4 ms·

Emergency room bills: what I learned from reading 1,182 ER bills

13 points by flippyhead 8y ago

sampagu 8y ago
https://www.bollymeditube.com/2018/12/how-to-increase-platelets-count.html https://www.bollymeditube.com/2018/12/how-to-increase-platel...
jellicle 8y ago
> $1 ointment/$76 ointment When prices can be 76 times higher at one facility than the one next door, with no notice to the patient until their bill is overdue, there's obviously no way to price compare at all and market functionality does not exist. > in-network/out-of-network Vox doesn't say it, but doctors and hospitals are purposely orchestrating the "out of network doctor in an in-network hospital" to raise their fees. It's a deceptive trade practice. The US medical system is broken. The solution is single-payer (none of these problems exist in single-payer systems).
- normal_man 8y ago
  Yeah, the idea that "shopping around" is something that people want to do, or is even possible to do, with health coverage is utterly absurd propaganda designed to discredit single payer policy.
  - rukittenme 8y ago
    What do you mean? I "shop around" for healthcare.
    - normal_man 8y ago
      You shop around for health insurance (which is another annoying nightmare altogether, and most people's only option for that is the provider chosen by their employer). If you were in an accident and taken by emergency services to the nearest hospital, you pay whatever they say and you didn't have any control as a "consumer." It's a mistake, and frankly barbaric, to think of healthcare as a "market." It should be a public service to all in the pursuit of a just society.
      - rukittenme 8y ago
        > If you were in an accident and taken by emergency services to the nearest hospital, you pay whatever they say and you didn't have any control as a "consumer." Which accounts for 4% of healthcare spending. Rare, unforeseen events are covered by insurance. That's how home insurance works. That's how car insurance works. That's how health insurance works. > It's a mistake, and frankly barbaric, to think of healthcare as a "market." I don't "think of" healthcare as a market. By definition, it is a market. Whether it functions well enough to any person's satisfaction is a matter of what that person values. > It should be a public service to all in the pursuit of a just society. Is a "just" society your only goal? A healthy society, a wealthy society, a free society. There are many goals which might conflict with a "just" society. How do you balance those objectives with social justice? --- Edit: I forgot to respond to my main point. Namely, that I do pick and choose healthcare based on who provides the best price. I shopped around my dentist. I shopped around for my root canal, I shopped for some eye issue I had, I shopped around for my general practitioner, I ask for alternatives when the doctor wants to prescribe medications. Which is to say. I do not shop around for health insurance (it is provided by my employer). I shop around for health care specifically.
- sgjohnson 8y ago
  The solution is absolute free market.
- theandrewbailey 8y ago
  The US has a de facto single payer system: the patient pays it all!
erentz 8y ago
My own experience with hospital billing: Had to go to ER in November, and I was admitted upstairs for a “rescue dose” of IVIG for neurological condition (similar to CIDP/GBS). We were told by the admitting doctor it should probably be covered by insurance but if not in his experience it should cost around $10,000 for all five infusions necessary, plus another $2,000 per day for the bed. The doses are infused over five separate infusions. Get one dose that night of 30g of IVIG. Next day new doctor comes and tells me he doesn’t think insurance will cover it, and he’s talked to the pharmacist and it will cost us $16,000 per infusion. We absolutely can’t afford that so get discharged. We now have an outstanding bill for $16,666.30 for 30 grams of IVIG that insurance didn’t cover. (Cue dramatic story about having to get rid of all of our stuff and being driven 3,000 miles across the country to change to a different insurance plan offered by my company.) I am now on regular infusions of IVIG, and a 40 gram infusion costs $3,700 at the contract rate the new insurance pays. That’s $94 per gram vs $555 that the hospital is trying to charge is. A 6 fold increase to a private individual who can’t afford it, without being told in advance the actual price or given the option to not get it.
- flippyhead 8y ago
  TBH it's stories like these that make it hard for me to not regard my doctors visits as adversarial.
- rasz 8y ago
  Afaik there is a EU wide law mandating display of products and services prices. Something like learning after the fact you just got financially ruined is unfathomable, what a corrupt system.

13 points by flippyhead 8y ago

https://www.bollymeditube.com/2018/12/how-to-increase-platelets-count.html https://www.bollymeditube.com/2018/12/how-to-increase-platel...

jellicle 8y ago

> $1 ointment/$76 ointment When prices can be 76 times higher at one facility than the one next door, with no notice to the patient until their bill is overdue, there's obviously no way to price compare at all and market functionality does not exist. > in-network/out-of-network Vox doesn't say it, but doctors and hospitals are purposely orchestrating the "out of network doctor in an in-network hospital" to raise their fees. It's a deceptive trade practice. The US medical system is broken. The solution is single-payer (none of these problems exist in single-payer systems).

normal_man 8y ago
Yeah, the idea that "shopping around" is something that people want to do, or is even possible to do, with health coverage is utterly absurd propaganda designed to discredit single payer policy.
- rukittenme 8y ago
  What do you mean? I "shop around" for healthcare.
  - normal_man 8y ago
    You shop around for health insurance (which is another annoying nightmare altogether, and most people's only option for that is the provider chosen by their employer). If you were in an accident and taken by emergency services to the nearest hospital, you pay whatever they say and you didn't have any control as a "consumer." It's a mistake, and frankly barbaric, to think of healthcare as a "market." It should be a public service to all in the pursuit of a just society.
    - rukittenme 8y ago
      > If you were in an accident and taken by emergency services to the nearest hospital, you pay whatever they say and you didn't have any control as a "consumer." Which accounts for 4% of healthcare spending. Rare, unforeseen events are covered by insurance. That's how home insurance works. That's how car insurance works. That's how health insurance works. > It's a mistake, and frankly barbaric, to think of healthcare as a "market." I don't "think of" healthcare as a market. By definition, it is a market. Whether it functions well enough to any person's satisfaction is a matter of what that person values. > It should be a public service to all in the pursuit of a just society. Is a "just" society your only goal? A healthy society, a wealthy society, a free society. There are many goals which might conflict with a "just" society. How do you balance those objectives with social justice? --- Edit: I forgot to respond to my main point. Namely, that I do pick and choose healthcare based on who provides the best price. I shopped around my dentist. I shopped around for my root canal, I shopped for some eye issue I had, I shopped around for my general practitioner, I ask for alternatives when the doctor wants to prescribe medications. Which is to say. I do not shop around for health insurance (it is provided by my employer). I shop around for health care specifically.
sgjohnson 8y ago
The solution is absolute free market.
theandrewbailey 8y ago
The US has a de facto single payer system: the patient pays it all!

erentz 8y ago

My own experience with hospital billing: Had to go to ER in November, and I was admitted upstairs for a “rescue dose” of IVIG for neurological condition (similar to CIDP/GBS). We were told by the admitting doctor it should probably be covered by insurance but if not in his experience it should cost around $10,000 for all five infusions necessary, plus another $2,000 per day for the bed. The doses are infused over five separate infusions. Get one dose that night of 30g of IVIG. Next day new doctor comes and tells me he doesn’t think insurance will cover it, and he’s talked to the pharmacist and it will cost us $16,000 per infusion. We absolutely can’t afford that so get discharged. We now have an outstanding bill for $16,666.30 for 30 grams of IVIG that insurance didn’t cover. (Cue dramatic story about having to get rid of all of our stuff and being driven 3,000 miles across the country to change to a different insurance plan offered by my company.) I am now on regular infusions of IVIG, and a 40 gram infusion costs $3,700 at the contract rate the new insurance pays. That’s $94 per gram vs $555 that the hospital is trying to charge is. A 6 fold increase to a private individual who can’t afford it, without being told in advance the actual price or given the option to not get it.

flippyhead 8y ago
TBH it's stories like these that make it hard for me to not regard my doctors visits as adversarial.
rasz 8y ago
Afaik there is a EU wide law mandating display of products and services prices. Something like learning after the fact you just got financially ruined is unfathomable, what a corrupt system.