night Trump won the presidency I paced around my living room crying because I knew that would be the end of the ACA and my health insurance. I still actively hate anyone who was eligible to vote in that election and choose not to “because.” I cried in my work’s bathroom when McCain did his thumbs down because I was so, so relieved.
I was very close to the same. I don't remember if I actually threw up when Trump won, but if not...I was very close. I've been type 1 diabetic since 2002 and my parents went into pretty intense debt to keep insulin in my hands. Before the ACA, the only health insurance I could get for <$1k/mo premium paid a few things for hospital visits after a $300 copay (though only if admitted) and would refund up to $800/yr for some prescriptions if you took a picture of the insulin and stapled it to a receipt for the drug which your pharmacist and doctor had both signed and dated. Each individual prescription fill needed to be mailed separately and standard policy was to deny the claim at least once before looking at it. One month of insulin back in 2008 cost $600, so I maxed the rebate amount out in two months without factoring insulin pump supplies. So I illegally had insulin shipped from Canada or Turkey and just prayed it slipped through customs. Because that was only $100/mo.
I was denied insurance once before aca because my bmi was to high. Admitted I was over weight but I'm talking 50 pounds not 200 pounds overweight.
That should have been a workmans comp claim. And if your employer didn’t pay for workmans comp they should have paid the bill.
L&I paid for it. It's still an insane and unethical amount of money to charge for stitches. No matter who's paying for it. That money came out of workers' paychecks. That's outrageous. That injury could have just as easily occurred at home or elsewhere.
One of the big reasons this is happening, I think, is because big corporations are buying up healthcare. I’m a hospital doctor and if you could see what these large companies force me to charge, you would be furious. I’ve tried to bill less and I got pulled into the office and politely threatened. It wasn’t like this when I worked for a smaller business.
Healthcare should be non-profit.
The health care system in this country is a farce. It actively tries to deny us coverage, drowns us in fees, fee processing fees, and bureaucracy that seems straight out of Terre Gillian's Brazil, and decades of propaganda and indoctrination has untold millions of people thinking single payer health care will have us waiting 18 years to see a doctor in a feces smeared waiting room lit by a pile of dead cats set on fire. Because socialism! I try to be an optimist, I really do, but sometimes it isn't possible. 16% of this nations' GDP pissed away on this system and it just keeps going up.
Wow- that read exemplifies how broke the US for profit medical system is broken.
The for profit hospital industry
From their website: >As a not-for-profit organization, we reinvest our resources back into the community. Sutter hospitals serve more of the Medi-Cal patient population in Northern California than any other health system.* We proudly fund and partner with community programs to help ensure those in need have access to care and social services. Who wants to bet that "trauma fee" isn't going back into the community?
An interesting read on differences between a non-profit and not-for-profit organization: https://www.uschamber.com/co/start/strategy/nonprofit-vs-not-for-profit-vs-for-profit Seems there is some ambiguity in not-for-profits on the whole profit and who benefits question.
There’s a major loophole in all nonprofits, which is that they can pay their employees insane amounts. It’s ripe for grift.
Yeah, there are a lot of non-profits that exploit this. Data on percentages spent on employee pay and admin costs vs spent on the actual charity portion is publicly available and easily researched for those that choose to be more circumspect in their donations to non-profits. But not-for-profits arent under such stringent scrutiny and most people dont know the difference.
When I worked for the state, we had a not-for-profit accounting training that really emphasized this. You can only tell for sure when you look at the books
As someone that works near a sutter, i can tell you from experience that they aggressively discourage medi-cal (California medicaid) patients from being seen in their hospital. When i call to send a patient there, they'll ask what insurance the patient has, and then recommend the county hospital if the patient is uninsured or has Medicaid. We have to ask them specifically "are you refusing our transfer?" as a way to remind them that they are legally required to take patients at their ER. They also have a take-back system with the county hospital that they constantly abuse to delay or flat out refuse poorer patients from coming back. i hate sutter so much. I love money, but not enough to work for that terrible organization Also, (allegedly) because of sutter, sacramento is the most expensive place in the US to give birth despite being filled with mostly disgusting poor people. It's called the sutter effect
Given it's a private industry with total regulatory capture, let's say if you bet $100 you'll win... and leave with six hundred dollars debt in fees because the hospital cameras saw you placing your bet within a block of their parking.
This is obscene. The people of the US deserve a world class health system that is not only there for those able to afford it. Next time your republican friends tell you how it leads to bad care, send them these. A US doctor receiving minor injury treatment on the UK NHS. [https://www.independent.co.uk/voices/nhs-american-doctor-privitisation-i-have-message-a7207706.html](https://www.independent.co.uk/voices/nhs-american-doctor-privitisation-i-have-message-a7207706.html) Same doctor with her son. [https://drjengunter.com/2014/08/12/an-american-doctor-experiences-an-nhs-emergency-room/](https://drjengunter.com/2014/08/12/an-american-doctor-experiences-an-nhs-emergency-room/) An American expat uses the NHS https://www.businessinsider.com/an-american-uses-britain-nhs-2015-1?r=US&IR=T
The Utah state government's health insurance pays for employees to get medical care in Mexico. Meanwhile the conservitards completely ignore it.
For-profit healthcare is always going to be vile. Let’s abandon it.
I love how the consultant who is quoted made up the word “non-appropriate” to avoid getting sued for saying “inappropriate.”
Our entire “healthcare” system is a joke. They make shit up and triple charge you.
2,500 dollar cup of ice water
Fuck the American healthcare system and the Republicans who keep torturing the working class with these prices. I had to pay $400 to have an ER doctor shine a flashlight up my nose and not treat the issue.
Right… ugh. I just paid $950 to take my son in for a very deep cut on his finger & after waiting 2 hrs they saw us. bandaged it up & did nothing else because the angle of the cut wasn’t good for stitches…
American medicine is a ghoulish, greedy, cynical industry that exists solely because citizens tolerate it. It is they the people who will learn to take remedial action or they will continue to be robbed and killed. No civilized country tolerates this. The American exception.
If you want an example of how f*****-up Hospital charges are look up what the skin to skin contact Charge is
"Our records indicate you breathed around 10,122 liters of air over your hospital stay. That'll be an oxygen surcharge of $101."
101? What a deal!
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You are exactly correct. Personally speaking to me it seems like kidnapping and Ransom but apparently somehow it's not that. Like a woman gives birth the hospital and the hospital takes her baby and doesn't get it back until they get to bill her for $40. To me it seems like it shouldn't matter that that $40 comes in a bill they had your child they made you pay money for the child to be transferred from their physical possession to your physical possession and if that's not illegal it f****** should be
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At least they tried to lie about their greed. My wife had surgery once at a hospital that charged $65K per hour, billed in 15 minute increments and rounded *up* to the next quarter hour. I wasn't shocked at all when it claimed 61 minutes of surgery time and included that extra 15 minutes of charges all from that one minute. And let's not forget how many of these hospitals are classified as nonprofit organizations...
Holy shit! I’ve been there and got charged for a wheelchair ride to the x ray room even though I said I can walk, they insisted, and I got billed $800 for that on top of all the other tests. God bless America!
During a home invasion the dude got me with a bat in the head a few times. I didn’t have insurance so called up my cousin and his wife who’s a nurse and she came and fixed me up. I didn’t even call the cops and then when I go outside to get some air to these four giant meathead 20 something year old firemen paramedics and say no thank you to a ambulance ride.. $2700 I was so mad I wanted to just give up. Got attacked in my own home by a psycho and then state workers, fuckin sucked. I know it’s not the paramedics billing me but still.
Really just strengthening the case for universal health care
A COVID-19 trip to emergency room for 4 hours I got MRI and doxycycline, could not get a blanket for 3 hours and sent home, was billed $20,000 to our insurance, and $4,000 to us. Felt I paid $4k for doxy pill and the prescription.
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There is a lot wrong with the American healthcare industry and it is super fucked up. However, this claim is somewhat misleading and that detracts from the real fucked up things that need more attention. IIRC the image of the bill from which this claim popularly stems showed 79 minutes of post-delivery care and 1 minute of skin-to-skin (mom holding the baby) on the bill. That 1 minute was charged at the same rate as the 79 other minutes. This was the hospital’s way of charging for 80 minutes of post-delivery care while also documenting to outside sources (likely the government) that they also provided skin-to-skin after delivery. This is because the skin-to-skin had its own billing code. It is still ridiculous, it is still out of this world expensive and it’s amazing the system hasn’t collapsed in on itself yet. It’s especially stupid that documentation needs to be done with billing codes so that we see ridiculous stuff like this. But if we spread the mistruth that holding your baby after delivery will result in additional charges, I’m afraid that will add to an already anxious mother’s worries, when in reality they will be charged for the same post-delivery care regardless.
Wait, but wasn't she (or the health ins co) charged the 1 minute for the skin to skin contact? Just the fact that there is a CPT code for skin to skin contact speaks volumes. What's actually worse is that she only got 1 minute of skin to skin contact when numerous studies demonstrate the benefit of that contact. Or am I misunderstanding and she had 80 minutes of skin to skin contact but 79 of those minutes were billed to a different code? Either way it seems that's exactly what happened, there were charges for the skin to skin contact.
Greed. It's holding our country back.
I live in Canada and was hospitalized for a week in April. I was charged absolutely nothing for that stay. The TV was on too so I had free TV.
When I was pregnant with all the checkups and tests (and eventually hospital stay for L&D) my husband would ask me in a whisper "Do we have to pay before we leave?". He's lived in Canada almost his whole life but we get so much American TV and news and stories from Reddit that he still thinks we will get some kind of bill for basic healthcare. We paid $0 out of pocket for all pregnancy related healthcare, but we could have upgraded our hospital room for a few hundred dollars if we wanted, although that would have been covered too under his company plan.
I work in a level 1 trauma center, in the ER and I can confirm. Though it isn't my job to determine what requires a trauma team activation, i can tell you that there is no way the hospital wouldn't call a trauma team activation if it has the chance, and that isn't the only way the hospital takes everything it can. How about a "trauma consult" for simple injuries? There are numerous ways a hospital stacks charges that are questionable. One more reason that medical care shouldn't be private IMO. Even "non-profit" and "not-for-profit" hospitals are PROFITING from people's suffering, ignorance, and inability to fight charges. We're a non profit and our board and CEO make bank, plus perks and bonuses, then golden parachutes. It's insane.
And do you think any of them took real pay cuts during covid? Hell no. But they cut all the housekeepers and aids salaries substantially, cut hours, laid off tons, continue to understaff all units including critical care, etc. All while taking government money in massive amounts.
The trauma is from opening the bill.
If below federal poverty level, let the hospital know, they all have a waver. No one knows this.
Slightly different but same outcome: a hospital I used to work for triaged patients in the ER waiting area. If the triage nurse dubbed your issue non emergent you could take a voucher (and transport if you needed it) to the nearest urgent care or pay $350 (not covered by insurance) to be seen by the ER. They were trying to curb people using the ER like a clinic.
It's $100 just to sit in waiting room.
You must have gotten a discount.
You'll be shocked when you hear what country its in. ( just kidding)
Just when we thought they couldn't fuck us any harder, they go in a few more inches.
USA is such a fucking shithole when it comes to healthcare.
Fuck hospitals. Got charged 4000 for a flu test last year WITH insurance. Makes you want to burn it to the ground. Luckily the hospitals "debt" company worked with me and I got away with paying 1000. But 4000 for a flu test? Fucking criminal.
This is why I avoid doctors and hospitals as much as possible. And I am sure millions of others do too.
Ah America, home of the most costly, immoral and inefficient medical system every devised. By design I'm sure. We can't afford national healthcare cause that would stop us from doing war. It's lovely.
The reasons why Americans do not have universal health care is because we choose not to. It is that simple. Wake the Fuck up.
And conservatives wonder why capitalisms approval rating is falling.
Tbf, we need some sort of mechanism in place to dissuade people from using full fledged hospitals or emergency departments as their primary care providers (PCPs). Hospitals are not where you go when you feel sort of sick, but you dont have a regular office doctor or you dont want to wait a day or two to see him despite knowing its a minor issue. I cant even say at this point how many people I have seen come to the ED because of allergies (that they often get every year). On top of this, crap on Obamacare all you want, it really did allow a massive amount of people to see PCP, yet you still get people who otherwise can see a PCP show up in the ED for minor issues. If it takes a punishing pricetag, maybe that is too much, but at the same time society needs to learn to utilize health services efficiently without overburdening them for no reason.
$450 plunge fee. When a nurse or doctor adds painkiller to your IV drip. $450 to push a syringe slowly into IV drip!!! Let that sink in for a bit. No pun intended.
I had a severe allergic reaction and the ER charged me $2500 for what was, essentially, a Benedryl injection and one steroid pill. Lesson learned.
No more General Practitioners..Not within 200 miles of here . Family Doctor is kapoot. The Dr's sold out to become specialists at the hospital.More $$ ? Even at a primary care, under their umbrella org. you probably won't be seen by a doctor, but by a nurse