6 ms·

This comment is hopelessly obtuse. Most Americans can't even afford a $1000 emergency expense; the $2400 expense you cite is already unaffordable. Add in any ER

This comment is hopelessly obtuse. Most Americans can't even afford a $1000 emergency expense; the $2400 expense you cite is already unaffordable. Add in any ER fees the hospital charges -- which can easily be part of what GP refers to -- and you'll probably get to that $10K figure anyway. Don't believe me? Here's what happened right here in SF when a bicyclist with a broken arm was taken to the local public hospital, SF General: "A few months later, Dang got a bill for $24,074.50. Premera Blue Cross, her health insurer, would only cover $3,830.79 of that — an amount that it thought was fair for the services provided. That left Dang with $20,243.71 to pay, which the hospital threatened to send to collections in mid-December." > came up with a number 400% higher. A moment with a calculator would show you that the number GP uses is 300% higher, not 400% :) https://fortune.com/recommends/banking/57-percent-of-americans-cant-afford-a-1000-emergency-expense/ https://fortune.com/recommends/banking/57-percent-of-america... https://www.vox.com/policy-and-politics/2019/1/7/18137967/er-bills-zuckerberg-san-francisco-general-hospital https://www.vox.com/policy-and-politics/2019/1/7/18137967/er...

nobody9999 4y ago
>This comment is hopelessly obtuse. Most Americans can't even afford a $1000 emergency expense; the $2400 expense you cite is already unaffordable. Add in any ER fees the hospital charges -- which can easily be part of what GP refers to -- and you'll probably get to that $10K figure anyway. I didn't say there weren't problems with the system, or that most folks (let alone homeless folks) could afford such things, but 400% more than the published cost? That's hyperbolic and, more importantly, incredibly imprecise. I see you disagree with that. I agree that you disagree with me. Have a lovely day. Edit: removed extraneous text.
- handoflixue 4y ago
  > That's hyperbolic and, more importantly, incredibly imprecise. In common USA English, use of a figure like "10K" suggests imprecision - it's a magnitude of order ballpark, a gesture at the logarithmic scale. This convention is useful because it's easy to remember a rough ballpark, but precise figures are going to quickly get muddied in details. It seems strange to complain about imprecision when someone has already clearly indicated that they're talking about a rough estimate.
  - nobody9999 4y ago
    >In common USA English, use of a figure like "10K" suggests imprecision - it's a magnitude of order ballpark, a gesture at the logarithmic scale. Really? As a life-long resident of the US, native US English speaker, and the child of a native US English speaker and a long-time resident of the US from another English-speaking country (UK) (both with post-baccalaureate degrees), I never heard that from anyone except you. Not teachers in primary or secondary school, nor in college. Nor have I seen that in any of the many usage guides I've read over the past half-century or so. Yes, "Forty days" in the Abrahamic[0] tradition is meant to be imprecise (i.e., meaning "a long time"), but the bible/torah/quran aren't guides to modern English, are they? Perhaps you could enlighten this American ignoramus as to the correctness of US English idiomatic phrasing in this light. It would be most appreciated. [0] https://en.wikipedia.org/wiki/Abrahamic_religions https://en.wikipedia.org/wiki/Abrahamic_religions Edit: Clarified prose.
    - handoflixue 4y ago
      I'm really not clear what you're asking, so all I can say is that nice round numbers are usually a ballpark estimate, while more precise figures suggest some actual calculations were involved. To be a bit technical: if there's only 1 significant figure, then you should take the number with a fair amount of salt. Unfortunately social rules like this usually aren't well documented. It's mostly a statistics thing: very few calculations produce an exactly even result, so more often than not someone has rounded things off. If you want to get really fancy you can start using context and tone to further infer whether someone is throwing out a ballpark estimate or a precise number, but that's well beyond the scope of a HN comment
      - nobody9999 4y ago
        >that's well beyond the scope of a HN comment Exactly my point. And even if I wanted to, there's wasn't any tone or context to draw on -- just a flat assertion. I'd add that, at least to me, a "ballpark" figure would be something reasonably close to an actual value e.g., $25 ballpark vs. $27.99. In the case to which I replied, it was more like "ballpark" $25, actual $9.99. Which "ain't the same fuckin' ballpark, it ain't the same league, it ain't even the same fuckin' sport."[0] [0] with apologies to Quentin Tarantino. Edit: Added an additional thought and some context.
- effingwewt 4y ago
  It's not hyperbolic at all. Here[1] is an article on the top stories on HN right now where a couple was charged 200k for a rabies shot. Posted prices here in the US are complete bullshit, as any medical code transcriber could tell you, or indeed anyone who's been to a US hospital and had to pay out of pocket. I once went to the emergency room at 1am. It was almost empty, no one walking the floors, but still took them 4 hours to get to me. They never checked my vitals or my weight, the doctor looked down my throat with a wooden stick, gave me one generic 200mg ibuprofen and sent me on my way. My bill was $3500. Their reasoning when I fought it? 'we only have very generalized codes and that's how we determine what to charge. Literally did nothing but waste my time and charged me 3500 for the privilege. I told them they wouldn't see a dime and I'd happily see them in court over it (no idea if I could even take them to court but I was beyond pissed). Bill was dropped to 250,which to me was still outrageous for a freaking ibuprofen (dollar store knockoff brand to boot!). Over one dollar per milligram of OTC medicine. This was now 15 years ago and the prices have done nothing but increase since. [1] https://news.ycombinator.com/item?id=35532458 https://news.ycombinator.com/item?id=35532458
  - nobody9999 4y ago
    >Bill was dropped to 250,which to me was still outrageous for a freaking ibuprofen (dollar store knockoff brand to boot!). Yes, medical billing in the US is hopelessly opaque. And I've had an even more egregious experience[0] myself. However, that $250 wasn't just for the ibuprofen and tongue depressor. It's for the physical plant, infrastructure and other operating expenses as well. Although the largest portion of that is likely the cost for the time of highly-trained personnel (nurses, doctors, etc.). How much do you earn in an hour? No. Don't tell me. I don't care. But I'm sure it's more than zero, right? Would you work for zero dollars an hour? If not, why are you ignoring the costs of paying hospital personnel? Not sure why you went to an emergency room. Those are for, wait for it...emergencies. Was it an actual emergency? If not, they should have charged you even more. [0] A physician to whom I was referred posited (incorrectly) that a skin lesion might be infected with MRSA[1] and insisted that I go to the hospital for testing and immediate IV antibiotics. I reluctantly (as I -- correctly -- believed that wasn't the case) did so. I was in the hospital for three days (the length of time -- at least they claimed it took that long -- to test for MRSA), after which time I was told (shocking...not!) that I was not, in fact, infected with MRSA and discharged. I received a bill for something like $100 and an "explanation of benefits" (EOB) from my insurance company. The "total cost" listed on the EOB was ~$12,000. Out of curiosity, I perused the detail and found that I was being "charged" for being in two hospital rooms at the same time (a neat trick, I wish I could replicate it) as well as having had a Pap smear[2], despite not (ever) having a cervix. I complained to the insurance company that there was obvious fraud going on. They responded that I shouldn't worry my pretty little head about it because I wasn't paying anyway. That made me even angrier and I demanded that this be investigated and addressed. A few days later, I was involved in a conference call with the insurer and someone from the billing department of the hospital in question. The insurer and the hospital went back and forth (performatively, I soon found) about billing codes, but when I pressed them on how I could possibly have had a pap smear when I don't have a female reproductive system, they finally fessed up and told me that the contract between the hospital and the insurer capped hospital stays/services at $500/day, and that the stuff in the EOB was complete bullshit. Just as the $3500 on your bill was complete bullshit. But $250 actually seems reasonable for an emergency room visit. Even with health insurance, I'm subject to a $150 co-payment for emergency room visits -- just for walking in the door and signing in. [1] https://www.mayoclinic.org/diseases-conditions/mrsa/symptoms-causes/syc-20375336 https://www.mayoclinic.org/diseases-conditions/mrsa/symptoms... [2] https://www.mayoclinic.org/tests-procedures/pap-smear/about/pac-20394841 https://www.mayoclinic.org/tests-procedures/pap-smear/about/...

nobody9999 4y ago

>This comment is hopelessly obtuse. Most Americans can't even afford a $1000 emergency expense; the $2400 expense you cite is already unaffordable. Add in any ER fees the hospital charges -- which can easily be part of what GP refers to -- and you'll probably get to that $10K figure anyway. I didn't say there weren't problems with the system, or that most folks (let alone homeless folks) could afford such things, but 400% more than the published cost? That's hyperbolic and, more importantly, incredibly imprecise. I see you disagree with that. I agree that you disagree with me. Have a lovely day. Edit: removed extraneous text.

handoflixue 4y ago
> That's hyperbolic and, more importantly, incredibly imprecise. In common USA English, use of a figure like "10K" suggests imprecision - it's a magnitude of order ballpark, a gesture at the logarithmic scale. This convention is useful because it's easy to remember a rough ballpark, but precise figures are going to quickly get muddied in details. It seems strange to complain about imprecision when someone has already clearly indicated that they're talking about a rough estimate.
- nobody9999 4y ago
  >In common USA English, use of a figure like "10K" suggests imprecision - it's a magnitude of order ballpark, a gesture at the logarithmic scale. Really? As a life-long resident of the US, native US English speaker, and the child of a native US English speaker and a long-time resident of the US from another English-speaking country (UK) (both with post-baccalaureate degrees), I never heard that from anyone except you. Not teachers in primary or secondary school, nor in college. Nor have I seen that in any of the many usage guides I've read over the past half-century or so. Yes, "Forty days" in the Abrahamic[0] tradition is meant to be imprecise (i.e., meaning "a long time"), but the bible/torah/quran aren't guides to modern English, are they? Perhaps you could enlighten this American ignoramus as to the correctness of US English idiomatic phrasing in this light. It would be most appreciated. [0] https://en.wikipedia.org/wiki/Abrahamic_religions https://en.wikipedia.org/wiki/Abrahamic_religions Edit: Clarified prose.
  - handoflixue 4y ago
    I'm really not clear what you're asking, so all I can say is that nice round numbers are usually a ballpark estimate, while more precise figures suggest some actual calculations were involved. To be a bit technical: if there's only 1 significant figure, then you should take the number with a fair amount of salt. Unfortunately social rules like this usually aren't well documented. It's mostly a statistics thing: very few calculations produce an exactly even result, so more often than not someone has rounded things off. If you want to get really fancy you can start using context and tone to further infer whether someone is throwing out a ballpark estimate or a precise number, but that's well beyond the scope of a HN comment
    - nobody9999 4y ago
      >that's well beyond the scope of a HN comment Exactly my point. And even if I wanted to, there's wasn't any tone or context to draw on -- just a flat assertion. I'd add that, at least to me, a "ballpark" figure would be something reasonably close to an actual value e.g., $25 ballpark vs. $27.99. In the case to which I replied, it was more like "ballpark" $25, actual $9.99. Which "ain't the same fuckin' ballpark, it ain't the same league, it ain't even the same fuckin' sport."[0] [0] with apologies to Quentin Tarantino. Edit: Added an additional thought and some context.
effingwewt 4y ago
It's not hyperbolic at all. Here[1] is an article on the top stories on HN right now where a couple was charged 200k for a rabies shot. Posted prices here in the US are complete bullshit, as any medical code transcriber could tell you, or indeed anyone who's been to a US hospital and had to pay out of pocket. I once went to the emergency room at 1am. It was almost empty, no one walking the floors, but still took them 4 hours to get to me. They never checked my vitals or my weight, the doctor looked down my throat with a wooden stick, gave me one generic 200mg ibuprofen and sent me on my way. My bill was $3500. Their reasoning when I fought it? 'we only have very generalized codes and that's how we determine what to charge. Literally did nothing but waste my time and charged me 3500 for the privilege. I told them they wouldn't see a dime and I'd happily see them in court over it (no idea if I could even take them to court but I was beyond pissed). Bill was dropped to 250,which to me was still outrageous for a freaking ibuprofen (dollar store knockoff brand to boot!). Over one dollar per milligram of OTC medicine. This was now 15 years ago and the prices have done nothing but increase since. [1] https://news.ycombinator.com/item?id=35532458 https://news.ycombinator.com/item?id=35532458
- nobody9999 4y ago
  >Bill was dropped to 250,which to me was still outrageous for a freaking ibuprofen (dollar store knockoff brand to boot!). Yes, medical billing in the US is hopelessly opaque. And I've had an even more egregious experience[0] myself. However, that $250 wasn't just for the ibuprofen and tongue depressor. It's for the physical plant, infrastructure and other operating expenses as well. Although the largest portion of that is likely the cost for the time of highly-trained personnel (nurses, doctors, etc.). How much do you earn in an hour? No. Don't tell me. I don't care. But I'm sure it's more than zero, right? Would you work for zero dollars an hour? If not, why are you ignoring the costs of paying hospital personnel? Not sure why you went to an emergency room. Those are for, wait for it...emergencies. Was it an actual emergency? If not, they should have charged you even more. [0] A physician to whom I was referred posited (incorrectly) that a skin lesion might be infected with MRSA[1] and insisted that I go to the hospital for testing and immediate IV antibiotics. I reluctantly (as I -- correctly -- believed that wasn't the case) did so. I was in the hospital for three days (the length of time -- at least they claimed it took that long -- to test for MRSA), after which time I was told (shocking...not!) that I was not, in fact, infected with MRSA and discharged. I received a bill for something like $100 and an "explanation of benefits" (EOB) from my insurance company. The "total cost" listed on the EOB was ~$12,000. Out of curiosity, I perused the detail and found that I was being "charged" for being in two hospital rooms at the same time (a neat trick, I wish I could replicate it) as well as having had a Pap smear[2], despite not (ever) having a cervix. I complained to the insurance company that there was obvious fraud going on. They responded that I shouldn't worry my pretty little head about it because I wasn't paying anyway. That made me even angrier and I demanded that this be investigated and addressed. A few days later, I was involved in a conference call with the insurer and someone from the billing department of the hospital in question. The insurer and the hospital went back and forth (performatively, I soon found) about billing codes, but when I pressed them on how I could possibly have had a pap smear when I don't have a female reproductive system, they finally fessed up and told me that the contract between the hospital and the insurer capped hospital stays/services at $500/day, and that the stuff in the EOB was complete bullshit. Just as the $3500 on your bill was complete bullshit. But $250 actually seems reasonable for an emergency room visit. Even with health insurance, I'm subject to a $150 co-payment for emergency room visits -- just for walking in the door and signing in. [1] https://www.mayoclinic.org/diseases-conditions/mrsa/symptoms-causes/syc-20375336 https://www.mayoclinic.org/diseases-conditions/mrsa/symptoms... [2] https://www.mayoclinic.org/tests-procedures/pap-smear/about/pac-20394841 https://www.mayoclinic.org/tests-procedures/pap-smear/about/...