8 ms·

Their Baby Died in the Hospital. Then Came the $257,000 Bill

55 points by astral303 5y ago

themodelplumber 5y ago
Ugh. A similar experience here in some ways; we lost twins at childbirth and had to work through a billing nightmare after spending almost a week at a university hospital that was 2h drive south of our home, hearing optimistic expectations from various doctors and surgeons. > Medical billing experts who reviewed the case described it as a dispute between a large hospital and a large insurer, with the patient stuck in the middle. This seems really, REALLY common...an individual ends up soaking up the most bitter aftershocks of a care incident and the accompanying battle between two possibly-responsible parties. I asked about one of these cases online for a friend at one point, and an insurance industry middle-man chimed in. Not to help out, but simply to become defensive, letting me know that he worked with these cases all the time, and you generally get what you pay for. So next time pay more for insurance, was his point. Meanwhile this person's Reddit profile was full of photos of his new Tesla. It made me sick to my stomach to have to tell my friend that yes, somebody replied, and no, it wasn't that helpful, and...let's change the subject for now.
- Cryptonic 5y ago
  What happened to you should not happen to anybody. This really makes me sad. Be strong
- kindle-dev 5y ago
  I do feel that insurers get the short-end of the stick. The doctors and hospital are the ones charging $257,000. And they're also driving Teslas. I've lost all respect for the hospital system after receiving a $47,000 surprise bill from an ER visit to get a single stitch.
  - s5300 5y ago
    The doctors and hospitals are only charging that much because of a long running history of insurers otherwise not paying out. If they charge $50, insurance will begrudgingly pay $5 if you're lucky. So you have to charge $5000 for something fairly simple, in order to hopefully get close to $500
    - kindle-dev 5y ago
      This argument makes no sense. Medical bills are the number 1 cause of bankruptcy. Hospitals knowingly employ out-of-network doctors so they can bill patients huge sums directly.
      - robbedpeter 5y ago
        Maybe some "John Q Public" meets "Man On Fire" could shake things up. The trouble with civility is the people and institutions who exploit it.
      - s5300 5y ago
        I'm speaking directly from word of more than one personal doctor friend and a family member of mine that is the head management of an emergency room. I may be completely incorrect with this information - but I was told that prices are so high due to people on the insurance side of things being dicks about it, not the doctors/hospitals. There is a massive issue with how the medical boards artificially restrict # of doctors/residents and what else, leading to price issues, but that is not the discussion we're having
    - noduerme 5y ago
      Agreed. This is a case where an unfree market has arrived at the most absurd and circuitous route to everyone getting a slice of the pie. It's crazy that a lot of Americans fight any reform of the insurance industry on the grounds that doing so would constitute socialism or an attack on the free market. What we have right now is the furthest thing from a free market. It's a set of local monopolies fixing prices, and another group (doctors) trying to get paid in a broken system.
  - aetherspawn 5y ago
    Uh, ouch. I got charged like $80 for two nurses to give me a venesection (half hour blood letting) and supervision, which was fully covered by our public health care system and billed the government directly. Didn’t even have to get a receipt. Australia.
    - me_me_me 5y ago
      They know it, you dont have to twits their knife :/
  - Calavar 5y ago
    Hospitals charge exorbitant fees because they know that insurance will only pay for a fraction of whatever they ask for. The real crime is how much of our healthcare dollars fund a behemoth of a bureaucratic apparatus for this cat and mouse game where insurance companies deny payment on technicalities and hospitals file counterclaims and overbill to compensate. An obscene amount of money is burned here and not a cent of it adds any value to patient care. This is a big reason of why we spend so much more on healthcare than European countries and don't have better results. And it's an excellent datapoint against the idea that the private sector is always less wasteful than the public sector. As an aside, the vast majority of what the hospital does collect goes to the hospital itself, not to the physician. If the sticker of price a surgery is $50000, you can expect the surgeon to get about $1000 of that.
  - Thorentis 5y ago
    How the fuck does a single stitch cost that much money? It's not like the Australian government is paying $47k to hospitals under Medicare. Things just don't cost that much.
    - deepsun 5y ago
      If patient sues the doctor that the stitches were wrong, legal costs may go above the $47k. Cost of doing business.
  - stevesearer 5y ago
    Not as extreme, but I burned my hands on bacon grease a few years back and needed a trip to the ER and some bandages on both hands. When they were signing me out, I asked what care I was supposed to do for the bandages and they said to come back tomorrow and someone could show me. A few weeks after, it was quite a surprise to receive a not one, but two pricey ER bills! While the hospital ended up waiving the second visit, I imagine many people either pay it or go into debt especially since it required a couple of hours during business hours to sort out.
  - DSingularity 5y ago
    Do you think most doctors are in it to stitch you up?
Cryptonic 5y ago
I will never understand why so many US people want their health system as it is. Maybe it is because of neoliberalism or communism fear propaganda of big money interests idk. I can simply not understand otherwise. I have long reached the maximum of having to pay near 800€ for public health care in Germany month by month with my salary - it covers me, my wife and two children. I'm well aware that most of the time the money is used for people who pay far less or nothing like retired, students, people with less income or refugees (solidarity it is called). Most of the time until I'm in need treatment myself... I love to live in a country where nobody goes bancrupt because of a health bill. Where nobody has to live in fear of death if he cannot afford treatment. Where nobody has to choose between money and a dead child or mother. Don't you see how many social and crime problems come from a missing health system? If I would live in constant fear of death or bancruptcy I might as well easier decide to rob a bank, do cyber crime or kill someone in anger with my gun (only source of fake power in my life) or do some insider trade or whatever. A death threat hanging over you and your family, if you lack financial success, is making you do wrong things (crime) and feel bad things (fear, anger, desperation) leading to undesired behaviour (even more crime, unhealthy life with stress and obesity and much more). An affordable and solidarity public health system is the foundation for a healthy society and mentally healthier citizens. It has exacly zero to do with communism or socialism, it's an investment in having a better country for everyone. Change my mind.
- s1artibartfast 5y ago
  Few are happy with the current status, but people differ on the solution.
  - srgpqt 5y ago
    Is this not a capitalist country? There should be multiple competing solutions for everyone to freely choose from. Nothing like this racketeering situation.
    - protomyth 5y ago
      Government prevents actual markets in the USA. The closest you get is elective surgeries. Hell, many states won't let you open a new hospital without getting the permission of existing hospitals. Not very capitalist.
haspoken 5y ago
https://archive.is/aIcBr https://archive.is/aIcBr
Gaussian 5y ago
Just terrible. There are thousands of similar, less sensational stories generated by the U.S. health system every month. All parties in the system are to blame, as all parties have twisted incentives—profit—when it comes to providing and paying for healthcare. This isn’t news, obviously, and without some kind of legislative sledgehammer that alters the potential earnings of millions of people who are now cogs in this system, the problem will remain intractable.
- arbuge 5y ago
  > legislative sledgehammer that alters the potential earnings of millions of people who are now cogs in this system Doing this all at once might not be palatable to a lot of people. In reality, boiling the frog slowly may be the better way to go here. Reduce their earnings a fraction each year, over say a 20 year timespan. Decreasing the eligibility age for Medicare each year by a year or so might partly accomplish this.
  - cloudwizard 5y ago
    It is much more likely that Insurers will buy Congress and the Medicare age will go up and Republican states will opt out.
ashishb 5y ago
Only in America, you have no idea what healthcare would cost before entering a hospital. When you go for a car maintenance/repair, they give you an upfront estimate. Nothing when they work on your body. I blame employer coverage that distorts the market. https://ashishb.net/all/why-not-abolish-employer-provided-health-insurance/ https://ashishb.net/all/why-not-abolish-employer-provided-he...
- black_13 5y ago
  Again ? Universal healthcare?
  - geoduck14 5y ago
    Universal Health care doesn't ensure you know the price before hand. If anything, it further obscures it because you don't pay, so you NEVER know the cost... but you DO pay, because nothing is free.
    - ashishb 5y ago
      Exactly. I would prefer having universal health care for emergencies while letting the market make non-emergency care (especially routine care) cheap and quick.
clarkmoody 5y ago
One shining light in the healthcare world is the Surgery Center of Oklahoma. It's a multi-specialty operation with all prices posted on their website. Pricing is clear and known up-front. The surgeons involved make a profit, and the patients are happy to pay their prices. Physicians own and operate the facility, pricing is transparent and set by the surgeons themselves. People come from all over the world, and the center continues to serve the public year after year. No, it's not an emergency room or a labor & delivery suite, so it's a it different than the article on this page. This is what free-market healthcare looks like: https://surgerycenterok.com/ https://surgerycenterok.com/
- MathCodeLove 5y ago
  That's incredible. Many people say we need free or heavily subsidized healthcare. I disagree, we need to remove legislation from healthcare entirely and let the free market figure things out.
  - bradknowles 5y ago
    A true free market is where someone can hold a gun to your head and make you pay them whatever they want, and you gladly do so because you got rid of all the police who could stop them. In a true free market, the guy with the biggest gun and the most money can buy everyone else out, so that he now has a complete monopoly. You don’t really want a true free market. You want a market with full price transparency. You want a market with lots of competition, and where no one in the market can get an unfair advantage over anyone else. And that only happens if it is a well-regulated market, which is a lot like a well-regulated militia.
    - MathCodeLove 5y ago
      I never said I wanted full laissez faire capitalism. I just want the healthcare market to have the same ability to operate in our current "free market" as other private businesses do. Usually when people say something regarding the "free market" they aren't calling for abolition of the government in it's entirety unless they explicitly mention such, but loosened legislative measures taken on a specific segment of the existing market.
simonblack 5y ago
The US medical system is absolutely broken. Big Medicine has the weight to steamroller individuals, so it does. It's absolutely disgusting. Other countries don't put up with this shit. Even very small and poor countries have a single-payer medical system with the government underwriting the bills for people who are disadvantaged, thus preventing the ridiculous '$1000 dollars for a bag of salt water' kind of charge. How come the 'exceptional, indispensable' country, the one that's 'the world's sole superpower' somehow can't afford it? It can of course, except that Big Medicine wants to have its cake and eat it too.

55 points by astral303 5y ago

Ugh. A similar experience here in some ways; we lost twins at childbirth and had to work through a billing nightmare after spending almost a week at a university hospital that was 2h drive south of our home, hearing optimistic expectations from various doctors and surgeons. > Medical billing experts who reviewed the case described it as a dispute between a large hospital and a large insurer, with the patient stuck in the middle. This seems really, REALLY common...an individual ends up soaking up the most bitter aftershocks of a care incident and the accompanying battle between two possibly-responsible parties. I asked about one of these cases online for a friend at one point, and an insurance industry middle-man chimed in. Not to help out, but simply to become defensive, letting me know that he worked with these cases all the time, and you generally get what you pay for. So next time pay more for insurance, was his point. Meanwhile this person's Reddit profile was full of photos of his new Tesla. It made me sick to my stomach to have to tell my friend that yes, somebody replied, and no, it wasn't that helpful, and...let's change the subject for now.

Cryptonic 5y ago
What happened to you should not happen to anybody. This really makes me sad. Be strong
kindle-dev 5y ago
I do feel that insurers get the short-end of the stick. The doctors and hospital are the ones charging $257,000. And they're also driving Teslas. I've lost all respect for the hospital system after receiving a $47,000 surprise bill from an ER visit to get a single stitch.
- s5300 5y ago
  The doctors and hospitals are only charging that much because of a long running history of insurers otherwise not paying out. If they charge $50, insurance will begrudgingly pay $5 if you're lucky. So you have to charge $5000 for something fairly simple, in order to hopefully get close to $500
  - kindle-dev 5y ago
    This argument makes no sense. Medical bills are the number 1 cause of bankruptcy. Hospitals knowingly employ out-of-network doctors so they can bill patients huge sums directly.
    - robbedpeter 5y ago
      Maybe some "John Q Public" meets "Man On Fire" could shake things up. The trouble with civility is the people and institutions who exploit it.
    - s5300 5y ago
      I'm speaking directly from word of more than one personal doctor friend and a family member of mine that is the head management of an emergency room. I may be completely incorrect with this information - but I was told that prices are so high due to people on the insurance side of things being dicks about it, not the doctors/hospitals. There is a massive issue with how the medical boards artificially restrict # of doctors/residents and what else, leading to price issues, but that is not the discussion we're having
  - noduerme 5y ago
    Agreed. This is a case where an unfree market has arrived at the most absurd and circuitous route to everyone getting a slice of the pie. It's crazy that a lot of Americans fight any reform of the insurance industry on the grounds that doing so would constitute socialism or an attack on the free market. What we have right now is the furthest thing from a free market. It's a set of local monopolies fixing prices, and another group (doctors) trying to get paid in a broken system.
- aetherspawn 5y ago
  Uh, ouch. I got charged like $80 for two nurses to give me a venesection (half hour blood letting) and supervision, which was fully covered by our public health care system and billed the government directly. Didn’t even have to get a receipt. Australia.
  - me_me_me 5y ago
    They know it, you dont have to twits their knife :/
- Calavar 5y ago
  Hospitals charge exorbitant fees because they know that insurance will only pay for a fraction of whatever they ask for. The real crime is how much of our healthcare dollars fund a behemoth of a bureaucratic apparatus for this cat and mouse game where insurance companies deny payment on technicalities and hospitals file counterclaims and overbill to compensate. An obscene amount of money is burned here and not a cent of it adds any value to patient care. This is a big reason of why we spend so much more on healthcare than European countries and don't have better results. And it's an excellent datapoint against the idea that the private sector is always less wasteful than the public sector. As an aside, the vast majority of what the hospital does collect goes to the hospital itself, not to the physician. If the sticker of price a surgery is $50000, you can expect the surgeon to get about $1000 of that.
- Thorentis 5y ago
  How the fuck does a single stitch cost that much money? It's not like the Australian government is paying $47k to hospitals under Medicare. Things just don't cost that much.
  - deepsun 5y ago
    If patient sues the doctor that the stitches were wrong, legal costs may go above the $47k. Cost of doing business.
- stevesearer 5y ago
  Not as extreme, but I burned my hands on bacon grease a few years back and needed a trip to the ER and some bandages on both hands. When they were signing me out, I asked what care I was supposed to do for the bandages and they said to come back tomorrow and someone could show me. A few weeks after, it was quite a surprise to receive a not one, but two pricey ER bills! While the hospital ended up waiving the second visit, I imagine many people either pay it or go into debt especially since it required a couple of hours during business hours to sort out.
- DSingularity 5y ago
  Do you think most doctors are in it to stitch you up?

Cryptonic 5y ago

I will never understand why so many US people want their health system as it is. Maybe it is because of neoliberalism or communism fear propaganda of big money interests idk. I can simply not understand otherwise. I have long reached the maximum of having to pay near 800€ for public health care in Germany month by month with my salary - it covers me, my wife and two children. I'm well aware that most of the time the money is used for people who pay far less or nothing like retired, students, people with less income or refugees (solidarity it is called). Most of the time until I'm in need treatment myself... I love to live in a country where nobody goes bancrupt because of a health bill. Where nobody has to live in fear of death if he cannot afford treatment. Where nobody has to choose between money and a dead child or mother. Don't you see how many social and crime problems come from a missing health system? If I would live in constant fear of death or bancruptcy I might as well easier decide to rob a bank, do cyber crime or kill someone in anger with my gun (only source of fake power in my life) or do some insider trade or whatever. A death threat hanging over you and your family, if you lack financial success, is making you do wrong things (crime) and feel bad things (fear, anger, desperation) leading to undesired behaviour (even more crime, unhealthy life with stress and obesity and much more). An affordable and solidarity public health system is the foundation for a healthy society and mentally healthier citizens. It has exacly zero to do with communism or socialism, it's an investment in having a better country for everyone. Change my mind.

s1artibartfast 5y ago
Few are happy with the current status, but people differ on the solution.
- srgpqt 5y ago
  Is this not a capitalist country? There should be multiple competing solutions for everyone to freely choose from. Nothing like this racketeering situation.
  - protomyth 5y ago
    Government prevents actual markets in the USA. The closest you get is elective surgeries. Hell, many states won't let you open a new hospital without getting the permission of existing hospitals. Not very capitalist.

haspoken 5y ago

https://archive.is/aIcBr https://archive.is/aIcBr

Gaussian 5y ago

Just terrible. There are thousands of similar, less sensational stories generated by the U.S. health system every month. All parties in the system are to blame, as all parties have twisted incentives—profit—when it comes to providing and paying for healthcare. This isn’t news, obviously, and without some kind of legislative sledgehammer that alters the potential earnings of millions of people who are now cogs in this system, the problem will remain intractable.

arbuge 5y ago
> legislative sledgehammer that alters the potential earnings of millions of people who are now cogs in this system Doing this all at once might not be palatable to a lot of people. In reality, boiling the frog slowly may be the better way to go here. Reduce their earnings a fraction each year, over say a 20 year timespan. Decreasing the eligibility age for Medicare each year by a year or so might partly accomplish this.
- cloudwizard 5y ago
  It is much more likely that Insurers will buy Congress and the Medicare age will go up and Republican states will opt out.

ashishb 5y ago

Only in America, you have no idea what healthcare would cost before entering a hospital. When you go for a car maintenance/repair, they give you an upfront estimate. Nothing when they work on your body. I blame employer coverage that distorts the market. https://ashishb.net/all/why-not-abolish-employer-provided-health-insurance/ https://ashishb.net/all/why-not-abolish-employer-provided-he...

black_13 5y ago
Again ? Universal healthcare?
- geoduck14 5y ago
  Universal Health care doesn't ensure you know the price before hand. If anything, it further obscures it because you don't pay, so you NEVER know the cost... but you DO pay, because nothing is free.
  - ashishb 5y ago
    Exactly. I would prefer having universal health care for emergencies while letting the market make non-emergency care (especially routine care) cheap and quick.

clarkmoody 5y ago

One shining light in the healthcare world is the Surgery Center of Oklahoma. It's a multi-specialty operation with all prices posted on their website. Pricing is clear and known up-front. The surgeons involved make a profit, and the patients are happy to pay their prices. Physicians own and operate the facility, pricing is transparent and set by the surgeons themselves. People come from all over the world, and the center continues to serve the public year after year. No, it's not an emergency room or a labor & delivery suite, so it's a it different than the article on this page. This is what free-market healthcare looks like: https://surgerycenterok.com/ https://surgerycenterok.com/

MathCodeLove 5y ago
That's incredible. Many people say we need free or heavily subsidized healthcare. I disagree, we need to remove legislation from healthcare entirely and let the free market figure things out.
- bradknowles 5y ago
  A true free market is where someone can hold a gun to your head and make you pay them whatever they want, and you gladly do so because you got rid of all the police who could stop them. In a true free market, the guy with the biggest gun and the most money can buy everyone else out, so that he now has a complete monopoly. You don’t really want a true free market. You want a market with full price transparency. You want a market with lots of competition, and where no one in the market can get an unfair advantage over anyone else. And that only happens if it is a well-regulated market, which is a lot like a well-regulated militia.
  - MathCodeLove 5y ago
    I never said I wanted full laissez faire capitalism. I just want the healthcare market to have the same ability to operate in our current "free market" as other private businesses do. Usually when people say something regarding the "free market" they aren't calling for abolition of the government in it's entirety unless they explicitly mention such, but loosened legislative measures taken on a specific segment of the existing market.

simonblack 5y ago

The US medical system is absolutely broken. Big Medicine has the weight to steamroller individuals, so it does. It's absolutely disgusting. Other countries don't put up with this shit. Even very small and poor countries have a single-payer medical system with the government underwriting the bills for people who are disadvantaged, thus preventing the ridiculous '$1000 dollars for a bag of salt water' kind of charge. How come the 'exceptional, indispensable' country, the one that's 'the world's sole superpower' somehow can't afford it? It can of course, except that Big Medicine wants to have its cake and eat it too.