4 ms·

It doesn't matter how much it costs because there is no such thing in America as informed consumer consent. If you're unconscious, they will treat you, bill you

It doesn't matter how much it costs because there is no such thing in America as informed consumer consent. If you're unconscious, they will treat you, bill you, and you become liable for an arbitrary debt. The Founding Fathers revolted for this type of arbitrary taxation but too many modern Americans are too docile and accepting of mistreatment and exploitation. I met a woman in a coffee shop in Redding CA who was about to defend her home, clothing, and means of transportation from creditors who forced her into bankruptcy while she was dying of stage IV cancer. This is the state of healthcare as a business first in America.

colordrops 3y ago
The problem is that people grow up with this ridiculous state of affairs, among many others, so there is no point of reference, and even when a moment of clarity hits that something might be wrong, there is a sense of hopelessness that nothing can be done because everyone else is still half-alseep.
tonightstoast 3y ago
I went to get a standard STD panel at an urgent care a few weeks back. I asked how much it would be beforehand (since I don't have insurance). The front desk person said "between $100 and $200". I left and paid $340 - which pissed me off but whatever. Then, the following week, I received a bill from the lab testing for $380. That infuriated me. In total I spent $720 after being initially quoted max $200. I tried to fight it but medical billing places remind me of the South Park episode about Cable Companies (where they're rubbing their nipples as the callers describe how they're being exploited). Truly an asinine system.
- cvccvroomvroom 3y ago
  You have to demand a coded bill ahead to time or you must refuse treatment. If it's not in writing, then there's no evidence. If they refuse, then you have to be willing to walk away. Also, pay by check including the phrase "payment in full".
  - tonightstoast 3y ago
    Agreed. I will be trying to get a coded bill beforehand but most places will tell you "everything we do is an estimate". Which is so bullshit, but brings me back to my original point: they know they can fuck you, and they enjoy doing it.
- sixothree 3y ago
  I had not reached the deductible on whatever plan I had at the time when I made an office visit for chronic sinusitis. I had been suffering for at least 6 months. It was affecting my work. The doctor was an hour late. My visit was terse and his recommendation was to use a saline nasal spray. Then he charged me $140. But I'm sure some right wing jerk in this thread is going to whine about how other countries pay more in taxes or something equally useless.
  - tonightstoast 3y ago
    Hahah I always love the useless appointments where it would be better care to talk with a nurse on Telehealth. I wonder if MDs realize their actions are losing them the war. I used to think it was dumb that NPs are gaining further ability to treat patients, but my last few experiences with MDs has been so poor that I am no longer "rooting" for them. If that makes sense.
    - sixothree 3y ago
      My story really isn't a story of price, but of quality and patient experience. I am hoping patients can start seeing these things before visiting a doctor.
calderwoodra 3y ago
Source? I don't believe the specific situation you described is true (unconscious and legally required to pay the bill).
- bandrami 3y ago
  It only recently got addressed legally and it's been a huge problem: https://www.consumerfinance.gov/ask-cfpb/what-is-a-surprise-medical-bill-and-what-should-i-know-about-the-no-surprises-act-en-2123/ https://www.consumerfinance.gov/ask-cfpb/what-is-a-surprise-... Anaesthesiologists seem to be the worst offenders
  - calderwoodra 3y ago
    Even prior to that, I believe health care providers are required to get written agreement from you in order to require you to pay (which you wouldn't be able to do unconscious). I've read [1] that Healthcare facilities often practice a dark pattern here though by combining both the consent to accept treatment and costs into one form/signature. But regardless of that, AFAIK, if you never consent to payment, you're not legally obligated to pay. Of course it would always be better if none of this shenanigans existed but... Yeah. [1] https://play.google.com/store/books/details?id=EViEDwAAQBAJ https://play.google.com/store/books/details?id=EViEDwAAQBAJ
- avs733 3y ago
  so speaking for myself, but I had a medical provider (medical equipment rental company) falsify my signature. Among other medical billing misadventures. My wife and I both have Ph.D.s I say that not to gloat but to reinforce how broken a system we have. You asked about consent - I recently had a hospital visit that included an ambulance trip. I was in no condition to provide consent, my wife didn't provide consent, but you better believe we got the bill (well insurance got the bills). That was just the start of the abject scams that exist throughout the medical system. I needed a wheelchair to leave the hospital and they had me sign one page of something (on an ipad, while I'm high on opioids) and then replicated that signature onto other documents I didn't sign. They, on a recorded phone call, tell me I signed three documents, I note that they are pixel for pixel identical signatures - and that I only have one of the three documents as a hard copy. They still say I owe them $12, well the debt collectors do...I remind them each time they call that they are going to spend more trying to collect this than its worth. Its been sold at least four times. Since then I have contacted: * my health insurance company's fraud line - they don't take reports from patients * state attorney general - no response * CMS - no response (theory - if they are doing this to me they are doing this to others) Broadly, from that one accident, I have had a lawyer send letters to two companies, filed suit against one, and simply decided I'm going to ignore 2 bills entirely because they are transparently fraudulent (IMHO). No one - short of an actual lawyer who used words like 'class action' has been any help in getting them to fix things. The other story, my health insurance company is repeatedly uninterested in being overbilled for every physical therapy visit...by hundreds of dollars per visit, across more than 20 visits. Thats a fun story. Orthopedic surgeon prescribed PT, simplest way is to do PT through the in clinic PT clinic. I go in twice a week for a month and pay my normal PT copay. Then the insurance starts getting really high bills and I get a request for more money. They listed the orthopedic surgeon as providing the PT. I contact the company, they say that is their 'billing policy'. I point out that the orthopedist is not licensed to provide PT, 'thats our policy'. The difference for me is $10 per visit for a specialist rather than normal copay. THe difference for the health insurance was around $300 per visit. I contact my health insurance - they poke aroudn and find out that the orthopedist owns the PT clinic - which 'employs' no physical therapists. The PTs are all employees of a separate corporate entity so it doesn't through any red flags in billing. Insurance ghosts me - literally, I have a case number from the fraud department that they have no record of or notes on. My wife and I had a conversation today about how we spend, between medical and general life bills, at least 3 hours per month ensuring we are not misbilled, or ripped off, or not provided the services we pay for. We find issues every month. There is a point where this is a generalized business model of fraud on customers and it needs to be stopped - there ought to be criminal charges.

colordrops 3y ago

The problem is that people grow up with this ridiculous state of affairs, among many others, so there is no point of reference, and even when a moment of clarity hits that something might be wrong, there is a sense of hopelessness that nothing can be done because everyone else is still half-alseep.

tonightstoast 3y ago

I went to get a standard STD panel at an urgent care a few weeks back. I asked how much it would be beforehand (since I don't have insurance). The front desk person said "between $100 and $200". I left and paid $340 - which pissed me off but whatever. Then, the following week, I received a bill from the lab testing for $380. That infuriated me. In total I spent $720 after being initially quoted max $200. I tried to fight it but medical billing places remind me of the South Park episode about Cable Companies (where they're rubbing their nipples as the callers describe how they're being exploited). Truly an asinine system.

cvccvroomvroom 3y ago
You have to demand a coded bill ahead to time or you must refuse treatment. If it's not in writing, then there's no evidence. If they refuse, then you have to be willing to walk away. Also, pay by check including the phrase "payment in full".
- tonightstoast 3y ago
  Agreed. I will be trying to get a coded bill beforehand but most places will tell you "everything we do is an estimate". Which is so bullshit, but brings me back to my original point: they know they can fuck you, and they enjoy doing it.
sixothree 3y ago
I had not reached the deductible on whatever plan I had at the time when I made an office visit for chronic sinusitis. I had been suffering for at least 6 months. It was affecting my work. The doctor was an hour late. My visit was terse and his recommendation was to use a saline nasal spray. Then he charged me $140. But I'm sure some right wing jerk in this thread is going to whine about how other countries pay more in taxes or something equally useless.
- tonightstoast 3y ago
  Hahah I always love the useless appointments where it would be better care to talk with a nurse on Telehealth. I wonder if MDs realize their actions are losing them the war. I used to think it was dumb that NPs are gaining further ability to treat patients, but my last few experiences with MDs has been so poor that I am no longer "rooting" for them. If that makes sense.
  - sixothree 3y ago
    My story really isn't a story of price, but of quality and patient experience. I am hoping patients can start seeing these things before visiting a doctor.

calderwoodra 3y ago

Source? I don't believe the specific situation you described is true (unconscious and legally required to pay the bill).

bandrami 3y ago
It only recently got addressed legally and it's been a huge problem: https://www.consumerfinance.gov/ask-cfpb/what-is-a-surprise-medical-bill-and-what-should-i-know-about-the-no-surprises-act-en-2123/ https://www.consumerfinance.gov/ask-cfpb/what-is-a-surprise-... Anaesthesiologists seem to be the worst offenders
- calderwoodra 3y ago
  Even prior to that, I believe health care providers are required to get written agreement from you in order to require you to pay (which you wouldn't be able to do unconscious). I've read [1] that Healthcare facilities often practice a dark pattern here though by combining both the consent to accept treatment and costs into one form/signature. But regardless of that, AFAIK, if you never consent to payment, you're not legally obligated to pay. Of course it would always be better if none of this shenanigans existed but... Yeah. [1] https://play.google.com/store/books/details?id=EViEDwAAQBAJ https://play.google.com/store/books/details?id=EViEDwAAQBAJ
avs733 3y ago
so speaking for myself, but I had a medical provider (medical equipment rental company) falsify my signature. Among other medical billing misadventures. My wife and I both have Ph.D.s I say that not to gloat but to reinforce how broken a system we have. You asked about consent - I recently had a hospital visit that included an ambulance trip. I was in no condition to provide consent, my wife didn't provide consent, but you better believe we got the bill (well insurance got the bills). That was just the start of the abject scams that exist throughout the medical system. I needed a wheelchair to leave the hospital and they had me sign one page of something (on an ipad, while I'm high on opioids) and then replicated that signature onto other documents I didn't sign. They, on a recorded phone call, tell me I signed three documents, I note that they are pixel for pixel identical signatures - and that I only have one of the three documents as a hard copy. They still say I owe them $12, well the debt collectors do...I remind them each time they call that they are going to spend more trying to collect this than its worth. Its been sold at least four times. Since then I have contacted: * my health insurance company's fraud line - they don't take reports from patients * state attorney general - no response * CMS - no response (theory - if they are doing this to me they are doing this to others) Broadly, from that one accident, I have had a lawyer send letters to two companies, filed suit against one, and simply decided I'm going to ignore 2 bills entirely because they are transparently fraudulent (IMHO). No one - short of an actual lawyer who used words like 'class action' has been any help in getting them to fix things. The other story, my health insurance company is repeatedly uninterested in being overbilled for every physical therapy visit...by hundreds of dollars per visit, across more than 20 visits. Thats a fun story. Orthopedic surgeon prescribed PT, simplest way is to do PT through the in clinic PT clinic. I go in twice a week for a month and pay my normal PT copay. Then the insurance starts getting really high bills and I get a request for more money. They listed the orthopedic surgeon as providing the PT. I contact the company, they say that is their 'billing policy'. I point out that the orthopedist is not licensed to provide PT, 'thats our policy'. The difference for me is $10 per visit for a specialist rather than normal copay. THe difference for the health insurance was around $300 per visit. I contact my health insurance - they poke aroudn and find out that the orthopedist owns the PT clinic - which 'employs' no physical therapists. The PTs are all employees of a separate corporate entity so it doesn't through any red flags in billing. Insurance ghosts me - literally, I have a case number from the fraud department that they have no record of or notes on. My wife and I had a conversation today about how we spend, between medical and general life bills, at least 3 hours per month ensuring we are not misbilled, or ripped off, or not provided the services we pay for. We find issues every month. There is a point where this is a generalized business model of fraud on customers and it needs to be stopped - there ought to be criminal charges.