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> We are talking about ER rooms here: people who need ER services are not in a position to do any sort of shopping around. Yup. In 2006, I was in a serious bi

> We are talking about ER rooms here: people who need ER services are not in a position to do any sort of shopping around. Yup. In 2006, I was in a serious bicycle accident in San Francisco w/ some head trauma. SF General was the only hospital in the area with a (Level 1?) ER that treats head trauma. I also had two broken arms. Even though I was in shock, I remember very clearly asking everyone involved in getting me from the accident site to the ER if SF General accepts Blue Cross, my insurance carrier. I was more concerned with facing a giant bill than my own health. Eventually someone said they do take Blue Cross, and I stopped worrying. Later I came to find out that SF General bills Blue Cross, but they do not have a contract with Blue Cross. 100% of my treatment was out of network. Then I got a bill for about 50,000 USD. Between that, trying to pay for physical therapy, and a disruption to ability to earn a living at the job that paid for my healthcare, I struggled for a long time after the accident.

aaronchall 9y ago
Were you able to negotiate that 50,000 bill down?
- amorphid 9y ago
  Eventually, yes. It took more than a year, and I eventually had to ask Gavin Newsom, the Mayor of San Francisco, for help. I highly recommend never having to negotiate how much you owe to multiple healthcare providers, unless you enjoy red tape & misery.
watwut 9y ago
Isn't that in category of fraud? They lied you about pricing.
- amorphid 9y ago
  The people I was asking were ambulance drivers, paramedics, nurses, etc. They weren't prepared to answer questions about the nuances of insurance agreements the hospital has with random insurance companies. I can't blame them. And it's completely possible I was not asking the question in a precise enough answer to get the information I needed. My main point was that your basically screwed before you arrive, and you're just gonna have to cope with it after the fact. Expecting a patient going into an emergency room to understand, or have the capacity to, navigate "the fine print" stuff is not realistic, yet that's exactly what they expect that patient to do. It is quite lame.
  - watwut 9y ago
    That does not really excuse the institution and a company might be fined in similar circumstance. It is not really random that you don't have a choice and nurse can't answer pricing issues correctly. Both don't just randomly happen to be beneficial for hospital. A lot of financial fraud by larger I stitutuon work exactly that way - put low level employees into situation where they are frauding either without knowing or by default or under pressure. If all management has to do is look the other way and collect benefit (and eventually blame paramedic), they will look the other way and punish employees who took longer to get you to hospital - cause you prefered cheaper one a bit further away. I don't expect injured patient to protect himself perfectly. However, I think we would all benefit if we labeled what happened to you accurately - a kind of fraud - instead of pretending it is ok, because system works that way.

aaronchall 9y ago

Were you able to negotiate that 50,000 bill down?

amorphid 9y ago
Eventually, yes. It took more than a year, and I eventually had to ask Gavin Newsom, the Mayor of San Francisco, for help. I highly recommend never having to negotiate how much you owe to multiple healthcare providers, unless you enjoy red tape & misery.

watwut 9y ago

Isn't that in category of fraud? They lied you about pricing.

amorphid 9y ago
The people I was asking were ambulance drivers, paramedics, nurses, etc. They weren't prepared to answer questions about the nuances of insurance agreements the hospital has with random insurance companies. I can't blame them. And it's completely possible I was not asking the question in a precise enough answer to get the information I needed. My main point was that your basically screwed before you arrive, and you're just gonna have to cope with it after the fact. Expecting a patient going into an emergency room to understand, or have the capacity to, navigate "the fine print" stuff is not realistic, yet that's exactly what they expect that patient to do. It is quite lame.
- watwut 9y ago
  That does not really excuse the institution and a company might be fined in similar circumstance. It is not really random that you don't have a choice and nurse can't answer pricing issues correctly. Both don't just randomly happen to be beneficial for hospital. A lot of financial fraud by larger I stitutuon work exactly that way - put low level employees into situation where they are frauding either without knowing or by default or under pressure. If all management has to do is look the other way and collect benefit (and eventually blame paramedic), they will look the other way and punish employees who took longer to get you to hospital - cause you prefered cheaper one a bit further away. I don't expect injured patient to protect himself perfectly. However, I think we would all benefit if we labeled what happened to you accurately - a kind of fraud - instead of pretending it is ok, because system works that way.