5 ms·

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

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/...
- devilbunny 4y ago
  For reference, a bacterial culture cannot be declared negative in less than 72 hours. That's the source of your three-day admission, although that's an odd beast - if you're stable, you can go home on oral antibiotics in most cases with an early followup. The "rules" of medicine are often quirky and very frequently frustrating (to both patients and doctors) - but they're rarely random.
  - nobody9999 4y ago
    >For reference, a bacterial culture cannot be declared negative in less than 72 hours. That's the source of your three-day admission, although that's an odd beast - if you're stable, you can go home on oral antibiotics in most cases with an early followup. Yeah. The doctor who visited this horror on me seems to have been a really bad doctor. Which is also why I changed GPs after this because he recommended this moron. I'm not a physician, but in 2008 when this was happening, I asked about oral antibiotics and was told they were ineffective for MRSA. That may have been ignorance or a lie. Or, perhaps things have changed in the past 15 years. I have no idea. Prior to hospitalization, he'd prescribed a topical sulfa drug (which, unknown to me until then I was allergic to) which made things much, much worse. In fact, I have permanent damage and discoloration to the skin on my leg. And I developed hives on the palms of my hands and the soles of my feet. It was a disaster -- but that wasn't the doctor's fault -- I didn't know I was allergic. After that debacle, I went to see a vascular specialist (the other guy was a "wound care" doctor), who suggested a compression stocking[0]. The lesion was completely healed in five days. Now I take a much more active approach when I have medical issues, having learned (the hard way) that I need to be my own best counsel when it comes to my health. That includes research, asking questions, making sure I have the relevant information to make appropriate medical decisions for myself. [0] https://health.clevelandclinic.org/what-you-should-know-about-compression-socks/ https://health.clevelandclinic.org/what-you-should-know-abou... Edit: added the missing link.
- effingwewt 4y ago
  Wow I'm sorry that happened to you. Truly. Yes I am paid for the work I do, but I wouldn't expect to be paid for the work I am supposed to but dont do. warning this will be a bit graphic/gross A bit more context on my event: I had an abscess on the upper part of my jaw that had my entire face swollen and a fever of 102+ when I went in. I was shaking all over with chills and sweating like I was in a sauna. They let me sit there in agony and never checked my vitals. Not my temperature, not my blood pressure- nothing. I begged them to lance it, anything. Ice for the swelling, even. Nothing. It was so bad after being in the hospital 4+ hours I went home and the abscess grew so bad it drained out the bottom of my tooth root. I could very well have died. And they used a fucking tongue depressor and handed me a 200mg ibuprofen. That was why I was so upset with the bill. I get it there's doctors and infra to pay for, but not for doing nothing, especially when we had free clinics in that city that could have helped me had it been normal business hours. I've paid thousands for stiches and complained, but at least I got the stiches, so I shut up and paid. I had slag get in my eye that had to be dug out with a needle. My eye was numbed, they removed the shards (the slag cooled when it hit my tears and shards were embedded in my eye). That cost me a grand total of 750. The penicillin eye drops they prescribed? 500 before I think it was goodrx where they have deals on scripts and I think I got them for 50. Point being they make this up as they go and there's zero reason for it to ever change. Edit for more color- the abscesses event was at an ER in a hospital that most definitely had the capability to at least get me to an actual doctor in the hospital side rather than keep me in ER. And this was before the prevalence of these new Emergency centers as I'd have gladly gone to one of those instead.

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/...

devilbunny 4y ago
For reference, a bacterial culture cannot be declared negative in less than 72 hours. That's the source of your three-day admission, although that's an odd beast - if you're stable, you can go home on oral antibiotics in most cases with an early followup. The "rules" of medicine are often quirky and very frequently frustrating (to both patients and doctors) - but they're rarely random.
- nobody9999 4y ago
  >For reference, a bacterial culture cannot be declared negative in less than 72 hours. That's the source of your three-day admission, although that's an odd beast - if you're stable, you can go home on oral antibiotics in most cases with an early followup. Yeah. The doctor who visited this horror on me seems to have been a really bad doctor. Which is also why I changed GPs after this because he recommended this moron. I'm not a physician, but in 2008 when this was happening, I asked about oral antibiotics and was told they were ineffective for MRSA. That may have been ignorance or a lie. Or, perhaps things have changed in the past 15 years. I have no idea. Prior to hospitalization, he'd prescribed a topical sulfa drug (which, unknown to me until then I was allergic to) which made things much, much worse. In fact, I have permanent damage and discoloration to the skin on my leg. And I developed hives on the palms of my hands and the soles of my feet. It was a disaster -- but that wasn't the doctor's fault -- I didn't know I was allergic. After that debacle, I went to see a vascular specialist (the other guy was a "wound care" doctor), who suggested a compression stocking[0]. The lesion was completely healed in five days. Now I take a much more active approach when I have medical issues, having learned (the hard way) that I need to be my own best counsel when it comes to my health. That includes research, asking questions, making sure I have the relevant information to make appropriate medical decisions for myself. [0] https://health.clevelandclinic.org/what-you-should-know-about-compression-socks/ https://health.clevelandclinic.org/what-you-should-know-abou... Edit: added the missing link.
effingwewt 4y ago
Wow I'm sorry that happened to you. Truly. Yes I am paid for the work I do, but I wouldn't expect to be paid for the work I am supposed to but dont do. warning this will be a bit graphic/gross A bit more context on my event: I had an abscess on the upper part of my jaw that had my entire face swollen and a fever of 102+ when I went in. I was shaking all over with chills and sweating like I was in a sauna. They let me sit there in agony and never checked my vitals. Not my temperature, not my blood pressure- nothing. I begged them to lance it, anything. Ice for the swelling, even. Nothing. It was so bad after being in the hospital 4+ hours I went home and the abscess grew so bad it drained out the bottom of my tooth root. I could very well have died. And they used a fucking tongue depressor and handed me a 200mg ibuprofen. That was why I was so upset with the bill. I get it there's doctors and infra to pay for, but not for doing nothing, especially when we had free clinics in that city that could have helped me had it been normal business hours. I've paid thousands for stiches and complained, but at least I got the stiches, so I shut up and paid. I had slag get in my eye that had to be dug out with a needle. My eye was numbed, they removed the shards (the slag cooled when it hit my tears and shards were embedded in my eye). That cost me a grand total of 750. The penicillin eye drops they prescribed? 500 before I think it was goodrx where they have deals on scripts and I think I got them for 50. Point being they make this up as they go and there's zero reason for it to ever change. Edit for more color- the abscesses event was at an ER in a hospital that most definitely had the capability to at least get me to an actual doctor in the hospital side rather than keep me in ER. And this was before the prevalence of these new Emergency centers as I'd have gladly gone to one of those instead.