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That's a shitty bill. It's also insane that US doctors and hospitals aren't required to post prices, keep prices reasonably within an allowed range, and are all
by 1letterunixname 4y ago
That's a shitty bill. It's also insane that US doctors and hospitals aren't required to post prices, keep prices reasonably within an allowed range, and are allowed to price gouge customers for however much they want without limit.
In Redding CA, I ran across a woman with a nasal infusion pump tube taped to her face in a coffee shop. She was hurriedly collecting paperwork for a hearing across the street. It turns out she was preparing to go through bankruptcy proceedings while she was dying from incurable Stage IV cancer. That the doctors and hospitals were vultures picking her life apart for money while she was dying but still alive and making her end-of-life as miserable as possible was adding insult to injury. Some hippocratic oath. More like hypocritical chisels out to monetize misery.
So when someone is out of money and dying in America, they are treated like criminals with court proceedings. At their hearing, they get a chance to justify their existence requires clothes, transportation, and housing while everything else goes to creditors.
- nradov 4y agoHospitals have been required to post price lists for several years. https://www.cms.gov/hospital-price-transparency https://www.cms.gov/hospital-price-transparency
- 1letterunixname 4y agoDoesn't matter. Nothing has changed.
- m0llusk 4y agoFrom this recent HN thread it looks like we still have a ways to go there: New health insurance "transparency data" looks suspiciously wrong https://news.ycombinator.com/item?id=35347647 https://news.ycombinator.com/item?id=35347647
- dheera 4y agoIt's meaningless unless you can get a price before you get services. The trouble is even if the price list says $500 for something, they'll charge you $8000 for "general classification" and $2000 for a Tylenol. I have a remote heart monitor at my bedside that, upon pressing a button, wirelessly retrieves data about arrythmia incidents from my implanted defibrillator and sends any incidents to the hospital. Every time I hit the button, even if there are ZERO incidents for them to review, I get hit with a $300 bill for some "general classification". So I hit the button less often than I'm supposed to.
- 1letterunixname 4y agoExactly. Come in unconscious and bleeding out from a car wreck: "No, no, no.. take me to the other hospital with lower prices. And I don't want $100 acetaminophen."
- dheera 4y agoNot all hospital visits are emergencies. I had an implanted defibrillator replaced recently. It's a life-saving device but I had a 3-month window to do it, so I most definitely picked "the other hospital" that I didn't have billing issues with the last time. Also, a car wreck should not be a reason to nickel-and-dime someone unreasonably. And if I knew they were giving me acetominaphen for $1000 and I could wait it out for an hour I'd 100% refuse it and ask a family member to bring me some from Walgreen's for <$10. I'm not exactly swimming in money here.
- justin_oaks 4y agoThis won't be effective unless the hospital is required to provide prices whenever people ask, such as requesting an estimate from your car mechanic. And not only providing the prices but being required to honor the price they give you, with some reasonable threshold of variance. These hospitals posting their prices reminds me of this classic section of "The Hitchhikers Guide to the Galaxy": "But the plans were on display..." "On display? I eventually had to go down to the cellar to find them." "That’s the display department." "With a flashlight." "Ah, well, the lights had probably gone." "So had the stairs." "But look, you found the notice, didn’t you?" "Yes," said Arthur, "yes I did. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying 'Beware of the Leopard.'
- nradov 4y agoDue to the No Surprises Act, healthcare providers are now legally required to give patients a good faith cost estimate in certain circumstances. https://www.cms.gov/nosurprises/consumers/understanding-costs-in-advance https://www.cms.gov/nosurprises/consumers/understanding-cost... https://www.cms.gov/nosurprises https://www.cms.gov/nosurprises
- nitwit005 4y ago> The hospital is required to make its charges public. NorthBay Health's online listing shows $547.65 for a rabies vaccine.
- 2muchcoffeeman 4y agoI checked the price at my local discount chemist. 115AUD or 76USD.
- andrewinardeer 4y agoDoes this price include administration of the vaccine as well or just the cost for the vaccine with syringe and professional services additional?
- bagels 4y agoHospital administrators don't take a hippocratic oath, unless they happened to also be doctors too.
- 1letterunixname 4y agoMost were. Still, their staff do. But the point you're appearing to make normalizes injustice if they didn't happen to take an oath. What does this have to do with anything?
- red-iron-pine 4y agoThe vast majority of hospital admin staff aren't. Plenty of secretaries, orderlies, cafeteria workers, and janitors. The accountants, IT, lawyers, and HR probably weren't doctors or nurses either.
- bagels 4y agoOnly pointing out that many didn't take an oath, not that what they're doing is ethical. Holding people to an oath they didn't take doesn't make much sense.
- dheera 4y agoI got charged $5000 for a 30-minute preventative echocardiogram (basically an ultrasound) that insurance was supposed to pay 100%. 20 emails later it's now at debt collectors, and I've contested the debt twice. I'm ready to appear in court if I have to. I'm ready to pay $8K in lawyer fees to get rid of this $5K bill because it's wrong. I just don't want this to impact my credit score because it's not my debt. I hate you, Stanford Healthcare.
- 1letterunixname 4y agoOh my word. 2018, I was on Medi-Cal (Medic-aid) and had a stress ECG, right heart catheterization, and 12-lead EKG when admitted to their cardiac unit for 3 days. Cost $0. Like a third-world country: in America, you're better off being either totally penniless or a billionaire. If you don't have a balance sheet of $5 megabucks, your life will be miserable. The advantage most European and other countries have under socialism is it means there's a minimum average quality of life everyone. Pay more in taxes but get a lot more in terms of a more dignified, healthier, and longer life free from the slavery of "gotcha!" gangster capitalism.
- myth2018 4y ago> Like a third-world country: in America, you're better off being either totally penniless or a billionaire. If you don't have a balance sheet of $5 megabucks, your life will be miserable. I live in a "third-world" country. My family and I have insurance and only use private hospitals -- the capitalist portion of the system. Never had as bad an incident as the ones you guys are reporting here. Just some minor annoyances. Not even the crappiest insurance companies do stuff like that, and they get terminated by the regulatory body if they start to mess up consistently. Although I don't use it directly, I'm overall well-informed about the realities of the public health system. It's bad, but not even close to what I've seen posted here. One can even obtain overly expensive meds for rare diseases -- it requires some legal effort, but it eventually works. Then I'd say that, when it comes to health systems, the USA is definitely way worse than some third-world countries -- and one of the main reasons I declined an invitation to work and live in there.
- akomtu 4y agoSomewhere in the hospital conference rooms, a model employee was giving a presentation about "average customers lifetime value (LTV) had increased by 25% YoY" thanks for his hard work. His promotion was finally approved that year. An accountant in an adjacent department was given a bonus for spotting a billing mistake that significantly underbilled a customer with stage 4 cancer. He was made employee of the month.
- JohnFen 4y agoMy mother got cancer (she survived it, fortunately). She had a fantastic insurance policy, made good money (well above the average income), and had money in the bank. Her medical costs ended up bankrupting her. That was where the scales fell from my eyes and I learned that what we're taught about the purpose of insurance (to protect us in the case of a catastrophic expense) is just pure BS.
- wizofaus 4y agoI assume you're using the word "fantastic" as in "imaginative or fanciful; remote from reality"?
- JohnFen 4y agoI mean it as in "much better than average", of course.
- seanmcdirmid 4y agoWas this before or after the ACA? As far as I understand it, the ACA got rid of ceilings on benefits and added a max pay per year.
- JohnFen 4y agoMuch before. But what did her in wasn't benefit ceilings, but rather the insurance company fighting everything they were obligated to pay out. it wore her down. It's very hard to fight the insurance company while at the same time fighting cancer. She got down to 80 pounds, couldn't eat, sleep, or do much of anything more than just hang in there. Constantly engaging in dispute resolution with the insurance company was not something she was capable of. And they knew it. That's why they fought paying out every nickel. Evil bastards. If it doesn't show, I have literally nothing good to say about the insurance industry.
- aniken 4y agoAre there by chance companies you could pay to do this on your behalf as a service? (get the money owed by insurance) Seems like something ChatGPT would be good at, if this doesn’t already exist, and then the company would charge a small percentage of what they force the insurance company to pay. If ChatGPT can ace the bar exam, you’d think it could devour all the related case law and coverage legalese from your policy, and generate effective legal responses.
- etrautmann 4y agoDoctors are NOT to blame here. It's almost as inscrutable and impossible for them to understand the process as the patients. Doctors often times have to battle insurance companies on behalf of the patients to get them the drugs they need with coverage. My wife is a cancer physician and spends hours on the phone convincing insurance companies that patients actually need the treatments she's proscribed. It's an infuriating waste of time. She also has little to no visibility into cost incurred by the patient, and often times there isn't a menu of options to pick from. She's not incentivized to perform extra testing/etc, and keeps patients costs in mind while providing care. I don't think that's rare among doctors. The whole system is frustrating, but yes mostly so for the patient.
- maxerickson 4y agoDoctors could, to some approximation anyway, go on strike. They endorse the system we have by working in it (and have not been silent participants in building either).
- TheNewsIsHere 4y agoThat particular deck is stacked against the favor of doctors and patients. After all, a care facility can probably be reasonably confident that if a patient needs help, doctors will feel compelled to care for them. Put another way, would you want to walk into a hospital/ER/your doctors office for something acute and get an apology that care is unavailable because the doctors are on strike?
- Gunnerhead 4y agoI imagine he’s suggesting a strike where they do not fill out the necessary billing paperwork, like Japanese bus drivers didn’t collect fares or the Canadian customs officers didn’t collect tariffs during their strikes. Not sure if that’s possible, but that’s how I’d think they can strike.
- TheNewsIsHere 4y ago
- wdr1 4y ago> It's also insane that US doctors and hospitals aren't required to post prices, This doesn't get a lot of attention because, well, what media outlet could write a positive article about Trump & get away with it, but healthcare price transparency was a big issue of his and during his administration the Hospital Price Transparency Final Rule was established. The rule was issued by the Centers for Medicare & Medicaid Services (CMS) in November 2019 and requires hospitals to post prices. The Trump administration argued that the rule would help to empower patients by providing them with more information about the costs of healthcare services, and that it would promote competition among hospitals and other providers, leading to lower prices and improved quality of care. The rule was initially challenged in court by a group of hospital organizations, but in June 2020, a federal judge upheld the rule, clearing the way for it to take effect on January 1, 2021.