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Doctors and nurses and supporting staff must exist I got a $800 bill for 10 minutes doctor visit (swollen toe). Not exaggerating a tiny bit. No insurance compa

Doctors and nurses and supporting staff must exist I got a $800 bill for 10 minutes doctor visit (swollen toe). Not exaggerating a tiny bit. No insurance company involved. "Must exist" is not an argument. Something is broken in the system where a doctor charges you $4,800 per hour. Insurance companies, obesity, poor lifestyle choices (all usual BS reasons I hear on TV) do not explain why this particular ####le charged me $4,800 per hour. This saddens me hearing that most discussions about healthcare are circling around the question of "how?" instead of asking ourselves "why so much?".

dalke 16y ago
Last year visiting California I was sick for over a week. 30 minutes for a prescription (which I knew would be the result of that visit) cost me $600. $300 for the doctor and the same for the hospital. In New Mexico (one of the poorest states in the US), the equivalent a few years previous cost me about $100. I stopped getting insurance because as a self-employed person it was expensive and rising. I played the odds and won. Sure doesn't make me feel happy.
- WildUtah 16y ago
  In a civilized country, if you knew what the prescription would be, you could just walk into a pharmacy and buy it. The dotor charges $600 and provides no value. He exists to charge rent on his DEA license.
  - enjo 16y ago
    You do realize how terrible that idea is right? We'd see the rates of antibiotic resistant bacteria go through the roof in the first week.
    - WildUtah 16y ago
      Lots of countries have sold antibiotics freely but the epidemic of resistence mostly seems to show up in the prescription-only countries where doctors push antibiotics on everyone with a cold in order to justify their offensive office visit fees. Also, even if there is a case for antibiotics, there still isn't any case for 95% of medications.
      - dalke 16y ago
        Any evidence for your claim? Drug resistant TB is highest in "the former USSR, the Baltic states, Argentina, India, and China, and was associated with poor or failing national tuberculosis control programmes". Some 10-40% of the people who take antibiotics don't finish a course of treatment because they are feeling better and think they don't need the hassle any more. The WHO and various countries including the US say there is an association with antibiotics in animal feeds and an increase in antibiotic resistance in human diseases. This has nothing to do with "doctors pushing antibodies." Drug resistant staph was first found in the UK. Do doctors in the UK face the same pressure to justify their so-called offensive office visit fees?
jrockway 16y ago
You went to the wrong doctor. When I get my bills for office visits, the rate is something like $300 on average (including lab tests). My insurance company then negotiates that down to something like $75, and then I pay the $10 co-pay. Now, all these numbers could be made up, but $300 seems about right for a doctor's visit when you consider how expensive it is to run a medical practice. It's not something I'd want to have to pay every week because I would die if I didn't, but it's not exactly financial ruination either. If I had some rare disease but still wanted to do a startup, I think I would just work for Starbucks for 20 hours a week or something, simply for the health insurance.
- _delirium 16y ago
  It's very difficult to price-shop, though, because unlike in most normal businesses, nobody seems to publish price lists, and they aren't very forthcoming giving quotes over the phone, either. So it's not too uncommon to end up with something absurd more or less by chance, especially if it's urgent to see a doctor. Unless I've totally missed it, there's certainly no hipmunk for medicine, where I can put in that I want X service, and get a list of doctors and prices within a 50-mile radius.
  - tertius 16y ago
    Your health insurance should have this service. I'm with Aetna and I can get lists of MDs within a 10 mile radius and I can get a price list of common procedures.
    - _delirium 16y ago
      True, but I was talking about the case where I don't have health insurance and want to price-shop for cash service. =]
      - tertius 16y ago
        I'm sure you can pick up the phone and call the doctors which are recommended to you.
rdouble 16y ago
Something is broken in the system where a doctor charges you $4,800 per hour That's about right. A few years ago, I thought I had food poisoning and 40 uninsured minutes in the ER set me back $3800. But I was "lucky." I've had friends who were in bicycle accidents and ended up with $13,000 and $37,000 hospital bills.
- Groxx 16y ago
  ER bills are absolutely insane. It's not hard to break a few dozen thousand dollars in almost no time for almost no treatment. It strikes me as opportunistic preying.
  - gthank 16y ago
    The way it works is they bill outrageous amounts in the expectation that they will either be totally stiffed or have to negotiate a much lower settlement (which is essentially what insurance companies do, AFAIK). In the rare case where somebody actually pays the full bill, they're subsidizing care for those who walk out on the bill (or part of it). This strikes me as an extremely broken way of doing things, but it seems to be the norm, so maybe it's a really, really bad Nash equilibrium.
    - Groxx 16y ago
      That only makes the costs even worse, especially ethically. They're sapping the most money from people least able to defend themselves from their preying.
      - gthank 16y ago
        Actually, most of the people least able to defend themselves walk out on it, just as the hospitals expect, because they have the least to lose. When you're already horribly impoverished, what does one more bill that you'll never be able to pay mean? The ones who really catch it in the shorts are people who have never been unable to pay off an obligation before: their credit and hard-earned reputations are probably ruined (the first for however long a bankruptcy takes to go off the books, the second possibly forever), their day-to-day lives will become a gigantic burden since a bankruptcy will demolish any accumulated wealth/assets, and that's not even considering what it will do to their self-image for them to feel like they aren't living up to their personal standard. Just so we're clear: I think this system is terrible, and desperately hope that something is done to fix it. I'm not sure what the right fix is, but I hope somebody out there finds it.
joelhaasnoot 16y ago
I had a 1000 euro bill for getting 4 wisdom teeth removed by the oral surgeon, in a hospital, where I was out in 30 min (two 15 min procedures). The beauty? I pay 100 euros a month in coverage, with a 175 euro deductable, which I easily went over that year. Oh, and doctor's visits are free. Welcome to the Netherlands... (and yes, we have waiting lists, and other issues with healthcare, but atleast it's affordable)
- deleted 16y ago
  [deleted]
- tertius 16y ago
  I wonder how much the surgeon is making. I.e. how much is paid to him through taxes?

dalke 16y ago

Last year visiting California I was sick for over a week. 30 minutes for a prescription (which I knew would be the result of that visit) cost me $600. $300 for the doctor and the same for the hospital. In New Mexico (one of the poorest states in the US), the equivalent a few years previous cost me about $100. I stopped getting insurance because as a self-employed person it was expensive and rising. I played the odds and won. Sure doesn't make me feel happy.

WildUtah 16y ago
In a civilized country, if you knew what the prescription would be, you could just walk into a pharmacy and buy it. The dotor charges $600 and provides no value. He exists to charge rent on his DEA license.
- enjo 16y ago
  You do realize how terrible that idea is right? We'd see the rates of antibiotic resistant bacteria go through the roof in the first week.
  - WildUtah 16y ago
    Lots of countries have sold antibiotics freely but the epidemic of resistence mostly seems to show up in the prescription-only countries where doctors push antibiotics on everyone with a cold in order to justify their offensive office visit fees. Also, even if there is a case for antibiotics, there still isn't any case for 95% of medications.
    - dalke 16y ago
      Any evidence for your claim? Drug resistant TB is highest in "the former USSR, the Baltic states, Argentina, India, and China, and was associated with poor or failing national tuberculosis control programmes". Some 10-40% of the people who take antibiotics don't finish a course of treatment because they are feeling better and think they don't need the hassle any more. The WHO and various countries including the US say there is an association with antibiotics in animal feeds and an increase in antibiotic resistance in human diseases. This has nothing to do with "doctors pushing antibodies." Drug resistant staph was first found in the UK. Do doctors in the UK face the same pressure to justify their so-called offensive office visit fees?

jrockway 16y ago

You went to the wrong doctor. When I get my bills for office visits, the rate is something like $300 on average (including lab tests). My insurance company then negotiates that down to something like $75, and then I pay the $10 co-pay. Now, all these numbers could be made up, but $300 seems about right for a doctor's visit when you consider how expensive it is to run a medical practice. It's not something I'd want to have to pay every week because I would die if I didn't, but it's not exactly financial ruination either. If I had some rare disease but still wanted to do a startup, I think I would just work for Starbucks for 20 hours a week or something, simply for the health insurance.

_delirium 16y ago
It's very difficult to price-shop, though, because unlike in most normal businesses, nobody seems to publish price lists, and they aren't very forthcoming giving quotes over the phone, either. So it's not too uncommon to end up with something absurd more or less by chance, especially if it's urgent to see a doctor. Unless I've totally missed it, there's certainly no hipmunk for medicine, where I can put in that I want X service, and get a list of doctors and prices within a 50-mile radius.
- tertius 16y ago
  Your health insurance should have this service. I'm with Aetna and I can get lists of MDs within a 10 mile radius and I can get a price list of common procedures.
  - _delirium 16y ago
    True, but I was talking about the case where I don't have health insurance and want to price-shop for cash service. =]
    - tertius 16y ago
      I'm sure you can pick up the phone and call the doctors which are recommended to you.

rdouble 16y ago

Something is broken in the system where a doctor charges you $4,800 per hour That's about right. A few years ago, I thought I had food poisoning and 40 uninsured minutes in the ER set me back $3800. But I was "lucky." I've had friends who were in bicycle accidents and ended up with $13,000 and $37,000 hospital bills.

Groxx 16y ago
ER bills are absolutely insane. It's not hard to break a few dozen thousand dollars in almost no time for almost no treatment. It strikes me as opportunistic preying.
- gthank 16y ago
  The way it works is they bill outrageous amounts in the expectation that they will either be totally stiffed or have to negotiate a much lower settlement (which is essentially what insurance companies do, AFAIK). In the rare case where somebody actually pays the full bill, they're subsidizing care for those who walk out on the bill (or part of it). This strikes me as an extremely broken way of doing things, but it seems to be the norm, so maybe it's a really, really bad Nash equilibrium.
  - Groxx 16y ago
    That only makes the costs even worse, especially ethically. They're sapping the most money from people least able to defend themselves from their preying.
    - gthank 16y ago
      Actually, most of the people least able to defend themselves walk out on it, just as the hospitals expect, because they have the least to lose. When you're already horribly impoverished, what does one more bill that you'll never be able to pay mean? The ones who really catch it in the shorts are people who have never been unable to pay off an obligation before: their credit and hard-earned reputations are probably ruined (the first for however long a bankruptcy takes to go off the books, the second possibly forever), their day-to-day lives will become a gigantic burden since a bankruptcy will demolish any accumulated wealth/assets, and that's not even considering what it will do to their self-image for them to feel like they aren't living up to their personal standard. Just so we're clear: I think this system is terrible, and desperately hope that something is done to fix it. I'm not sure what the right fix is, but I hope somebody out there finds it.

joelhaasnoot 16y ago

I had a 1000 euro bill for getting 4 wisdom teeth removed by the oral surgeon, in a hospital, where I was out in 30 min (two 15 min procedures). The beauty? I pay 100 euros a month in coverage, with a 175 euro deductable, which I easily went over that year. Oh, and doctor's visits are free. Welcome to the Netherlands... (and yes, we have waiting lists, and other issues with healthcare, but atleast it's affordable)

deleted 16y ago
[deleted]
tertius 16y ago
I wonder how much the surgeon is making. I.e. how much is paid to him through taxes?