8 ms·

SF hospital charged $15K ‘trauma response fee’ for baby that needed no treatment

115 points by guard0g 8y ago

mc32 8y ago
That's insane. Unfortunately politicians will not touch this issue because most people either have insurance which covers these idiotic baseless fees or indigent people go to the emergency room and avoid these fees as well. But the poor sap who wants to do things the right way gets effed over like these people. What a shame. I don't care who, Bernie, Trump, some socialist, take this cause (hospital billing) and have them come correct. They need someone to get tough and straighten them out. I mean, it's legalized robbery. Nothing less.
- lamlam 8y ago
  I've often wondered if we could open up private clinics in Canada for Americans where we charge reasonable rates. Kind of start a medical tourism industry by the border.
  - duxup 8y ago
    Comfy buses would be nice. Maybe some outpatient services where you recover at a local sporting event, fishing maybe....
  - vmlinuz 8y ago
    Thailand has a fairly large medical tourism industry - a number of hospitals in Bangkok are considered world-class (if not world-leading). I know a few people who just go there once a year for a weekend for their annual check-up, since the difference in price from doing it in a decent private hospital in Hong Kong can cover the cost of flights and accommodation, plus you get a weekend in Bangkok which is nice...
  - pkaye 8y ago
    Would not help because many of those without insurance cannot afford a trip up to Canada. And secondly it will not help for emergency care.
    - lamlam 8y ago
      While many would not be able to afford a trip to Canada, I would think there would still be a sizeable number who live within 1-2h from the border who could drive there for non-emergency care.
- annablaylock 8y ago
  Politicians won't touch this issue because healthcare costs are approaching 20% of GDP and every election since the 70s has been a jobs election.
- nshelly 8y ago
  The amount an health insurance company pays is kept secret and we can assume is far less. Otherwise, insurance companies would find ways to open up more hospitals to compete with the large irrational ones, or face huge costs. The hospitals know they can get away these amounts on paper, so they do. We should demand price transparency -- as we do for almost all direct-to-consumer purchases. Businesses can charge different amounts for volume purchases to other businesses, but it would be considered discriminatory if a restaurant didn't show their prices and then when you got your bill, it said -- oh, your company's not paying for it -- so it's $15,000 in extra fees.
  - adrr 8y ago
    Is it a secret? I get letters from my insurance company about how much they paid for medical treatment and even the provider sends me invoices with how much insurance paid. Last one was for blood tests were the provider(think was labcorp) charged $200 for a test and insurance paid $20.
    - nshelly 8y ago
      Good point. Prices for each CPT code accepted by by insurance company are kept secret, and the chargemaster published by a hospital is so inflated it's basically useless. For some diagnostic tests, it's pretty straightforward to understand, but for others like an ER bill where there can be dozens of claim lines and codes, it can be really hard to understand and the patient is relatively powerless to do anything about it after the fact.
  - semerda 8y ago
    No secret. It's all itemized on your insurance bill. What is secret is the deal insurance companies have with hospitals which allows hospitals to charge astronomical fees. That is then ultimately passed on to companies/patients through high premiums. And no one really chucks a stint over it with public shaming so the vicious cycle continues.
    - nshelly 8y ago
- axaxs 8y ago
  This is something I really hope Trump hits on. He's proven repeatedly he doesn't care what is popular, and was booed during the debates for saying that he wouldn't let people die in the streets, as sick as that situation is. I like that about Trump, he sets popularity aside in his decisions. That said, this is my single biggest issue at the moment. I have great health insurance, probably better than 90 pct of people here. It's not about me, it's about a broken system. I, or any of us, could lose our coverage in the blink of an eye. I will fully support any candidate who runs on nationalised healthcare. I don't care if my taxes go up. Our country is gross that people are afraid to seek treatment, or even ride an ambulance, because of our broken system. And I say this as a fiscal conservative...
  - mc32 8y ago
    It'd be great if he or anyone did. Unfortunately, I don't think it will be picked up by traditional politicians because doctors are active donors and they don't want to upset that. But, who knows. If it becomes a populist cause, maybe... maybe.
    - axaxs 8y ago
      That's what I don't understand. The parties are at each others throats, even physically. I think the majority of both parties support reform and/or single payer. It seems like such an easy political win, even if not an easily solvable problem.
      - greywolf 8y ago
        that's soo disinformed. there's absolutely no sign republicans or even most of democrats will support single payer
    - TangoTrotFox 8y ago
      Doctors aren't the schemers here. When a doctor submits a claim to your insurance for let's say $500 what he gets back is a magic and opaque number. His only choice is take it, or don't accept your insurance. For programs like medicaid this number is often a tiny fraction of what was charged, which is why some doctors or hospitals simply will not accept it. If you pay in cash at a doctor you'll often pay a much more reasonable price, and that's because they're not at the whims of insurance companies who incentivize them to charge as much as they possibly can.
- tolk460 8y ago
  Article mentions the bulk of the bill was a "trauma activation". This is an alert from the EMS units to the hospital that they are bringing a patient with indications of trauma requiring additional medical resources to be diverted. The reaction and resources differ per trauma facility. SFGH is a level 1 center [1]. There are better news sources that describe the trauma system within the context of this story. My opinion based on limited information within the article is that the field EMS suspected a closed head injury. The trauma "doctors at the hospital quickly determined that baby Jeong Whan was fine". If the baby had an MRI instead of a medical exam by a team of specialists, the headline would lose some weight. The fee is to staff ED specialists 24/7. I believe the better question is: "should we charge for resources that were used but stood down after initial assessment by the trauma team?" From the perspective of the EMS field, there are protocols that describe tbe patient condition, mechanism of injury and other indicators which dictate a trauma activation. [1] https://en.m.wikipedia.org/wiki/Trauma_center#Level_I https://en.m.wikipedia.org/wiki/Trauma_center#Level_I
  - mc32 8y ago
    Sorry but $15 grand for “Activating trauma protocol” which was then rescinded is ridiculous and an absurd amount. It’s bald robbery.
  - riquito 8y ago
    > If the baby had an MRI instead of a medical exam by a team of specialists, the headline would lose some weight. How so? In my country (Italy) for an MRI I would pay from 42 USD to 81 USD, depending on my income. Not saying that's its real cost since we pay taxes to grant this to everyone, but from here to 18k...
    - rasz 8y ago
      Bad comparison. Italy has far inferior health system, barely able to provide 2x better infant mortality rate at 1/3 the cost when compared to US. /sarcasm
  - taneq 8y ago
    Just how many specialists were they keeping available, and how much do those specialists cost? Let's say five different preeminent medical professionals were needed to respond to that emergency. Let's say that it used an hour each of their time. That's still $1000 an hour, which is exorbitant regardless of your credentials. And that's the most charitable evaluation. They "quickly determined that the baby was fine." So what did the hospital do, charge out the entire cost of running the ER to one unlucky family since they were the only case who was brought in that hour?
- thatfrenchguy 8y ago
  Fucking Universal healthcare is the only solution for this garbage.
  - semerda 8y ago
    With universal healthcare come other issues like waiting months for a bed. The real solution (and it's maybe 100 years away) is automating hospitals to a point where humans no longer play a role in healthcare management and it's 100% funded by the state/country. Maybe we won't even have hospitals and instead a portable home healthcare unit. One can dream ;-)
    - ashildr 8y ago
      We have universal healthcare in Germany. The longest time I had to wait was 17 days for a stationary colonoscopy because I wanted that exact hospital. And a MRI of the knee would have been 12 days of waiting until I called different radiologists in my area and got one the nextday. * Yes, our healthcare can be improved and politics is constantly trying to make it worse. But I doubt that the average person waiting for a bed in Germany can even afford a bed in the US. * ah, no co-pay by the way, I have no idea how expensive those things are.
      - mnm1 8y ago
        Co-pay / co-insurance can run into the thousands literally up to your out of pocket maximum. For me as an individual, I think that's about $4-5k and for a family about $8-10k but this is with the second best insurance available. That's every year, an amount that you might have to pay if you are sick. With a chronic condition or a major trip to the hospital one is very likely to hit those limits. Not to mention the months to years of dealing with bills afterwards, when one is trying to recover, and companies wrongly billing, billing for too much, not billing insurance, double billing. No drawbacks to universal healthcare even come close to this absolute fucking hell. It's hell for the patients' family, so one can only imagine how it is for the patient. And then, of course, there are the times when care is simply refused outright and your father dies the day after he leaves the hospital ... but hey, insurance companies gotta make money off of some people dying. They don't care it's someone's father or mother or children.
deleted 8y ago
[deleted]
duxup 8y ago
My oldest bumped his head as a baby, went to the ER, he had a great time seeing and visiting with the nurses and doctors (he couldn't speak, but he knew how to get a response). I think it cost us $150 (with insurance) rather than 51k... On the other hand his birth was near $200k because he was born early and had a long hospital stay (he's fine now, long term premature outcomes are amazing). Nothing we could have done to prevent it, know it was coming, it would have financially destroyed us at that time had we not had insurance. The US healthcare system is borked.
- labster 8y ago
  It's entirely possible that the hospital charged the insurance $51k and the insurance only allowed $500, of which $150 was your portion. No one knows what the real cost of anything is at hospitals, and even if you do have the time to shop around, you can't. There's no way to price compare as no one will tell you the price of everything in advance, and often surgeons pick their hospital anyway.
  - refurb 8y ago
    If you look at your insurance paperwork it will tell you exactly what the hospital is paid and what your portion is. Not uncommon for the hospital to be paid 25-33% of the bill. Sometimes a lot less than that. One of the reasons the list price is so high is due to “usual and customary” laws. An insurance company can’t pay for than that, so hospitals set it extraordinarily high. Also, contract negotiations are based on chargemaster rate and discount. They keep cranking up the list price and insurance comes back and increases the discount.
yellowapple 8y ago
"Zuckerberg San Francisco General Hospital (SFGH)" This has to be satire. ...right?
- aplummer 8y ago
  That he/Priscilla donates to the hospital and they name it after him? That’s pretty common...
- wl 8y ago
  He donated a lot of money to get his name on that hospital. Marc Benioff did the same thing with UCSF's Children's Hospital.
- mentalhealth 8y ago
  I'm sure he's proud to have his name on the only major trauma center in the US without a helipad due to NIMBY pressure.
- sushid 8y ago
  Go give $75mm to your local hospital. I'm sure they're willing to do the same.
  - thatfrenchguy 8y ago
    California gave like 200m$ and it’s not called the California hospital though.
- pascalxus 8y ago
  All those billions and they give it to this ripoff hospital that bankrupts unsuspecting people when they're at their most vulnerable moments.
maxxxxx 8y ago
American hospitals are just big ripoff machines. The whole nonsense with insurance negotiated, uninsured, in-network, out-of-network fees needa to go. Just post one price for a service for all. My girlfriend had a few surgeries over the last few years. The only conclusion I could draw from the bills was that a) they make up prices as they go b) they like to charge for things that never happened or put a several thousand percent markup on things They said that Obamacare was broken beyond repair. The same should be said for the current system and its billing practices.
- Gibbon1 8y ago
  I any other business tried to operate like hospitals do people would go to jail. Because what they do is fraud and extortion.
- labster 8y ago
  The current system is Obamacare, which is objectively terrible. It's just that the system before ACA was even worse. Until conservatives realize that there is no free market in health care without government intervention, guilds and cartels will continue.
  - masonic 8y ago
    Obama/Pelosi/Reid could have implemented single-payer instead of Obamacare, but the latter makes their donors much more money.
    - labster 8y ago
      I remember 2008, and the path to 60 votes, and this was simply not true. Perhaps if Obama had started negotiating from single-payer, they maybe had would have gotten a public option. But a decade ago not enough democratic voters supported single-payer.
      - masonic 8y ago
        I remember 2008 Obama wasn't even President until 2009. It is true. The Democrats had a filibuster-proof 60-member caucus[0] in the Senate, full control of the House, and the Presidency. They didn't need (and didn't get) a single Republican vote. But as they delayed while busy loading the bill with even more disastrous spending (e.g. community pools, Risk Corridors, etc.), their Senate supermajority fell to 59. [0] https://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00396 https://www.senate.gov/legislative/LIS/roll_call_lists/roll_...
xor1 8y ago
My insurance was billed $8000 for an MRI and paid out $7000. I was only responsible for $500, but it was really upsetting because I'd had one before and only had to pay $50. The high cost came from the facility being on hospital grounds, which I wasn't aware of since I entered the area leading to the radiology center through an entrance that didn't look anything like the inside of a hospital.
- duxup 8y ago
  A number of years ago I called and asked what the cost for a procedure was at a local hospital.... they struggled to even tell me within a weeks time. The system is just insane.
  - maxxxxx 8y ago
    When I had an HSA I also tried to get prices upfront. It's pretty much impossible to get any quote from medical providers. They just won't tell you.
    - duxup 8y ago
      It's a system so mad that there is no way to do it right even no matter how hard you try.
    - pkaye 8y ago
      I'm in the Kaiser Plan in California. The hospital is also the insurance provider. Generally they are pretty good but even they sometimes cannot tell you the costs ahead of time. Their saving grace is that for most things they have a copay system with a fixed amount out of pocket.
- BadassFractal 8y ago
  The healthcare system is a literal financial minefield. Seems like you better have a lawyer by your side to negotiate these arbitrary prices the instant you realize you're going in for anything non-trivial.
- Gibbon1 8y ago
crazygringo 8y ago
Curious... for international patients... if they just don't pay, is there anything the hospital can do? It's not like it's going to affect their credit rating in Korea or anything?
- duxup 8y ago
  Nothing they can do, having said that I belive if the patient is from a place that has a national system, they pay. On the other hand medical bankruptcy is sadly frequent in the US so international patients isn't really a concern.
  - mc32 8y ago
    I think also they get put on a list if they ever enter the country again.
    - koliber 8y ago
      What kind of list?
      - mc32 8y ago
        That was hearsay from a foreigner who, it seems, may have not had all the facts. Looking around, it looks like while not impossible, it's unlikely the State Dept puts much weight on outstanding (medical) debt: from reddit: https://www.reddit.com/r/legaladvice/comments/1m7p78/foreigner_owing_medical_bill_in_us/ https://www.reddit.com/r/legaladvice/comments/1m7p78/foreign... On the other hand, looks like the UK does hold debts against a would be visitor, according to forums.
        DanBC 8y ago
        The English NHS does charge some people for some treatment, and non-payment can be used to deny citizenship (and maybe visas). Emergency care and primary care are always free for everyone, and will not lead to charges, and so non-payment isn't an issue.
pash 8y ago
John Cochrane, a well known financial economist and former president of the American Finance Association, last month wrote a blog post [0] reacting to a similar article in Bloomberg about the pricing of air ambulance services. If you want to see how bizarre the structure of our markets for healthcare services looks to an economist, I encourage you to read it. I wonder if there’s a collection of this sort of article somewhere, all these journalistic accounts of ordinary people’s financially nightmarish encounters with the American market for healthcare. It feels like I’ve read dozens of them, and they’re all basically similar, not just in the facts they relate of each debacle, but also in their lack of insight into what’s really so fundamentally broken about our healthcare markets. 0. https://johnhcochrane.blogspot.com/2018/06/cross-subsidies.html https://johnhcochrane.blogspot.com/2018/06/cross-subsidies.h...
- Lazare 8y ago
  That's a superb article, and it makes some extremely valuable points. It wouldn't be that hard to just take a bunch of tax money, and provide a bunch of health care. Or alternatively, provide a bunch of health insurance. But since the US isn't willing to do that, but does want the services, we get this. There's no free lunch, and the harder you try and find one, the more warped (and, ultimately, expensive) it's going to end up being.
  - em3rgent0rdr 8y ago
    > "It wouldn't be that hard to just take a bunch of tax money, and provide a bunch of health care. Or alternatively, provide a bunch of health insurance." Elaborate, please, if it is so easy.
    - malmsteen 8y ago
      You know, like in every european country.
      - em3rgent0rdr 8y ago
        Well you got me! Yeah, I guess they do just tax the hell out of people in Europe and then provide basic healthcare, and call it an easy success!
herodotus 8y ago
If you are a foreign traveller in the US, and you need medical attention, if at all possible use a drop-in clinic instead of any hospital. Even the so-called non-profit hospitals charge outrageous fees.
king_nothing 8y ago
Holy $#17. I was in Stanford’s cardiac unit for some days, the actual bill must be $35k.
krapht 8y ago
Is it insane? Did people read the article? The critical trauma unit was activated. I suppose if people are called in to work, they shouldn't get paid if it turns out they aren't needed?
- dagenix 8y ago
  18k?
  - x0x0 8y ago
    18k is high, but it costs serious money to run a level 1 trauma center. In particular, it must be staffed enough to provide all specialties 24x7.
    - dagenix 8y ago
      It's reasonable it's not cheap. 18k, however, is ridiculous.
    - kalleboo 8y ago
      If you want to avoid the fee, can you tell the ambulance drivers to take you to a shittier ER with a lower cost?
    - pas 8y ago
      But then what OP said, that people had to be called in makes no sense, right? There were people there anyway, an attending physician looked at the child, talked to the parents (all doctors want is your anamnesis!) determined that nothing to worry about, maybe keep them in observation, and that's it. There's not even a word about doing an Xray/CT or any kind of imaging to check for internal bleeding. Probably the "activation" of the Trauma Unit is that when they called 911, the hospital booked them and was ready to receive them.
- wiradikusuma 8y ago
  so, you're saying that when somebody called, "my baby's head hit the floor", they can assemble the whole Avengers just because?
gU9x3u8XmQNG 8y ago
I genuinely wonder where this money goes, if paid. It seems rather unrealistic to believe these costs can be genuinely justified, with an independent audit? Right? The genuine cost to business cannot be this high. These values are utterly unreasonable. Someone, somewhere; is doing something extremely unethical. The fact this can even happen somewhat indicates there’s a lot of “power” involved. — Edit: another poster had mentioned that some costs are included to cover other admissions in which fees are not paid - no matter the reason. So, whilst this seems quite logical; it bothers me this is not clearly indicated. Its a pretty poor attempt to fix a clear, and genuine, other problem.
- will4274 8y ago
  I can get close to the math by being extremely generous. 15k of tramua fees. ~10 specialists on call for tramua. That implies each specialist got about 1.5k for the call. ~2 hours of work, maybe payment for transport time so super generous call it 4 hours. If normal pay is 1x and overtime is 1.5x, must stay by the phone critical on call is 2x? This computes the specialists as getting paid an average of $200 per hour normally. This is all pretty crazy - $200/hour for a brain surgeon, sure, but there's no way the nurse is getting that. One of the big missing data points is how many people were called in. 15k is pretty reasonable if a 50 person team was called in - but then, why would a 50 person team be called in?
  - gU9x3u8XmQNG 8y ago
    Interesting! I guess minimum callout fees, etc - in your proposed scenario including a large callout of resources. Hmmm! Thanks for your reply!
SCdF 8y ago
OK so I know that emergency care not being free is madness, and _you_ know that emergency care not being free is madness, but what are the arguments from people who don't think this sound like? Also, I wonder how feasible it would be for foreign governments to pay for the emergency care of their citizens when they have issues in America, and fund it by charging visiting American's American-style medical bills for any medical care they receive while there.
- kalleboo 8y ago
  > but what are the arguments from people who don't think this sound like? The two I see are mostly 1. "I don't want to pay for other people's healthcare. Other people make poor health [dietary, etc] and financial [they're poor] decisions and they should pay for it themselves." A lot of young people do not want to pay it forward for the healthcare they will need when they get old ("I haven't been to a hospital in years! I'm healthy!"). 2. Distrust in the government in running a fair and efficient system ("death panels" etc)
peterwwillis 8y ago
A French friend of mine needed some emergency operation while he was in the States. He bought a round trip ticket to Paris, left, got the operation done, came back to the States. Saved $10,000.
- BadassFractal 8y ago
  Isn't medical tourism a big industry these days? People flying to India or Mexico for treatment?
  - riquito 8y ago
    It's not medical tourism if you go back to your home country instead of requesting help to the country you're visiting
    - BadassFractal 8y ago
      Heh that's a good point. Medical homecoming?
    - eesmith 8y ago
      It isn't? https://en.wikipedia.org/wiki/Medical_tourism https://en.wikipedia.org/wiki/Medical_tourism gives these examples: > in January 2008, Hannaford Bros., a supermarket chain based in Maine, began paying the entire medical bill for employees to travel to Singapore for hip and knee replacements, including travel for the patient and companion ... > In 2000, Blue Shield of California began the United States' first cross-border health plan. Patients in California could travel to one of the three certified hospitals in Mexico for treatment under California Blue Shield.
      - peterwwillis 8y ago
        That's the opposite of going to your home country.
        8y ago
mastrsushi 8y ago
What does this have to do with HackerNews? This site is turning into mini Reddit.
- abritinthebay 8y ago
  It’s basically reddit of 2009.
- craftyguy 8y ago
  What, do tell, is your definition of what should be posted to HN? I suppose you read this[0] and this [1], which address your question about what content is appropriate, and how to comment on content you believe is inappropriate? 0. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html 1. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- discordance 8y ago
  I think this is an extremely relevant topic for the HN community. If there is one area that begs to be fixed, disrupted and overhauled it is US health and scammy insurance industry.
bprasanna 8y ago
Healthcare in US is a best example of how a Healthcare shouldn't be. The citizens of the country shouldn't be scared of going to hospital. Countries like India may have corruption, but their people, even the poorest, have the option to consult doctor free of cost or at the cost they can afford. The Healthcare in US is in the clutches of Insurance companies.
- kamaal 8y ago
  >> Countries like India may have corruption, but their people, even the poorest, have the option to consult doctor free of cost or at the cost they can afford. For something small, like Fever or Stomach Upset may be. For bigger problems its not easy, and most of the time they just give up(Embrace death). In Bangalore, there is a hospital called Bowring and Lady Curzon Hospital, its sort of like a government hospital. For decades its well known that when burn patients arrive, and if the victim is really poor, they silently recommend euthanasia. And most people opt for it. Its just the cost of treatment is too expensive, and the whole family goes down in the financial burden that follows. Also please take a look at government hospitals like NIMHANS in Bangalore, its like the most depressing place you will visit in your life. You have to pay bribes for simple things like IV drip. And most people are very ill and sleep on the footpaths and hospital compound. Most of the times let alone having money for treatment they don't even have money to go back home to their small towns and villages. Personally I had experience with one relative who got Guillane barre syndrome, their family comes from Kolar(A place 70 kms from Bangalore). He was a flower seller. He refused our help out of self esteem, but we had to bribe through ward boys, nurses and doctor secretly without him knowing to speed up things and get him everything from a bed to the right treatment.
  - sizzle 8y ago
    This is heartbreaking. How can we solve the problem of overpopulation? What happens to poor people in America under the same circumstances of poor in India when seeking healthcare?
viach 8y ago
It might be the hospital did an ICO and offers services for it's tokens now. Understandable then.
pascalxus 8y ago
There really should be laws against that sort of thing. Maybe some price ceilings per service
wattengard 8y ago
I'm norwegian. I have two kids, and have used the emergency care unit a couple of times throughout my life. Total cost $0 in care fees. (They are allowed to charge for stuff like bandages and such for non layovers, usually $5-$20 each visit). We don't have health insurance, but some insurance companies have begun selling "treatment guarantee" which guarantees start of treatment typically within 14 days of injury. (For non life threatening ailments of course. Elbow pains, leg pains, such..) The best thing about those are that they are usually paid for by your employer because they want you back at work as soon as possible :D (The premium is added to our income tax though) Socialism hell yeah!
BadassFractal 8y ago
Follow the money, I guess. Who's pocketing the 15 grand worth of trauma activation?
karterk 8y ago
Recently a friend of mine visited the emergency care in a private hospital in downtown SF with heavy stomach pain. It turned out to be a partial bowel obstruction, which thankfully sorted itself out with some conservative treatment. My friend was discharged in a couple of days... with a bill of 70K USD. Except for an IV and a Ryles tube, there was hardly any other intervention. Having just finished college, my friend did not have an insurance plan that could cover such a huge bill. Thankfully the state stepped in to help since the yearly income was below the federal poverty line. Otherwise, I can't imagine the plight. For once, my friend was thankful for being a broke college grad.
- ashildr 8y ago
  Students in Germany usually have free healthcare from their parents mandatory insurance, if they are older than 25 most have to pay about €70 and from 30 they usually have to pay about €115. These are the rates for the public insurances, private insurance are usually cheaper for youngpeople but have other problems.
ilotro 8y ago
Every now and then I seriously consider moving to the US, but the healthcare system scared the crap out of me. I can't imagine how stressful it must be to have to depend on your employer for health insurance.
throw_away2 8y ago
I've said here before that I hope I get mauled and eaten by wolves to avoid the entire healthcare industry, but now I'm thinking about offering wolves as a service.
dmarlow 8y ago
If there is one area ripe for disruption, it's US health care. A few months ago my wife was showing me atrocious bills people were posting on FB, I didn't know whether to laugh or cry. It hit home because we "accidentally" got a bill when an in-network lab sent a blood test to an out of network testing facility and we got a $14k bill... for a blood test. Just recently, a 2 hour ER visit for my toddler cost $3.5k for a breathing treatment, some Tylenol and some influenza tests. All part of my high deductible plan. I used to be on the side against healthcare reform. I'm now counting the seconds until we have ANY regulation to stop this madness.
- flak48 8y ago
  > I used to be on the side against healthcare reform. Why?
  - dmarlow 8y ago
    Because I had an amazing healthcare plan and was too naive at the time.
sexy_seedbox 8y ago
Of all the news outlets available, why is Jack Ma's Hong Kong newspaper linked?
anonu 8y ago
My wife recently gave birth to our first child. Normal delivery - 2 nights in a hospital. Then we had to go back again for jaundice - nothing serious - but added another 2 nights in a hospital room. All said and done my insurance was billed $64,000 for what is considered a normal uncomplicated birth. That is insane to me. If you go over the bill carefully, instantly 50% of that disappears because I've "saved" by being with my insurance provider. What if I had no insurance? Would I get billed that insane number and have to spend hours whittling it down? My dad was commenting on how the drug he takes regularly in his home country (outside the US) is 1/10th the price of what it costs here. The health insurance system is broken in USA (who knew?). Everything is artificially over-inflated because it all gets "negotiated" down in the end. This creates a lot of room to maximize your net revenue when you set prices arbitrarily high.
rusk 8y ago
Privatise they said, run things like a business they said ...
dzink 8y ago
The issue here is that the head hit was activated as a trauma. Trauma activation criteria are different for every hospital. If the criteria is lower, you get situations like these. Trauma teams legitimately require such expense. There are surgeons, nurses, neurosurgeons, and others on call 24/7 sleeping on the hospital so they can get to victims of trauma within 5minites. Gunshots, stab wounds, car accidents, massive balconies falling with kids on them, etc, all require legitimate trauma activations. So do drinks and homeless people who get hit by cars or stabbed in the middle of the night, and many who don’t have insurance are still treated by the hospital. Some hospitals bill all patients 7-10 times the actual costs, get paid 1-2 times actual by insurance. Uninsured either don’t pay, or negotiate down, or are plagued by the full bill designed to compensate for the others who don’t pay. If a hospital isn’t able to cover the costs of a trauma team, that means they lose their trauma designation and any local patients bleeding out because of trauma have to be trekked by ambulance or helicopter to the next trauma center, which in SF is Stanford or John Muir in the East Bay. They might have needed to pay another 25k if a chopper was called for this.
- nerbert 8y ago
  Curiously enough this only happens in the US. It seems that there is a rationale behind every decision that is made here, and yet the overall system doesn’t work for most people. In that case this case can as well be summarized as: hospital seizes opportunity to maximize profits on baby, then every decision in the chain becomes clear.
mnm1 8y ago
First, they're from South Korea. Paying even a cent of this would be a stupidly bad financial idea. Why? There is absolutely no reason. Let the hospital send the bill to some creditors and let them try to collect in South Korea. Honestly, the situation is laughable. Second, the article thinks that this was fraud. Figures. It may not be too late for them to call the hospital and point this out and ask them to zero out the balance. This hospital, when it had its prior name, did something similar for a friend of mine, albeit his bill was about $1-2k and it was not fraud. Considering they might be on the wrong side of the law, this seems like a solution both sides can get behind.
Beldur 8y ago
My personal story from Germany: My 14 month old son got a deaseae in the spine so he could not walk anymore. We spent 4 weeks in the hospital. 1 week until it was diagnosed in the MRT, 3 weeks with 3 different antibiotic treatment and another two month antibiotics at home. All this while my wife continued to study for her PHD so I stayed away from work and lived with my son in the hospital. This whole experience did cost us around 200€ (incl. gasoline to drive to the hospital) while still getting full income from my employer.
Svoka 8y ago
Break a leg. Well. I broke femur near San Luis Obispo. I was admitted to hospital, was charged over $19000 (that is nineteen thousands dollars) per night for bed. Just for bed. And it was a "cheap" option with person crying in agony next to me whole time. Total bill was 74k$ dollars just for hospital service. Emergency services, E.R., surgery, anesthesiology all Extra. Welcome to US. P.S. With that prices, hospital easily would make it in top 20 most expensive hotel rooms of the world, except I didn't have a choice but to pay for it.

115 points by guard0g 8y ago

mc32 8y ago

That's insane. Unfortunately politicians will not touch this issue because most people either have insurance which covers these idiotic baseless fees or indigent people go to the emergency room and avoid these fees as well. But the poor sap who wants to do things the right way gets effed over like these people. What a shame. I don't care who, Bernie, Trump, some socialist, take this cause (hospital billing) and have them come correct. They need someone to get tough and straighten them out. I mean, it's legalized robbery. Nothing less.

lamlam 8y ago
I've often wondered if we could open up private clinics in Canada for Americans where we charge reasonable rates. Kind of start a medical tourism industry by the border.
- duxup 8y ago
  Comfy buses would be nice. Maybe some outpatient services where you recover at a local sporting event, fishing maybe....
- vmlinuz 8y ago
  Thailand has a fairly large medical tourism industry - a number of hospitals in Bangkok are considered world-class (if not world-leading). I know a few people who just go there once a year for a weekend for their annual check-up, since the difference in price from doing it in a decent private hospital in Hong Kong can cover the cost of flights and accommodation, plus you get a weekend in Bangkok which is nice...
- pkaye 8y ago
  Would not help because many of those without insurance cannot afford a trip up to Canada. And secondly it will not help for emergency care.
  - lamlam 8y ago
    While many would not be able to afford a trip to Canada, I would think there would still be a sizeable number who live within 1-2h from the border who could drive there for non-emergency care.
annablaylock 8y ago
Politicians won't touch this issue because healthcare costs are approaching 20% of GDP and every election since the 70s has been a jobs election.
nshelly 8y ago
The amount an health insurance company pays is kept secret and we can assume is far less. Otherwise, insurance companies would find ways to open up more hospitals to compete with the large irrational ones, or face huge costs. The hospitals know they can get away these amounts on paper, so they do. We should demand price transparency -- as we do for almost all direct-to-consumer purchases. Businesses can charge different amounts for volume purchases to other businesses, but it would be considered discriminatory if a restaurant didn't show their prices and then when you got your bill, it said -- oh, your company's not paying for it -- so it's $15,000 in extra fees.
- adrr 8y ago
  Is it a secret? I get letters from my insurance company about how much they paid for medical treatment and even the provider sends me invoices with how much insurance paid. Last one was for blood tests were the provider(think was labcorp) charged $200 for a test and insurance paid $20.
  - nshelly 8y ago
    Good point. Prices for each CPT code accepted by by insurance company are kept secret, and the chargemaster published by a hospital is so inflated it's basically useless. For some diagnostic tests, it's pretty straightforward to understand, but for others like an ER bill where there can be dozens of claim lines and codes, it can be really hard to understand and the patient is relatively powerless to do anything about it after the fact.
- semerda 8y ago
  No secret. It's all itemized on your insurance bill. What is secret is the deal insurance companies have with hospitals which allows hospitals to charge astronomical fees. That is then ultimately passed on to companies/patients through high premiums. And no one really chucks a stint over it with public shaming so the vicious cycle continues.
  - nshelly 8y ago
axaxs 8y ago
This is something I really hope Trump hits on. He's proven repeatedly he doesn't care what is popular, and was booed during the debates for saying that he wouldn't let people die in the streets, as sick as that situation is. I like that about Trump, he sets popularity aside in his decisions. That said, this is my single biggest issue at the moment. I have great health insurance, probably better than 90 pct of people here. It's not about me, it's about a broken system. I, or any of us, could lose our coverage in the blink of an eye. I will fully support any candidate who runs on nationalised healthcare. I don't care if my taxes go up. Our country is gross that people are afraid to seek treatment, or even ride an ambulance, because of our broken system. And I say this as a fiscal conservative...
- mc32 8y ago
  It'd be great if he or anyone did. Unfortunately, I don't think it will be picked up by traditional politicians because doctors are active donors and they don't want to upset that. But, who knows. If it becomes a populist cause, maybe... maybe.
  - axaxs 8y ago
    That's what I don't understand. The parties are at each others throats, even physically. I think the majority of both parties support reform and/or single payer. It seems like such an easy political win, even if not an easily solvable problem.
    - greywolf 8y ago
      that's soo disinformed. there's absolutely no sign republicans or even most of democrats will support single payer
  - TangoTrotFox 8y ago
    Doctors aren't the schemers here. When a doctor submits a claim to your insurance for let's say $500 what he gets back is a magic and opaque number. His only choice is take it, or don't accept your insurance. For programs like medicaid this number is often a tiny fraction of what was charged, which is why some doctors or hospitals simply will not accept it. If you pay in cash at a doctor you'll often pay a much more reasonable price, and that's because they're not at the whims of insurance companies who incentivize them to charge as much as they possibly can.
tolk460 8y ago
Article mentions the bulk of the bill was a "trauma activation". This is an alert from the EMS units to the hospital that they are bringing a patient with indications of trauma requiring additional medical resources to be diverted. The reaction and resources differ per trauma facility. SFGH is a level 1 center [1]. There are better news sources that describe the trauma system within the context of this story. My opinion based on limited information within the article is that the field EMS suspected a closed head injury. The trauma "doctors at the hospital quickly determined that baby Jeong Whan was fine". If the baby had an MRI instead of a medical exam by a team of specialists, the headline would lose some weight. The fee is to staff ED specialists 24/7. I believe the better question is: "should we charge for resources that were used but stood down after initial assessment by the trauma team?" From the perspective of the EMS field, there are protocols that describe tbe patient condition, mechanism of injury and other indicators which dictate a trauma activation. [1] https://en.m.wikipedia.org/wiki/Trauma_center#Level_I https://en.m.wikipedia.org/wiki/Trauma_center#Level_I
- mc32 8y ago
  Sorry but $15 grand for “Activating trauma protocol” which was then rescinded is ridiculous and an absurd amount. It’s bald robbery.
- riquito 8y ago
  > If the baby had an MRI instead of a medical exam by a team of specialists, the headline would lose some weight. How so? In my country (Italy) for an MRI I would pay from 42 USD to 81 USD, depending on my income. Not saying that's its real cost since we pay taxes to grant this to everyone, but from here to 18k...
  - rasz 8y ago
    Bad comparison. Italy has far inferior health system, barely able to provide 2x better infant mortality rate at 1/3 the cost when compared to US. /sarcasm
- taneq 8y ago
  Just how many specialists were they keeping available, and how much do those specialists cost? Let's say five different preeminent medical professionals were needed to respond to that emergency. Let's say that it used an hour each of their time. That's still $1000 an hour, which is exorbitant regardless of your credentials. And that's the most charitable evaluation. They "quickly determined that the baby was fine." So what did the hospital do, charge out the entire cost of running the ER to one unlucky family since they were the only case who was brought in that hour?
thatfrenchguy 8y ago
Fucking Universal healthcare is the only solution for this garbage.
- semerda 8y ago
  With universal healthcare come other issues like waiting months for a bed. The real solution (and it's maybe 100 years away) is automating hospitals to a point where humans no longer play a role in healthcare management and it's 100% funded by the state/country. Maybe we won't even have hospitals and instead a portable home healthcare unit. One can dream ;-)
  - ashildr 8y ago
    We have universal healthcare in Germany. The longest time I had to wait was 17 days for a stationary colonoscopy because I wanted that exact hospital. And a MRI of the knee would have been 12 days of waiting until I called different radiologists in my area and got one the nextday. * Yes, our healthcare can be improved and politics is constantly trying to make it worse. But I doubt that the average person waiting for a bed in Germany can even afford a bed in the US. * ah, no co-pay by the way, I have no idea how expensive those things are.
    - mnm1 8y ago
      Co-pay / co-insurance can run into the thousands literally up to your out of pocket maximum. For me as an individual, I think that's about $4-5k and for a family about $8-10k but this is with the second best insurance available. That's every year, an amount that you might have to pay if you are sick. With a chronic condition or a major trip to the hospital one is very likely to hit those limits. Not to mention the months to years of dealing with bills afterwards, when one is trying to recover, and companies wrongly billing, billing for too much, not billing insurance, double billing. No drawbacks to universal healthcare even come close to this absolute fucking hell. It's hell for the patients' family, so one can only imagine how it is for the patient. And then, of course, there are the times when care is simply refused outright and your father dies the day after he leaves the hospital ... but hey, insurance companies gotta make money off of some people dying. They don't care it's someone's father or mother or children.

deleted 8y ago

[deleted]

duxup 8y ago

My oldest bumped his head as a baby, went to the ER, he had a great time seeing and visiting with the nurses and doctors (he couldn't speak, but he knew how to get a response). I think it cost us $150 (with insurance) rather than 51k... On the other hand his birth was near $200k because he was born early and had a long hospital stay (he's fine now, long term premature outcomes are amazing). Nothing we could have done to prevent it, know it was coming, it would have financially destroyed us at that time had we not had insurance. The US healthcare system is borked.

labster 8y ago
It's entirely possible that the hospital charged the insurance $51k and the insurance only allowed $500, of which $150 was your portion. No one knows what the real cost of anything is at hospitals, and even if you do have the time to shop around, you can't. There's no way to price compare as no one will tell you the price of everything in advance, and often surgeons pick their hospital anyway.
- refurb 8y ago
  If you look at your insurance paperwork it will tell you exactly what the hospital is paid and what your portion is. Not uncommon for the hospital to be paid 25-33% of the bill. Sometimes a lot less than that. One of the reasons the list price is so high is due to “usual and customary” laws. An insurance company can’t pay for than that, so hospitals set it extraordinarily high. Also, contract negotiations are based on chargemaster rate and discount. They keep cranking up the list price and insurance comes back and increases the discount.

yellowapple 8y ago

"Zuckerberg San Francisco General Hospital (SFGH)" This has to be satire. ...right?

aplummer 8y ago
That he/Priscilla donates to the hospital and they name it after him? That’s pretty common...
wl 8y ago
He donated a lot of money to get his name on that hospital. Marc Benioff did the same thing with UCSF's Children's Hospital.
mentalhealth 8y ago
I'm sure he's proud to have his name on the only major trauma center in the US without a helipad due to NIMBY pressure.
sushid 8y ago
Go give $75mm to your local hospital. I'm sure they're willing to do the same.
- thatfrenchguy 8y ago
  California gave like 200m$ and it’s not called the California hospital though.
pascalxus 8y ago
All those billions and they give it to this ripoff hospital that bankrupts unsuspecting people when they're at their most vulnerable moments.

maxxxxx 8y ago

American hospitals are just big ripoff machines. The whole nonsense with insurance negotiated, uninsured, in-network, out-of-network fees needa to go. Just post one price for a service for all. My girlfriend had a few surgeries over the last few years. The only conclusion I could draw from the bills was that a) they make up prices as they go b) they like to charge for things that never happened or put a several thousand percent markup on things They said that Obamacare was broken beyond repair. The same should be said for the current system and its billing practices.

Gibbon1 8y ago
I any other business tried to operate like hospitals do people would go to jail. Because what they do is fraud and extortion.
labster 8y ago
The current system is Obamacare, which is objectively terrible. It's just that the system before ACA was even worse. Until conservatives realize that there is no free market in health care without government intervention, guilds and cartels will continue.
- masonic 8y ago
  Obama/Pelosi/Reid could have implemented single-payer instead of Obamacare, but the latter makes their donors much more money.
  - labster 8y ago
    I remember 2008, and the path to 60 votes, and this was simply not true. Perhaps if Obama had started negotiating from single-payer, they maybe had would have gotten a public option. But a decade ago not enough democratic voters supported single-payer.
    - masonic 8y ago
      I remember 2008 Obama wasn't even President until 2009. It is true. The Democrats had a filibuster-proof 60-member caucus[0] in the Senate, full control of the House, and the Presidency. They didn't need (and didn't get) a single Republican vote. But as they delayed while busy loading the bill with even more disastrous spending (e.g. community pools, Risk Corridors, etc.), their Senate supermajority fell to 59. [0] https://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00396 https://www.senate.gov/legislative/LIS/roll_call_lists/roll_...

xor1 8y ago

My insurance was billed $8000 for an MRI and paid out $7000. I was only responsible for $500, but it was really upsetting because I'd had one before and only had to pay $50. The high cost came from the facility being on hospital grounds, which I wasn't aware of since I entered the area leading to the radiology center through an entrance that didn't look anything like the inside of a hospital.

duxup 8y ago
A number of years ago I called and asked what the cost for a procedure was at a local hospital.... they struggled to even tell me within a weeks time. The system is just insane.
- maxxxxx 8y ago
  When I had an HSA I also tried to get prices upfront. It's pretty much impossible to get any quote from medical providers. They just won't tell you.
  - duxup 8y ago
    It's a system so mad that there is no way to do it right even no matter how hard you try.
  - pkaye 8y ago
    I'm in the Kaiser Plan in California. The hospital is also the insurance provider. Generally they are pretty good but even they sometimes cannot tell you the costs ahead of time. Their saving grace is that for most things they have a copay system with a fixed amount out of pocket.
BadassFractal 8y ago
The healthcare system is a literal financial minefield. Seems like you better have a lawyer by your side to negotiate these arbitrary prices the instant you realize you're going in for anything non-trivial.
Gibbon1 8y ago

crazygringo 8y ago

Curious... for international patients... if they just don't pay, is there anything the hospital can do? It's not like it's going to affect their credit rating in Korea or anything?

duxup 8y ago
Nothing they can do, having said that I belive if the patient is from a place that has a national system, they pay. On the other hand medical bankruptcy is sadly frequent in the US so international patients isn't really a concern.
- mc32 8y ago
  I think also they get put on a list if they ever enter the country again.
  - koliber 8y ago
    What kind of list?
    - mc32 8y ago
      That was hearsay from a foreigner who, it seems, may have not had all the facts. Looking around, it looks like while not impossible, it's unlikely the State Dept puts much weight on outstanding (medical) debt: from reddit: https://www.reddit.com/r/legaladvice/comments/1m7p78/foreigner_owing_medical_bill_in_us/ https://www.reddit.com/r/legaladvice/comments/1m7p78/foreign... On the other hand, looks like the UK does hold debts against a would be visitor, according to forums.
      - DanBC 8y ago
        The English NHS does charge some people for some treatment, and non-payment can be used to deny citizenship (and maybe visas). Emergency care and primary care are always free for everyone, and will not lead to charges, and so non-payment isn't an issue.

pash 8y ago

John Cochrane, a well known financial economist and former president of the American Finance Association, last month wrote a blog post [0] reacting to a similar article in Bloomberg about the pricing of air ambulance services. If you want to see how bizarre the structure of our markets for healthcare services looks to an economist, I encourage you to read it. I wonder if there’s a collection of this sort of article somewhere, all these journalistic accounts of ordinary people’s financially nightmarish encounters with the American market for healthcare. It feels like I’ve read dozens of them, and they’re all basically similar, not just in the facts they relate of each debacle, but also in their lack of insight into what’s really so fundamentally broken about our healthcare markets. 0. https://johnhcochrane.blogspot.com/2018/06/cross-subsidies.html https://johnhcochrane.blogspot.com/2018/06/cross-subsidies.h...

Lazare 8y ago
That's a superb article, and it makes some extremely valuable points. It wouldn't be that hard to just take a bunch of tax money, and provide a bunch of health care. Or alternatively, provide a bunch of health insurance. But since the US isn't willing to do that, but does want the services, we get this. There's no free lunch, and the harder you try and find one, the more warped (and, ultimately, expensive) it's going to end up being.
- em3rgent0rdr 8y ago
  > "It wouldn't be that hard to just take a bunch of tax money, and provide a bunch of health care. Or alternatively, provide a bunch of health insurance." Elaborate, please, if it is so easy.
  - malmsteen 8y ago
    You know, like in every european country.
    - em3rgent0rdr 8y ago
      Well you got me! Yeah, I guess they do just tax the hell out of people in Europe and then provide basic healthcare, and call it an easy success!

herodotus 8y ago

If you are a foreign traveller in the US, and you need medical attention, if at all possible use a drop-in clinic instead of any hospital. Even the so-called non-profit hospitals charge outrageous fees.

king_nothing 8y ago

Holy $#17. I was in Stanford’s cardiac unit for some days, the actual bill must be $35k.

krapht 8y ago

Is it insane? Did people read the article? The critical trauma unit was activated. I suppose if people are called in to work, they shouldn't get paid if it turns out they aren't needed?

dagenix 8y ago
18k?
- x0x0 8y ago
  18k is high, but it costs serious money to run a level 1 trauma center. In particular, it must be staffed enough to provide all specialties 24x7.
  - dagenix 8y ago
    It's reasonable it's not cheap. 18k, however, is ridiculous.
  - kalleboo 8y ago
    If you want to avoid the fee, can you tell the ambulance drivers to take you to a shittier ER with a lower cost?
  - pas 8y ago
    But then what OP said, that people had to be called in makes no sense, right? There were people there anyway, an attending physician looked at the child, talked to the parents (all doctors want is your anamnesis!) determined that nothing to worry about, maybe keep them in observation, and that's it. There's not even a word about doing an Xray/CT or any kind of imaging to check for internal bleeding. Probably the "activation" of the Trauma Unit is that when they called 911, the hospital booked them and was ready to receive them.
wiradikusuma 8y ago
so, you're saying that when somebody called, "my baby's head hit the floor", they can assemble the whole Avengers just because?

gU9x3u8XmQNG 8y ago

I genuinely wonder where this money goes, if paid. It seems rather unrealistic to believe these costs can be genuinely justified, with an independent audit? Right? The genuine cost to business cannot be this high. These values are utterly unreasonable. Someone, somewhere; is doing something extremely unethical. The fact this can even happen somewhat indicates there’s a lot of “power” involved. — Edit: another poster had mentioned that some costs are included to cover other admissions in which fees are not paid - no matter the reason. So, whilst this seems quite logical; it bothers me this is not clearly indicated. Its a pretty poor attempt to fix a clear, and genuine, other problem.

will4274 8y ago
I can get close to the math by being extremely generous. 15k of tramua fees. ~10 specialists on call for tramua. That implies each specialist got about 1.5k for the call. ~2 hours of work, maybe payment for transport time so super generous call it 4 hours. If normal pay is 1x and overtime is 1.5x, must stay by the phone critical on call is 2x? This computes the specialists as getting paid an average of $200 per hour normally. This is all pretty crazy - $200/hour for a brain surgeon, sure, but there's no way the nurse is getting that. One of the big missing data points is how many people were called in. 15k is pretty reasonable if a 50 person team was called in - but then, why would a 50 person team be called in?
- gU9x3u8XmQNG 8y ago
  Interesting! I guess minimum callout fees, etc - in your proposed scenario including a large callout of resources. Hmmm! Thanks for your reply!

SCdF 8y ago

OK so I know that emergency care not being free is madness, and _you_ know that emergency care not being free is madness, but what are the arguments from people who don't think this sound like? Also, I wonder how feasible it would be for foreign governments to pay for the emergency care of their citizens when they have issues in America, and fund it by charging visiting American's American-style medical bills for any medical care they receive while there.

kalleboo 8y ago
> but what are the arguments from people who don't think this sound like? The two I see are mostly 1. "I don't want to pay for other people's healthcare. Other people make poor health [dietary, etc] and financial [they're poor] decisions and they should pay for it themselves." A lot of young people do not want to pay it forward for the healthcare they will need when they get old ("I haven't been to a hospital in years! I'm healthy!"). 2. Distrust in the government in running a fair and efficient system ("death panels" etc)

peterwwillis 8y ago

A French friend of mine needed some emergency operation while he was in the States. He bought a round trip ticket to Paris, left, got the operation done, came back to the States. Saved $10,000.

BadassFractal 8y ago
Isn't medical tourism a big industry these days? People flying to India or Mexico for treatment?
- riquito 8y ago
  It's not medical tourism if you go back to your home country instead of requesting help to the country you're visiting
  - BadassFractal 8y ago
    Heh that's a good point. Medical homecoming?
  - eesmith 8y ago
    It isn't? https://en.wikipedia.org/wiki/Medical_tourism https://en.wikipedia.org/wiki/Medical_tourism gives these examples: > in January 2008, Hannaford Bros., a supermarket chain based in Maine, began paying the entire medical bill for employees to travel to Singapore for hip and knee replacements, including travel for the patient and companion ... > In 2000, Blue Shield of California began the United States' first cross-border health plan. Patients in California could travel to one of the three certified hospitals in Mexico for treatment under California Blue Shield.
    - peterwwillis 8y ago
      That's the opposite of going to your home country.
      - 8y ago

mastrsushi 8y ago

What does this have to do with HackerNews? This site is turning into mini Reddit.

abritinthebay 8y ago
It’s basically reddit of 2009.
craftyguy 8y ago
What, do tell, is your definition of what should be posted to HN? I suppose you read this[0] and this [1], which address your question about what content is appropriate, and how to comment on content you believe is inappropriate? 0. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html 1. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
discordance 8y ago
I think this is an extremely relevant topic for the HN community. If there is one area that begs to be fixed, disrupted and overhauled it is US health and scammy insurance industry.

bprasanna 8y ago

Healthcare in US is a best example of how a Healthcare shouldn't be. The citizens of the country shouldn't be scared of going to hospital. Countries like India may have corruption, but their people, even the poorest, have the option to consult doctor free of cost or at the cost they can afford. The Healthcare in US is in the clutches of Insurance companies.

kamaal 8y ago
>> Countries like India may have corruption, but their people, even the poorest, have the option to consult doctor free of cost or at the cost they can afford. For something small, like Fever or Stomach Upset may be. For bigger problems its not easy, and most of the time they just give up(Embrace death). In Bangalore, there is a hospital called Bowring and Lady Curzon Hospital, its sort of like a government hospital. For decades its well known that when burn patients arrive, and if the victim is really poor, they silently recommend euthanasia. And most people opt for it. Its just the cost of treatment is too expensive, and the whole family goes down in the financial burden that follows. Also please take a look at government hospitals like NIMHANS in Bangalore, its like the most depressing place you will visit in your life. You have to pay bribes for simple things like IV drip. And most people are very ill and sleep on the footpaths and hospital compound. Most of the times let alone having money for treatment they don't even have money to go back home to their small towns and villages. Personally I had experience with one relative who got Guillane barre syndrome, their family comes from Kolar(A place 70 kms from Bangalore). He was a flower seller. He refused our help out of self esteem, but we had to bribe through ward boys, nurses and doctor secretly without him knowing to speed up things and get him everything from a bed to the right treatment.
- sizzle 8y ago
  This is heartbreaking. How can we solve the problem of overpopulation? What happens to poor people in America under the same circumstances of poor in India when seeking healthcare?

viach 8y ago

It might be the hospital did an ICO and offers services for it's tokens now. Understandable then.

pascalxus 8y ago

There really should be laws against that sort of thing. Maybe some price ceilings per service

wattengard 8y ago

I'm norwegian. I have two kids, and have used the emergency care unit a couple of times throughout my life. Total cost $0 in care fees. (They are allowed to charge for stuff like bandages and such for non layovers, usually $5-$20 each visit). We don't have health insurance, but some insurance companies have begun selling "treatment guarantee" which guarantees start of treatment typically within 14 days of injury. (For non life threatening ailments of course. Elbow pains, leg pains, such..) The best thing about those are that they are usually paid for by your employer because they want you back at work as soon as possible :D (The premium is added to our income tax though) Socialism hell yeah!

BadassFractal 8y ago

Follow the money, I guess. Who's pocketing the 15 grand worth of trauma activation?

karterk 8y ago

Recently a friend of mine visited the emergency care in a private hospital in downtown SF with heavy stomach pain. It turned out to be a partial bowel obstruction, which thankfully sorted itself out with some conservative treatment. My friend was discharged in a couple of days... with a bill of 70K USD. Except for an IV and a Ryles tube, there was hardly any other intervention. Having just finished college, my friend did not have an insurance plan that could cover such a huge bill. Thankfully the state stepped in to help since the yearly income was below the federal poverty line. Otherwise, I can't imagine the plight. For once, my friend was thankful for being a broke college grad.

ashildr 8y ago
Students in Germany usually have free healthcare from their parents mandatory insurance, if they are older than 25 most have to pay about €70 and from 30 they usually have to pay about €115. These are the rates for the public insurances, private insurance are usually cheaper for youngpeople but have other problems.

ilotro 8y ago

Every now and then I seriously consider moving to the US, but the healthcare system scared the crap out of me. I can't imagine how stressful it must be to have to depend on your employer for health insurance.

throw_away2 8y ago

I've said here before that I hope I get mauled and eaten by wolves to avoid the entire healthcare industry, but now I'm thinking about offering wolves as a service.

dmarlow 8y ago

If there is one area ripe for disruption, it's US health care. A few months ago my wife was showing me atrocious bills people were posting on FB, I didn't know whether to laugh or cry. It hit home because we "accidentally" got a bill when an in-network lab sent a blood test to an out of network testing facility and we got a $14k bill... for a blood test. Just recently, a 2 hour ER visit for my toddler cost $3.5k for a breathing treatment, some Tylenol and some influenza tests. All part of my high deductible plan. I used to be on the side against healthcare reform. I'm now counting the seconds until we have ANY regulation to stop this madness.

flak48 8y ago
> I used to be on the side against healthcare reform. Why?
- dmarlow 8y ago
  Because I had an amazing healthcare plan and was too naive at the time.

sexy_seedbox 8y ago

Of all the news outlets available, why is Jack Ma's Hong Kong newspaper linked?

anonu 8y ago

My wife recently gave birth to our first child. Normal delivery - 2 nights in a hospital. Then we had to go back again for jaundice - nothing serious - but added another 2 nights in a hospital room. All said and done my insurance was billed $64,000 for what is considered a normal uncomplicated birth. That is insane to me. If you go over the bill carefully, instantly 50% of that disappears because I've "saved" by being with my insurance provider. What if I had no insurance? Would I get billed that insane number and have to spend hours whittling it down? My dad was commenting on how the drug he takes regularly in his home country (outside the US) is 1/10th the price of what it costs here. The health insurance system is broken in USA (who knew?). Everything is artificially over-inflated because it all gets "negotiated" down in the end. This creates a lot of room to maximize your net revenue when you set prices arbitrarily high.

rusk 8y ago

Privatise they said, run things like a business they said ...

dzink 8y ago

The issue here is that the head hit was activated as a trauma. Trauma activation criteria are different for every hospital. If the criteria is lower, you get situations like these. Trauma teams legitimately require such expense. There are surgeons, nurses, neurosurgeons, and others on call 24/7 sleeping on the hospital so they can get to victims of trauma within 5minites. Gunshots, stab wounds, car accidents, massive balconies falling with kids on them, etc, all require legitimate trauma activations. So do drinks and homeless people who get hit by cars or stabbed in the middle of the night, and many who don’t have insurance are still treated by the hospital. Some hospitals bill all patients 7-10 times the actual costs, get paid 1-2 times actual by insurance. Uninsured either don’t pay, or negotiate down, or are plagued by the full bill designed to compensate for the others who don’t pay. If a hospital isn’t able to cover the costs of a trauma team, that means they lose their trauma designation and any local patients bleeding out because of trauma have to be trekked by ambulance or helicopter to the next trauma center, which in SF is Stanford or John Muir in the East Bay. They might have needed to pay another 25k if a chopper was called for this.

nerbert 8y ago
Curiously enough this only happens in the US. It seems that there is a rationale behind every decision that is made here, and yet the overall system doesn’t work for most people. In that case this case can as well be summarized as: hospital seizes opportunity to maximize profits on baby, then every decision in the chain becomes clear.

mnm1 8y ago

First, they're from South Korea. Paying even a cent of this would be a stupidly bad financial idea. Why? There is absolutely no reason. Let the hospital send the bill to some creditors and let them try to collect in South Korea. Honestly, the situation is laughable. Second, the article thinks that this was fraud. Figures. It may not be too late for them to call the hospital and point this out and ask them to zero out the balance. This hospital, when it had its prior name, did something similar for a friend of mine, albeit his bill was about $1-2k and it was not fraud. Considering they might be on the wrong side of the law, this seems like a solution both sides can get behind.

Beldur 8y ago

My personal story from Germany: My 14 month old son got a deaseae in the spine so he could not walk anymore. We spent 4 weeks in the hospital. 1 week until it was diagnosed in the MRT, 3 weeks with 3 different antibiotic treatment and another two month antibiotics at home. All this while my wife continued to study for her PHD so I stayed away from work and lived with my son in the hospital. This whole experience did cost us around 200€ (incl. gasoline to drive to the hospital) while still getting full income from my employer.

Svoka 8y ago

Break a leg. Well. I broke femur near San Luis Obispo. I was admitted to hospital, was charged over $19000 (that is nineteen thousands dollars) per night for bed. Just for bed. And it was a "cheap" option with person crying in agony next to me whole time. Total bill was 74k$ dollars just for hospital service. Emergency services, E.R., surgery, anesthesiology all Extra. Welcome to US. P.S. With that prices, hospital easily would make it in top 20 most expensive hotel rooms of the world, except I didn't have a choice but to pay for it.