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My family in Germany throws a fit when they have to pay 50 Euro for something. In the US you can happy if your cost for seeing a doctor is less than 4 digits.
by maxxxxx 8y ago
My family in Germany throws a fit when they have to pay 50 Euro for something. In the US you can happy if your cost for seeing a doctor is less than 4 digits.
- jsight 8y agoIn fairness, the US typically does not cost $1k+ for a simple doctor visit.
- vonmoltke 8y ago> In the US you can happy if your cost for seeing a doctor is less than 4 digits. My wife and I have never paid four figures for a doctor visit, despite having two surgeries (one oral), a calf strain, and a dislocated shoulder (with ER visit) between us. The state of medical care in the US is bad enough as it is; you don't need to make up hyperbolic bullshit to make it seem worse.
- mikeash 8y agoI went to the ER thinking I was having a heart attack, and it turned out there was nothing wrong. The doctor who saw me afterwards thought it might have been intestinal spams. I got to pay $6,000 for that bit of entertainment.
- exodus_de 8y agoLet me guess - your deductible is 6000$?
- kradroy 8y agoDid you pay the bill outright without negotiating?
- mikeash 8y agoYes. I couldn’t find an angle to negotiate with. I could afford to pay, so trying to use hardship as a lever to bring down the bill wouldn’t have been honest.
- tathougies 8y agoNormally you just call and say youd like to lower the bill
- dboreham 8y agoIn my experience that doesn't work.
- kradroy 8y agoIf you're willing to risk your credit score for a bit, just don't pay the bill. Eventually some entity down the line will accept less. If you don't want to do that, then you have to eat it; immediately or in installments.
- mikeash 8y agoWhy would they respond with anything besides “fuck you, pay me”? When I did ask, their response was basically a more nicely worded version of that.
- rhexs 8y agoNot so easy if you’re google-able and clearly work in tech. They won’t squeeze blood from a stone, but if they smell money, they aren’t going to negotiate. The advice frequently found on reddit about negotiating is good, but keep in mind it’s targeted at individuals with, best case, 0 net worth and worst case hundreds of thousands in debt. Your mileage will vary depending on the bill collector, hospital system, staff etc., but keep in mind someone has to be paying the bills. American, work in tech, post on Hackernews? It’s probably going to be you. Always worth a shot though. Worst case they’ll usually let you go on a 0% APR payment plan for years and years.
- splintercell 8y agoI really don't understand this 'labor theory of value' thinking. Just because there wasn't anything wrong doesn't mean you don't have to pay a person for their services.
- mikeash 8y agoThat’s not what I’m saying at all. I’m saying that the cost was way too high. How much does an ER visit like that cost in a sane country? I mean the actual cost, not the “free” that the patient might see from a socialized system. It’s nowhere near that high.
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- maxxxxx 8y agoI fell down the stairs and had a muscle spasm in my back. Had to go an ER. I had insurance that was considered good and it still cost me $350 for 10 minutes with the doctor and a bottle of muscle relaxers.
- exodus_de 8y agoAn ER visit is not the same as a simple doctor's visit. If ER visits are necessary (questionable in this case), they are covered by insurance - by law. Your deductible still applies.
- maxxxxx 8y agoWho cares about the deductible? It’s still a ripoff. My girlfriend had an eye infection while we were in Germany. We went to an eye doctor and paid 25 Euro cash including an ointment. The US is just horribly expensive and very unpredictable.
- exodus_de 8y ago> Who cares about the deductible? It’s still a ripoff. You should care about the deductible, cause you entered the contract, silly. Get private insurance in Germany, there's also a deductible, unless you want to pay more. > We went to an eye doctor and paid 25 Euro cash including an ointment. The US is just horribly expensive and very unpredictable. That's because of price fixing (GOÄ). It's all they can charge. And they were probably happy about it because had you been insured they would've only gotten maybe half that.
- maxxxxx 8y agoIn what way is your comment about price fixing relevant? I don't care if the lower price is because of price fixing or not.
- exodus_de 8y agoYes, you don't care because you're completely ignorant. How would you feel about your job if I set the price for your wages at 12€/hour? Price fixing causes shortages and/or lowers quality. I hope you don't have to go to a German hospital and catch yourself some MRSA, or wait months in agony to get an MRI to diagnose your neurological disorder, or get an appointment with basically any specialist. Because that's the reality of German healthcare. Been there, done that (except for the MRSA thing, that only killed a couple of not-so-close relatives).
- jdmichal 8y agoYou walked away from multiple ER visits including surgeries for less than four digits out of pocket? Maybe consider that your experience is the exceptional, not the people you call hyperbolic. My son had a laceration glued together (dermabond in lieu of one or two stitches) and that was either close to or slightly over four digits after totaling the hospital bill and doctor bill, both in network.
- MertsA 8y agoMy son just had a laceration that needed closed up a week ago. We didn't even take him to the ER, just his pediatrician who saw him for all of 5 minutes. She didn't even use any skin adhesives to close up the wound, she just taped it together and called it good. $120 for literally putting on a bandaid that came apart before we even finished the car ride home leaving us to tape it up properly ourselves.
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- specialist 8y agoHow much support stuff does your doctor have? Industry wide, admin expenses are now 5x the cost of the care providers. Your doctor probably needs $X revenue per hour just to keep the lights on.
- dsfyu404ed 8y agoYou didn't pay $120 for the doctor to slap on a band-aid. You paid $120 for the peace of mind of having a "trained professional" do it and tell you that was an acceptable solution. It's the same reason people call plumbers to snake drains and pay mechanics to change brakes. Those are basic things that the least trained workers in those industries are capable of doing but you pay a premium to not have to think about it.
- 8y ago
- seanmcdirmid 8y agoA basic non-complication natural child birth will cost at least a couple of thousand out of pocket for most insurances.
- JshWright 8y agoWith insurance, more complicated births aren't that much more. We were out of pocket $4k for the birth of our twins (maxed our deductible). The total 'sticker price; was over a million USD (they spent a combined 10 weeks in the NICU).
- wolco 8y agoOver a million for 10 weeks in nicu? Who sets these rates?
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- sbov 8y agoOur local hospital tried to charge our insurance $20k for 1 hour of the recovery room and $25k for 1 hour of the surgery room. We have a friend whose hospital tried to charge them $15k for a delivery room they never used - never used because the doctors forgot about them and she delivered her own baby in the hallway. Talk about two major fuckups in a row.
- JshWright 8y agoTo be "fair" that also includes the c-section delivery...
- pbnjay 8y agoMy 6yo son went to the ER with blue lips and we ended up with a $1400 bill for a glorified strep test.
- throwaway6734 8y agoWife passed out on the way out of the hospital after getting an IUD put in. With insurance we paid $800 for her to lay in the Er for 3 hours.
- jedberg 8y agoWait until you need dental surgery. I've never found a dental insurance that allows paying out more than $1,500/year. One gum graft alone is about $2,000. Dentures, replacement teeth, these all cost multiple thousands of dollars.
- deleted 8y ago[deleted]
- germinalphrase 8y agoI stepped on a coal that was knocked out of a bbq grill at a 4th of July party. I went back and forth on whether I should go to the doctor, but the nurse line suggested that I should. 30 minutes, a nurse and doctor saying “don’t pop the blister”, and two Vicodin later I had a $2500 bill to pay off as a broke college student. I guess I shouldn’t have gotten injured on a federal holiday.
- Spooky23 8y agoIt happens with high deductible plans. When I had back surgery I was with a public employer PPO. Total out of pocket was like $300 for about $500k of procedures. Half the people in my recovery PT were selling cars and emptying 401ks to make the mortgage.
- maxxxxx 8y agoThat’s the crazy thing about the US system. For a lot of people things work smoothly like it did for you. Then you have a significant number of other people who get totally screwed with out of network stuff, billing errors and the insurance declining payment for random things. These people now have to have to negotiate often for years, fight collection agencies and often end up owing thousands and tens of thousands of dollars. It’s a big gamble and there is pretty much nothing you can do to protect yourself.
- njepa 8y agoThat is generally the failure mode of complex systems. Say if you made flawed software a couple of decades ago, chances were it crashed. Today flawed software will produce many different errors. Not that the former is necessarily better, just that it is something to understand about the modern world were we aren't limited by scarcity. Same thing with e.g. food or education.
- vonmoltke 8y ago> It happens with high deductible plans. I never said it doesn't happen, which seems to be the strawman most people are responding to. However, there is a huge gap between "it happens" and > happy if your cost for seeing a doctor is less than 4 digits which I indicates this is common and typical.
- Spooky23 8y agoIt depends on who you are and what you do. My health insurance costs more than what a typical minimum wage workers gross compensation.
- specialist 8y agoJust one of my blood tests alone cost $4,600. Surprise billing. "Out of network". Didn't even know to ask. Doctor, lab, everything all under the same roof. Why would any one even think to ask?
- exodus_de 8y ago> My family in Germany throws a fit when they have to pay 50 Euro for something. Socialized insurance rates in Germany are 15% of income. Unless your family doesn't earn any money, they have been paying far more than 50 Euros. > In the US you can happy if your cost for seeing a doctor is less than 4 digits. That isn't generally true. Every insurance plan is different. Cheap plans have a high deductible. It's similar to private insurance in Germany. It's basically like this: If you're gonna be poor, go to Germany. Everyone else will pay for you. If you're going to earn well, leave Germany, otherwise you're going to be paying for everyone else.
- maxxxxx 8y ago"It's basically like this: If you're gonna be poor, go to Germany. Everyone else will pay for you. If you're going to earn well, leave Germany, otherwise you're going to be paying for everyone else." You should add this to your algorithm for location choice: If you get a serious health problem and want to become poor, come to the US.
- refurb 8y agoYou’re not that far off from reality. I’m currently in the US because career opportunities are far superior here. However, if I were to get seriously and chronically sick I would back to my home country. Not that i couldn’t get very good care in the US, but the system here is just a massive burden compared to countries with universal coverage.
- exodus_de 8y ago> You should add this to your algorithm for location choice: If you get a serious health problem and want to become poor, come to the US. If you already have a serious health problem, you'll be hard pressed to find any country to take you and just take care of it pro-bono, if you're uninsured. German public insurance only covers the bare minimum. I know enough people who are poor because of serious health issues. Sure, their medical costs were covered, but they're now welfare cases. They can't afford many treatments that would make their lives better. They would've had to buy extra insurance, but they chose not to, or couldn't afford it. Relating that to the US: Don't skimp on insurance. Don't get an insurance that is capped at a low number, otherwise you will go bankrupt if shit hits the fan.