6 ms·

I 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 wit

I 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 ago
An 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 ago
  Who 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 ago
      In 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 ago
        Yes, 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).
        maxxxxx 8y ago
        "you're completely ignorant" Thanks. Very stylish.
        kmlx 8y ago
        mate, the health situation in the US is a joke. the US is less healthy than Oman and Slovenia.
      - exodus_de 8y ago
        Since the previous comment got flagged for "tone" (presumably), here's just facts: - MRSA rates in german hospital are extremely high - waiting times for specialists are measured in months - rushed appointments and higher likelihood of diagnostic mistakes - two-class system (public/private) that by law shuts out ordinary workers from better private care - doctors are leaving in droves for countries like Switzerland (after spending decades in the "free" German education system) All of these are results of price-fixing that people absolutely should care about. Proper healthcare costs money, especially in a developed country. I'm getting downvoted into oblivion, presumably by people who fetishize a socialized system they themselves do not have and know very little about. It's enraging to say the least.
    - jimbokun 8y ago
      "You should care about the deductible, cause you entered the contract, silly." This is stupid. There is no real way to shop and bring down health insurance costs in the US. It's tied to your job, meaning you would need to get many job offers, and turn them down when you find out the actual insurance costs until you find one that's better, and ignoring other employment factors. And then everything can change the next time open enrollment comes around. Don't like the deductible, time to start the job search again! Oh, and the deductibles are probably about the same at all the other companies, anyway. It's just a stupid system from top to bottom, locked into place because our political representatives are completely uninterested in governing.
      - exodus_de 8y ago
        Insurance isn't tied to your job. You can (and often should) forego the employer's plan and purchase insurance on the open market. Most insurances have some form of deductible, it's what keeps them affordable. Insurance should be protecting you against a huge financial fallout, not against petty expenses. I agree it is a stupid system though and I'll tell you why: People want something for nothing. They want coverage for everyone, they don't want a tax, but they don't want compulsion to purchase and they also want to force insurers to take people with pre-existing conditions. Insurance can't work that way, the money has to come from somewhere. If there was a compulsion to purchase, the system could work, as it does in many other countries. That's probably unconstitutional though, so it probably wouldn't stand. Lastly you have "Medicare for all" which would basically bankrupt hospitals if you extrapolate from what current Medicare does to them financially. You honestly can't blame representatives for dealing with voters that understand nothing and want everything. They voted for Obamacare, then they voted for Trump to make Obamacare even worse. I don't even want to know what's next...
        jimbokun 8y ago
        Thanks for engaging, your comments are interesting and thought provoking. "If there was a compulsion to purchase, the system could work, as it does in many other countries." Wasn't that one of the major points of Obamacare, to make strides in that direction? And it did pass Supreme Court scrutiny, who decided yes it is a tax, and yes the government is allowed to tax us. "Lastly you have "Medicare for all" which would basically bankrupt hospitals if you extrapolate from what current Medicare does to them financially." Across our economy, competition and technology drive higher quality at lower cost. Doctors and hospitals need to have an incentive structure that rewards keeping the most people healthy at the lowest cost. "Capitation" models are meant to provide these incentives, where you don't get paid for "doing things" to patients, like ordering tests or performing surgeries. You get paid a fixed sum per patient to keep them healthy, adjusted for the "risk" associated with the patient (for example, if they have a chronic condition that needs ongoing treatment). So an intelligent "Medicare for All" system could be designed to incentivize innovation and cost cutting and overall patient health, if implemented intelligently.
splintercell 8y ago
What is included in that fee is malpractice insurance premiums (because it isn't that nothing can go wrong in that 10 min interaction which causes you to sue the doctor) paid by the doctor. On the top of that, he didn't charge you for what it was, but for what it wasn't and confirming it. Take for instance if that muscle spasm actually lead to something darn serious, the doctor ruled that out, that's why he sent you back after 10 mins. For some weird reason (or counter-intuitive economic reasoning which everyone has got), if you had a serious problem, and the doctor had identified it in that 10 mins, then you'd be ok with that billing. See it this way, if you're tech security contractor and the CEO calls you urgently to come take a look at suspicious behavior on his computer which he thinks might be a hacker hacking his computer, but it turns out to be a quite known windows bug, that doesn't mean you shouldn't charge him your regular fee if it was an actual hacking attempt. You're getting paid for being on call.
- noelsusman 8y ago
  That price has little to do with malpractice premiums. You're paying for the fact that the ER was there, fully staffed, ready to treat literally anything that you could have walked in with at a moment's notice. That and you're subsidizing people who don't pay.
vonmoltke 8y ago
$359 is an order of magnitude less than four figures. It's also about what we paid for my wife's shoulder. Which, like I said, is bad enough on its own.

exodus_de 8y ago

An 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 ago
Who 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 ago
    In 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 ago
      Yes, 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).
      - maxxxxx 8y ago
        "you're completely ignorant" Thanks. Very stylish.
      - kmlx 8y ago
        mate, the health situation in the US is a joke. the US is less healthy than Oman and Slovenia.
    - exodus_de 8y ago
      Since the previous comment got flagged for "tone" (presumably), here's just facts: - MRSA rates in german hospital are extremely high - waiting times for specialists are measured in months - rushed appointments and higher likelihood of diagnostic mistakes - two-class system (public/private) that by law shuts out ordinary workers from better private care - doctors are leaving in droves for countries like Switzerland (after spending decades in the "free" German education system) All of these are results of price-fixing that people absolutely should care about. Proper healthcare costs money, especially in a developed country. I'm getting downvoted into oblivion, presumably by people who fetishize a socialized system they themselves do not have and know very little about. It's enraging to say the least.
  - jimbokun 8y ago
    "You should care about the deductible, cause you entered the contract, silly." This is stupid. There is no real way to shop and bring down health insurance costs in the US. It's tied to your job, meaning you would need to get many job offers, and turn them down when you find out the actual insurance costs until you find one that's better, and ignoring other employment factors. And then everything can change the next time open enrollment comes around. Don't like the deductible, time to start the job search again! Oh, and the deductibles are probably about the same at all the other companies, anyway. It's just a stupid system from top to bottom, locked into place because our political representatives are completely uninterested in governing.
    - exodus_de 8y ago
      Insurance isn't tied to your job. You can (and often should) forego the employer's plan and purchase insurance on the open market. Most insurances have some form of deductible, it's what keeps them affordable. Insurance should be protecting you against a huge financial fallout, not against petty expenses. I agree it is a stupid system though and I'll tell you why: People want something for nothing. They want coverage for everyone, they don't want a tax, but they don't want compulsion to purchase and they also want to force insurers to take people with pre-existing conditions. Insurance can't work that way, the money has to come from somewhere. If there was a compulsion to purchase, the system could work, as it does in many other countries. That's probably unconstitutional though, so it probably wouldn't stand. Lastly you have "Medicare for all" which would basically bankrupt hospitals if you extrapolate from what current Medicare does to them financially. You honestly can't blame representatives for dealing with voters that understand nothing and want everything. They voted for Obamacare, then they voted for Trump to make Obamacare even worse. I don't even want to know what's next...
      - jimbokun 8y ago
        Thanks for engaging, your comments are interesting and thought provoking. "If there was a compulsion to purchase, the system could work, as it does in many other countries." Wasn't that one of the major points of Obamacare, to make strides in that direction? And it did pass Supreme Court scrutiny, who decided yes it is a tax, and yes the government is allowed to tax us. "Lastly you have "Medicare for all" which would basically bankrupt hospitals if you extrapolate from what current Medicare does to them financially." Across our economy, competition and technology drive higher quality at lower cost. Doctors and hospitals need to have an incentive structure that rewards keeping the most people healthy at the lowest cost. "Capitation" models are meant to provide these incentives, where you don't get paid for "doing things" to patients, like ordering tests or performing surgeries. You get paid a fixed sum per patient to keep them healthy, adjusted for the "risk" associated with the patient (for example, if they have a chronic condition that needs ongoing treatment). So an intelligent "Medicare for All" system could be designed to incentivize innovation and cost cutting and overall patient health, if implemented intelligently.

splintercell 8y ago

What is included in that fee is malpractice insurance premiums (because it isn't that nothing can go wrong in that 10 min interaction which causes you to sue the doctor) paid by the doctor. On the top of that, he didn't charge you for what it was, but for what it wasn't and confirming it. Take for instance if that muscle spasm actually lead to something darn serious, the doctor ruled that out, that's why he sent you back after 10 mins. For some weird reason (or counter-intuitive economic reasoning which everyone has got), if you had a serious problem, and the doctor had identified it in that 10 mins, then you'd be ok with that billing. See it this way, if you're tech security contractor and the CEO calls you urgently to come take a look at suspicious behavior on his computer which he thinks might be a hacker hacking his computer, but it turns out to be a quite known windows bug, that doesn't mean you shouldn't charge him your regular fee if it was an actual hacking attempt. You're getting paid for being on call.

noelsusman 8y ago
That price has little to do with malpractice premiums. You're paying for the fact that the ER was there, fully staffed, ready to treat literally anything that you could have walked in with at a moment's notice. That and you're subsidizing people who don't pay.

vonmoltke 8y ago

$359 is an order of magnitude less than four figures. It's also about what we paid for my wife's shoulder. Which, like I said, is bad enough on its own.