7 ms·

A two week hospital stay is orders of magnitude more than $10k, so presumably the $10k representes the out of pocket portion of the care. I suspect the maximum

A two week hospital stay is orders of magnitude more than $10k, so presumably the $10k representes the out of pocket portion of the care. I suspect the maximum annual out of pocket.

beebmam 4y ago
Exactly right. People with insurance have zero idea how much medical care actually costs because it's really hard to keep up with all the health insurance documents one receives. Try being hospitalized without insurance. You'll find out really fast. (I was, twice, circa 2010. I was unemployed and uninsured)
- DebtDeflation 4y ago
  People who get their insurance through their employer also typically have no idea how much their insurance premium costs because the average employer pays 70-80% of the actual monthly premium and what gets deducted from your paycheck every month is just the remainder.
  - nightski 4y ago
    I'm guessing you are correct, seeing as in a similar fashion I'd imagine there are a lot of people who have no idea what their 401(k) is even invested in. However when going through the annual election process it generally makes it very clear how much you are paying out of each paycheck and what the employer contributes. Now whether people pay attention at all I can't say.
    - lotsofpulp 4y ago
      It is also listed in W-2 box 12 code DD. And many employers include the employer contribution on paystubs.
- munk-a 4y ago
  I would suggest a slight shift in wording from "how much medical care actually costs" to "how much medical care actually bills" since as we've seen both by examining the meteoric raise in healthcare billing from 1930s-today and by comparing the US health system to single payer systems abroad it's pretty clear that the billing for US medications, procedures, therapies and other healthcare items is completely fabricated and arbitrary when compared to the costs. I think Obama-care (as much as I still support it in contrast to just letting private healthcare continue as-is) actually made things worse in the US by letting insurers and providers use the government involvement as a justification for their BS.
  - tzs 4y ago
    It's probably more complicated than that. When you compare US costs to countries like the UK, France, Germany, Japan, and similar it is indeed true that US is significantly more expensive. It is also true that over time US costs are rising significantly. However, the ratio of US costs to the costs of other countries has stayed roughly the same over time. In other words, the rest of them are having the same problem of rising costs that the US is, and their costs are rising at roughly the same rate. We pay a lot more than they do now because we paid a lot more than them a long time ago. This is worrisome, because it suggests that even if we can lower our health care costs to be in line with the rest of the developed world we are still heading for unaffordable healthcare--all we'd be doing is making so we reach that when the rest of the world does instead of a few years before they do. Here's some comments from earlier discussions with numbers and a link to the data [1] [2]. [1] https://news.ycombinator.com/item?id=32744920 https://news.ycombinator.com/item?id=32744920 [2] https://news.ycombinator.com/item?id=29768484 https://news.ycombinator.com/item?id=29768484
    - nradov 4y ago
      The majority of healthcare spending goes toward treating patients with chronic conditions primarily caused by lifestyle factors such as overeating, lack of exercise, and substance abuse. There is effectively infinite demand for healthcare services in that population. Depending on how you count, something like 1/7 of all healthcare dollars go to type-2 diabetes and related conditions alone. There is certainly some inefficiency in the US healthcare system but mostly it reflects the poor health of the population. Switching to some form of socialized medicine won't fix that problem. Other developed countries are doing a little better at the moment but they're on the same trend line and will inevitably hit the same crisis. At some point if we want to prevent a systemic collapse we're going to have to get serious about emphasizing prevention over treatment.
- mindslight 4y ago
  > Try being hospitalized without insurance. You'll find out really fast Actually no, you still won't. Because the hospitals send out fraudulently inflated/overitemized bills to help their negotiating positions. To know how much medical care actually costs, you need to have "insurance" and read through the itemized bills and explanations of benefits. The top line large number is the fraudulent amount that has no basis in reality, there is an "adjustment" based on the rates the "insurance" company has actually agreed to pay, there is the amount the "insurance" company pays them, and then there is your portion. Adding the last two, or taking the first minus the second, is as close to knowing how much something costs as you can get in this fucked up system. Also it bears repeating, never pay a medical bill unless you're damn sure you're responsible for the amount [0]. Even if you have "insurance", often you'll get sent the fraudulent bill right away, and it will take a month or two for "insurance" to bother doing their job. Also billing departments have no problem blatantly lying to you about your (non) responsibility for the fraudulent bill, since it might get them more money. [0] Of course some times they have you over a barrel like ongoing care getting denied if you have an unpaid balance. In which case you just have to eat it and then hassle your "insurance" company for half a year to get your money back.
  - peteradio 4y ago
    > Also it bears repeating, never pay a medical bill unless you're damn sure you're responsible for the amount [0]. Even if you have "insurance", often you'll get sent the fraudulent bill right away, and it will take a month or two for "insurance" to bother doing their job. Also billing departments have no problem blatantly lying to you about your (non) responsibility for the fraudulent bill, since it might get them more money. In practice how do you do this? I've never got a medical bill that made complete sense to me and when I did argue it went around in circles for so many months that it was not worth my time so I just paid it.
    - mindslight 4y ago
      Most of the time, just wait a few months for them to bill your "insurance" and for it to do its thing. The "due dates" on medical bills are basically meaningless. Then, you need to know your general deductible and copayment schedule. The bill should show original charges (fraudulent), "adjustments" to those charges to make them line up with what your "insurance" company has negotiated to pay, and then payment by the "insurance" company. The part remaining that you need to pay should line up with your deductible. If you've got a large deductible (common) and this is one of your first bills, then the "insurance" company won't have anything to pay, but there will still be an adjustment. If you think that is off, you can contact your "insurance" company to check if it matches their negotiated rates. In my experience, their customer service departments haven't been totally gutted yet. Calling the provider's billing department is generally pointless unless/until you know exactly what you're talking about. Once, a phone rep (at a small place even) called me to nag me about a bill. I told them that their charge was above the Medicare limit for a service, and that it needed to be corrected before I could pay. In response, they insisted harder that I "owed it" and I "had to pay". I told them they were wrong, ended the conversation, and just waited. Lo and behold 4-5 months later they finally billed the "insurance" and sent the correct bill. I think they were just hoping I'd fall for their fraud so they could pocket a few extra bucks. I'm certainly not an expert on this subject in particular, just generally experienced at cutting through the avalanches of paper that psychopaths try to bury us with.
Rebelgecko 4y ago
So it sounds like Obamacare did cover the vast majority of the cost?
- ceejayoz 4y ago
  Yes. People just don't understand what their plan's deductibles mean, and the protections the ACA offers. The parent poster likely benefits from the following items on https://en.wikipedia.org/wiki/Affordable_Care_Act https://en.wikipedia.org/wiki/Affordable_Care_Act: > Annual and lifetime coverage caps on essential benefits were banned. > Insurers are forbidden from dropping policyholders when they become ill. > All policies must provide an annual maximum out-of-pocket (MOOP) payment cap for an individual's or family's medical expenses (excluding premiums). After the MOOP payment is reached, all remaining costs must be paid by the insurer.
  - HarryHirsch 4y ago
    The problem field is slighty different: if your income is constrained and you are generally in good health you are going to choose a low premium plan with consequent higher deductible. When it's your turn to end up in hospital you get to pay up to the (substantial for you) out-of-pocket limit, even though you belong to the demographic that cannot afford it and Obamacare was sold to you as making healthcare affordable and accessible. Obama was a sellout.
    - ceejayoz 4y ago
      All of this was true pre-ACA, but worse (in my family's case, much worse; we went bankrupt over $90k in medical bills back in the 2000s). As it was, the thing barely passed.
      - HarryHirsch 4y ago
        Ezekiel 4:12-15 applies: ’Eat the food as you would a loaf of barley bread; bake it in the sight of the people, using human excrement for fuel.’ ... I said, ‘Not so, Sovereign Lord! I have never defiled myself.’ ‘Very well,’ he said, ‘I will let you bake your bread over cow dung instead of human excrement.’ We could be dealing with worse shit, however shit remains shit.
robomartin 4y ago
>A two week hospital stay is orders of magnitude more than $10k, so presumably the $10k representes the out of pocket portion of the care. No, that's not the case at all. We had to negotiate with the hospital and settled for this amount. The ACA covered none of it or a very small portion. I don't remember the actual bill, my wife dealt with all of it (she is a doctor and knows how to discuss such things with hospitals).
- thrwy_918 4y ago
  > The ACA covered none of it or a very small portion The ACA is not an insurance plan, so I assume you are using "ACA" as shorthand for "ACA-compliant insurance coverage". It is simply not plausible that an ACA-compliant plan would wholesale "not cover" a hospital stay for myocarditis, absent extremely niche and bizarre circumstances. Given that you don't seem very familiar with the specifics, I have to assume that your information is either missing some very important details, or incorrect.
  - ministryoftruth 4y ago
    The reason that it's not covered is that insurance plans don't cover damages caused by experimental procedures that the insured chose to participate in. Recall that the vaccine is not FDA approved for children (only adults), it only has an emergency use authorization for children.
    - lotsofpulp 4y ago
      That is not true. Health insurance in the US has to cover all healthcare, but not experimental treatment. Suppose the insured did use a non evidence supported vaccine or whatever, the vaccine itself would not be covered by insurance, but the healthcare needed by the damage caused by the use of unsupported medicine would be covered. Similarly, health insurance has to pay for your healthcare if you get into a car accident and do not have sufficient auto insurance to pay for your healthcare costs. Technically, you are sort of buying redundant insurance if you buy PIP.
    - 4y ago
threatofrain 4y ago
A two week stay at the hospital may have amounted to over $170k at the optimistically low end.
- pantalaimon 4y ago
  How?! Did they have to build an extra annex to the building just for that?
  - finder83 4y ago
    And there lies the issue with propping up the demand side of the equation with unlimited money from the government rather than regulating the supply side with affordable charges.
    - threatofrain 4y ago
      I don't think you can use ordinary market dynamics to regulate healthcare. During an emergency you should be driving to the closest hospital, not the most affordable one. And during an emergency you really have no insight as to how much of an emergency you have on your hands. Healthcare can essentially demand your entire worth. The market also has not even provided sufficient incentive for hospitals to announce their prices up-front.
      - finder83 4y ago
        That's kind of my point actually. I do think hospitals should publish their rates and so be forced to compete, but the government should also be regulating the price of services, overhead, and medicines for everyone instead of just medicare/medicaid patients. It's such an essential service that going to a hospital shouldn't be a decision to ruin you for life or not financially while hospital administrators, pharmaceuticals, insurance companies, and lawyers are raking in millions or billions. Instead, there should be some guarantee that you are getting "fair" rates. I'm of the personal political opinion that almost always when the government steps in to fund things on the demand side of the market equation it leads to massive growth in costs and burden for consumers. Universities are another great example of this. If they do step in, they also have to regulate the supply side as the free market is effectively broken at that point, and people who...say want to pay their own bills or for their own education by working or don't qualify for whatever government program is helping others, are screwed by the system. Government intervention always seems to rake money into companies' pockets rather than helping consumers and tax payers.
roflyear 4y ago
My zero deductible Obamacare plan is $400/m for just me. I imagine OP has like five kids??

A two week hospital stay is orders of magnitude more than $10k, so presumably the $10k representes the out of pocket portion of the care. I suspect the maximum annual out of pocket.

beebmam 4y ago

Exactly right. People with insurance have zero idea how much medical care actually costs because it's really hard to keep up with all the health insurance documents one receives. Try being hospitalized without insurance. You'll find out really fast. (I was, twice, circa 2010. I was unemployed and uninsured)

DebtDeflation 4y ago
People who get their insurance through their employer also typically have no idea how much their insurance premium costs because the average employer pays 70-80% of the actual monthly premium and what gets deducted from your paycheck every month is just the remainder.
- nightski 4y ago
  I'm guessing you are correct, seeing as in a similar fashion I'd imagine there are a lot of people who have no idea what their 401(k) is even invested in. However when going through the annual election process it generally makes it very clear how much you are paying out of each paycheck and what the employer contributes. Now whether people pay attention at all I can't say.
  - lotsofpulp 4y ago
    It is also listed in W-2 box 12 code DD. And many employers include the employer contribution on paystubs.
munk-a 4y ago
I would suggest a slight shift in wording from "how much medical care actually costs" to "how much medical care actually bills" since as we've seen both by examining the meteoric raise in healthcare billing from 1930s-today and by comparing the US health system to single payer systems abroad it's pretty clear that the billing for US medications, procedures, therapies and other healthcare items is completely fabricated and arbitrary when compared to the costs. I think Obama-care (as much as I still support it in contrast to just letting private healthcare continue as-is) actually made things worse in the US by letting insurers and providers use the government involvement as a justification for their BS.
- tzs 4y ago
  It's probably more complicated than that. When you compare US costs to countries like the UK, France, Germany, Japan, and similar it is indeed true that US is significantly more expensive. It is also true that over time US costs are rising significantly. However, the ratio of US costs to the costs of other countries has stayed roughly the same over time. In other words, the rest of them are having the same problem of rising costs that the US is, and their costs are rising at roughly the same rate. We pay a lot more than they do now because we paid a lot more than them a long time ago. This is worrisome, because it suggests that even if we can lower our health care costs to be in line with the rest of the developed world we are still heading for unaffordable healthcare--all we'd be doing is making so we reach that when the rest of the world does instead of a few years before they do. Here's some comments from earlier discussions with numbers and a link to the data [1] [2]. [1] https://news.ycombinator.com/item?id=32744920 https://news.ycombinator.com/item?id=32744920 [2] https://news.ycombinator.com/item?id=29768484 https://news.ycombinator.com/item?id=29768484
  - nradov 4y ago
    The majority of healthcare spending goes toward treating patients with chronic conditions primarily caused by lifestyle factors such as overeating, lack of exercise, and substance abuse. There is effectively infinite demand for healthcare services in that population. Depending on how you count, something like 1/7 of all healthcare dollars go to type-2 diabetes and related conditions alone. There is certainly some inefficiency in the US healthcare system but mostly it reflects the poor health of the population. Switching to some form of socialized medicine won't fix that problem. Other developed countries are doing a little better at the moment but they're on the same trend line and will inevitably hit the same crisis. At some point if we want to prevent a systemic collapse we're going to have to get serious about emphasizing prevention over treatment.
mindslight 4y ago
> Try being hospitalized without insurance. You'll find out really fast Actually no, you still won't. Because the hospitals send out fraudulently inflated/overitemized bills to help their negotiating positions. To know how much medical care actually costs, you need to have "insurance" and read through the itemized bills and explanations of benefits. The top line large number is the fraudulent amount that has no basis in reality, there is an "adjustment" based on the rates the "insurance" company has actually agreed to pay, there is the amount the "insurance" company pays them, and then there is your portion. Adding the last two, or taking the first minus the second, is as close to knowing how much something costs as you can get in this fucked up system. Also it bears repeating, never pay a medical bill unless you're damn sure you're responsible for the amount [0]. Even if you have "insurance", often you'll get sent the fraudulent bill right away, and it will take a month or two for "insurance" to bother doing their job. Also billing departments have no problem blatantly lying to you about your (non) responsibility for the fraudulent bill, since it might get them more money. [0] Of course some times they have you over a barrel like ongoing care getting denied if you have an unpaid balance. In which case you just have to eat it and then hassle your "insurance" company for half a year to get your money back.
- peteradio 4y ago
  > Also it bears repeating, never pay a medical bill unless you're damn sure you're responsible for the amount [0]. Even if you have "insurance", often you'll get sent the fraudulent bill right away, and it will take a month or two for "insurance" to bother doing their job. Also billing departments have no problem blatantly lying to you about your (non) responsibility for the fraudulent bill, since it might get them more money. In practice how do you do this? I've never got a medical bill that made complete sense to me and when I did argue it went around in circles for so many months that it was not worth my time so I just paid it.
  - mindslight 4y ago
    Most of the time, just wait a few months for them to bill your "insurance" and for it to do its thing. The "due dates" on medical bills are basically meaningless. Then, you need to know your general deductible and copayment schedule. The bill should show original charges (fraudulent), "adjustments" to those charges to make them line up with what your "insurance" company has negotiated to pay, and then payment by the "insurance" company. The part remaining that you need to pay should line up with your deductible. If you've got a large deductible (common) and this is one of your first bills, then the "insurance" company won't have anything to pay, but there will still be an adjustment. If you think that is off, you can contact your "insurance" company to check if it matches their negotiated rates. In my experience, their customer service departments haven't been totally gutted yet. Calling the provider's billing department is generally pointless unless/until you know exactly what you're talking about. Once, a phone rep (at a small place even) called me to nag me about a bill. I told them that their charge was above the Medicare limit for a service, and that it needed to be corrected before I could pay. In response, they insisted harder that I "owed it" and I "had to pay". I told them they were wrong, ended the conversation, and just waited. Lo and behold 4-5 months later they finally billed the "insurance" and sent the correct bill. I think they were just hoping I'd fall for their fraud so they could pocket a few extra bucks. I'm certainly not an expert on this subject in particular, just generally experienced at cutting through the avalanches of paper that psychopaths try to bury us with.

Rebelgecko 4y ago

So it sounds like Obamacare did cover the vast majority of the cost?

ceejayoz 4y ago
Yes. People just don't understand what their plan's deductibles mean, and the protections the ACA offers. The parent poster likely benefits from the following items on https://en.wikipedia.org/wiki/Affordable_Care_Act https://en.wikipedia.org/wiki/Affordable_Care_Act: > Annual and lifetime coverage caps on essential benefits were banned. > Insurers are forbidden from dropping policyholders when they become ill. > All policies must provide an annual maximum out-of-pocket (MOOP) payment cap for an individual's or family's medical expenses (excluding premiums). After the MOOP payment is reached, all remaining costs must be paid by the insurer.
- HarryHirsch 4y ago
  The problem field is slighty different: if your income is constrained and you are generally in good health you are going to choose a low premium plan with consequent higher deductible. When it's your turn to end up in hospital you get to pay up to the (substantial for you) out-of-pocket limit, even though you belong to the demographic that cannot afford it and Obamacare was sold to you as making healthcare affordable and accessible. Obama was a sellout.
  - ceejayoz 4y ago
    All of this was true pre-ACA, but worse (in my family's case, much worse; we went bankrupt over $90k in medical bills back in the 2000s). As it was, the thing barely passed.
    - HarryHirsch 4y ago
      Ezekiel 4:12-15 applies: ’Eat the food as you would a loaf of barley bread; bake it in the sight of the people, using human excrement for fuel.’ ... I said, ‘Not so, Sovereign Lord! I have never defiled myself.’ ‘Very well,’ he said, ‘I will let you bake your bread over cow dung instead of human excrement.’ We could be dealing with worse shit, however shit remains shit.

robomartin 4y ago

>A two week hospital stay is orders of magnitude more than $10k, so presumably the $10k representes the out of pocket portion of the care. No, that's not the case at all. We had to negotiate with the hospital and settled for this amount. The ACA covered none of it or a very small portion. I don't remember the actual bill, my wife dealt with all of it (she is a doctor and knows how to discuss such things with hospitals).

thrwy_918 4y ago
> The ACA covered none of it or a very small portion The ACA is not an insurance plan, so I assume you are using "ACA" as shorthand for "ACA-compliant insurance coverage". It is simply not plausible that an ACA-compliant plan would wholesale "not cover" a hospital stay for myocarditis, absent extremely niche and bizarre circumstances. Given that you don't seem very familiar with the specifics, I have to assume that your information is either missing some very important details, or incorrect.
- ministryoftruth 4y ago
  The reason that it's not covered is that insurance plans don't cover damages caused by experimental procedures that the insured chose to participate in. Recall that the vaccine is not FDA approved for children (only adults), it only has an emergency use authorization for children.
  - lotsofpulp 4y ago
    That is not true. Health insurance in the US has to cover all healthcare, but not experimental treatment. Suppose the insured did use a non evidence supported vaccine or whatever, the vaccine itself would not be covered by insurance, but the healthcare needed by the damage caused by the use of unsupported medicine would be covered. Similarly, health insurance has to pay for your healthcare if you get into a car accident and do not have sufficient auto insurance to pay for your healthcare costs. Technically, you are sort of buying redundant insurance if you buy PIP.
  - 4y ago

threatofrain 4y ago

A two week stay at the hospital may have amounted to over $170k at the optimistically low end.

pantalaimon 4y ago
How?! Did they have to build an extra annex to the building just for that?
- finder83 4y ago
  And there lies the issue with propping up the demand side of the equation with unlimited money from the government rather than regulating the supply side with affordable charges.
  - threatofrain 4y ago
    I don't think you can use ordinary market dynamics to regulate healthcare. During an emergency you should be driving to the closest hospital, not the most affordable one. And during an emergency you really have no insight as to how much of an emergency you have on your hands. Healthcare can essentially demand your entire worth. The market also has not even provided sufficient incentive for hospitals to announce their prices up-front.
    - finder83 4y ago
      That's kind of my point actually. I do think hospitals should publish their rates and so be forced to compete, but the government should also be regulating the price of services, overhead, and medicines for everyone instead of just medicare/medicaid patients. It's such an essential service that going to a hospital shouldn't be a decision to ruin you for life or not financially while hospital administrators, pharmaceuticals, insurance companies, and lawyers are raking in millions or billions. Instead, there should be some guarantee that you are getting "fair" rates. I'm of the personal political opinion that almost always when the government steps in to fund things on the demand side of the market equation it leads to massive growth in costs and burden for consumers. Universities are another great example of this. If they do step in, they also have to regulate the supply side as the free market is effectively broken at that point, and people who...say want to pay their own bills or for their own education by working or don't qualify for whatever government program is helping others, are screwed by the system. Government intervention always seems to rake money into companies' pockets rather than helping consumers and tax payers.

roflyear 4y ago

My zero deductible Obamacare plan is $400/m for just me. I imagine OP has like five kids??