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SF hospital charged $15K ‘trauma response fee’ for baby that needed no treatment
- firefoxd 8y agoOk, in the US we are one medical trip away from complete bankruptcy. Not too long ago there was an article saying the average person in America doesn't have $400 stashed away for an emergency. So what do you do when you get this bill? You can't pay, you don't have the money. What do you do?
- steanne 8y agoyou don't go. https://globalnews.ca/news/4311663/massachusetts-subway-injury-ambulance-cost/ https://globalnews.ca/news/4311663/massachusetts-subway-inju...
- mirimir 8y agoAs I understand it, bankruptcy is often not necessary. In the US, public hospitals must provide service to patients who can not pay. So they typically forgive unpaid fees. But private hospitals and clinics are more likely to sell unpaid balances to collection agencies. And then bankruptcy is the only way out. Also, if they know that you won't be able to pay, they may do whatever's needed to keep you alive, and then transfer you to a public hospital.
- Jach 8y agoYou contest what you can, and then you arrange a payment plan... also I believe the median surplus income (mean is higher) per month in America is ~$1k, most Americans just do something with it (leave it in checking account, invest it, or spend it) instead of putting it in a separate savings account. Your general complaint about high medical costs is on point of course, but for most people in America they could pay off a dumb $18k bill over a period of time if they had to.
- tscs37 8y agoWhat if something else happens during that time? 1k$ surplus income per month on a 18k$ bill means you'd have to forfeit all surplus income for 18 months. If any other medical emergency happens and you have another 18k bill? Or a car accident (of which there are a lot)? Or car just breaks down? What if you get fired and spend a few months searching a new job? This isn't exactly financial security with such a bill pending over your head plus numerous other bills being a possibility.
- Jach 8y ago> 1k$ surplus income per month on a 18k$ bill means you'd have to forfeit all surplus income for 18 months. Sure, if you were intent on paying it off as quickly as possible. Most likely your payment plan would be less than that. Ultimately if enough "what if something else happens?" happen, you file for bankruptcy. There's no such thing as financial security for anyone when you deal in the world of what-ifs.
- tscs37 8y agoThere is financial security for me. I don't have to worry about not being able to pay my hospital bill. I won't have to file for bankruptcy because I'm unable to pay because that doesn't happen. So there is certainly some financial security for anyone in the world of what-ifs, atleast as far as medical coverage is concerned.
- Ra1d3n 8y agoOne of the reasons I have basically given up my fantasy of moving to the USA is the russian roulette that you seem to have to play with your health and its insurance.
- rogerb 8y agoIf you have insurance through your employer you'll be ok. If you don't you'll pay anywhere between $800 and $3000, a month, for healtcare.
- ColinWright 8y agoThe article seems to be saying that in some cases the insurer assesses what the hospital is charging, decides it's too high, doesn't pay it all, and then you owe the hospital thousands of dollars despite being fully insured. So I don't believe your assertion.
- pas 8y agoThat was a travel insurance, "completely" different from the US healthcare insurance providers, where the issue is in-network and out-network providers, etc.
- pimeys 8y agoWhat happens if you get fired from your job suddenly? And if you happen to have pre-existing conditions, such as a type 1 diabetes, that is known for being very expensive to treat? How can you live with this fear?
- Jach 8y agoMy mom lost her job with benefits, and a month later fell down some stairs and broke her arm. Eventually she was able to get an insurance plan (after getting a new job) for something like $200 or $300 per month (there are in fact cheaper ones depending on your need of coverage and state), while paying off the bills from the broken arm event. Personally speaking, I have no fear of a similar event happening to me. If it happened, I'd figure something out, or die. Generally speaking, "what we think is unbearable proves to be bearable."
- rogerb 8y agoIn Australia we went to the doctor after my kid had an allergic reaction. They medicated him, had a nurse within 10 feet and kept him for 6 hours until symptons receded. Total cost - AUD$40. The US systom is absolutely insane, expensive and delivers worse results.
- cm2187 8y agoI am pretty sure $40 isn’t the cost of the exams. It is being subsidised by other tax payers. We can discuss the merits of this approach but it is not necessarily cheaper overall.
- artpop 8y agoDing ding ding. Look at the brain on Brad!
- anxiouspete 8y agoOf course it's not, but the difference here is that OP isn't made insolvent, or forced to sell their home, to pay their hospital bill.
- timack 8y agoHealth expenditure per capita in the US is about twice that of Australia so it does appear to be cheaper overall.
- DanBC 8y agoThe US government pays more for healthcare in the US than many other countries. When you add in private insurance the US far outspends outher countries for healthcare. But they don't have better results. For example, the US has a shorter average lifespan than many countries.
- davrosthedalek 8y agoOf course that was not the total cost. That was just the cost to you at that moment. The rest is paid by the society. The real total is probably still a lot less than the cost in the US would have been.
- vinchuco 8y agoCan medical tourism grow enough to bring medical costs down by competition?
- Molaxx 8y agoMean while corrupting and wrecking other countries healthy(ish) national health systems? No thank you.
- vinchuco 8y agoCould you clarify how? I don't see how that follows.
- williamdclt 8y agoa country healthcare system is not designed to support people of other countries that come because their own healthcare sucks.
- geomark 8y agoMany countries have arranged to do just that because they make a profit from it. The popular medical tourism desitinations provide world class care at a fraction of the cost of the same or inferior care in the US. The medical tourists pay cash on delivery. The providers make handsome profits, despite charging substantially less. Lots of factors behind why it works. Mostly rooted in market forces.
- deleted 8y ago[deleted]
- vidarh 8y agoNot for free, but the UK's NHS for example are allowed to operate private clinics and some NHS trusts derive substantial extra income from that as a means to alleviate funding shortfalls while making better use of spare capacity.
- ben_w 8y ago
- jblazevic 8y agoHow is this practice of inflating prices while exploiting urgency and lack of choice not clearly fradulent and illegal?
- ekianjo 8y agoThere are emerging alternatives on the market: https://reason.com/reasontv/2017/10/16/doctors-direct-primary-care https://reason.com/reasontv/2017/10/16/doctors-direct-primar... Note that the current system is actively fighting off the development of such alternatives...
- cbluth 8y agoThe medical system in the US is rampant with this sort of thing, what a shame.
- consz 8y agoWhat's the long term stable state for American health care? Given the difference between the rate at which healthcare costs grow and the rate at which wages grow, it will only take a couple decades before the former is larger than the latter -- and at that point, only a few years until it starts becoming (large) integer multiples of the latter. So what's the plan then? Obviously, nobody will actually be capable of paying those costs. Will people simply choose to die, or leave untreated most medical issues? Even in the case in the article's title, how could any non-billionaire justify paying such a cost? They don't even live here -- I could never imagine what sort of calculus would lead me to even pay a single dollar to someone requesting such an obscene price for so few services rendered.
- jarfil 8y agoUS Healthcare costs are fake, hospitals don't really expect to get the whole sum after they apply discounts for insurance companies, so they make them appear bigger just to get what they intended. It's only people who don't have a strong insurance company to fight on their side who get ripped to shreds.
- guidedlight 8y agoIt sounds like this "trauma activation", has replaced the triage system. Where a triage department will determine the severity of the emergency injury, and associate an appropriate medical response. The triage activation assembles a team of experts that treats every emergency patient with the same high level response, similarly because doing so attracts a higher fee.
- amelius 8y agoGiving an upfront indication of the costs would have been the least they could have done.
- Broken_Hippo 8y agoThat is near impossible, and still gives folks little to no choice in an emergency. "to keep your child from possibly dying, you'll wind up paying at least $15,000, depending on the diagnosis" Of course, that last bit was completely unknown upfront. It is hard enough to shop around for non-emergency gall bladder surgery, let alone actual emergencies.
- DanielBMarkham 8y agoMy wife has sleep apnea, so during her normal annual checkup the doc wrote her a prescription for a CPAP. She goes to the local vendor, they tell her to pick out whichever machine she'd like. She would rent it for a few months to make sure she liked it. The insurance company would pick up the bill. Many months later we just got a bill for $500. She calls them. They tell her that this is the balance owed on the machine. Now they've already billed the insurance company four thousand dollars for the machine. The insurance company paid about a quarter of that. Then she the rents on top of that. And now they want the balance. The bill came completely out of the blue. They won't take it back. So she's thinking about selling it. Going online the machine is only worth 500 bucks brand new. They're basically selling the same machine three different times: once to the insurance company, once on a rent-to-own deal, and once as a bill coming from nowhere. I don't know in what universe this is not considered plain old fraud. The billing situation in healthcare in the U.S. has become so byzantine and complicated that's it has basically turned into a shell game of screw-the-consumer. I don't want to talk about why it happens. I don't want to talk about solutions. I will say that the politics of healthcare has led us here -- nothing else but that. And the more we argue the worst it will continue getting. I do want to note that it seems like every month or so there's some new horror story. It's so bad that the vast majority of the time nobody talks about it. It's an awful mess.
- steanne 8y agoprevious discussion: https://news.ycombinator.com/item?id=17468788 https://news.ycombinator.com/item?id=17468788
- Beldur 8y agoMy 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.
- yani 8y agoThe hospitals are assembling a team of experts to deal with extreme injuries of patients. Patients then refuse to pay this bill but forget that if this team was not there they could have lost their life. Any trauma to the head is life threatening - people die from slipping in the bathroom.
- jsumrall 8y agoIs this a case where having better insurance would protect you from the hospital? Not sure how insurance or billing in the US works, but in the article one person broke their ankle and their insurance negotiated the price with the hospital, and then the hospital still came after the person for the costs that the insurance company negotiated to not pay.
- purplelobster 8y agoNot a huge loss for the US, but I will probably never go back due to this. Even if you have insurace, your life will be hell for a while due to having to fight your insurance company over a tremendous bill. I don't want to have to think twice if I should bring in my son to the hospital or not, and frankly, the US doesn't have anything unique enough to offer to offset that risk. I'm also doing my best to stay away from conferences, preferring instead Canada, European or Asian destinations.