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> Patients in states like Texas and Colorado have reported receiving bills for thousands of dollars from emergency departments If you’re paying more than sever

> Patients in states like Texas and Colorado have reported receiving bills for thousands of dollars from emergency departments If you’re paying more than several hundred dollars for non-admitted treatment you’re being swindled. Outside a few treatments such as dialysis and chemotherapy anything that expensive warrants admission.

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afarrell 8y ago
> swindled Do people generally have a choice what ER they go to? I’ve definitely seen people complain on the internet because they were passed out on the sidewalk and someone called an ambulance on them which stuck them with a large bill.
- mathgeek 8y ago
  This always raises an interesting question about the concept of charging someone for a service that they did not have an opportunity to ask for or consent to until after the fact. On one hand, you have doctors wanting to save or improve someone's life. On the other hand, especially when death is the result despite attempts to safe the patient's life, the person/estate has now incurred a cost that was potentially undesired.
  - JshWright 8y ago
    We (EMS) operate under "implied consent" in those cases. If someone is incapable of consenting to treatment, we assume that they would want to treated (because that's a better failure mode than not treating someone who does want it).
  - afarrell 8y ago
    The issue here is that we as a society recognize different standards of consent. In the framework of Medical Consent, if someone is unconscious, then they are implicitly consenting to medical treatment[1][2]. I don't have any background in contract law besides occasionally reading /r/legaladvice, but it seems unlikely that that matches our common-law concept of consent to a contract. So where does that obligation to pay for the ambulance come from? It doesn't exist in the UK, but did it before 1948? Are there statutes in US states which create that obligation? [1] First aid training my MIT's Office of Emergency Management [2] First Aid training my St. Johns Ambulance in London.
- Spooky23 8y ago
  Yes, you can ask to be taken wherever. I grew up in a rural area and it was a big deal, because the volunteers were EMTs only and meeting the county paramedic could cost $500, and sometimes they would ask for air transport, which was either free (provided by state police) or $5,000+, depending on the day. Insurance pays $0 if you are not admitted.
- dragonwriter 8y ago
  > Do people generally have a choice what ER they go to? Yes, people often take themselves to an ER and have more than one within reasonable range. > I’ve definitely seen people complain on the internet because they were passed out on the sidewalk and someone called an ambulance on them which stuck them with a large bill The majority of ER visits are not people who had an ambulance summoned when they were unconscious, but, yes, in that case people generally don't have a choice about whether they go to an ER or which one.
lazyasciiart 8y ago
There's plenty of scans that cost more than that on their own. I got dramatically run over as a pedestrian and while I turned out fine (for heavily bruised values of fine), I was certainly happy for them to verify that with a CAT scan and some xrays of the more scraped up limbs instead of have them say that it was probably just shock and since I couldn't remember if I had hit my head we could assume it was ok.
- ixacto 8y ago
  Heck I went to the er for chest pains and what felt like an irregular heartbeat when I was 24. Had and ekg and everything. Was still around $300 (after jnsurance) even tho I was fine and it turned out to just be anxiety and dehydration. There is no way I should be convinced by some fucking insurance company that something like this would be better seen in urgent care. What about the 0.1% of people where it actually is serious? What if that allergy to peanuts your kid has is actually life threatening? You want the most comprehensive care available at the time available ASAP.

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afarrell 8y ago

> swindled Do people generally have a choice what ER they go to? I’ve definitely seen people complain on the internet because they were passed out on the sidewalk and someone called an ambulance on them which stuck them with a large bill.

mathgeek 8y ago
This always raises an interesting question about the concept of charging someone for a service that they did not have an opportunity to ask for or consent to until after the fact. On one hand, you have doctors wanting to save or improve someone's life. On the other hand, especially when death is the result despite attempts to safe the patient's life, the person/estate has now incurred a cost that was potentially undesired.
- JshWright 8y ago
  We (EMS) operate under "implied consent" in those cases. If someone is incapable of consenting to treatment, we assume that they would want to treated (because that's a better failure mode than not treating someone who does want it).
- afarrell 8y ago
  The issue here is that we as a society recognize different standards of consent. In the framework of Medical Consent, if someone is unconscious, then they are implicitly consenting to medical treatment[1][2]. I don't have any background in contract law besides occasionally reading /r/legaladvice, but it seems unlikely that that matches our common-law concept of consent to a contract. So where does that obligation to pay for the ambulance come from? It doesn't exist in the UK, but did it before 1948? Are there statutes in US states which create that obligation? [1] First aid training my MIT's Office of Emergency Management [2] First Aid training my St. Johns Ambulance in London.
Spooky23 8y ago
Yes, you can ask to be taken wherever. I grew up in a rural area and it was a big deal, because the volunteers were EMTs only and meeting the county paramedic could cost $500, and sometimes they would ask for air transport, which was either free (provided by state police) or $5,000+, depending on the day. Insurance pays $0 if you are not admitted.
dragonwriter 8y ago
> Do people generally have a choice what ER they go to? Yes, people often take themselves to an ER and have more than one within reasonable range. > I’ve definitely seen people complain on the internet because they were passed out on the sidewalk and someone called an ambulance on them which stuck them with a large bill The majority of ER visits are not people who had an ambulance summoned when they were unconscious, but, yes, in that case people generally don't have a choice about whether they go to an ER or which one.

lazyasciiart 8y ago

There's plenty of scans that cost more than that on their own. I got dramatically run over as a pedestrian and while I turned out fine (for heavily bruised values of fine), I was certainly happy for them to verify that with a CAT scan and some xrays of the more scraped up limbs instead of have them say that it was probably just shock and since I couldn't remember if I had hit my head we could assume it was ok.

ixacto 8y ago
Heck I went to the er for chest pains and what felt like an irregular heartbeat when I was 24. Had and ekg and everything. Was still around $300 (after jnsurance) even tho I was fine and it turned out to just be anxiety and dehydration. There is no way I should be convinced by some fucking insurance company that something like this would be better seen in urgent care. What about the 0.1% of people where it actually is serious? What if that allergy to peanuts your kid has is actually life threatening? You want the most comprehensive care available at the time available ASAP.