$106,911.93 medical bill for swallowed denture

Simper

I have a private insurance policy that will only be helpful in a life threatening event because that’s the only thing i can afford. It has a very high deductible before it will kick in. It does not cover most things that people expect insurance to cover.

I have an issue with doctors offices not believing me when i tell them that my insurance will not be covering anything. This got me in a tight spot when I needed blood work done and I asked how much it was going to cost me before I would consent to the test. The doctors office told me that the insurance would cover it even though I repeatedly told them it would not. Then they told me that they checked with the insurance company and had confirmation that it was covered.

So naive me believed them and when through with the test without ever getting the cost estimate I asked for. I assumed when a doctors office tells you that they checked on something it would be the truth. About 6 months later i get a bill for $400 for the blood work. I called the doctors office and the insurance company. Turns out the doctors office never checked with the insurance company but were very surprised it was not covered. I still got stuck with the bill (which i fortunately was able to pay for with savings) and now I check with the insurance company myself first and demand a cost estimate before any medical visit or procedure. Live and learn.

Ronald Pottol

I have seen hospital bills that stated 50% off, if paid within 30 days, so the uninsured may have some discounts available to them.

Tim

Actually, for the “billed” amount, this sounds a little low. I have, unfortunately, much experience with hospital stays. $100K for 5-6 days is normal for the hospital to bill. For an ICU, it is usually more. (I am in an expensive area). Fortunately, I have reasonable insurance, Of the course of 2+ years of a family member’s treatment, I have a spread sheet that says the insurance company’s negotiated rate is 11% of the hospital’s billed rate.

I have heard from others with less insurance that they can often negotiate down, sometimes to the insurance company’s rate. I have also heard of people getting “divorces” to protect the family assets. One parent becomes poor and the other keeps the house, investments etc. so they can get treatment. The hospital (at least ours) doesn’t refuse treatment thankfully. My rule of thumb: try not to get sick…

Anonymous

I had a minor procedure done in my ob/gyn clinic and the Dr billed for 1000 but got paid just under $500 as the pre agreed rate. I only had to pay $15 .

If this same procedure was done in a hospital the bill would have been 7-15,000 and my portion would have been at least $500.

I am amazed how much “discount” the insurance companies get for the services.

Anonymous

I pay over $15k annually for health insurance. My wife pays a similar ammount. We will be faced with approximately $8000 in copays and fees by June of next year. My wife’s perscriptions aren’t covered fully (2 seperate insurance policies will pay for about half of what three seperate specialists have prescribed). After paying off our last 8k medical bout I was hit with 18 months and going 15% pay cuts. My wife has sustained a 60% paycut in the last 6 months. All this means is that we have just about 8k in cash saved up. Just enough to pay our soon to balloon medical bills. If anything catastrophic happens we’ll be joining the medically bankrupt within a year. And we are insured, yeah!

fnc

I’d be very interested in seeing how the cost of bankruptcies due to medical care is spread over society. It doesn’t seem to me like that debt would just disappear down a hole. Providers’ prices have to go up to make up for the loss of revenue, and now we have a person who can’t buy make large purchases on credit as well, that’s got to represent at least some loss to the economy.

I’m not saying making the government write a big blank check to the medical providers is the right way to go, but I don’t think what we have now is really the best system in the world either.

redesigned

unregulated capitalism eventually turns into monolithic monopolies that are the antithesis of true capitalism.

even the originator of the concept of capitalism was for regulated capitalism to keep a fair level playing field.

markets do not regulate themselves despite the myth of free markets being self correcting. many people in the US are duped into believing in a form of capitalism promoted by large corporations seeking less regulations so they can dominate a marketplace and remove all competition.

Norman

If he was Canadian, he would have been made to wait until the dentures “left naturally”.

Trust me, I’m living in this system now.

spiderking

Uh huh. Want to make some disparaging remarks about the Canadian military while you’re at it?
You’re lying and not funny.
redesigned

If he was Canadian, he would have been made to wait until the dentures “left naturally”. Trust me, I’m living in this system now.

Total BS. I’m living in canada right now as well and have never had to wait for any of my medical care. I’ve walked into the ER several times and had immediate free treatment. Even though i am a US citizen. It is the best health care i have ever received. Having extensive experience in both systems, I can unquestionably state that the Canadian system is far superior. The world health organization agrees as well which is why Canada ranks 6th and the US 29th.

Either you are a republican/conservative from the US trying to dupe people, or the experiences you have had are more a testament to services in your local area, not Canada as a whole.
Kickstart

Absolute nonsense.

Is it Pepsi Blue I smell?
Anonymous

Malarkey, Norman. I’ve used the Canadian health care system, and it’s first-rate.

Cowicide

You really could make an entire website just for American healthcare nightmare stories like this.

Nightmare stories…? Sound too much like fantasy. I think HORROR is more appropriate considering all the true-life pain, anguish and actual deaths involved.

Anyway… here you go…

http://www.michaelmoore.com/words/mikes-letter/send-me-your-health-care-horror-stories-an-appeal-from-michael-moore

Cowicide

Oh and another guy many have been programmed to hate….

Congressman Grayson: Stories Of Those Who Died Because They Didn’t Have Health Insurance pt.1

http://www.youtube.com/watch?v=8hcwtM8fD9A

mlcatl

As alluded to above, this bill has nothing to do with reality UNLESS YOU ARE UNINSURED. Medicare and all insurance companies get a discount. If you want to pay cash, you can get a substantial discount if you pay up front, but once it is billed, It becomes subject an arcane set of government regulation, if the doctor/clinic/hospital accepts Medicare (basically everyone.) Those sets of regulations make it quite risky

(Risky = Medicare can say “we want the discount you gave those people, since it is less than what we paid you. Therefore you owe us 3 times the difference going back X years. Oh, and stop practicing medicine until we figure this out. And you might want to get a criminal lawyer because the supplemental insurance that covered these patients has decided that’s insurance fraud, in addition to the civil liability that we have assigned. Oh, and since you are being investigated for fraud, the medical board has temporarily suspend your license until we get this all worked out.”
)

It’s crazy. The irony is that Medicare does a pretty good job of administering healthcare. They have 1% overhead vs.the 15-30% overhead of a private insurance company. You rarely hear of Medicare not paying for a treatment, just private insurers.

More on this here:

http://www.wpta.org/reimbursement/WPTA%20Cash%20Discounts%20Article.pdf

If you have a problem that can be taken care of in an office, you are better going to a place that doesn’t take insurance and bargain. I’m a doctor. I’ve done it. Most of my patients in that practice were working class and uninsured. I met the market price and they are happy and come back.

Cowicide

Yeah… but… you’re just a Doctor so Iâ€™m sure you have no idea what you’re talking about! [sarcasm]

Seriously, thanks for your knowledgeable post! [minus sarcasm]
redesigned

As alluded to above, this bill has nothing to do with reality UNLESS YOU ARE UNINSURED.

UNTRUE, private insurance companies are in the business of making profit for their investors. They will do anything they can to reject a claim and avoid paying it. I’ve known a number of people who were insured and still got stuck with the bill. A number of posters in this forum have pointed out the same thing. seriously, you’ve obviously never had do deal with a really sick or dying relative in the US or you’d know just how bad the system really is.
Charlotte Corday

“…The irony is that Medicare does a pretty good job of administering healthcare. They have 1% overhead…”

Any doctor’s office will call BS on this in a nanosecond. They have had to hire battalions of coders and consultants to help them get what they are entitled to be paid under Medicare’s Byzantine regulations. Google “E/M coding consultants” for samples.

Then Medicare defines “fraud” in such a broad way that honest misinterpretation of its vague rules can send doctors to jail.

Then there’s the revolving door whereby Medicare administrators and lawyers leave their jobs and set up shop charging stiff fees to help doctors and hospitals navigate the regulatory maze which those former bureaucrats themselves created.

So Medicare has resulted in massive overhead costs, it’s just that the FedGov has told providers, “You eat this cost”. It would be much the same under a single payer system.

dculberson

Wait… as I’m reading this statement of benefits, the insurance company negotiated the hospital payment down to $1,100. That doesn’t seem right. What am I interpreting wrong here??

Hakan

FSM bless the NHS….

Hey, Tories! Hands off the “socialist health service”, it works, don’t attempt to tinker with it and break it and make it like this horrible example!

Chinny Racoon

Yes, the NHS is probably the BEST thing about living in the UK. Coming joint first with the BBC. It’s a shame that there seem to be so many people who want to privatise or split up both, both in government and ordinary people who don’t realise just how good it is.
Anonymous

Hakan, every other civilized first-world country has national health care. I wish we were as embarrassed by that as we should be.

arikol

Living in Sweden rocks!
I once had to pay $20 dollars for a hospital visit (biggest hospital bill I’ve received).
I had to take my son to the hospital due to swine flu (fever was running out of control, scary stuff),cost me nothing.
I do have to pay for dental care (not cheap) but all children receive dental care for free until age 18.

Ahhh, the joy of living in a socialist country! (not communist, for those who don’t understand the difference, look it up!)

jonathan_v

What *REALLY* infuriates me about our medical system is this:

1. Insured Patient Sees Bill for $110k
2. Insurance Company Pays reduced bill of $30k , as per their agreement with doctor/hospital/etc to pay money immediately in exchange for steep discounts.

1. UnInsured Patient Sees Bill for $110k
2. UnInsured Patient doesn’t know they can try to negotiate down because insurance companies have HUGE reductions on bills, or the hospital refuses to do a one-on-one negotiation (because it takes as much time to negotiate on one person as it does for 1500 patients with one provider ) therefore becomes bankrupt trying to pay the entire 110k.

That discrepancy is the root of evil in our healthcare farce.

Grant Hamilton

You left out a couple steps…

3. Patient pays $1000 deductable.
4. Patient yells at doctor at follow-up visit about how HE (not the hospital) gouged him and must fly to work every morning in his personal helicopter.

I agree with the poster who asked for a free-market solution to this mess. There is no such thing as free healthcare. You can pay for it at the front desk at the time of service or through higher taxes (since nobody will cut spending on unnecessary wars) or through the invisible tax of inflation. If the government inserts themselves into the process, you’ll also have to foot the bill for their bureaucracy. If we actually individually paid for our healthcare (just like we pay for our car repairs, dental work, legal fees, food, etc.) then all the incentives would align. People with lifestyle-induced diseases (a HUGE portion of or expenses) would have more of a direct incentive to take care of themselves. The prices would come down because hospitals and doctors would need to publish their fees and we’d eliminate the massive waste of money that pays for all the billers, coders, insurance companies and so on. If healthcare becomes “free” get ready for infinite demand.

Just to be clear, we should still have health insurance but it should be for catastrophic illness. Just like your car insurance covers hitting a pole but not the oil change.
- grimc
  
  Just to be clear, we should still have health insurance but it should be for catastrophic illness. Just like your car insurance covers hitting a pole but not the oil change.
  
  Insurance would cover replacement of the engine if it seized up due to lack of oil changes. Besides, health insurance and auto insurance is an awful comparison. You can total out a car. How do you total out a life?
  - Anonymous
    
    What kind of car insurance do you have? I would be stuck paying for it out of pocket.
    
    The problem I see with this debate is that the US is dramatically different structurally when compared to other countries and their associated health care systems. In Canada (or Sweeden or Germany) the federal government can get away with paying 65% or more of the cost of health care, because a strong centralized government is A O.K. with the populus. In the US, we have a cnstant give and take between what the sum of the American people want and what the rednecks in Bum$#@%, Texas would prefer. That and the middle ground that the US wants to reach is not very efficent; a heavily regulated public market like Massachusetts has failed dramatically at reducing costs.
- Thorzdad
  
  Just to be clear, we should still have health insurance but it should be for catastrophic illness. Just like your car insurance covers hitting a pole but not the oil change.
  
  That’s a bad analogy. Catastrophic-only coverage would still leave a huge range of highly expensive medical services uncovered. There are far too many people today without coverage who can’t afford the $100+ it costs to go to their GP. Then there are imaging services like CT scans that can easily cost thousands. The result is that they simply don’t go to the doctor.
  
  Without coverage for primary diagnostic services, GP visits, etc., I’m afraid the rate of people using catastrophic-only insurance would skyrocket, as conditions that could have been detected with a simple GP visit and a scan go undiagnosed and untreated until they become…well…catastrophic.
  - Grant Hamilton
    
    The point I was making is that the visit to the GP would be about $30 (all they currently get anyway) and a CT scan might be a couple hundred. If we had meaningful tort reform so that doctors could stop practicing defensive medicine, we’d have a lot fewer CT scans in the first place. I can’t even count the number of people I see with nasal fractures who bring in CT scans. A nasal fracture can be diagnosed with your fingers.
    
    Regarding the other poster who thinks his insurance is going to pay for his seized engine due to a lack of maintenance, I challenge you to try that one. Good luck.
    - T Nielsen Hayden
      
      Something seems to have gone wonky with my user account. As a result, I’ve been posting anonymously all day without realizing it. In this thread, messages 25, 44, 45, 51, and 52 are mine.
      
      Chinny Racoon: just think, your health care could be as good as your now-privatized rail service.
      
      Grant Hamilton: “Meaningful tort reform”? You fell for that one too? “Tort reform” is code for “making a bunch of changes in the legal system that will relieve large corporations of liability for the demonstrable harm they do to individuals.”
      
      If you want proof, look into all the circulating stories about ridiculous jury awards in personal injury lawsuits. It’s not just that the stories are false or falsified (though it’s been repeatedly demonstrated that they are); it’s that they’re professionally written and circulated. The “personal injury lawsuits are a ripoff” meme has been a fully funded professional astroturf campaign for decades now.
      
      I can’t believe you didn’t know that.
    - Brainspore
      
      If you want proof, look into all the circulating stories about ridiculous jury awards in personal injury lawsuits.
      
      My favorite is the infamous myth that someone out there got fabulously rich by spilling McDonald’s coffee on her lap and experiencing mild discomfort as a result. There are so many things wrong with the way that story is usually told that it’s hard to know where to start.
    - Grant Hamilton
      
      I can’t think of a single colleague who doesn’t practice defensive medicine.
      
      Regarding your assertion that I am making things up about lifestyle induced diseases, check the CDC. http://www.cdc.gov/nchs/fastats/lcod.htm Numbers 1, 2, 3, 4, and 7 are mostly self-inflicted due to smoking, drinking, lack of exercise and obesity.
      
      If you wan’t to debate this, use some facts, not passive-aggressive ad-hominem attacks.
    - Thorzdad
      
      The point I was making is that the visit to the GP would be about $30 (all they currently get anyway) and a CT scan might be a couple hundred. If we had meaningful tort reform so that doctors could stop practicing defensive medicine, we’d have a lot fewer CT scans in the first place.
      
      That’s wildly speculative (or outright naive) on your part on those prices. I think you can get a much more accurate vision of what those costs would be if you simply told your GP that you have no insurance and what your office visit will cost. I guarantee is won’t be a mere $30. My GP charges $100 if you have no insurance. Period.
      
      I had to have a scan done of my back last year. Before I could be admitted, I had to sign an contract that stated that I agreed to pay the full price of the procedure, if insurance did not, or if I had no insurance. The price stated? $1,600. For 10 seconds in the scanner. And this is in a city that has several imaging centers competing for business. This, I think, is more indicative of what things would be like if insurance was limited to catastrophic coverage.
      
      As for tort reform…Texas passed tort reform. There’s been no reduction in costs to the consumer or in the number of supposedly unnecessary procedure.
    - Anonymous
      
      The reason your examples haven’t worked is because you are only changing one variable. Tort reform with our current third-party payor system isn’t going to put any market pressure on prices. I’m a doctor. I’m not making this stuff up. Your hospital bill is probably 3x what it would normally be because, by the time you account for all the charity care and insurance contracts, you get reimbursed about $0.30 on the dollar. It doesn’t take a genius to realize that you need to triple the prices if you want to keep the lights on. Besides the economic benefits of eliminating most insurance, wouldn’t you rather just have your health-care between you and your doctor without having to get permission for everything and having to appeal and then getting extra bills and so on? Third-party payors have driven a wedge between the doctors and their patients. Our system works perfectly for how we have designed it (poorly IMO). If you opened a restaurant that had no prices on the menu and you knew that someone else would be paying, what would you order? Think the waiter would talk you out of that (especially if they thought you might sue them someday for not serving them the right food)? But of course it is in the interest of the payor not to pay so now everyone is in conflict. Since the care can’t be “free,” doesn’t it make sense to just pay for what you need and know what it costs?
  - Charlotte Corday
    
    One problem with health care which covers every service from the first dollar is the pressure to include all sorts of questionable services such as “music therapy” and out-n-out woo such as chiropractic and naturopathy.
    
    Mandating that this sort of stuff be covered drives up cost for everyone, and I should certainly be permitted to buy a policy that covers just the science, not the woo.
- Anonymous
  
  Grant Hamilton, how lovely to hear it’s all so simple. I can only imagine that you’ve never had a serious injury or illness, and have always had coverage.
  
  You know the joke about the Underpants Gnomes and profits? The logic of saying “all the incentives would align” is on exactly the same level.
  
  Furthermore, the idea that most medical costs are for “lifestyle-induced diseases” is a pathetic fraud cooked up by professional disinformationalists. I’m surprised that someone who’s intelligent enough to enjoy reading Boing Boing would fall for it. If most illness were lifestyle-induced, the Middle Ages would have had a far longer life expectancy than we do, and poor but hard-working populations should be practically immortal. The Middle Ages didn’t, the Hunzas and Albanians and Georgians aren’t, and the assertion is simply not true.
  
  As for your proposal that “insurance should only cover catastrophic illness,” I’ll repeat what I said earlier: you obviously have no acquaintance with the subject. An idea like yours could only come from someone who has no idea how much a treatable chronic illness can cost.
Bryan Price

I have to agree. Although I think your $30K is too high. I had a procedure where the bill was $125K, and that was for 24 hours of care. I still had to pay my $40 copay.

By the time this was paid by the insurance company, it had been reduced down to $23K.

I’ve gone through this now 3 times (I won’t be going through it again, for good or bad).

Anonymous

Not too unusual. It might, in fact, be pretty cheap.

I was assaulted in a remote area, resulting in injuries which might have been life threatening without prompt treatment.

I was flown by helicopter to the closest trauma center where I was treated and released. Total time arrival-treatment-discharge was just under 6 hours. Total flight time was 1 hour.

That bill was $50,000, and it has bankrupted me.

sloverlord

You really could make an entire website just for American healthcare nightmare stories like this. It’d be like ICanHazCheezburger, except instead of cute pictures of cats it’d be, y’know, people having their lives ruined.

Punt Speedchunk

There actually is a site for comparing medical stories in the U.S. and abroad: http://www.pluralofanecdote.com
Anonymous

I saw your post, and checked – you’re right, there are no sites out there devoted to medical fails etc. So I created one :) http://www.failmed.com/

Help me populate it by submitting ideas :)
Cowicide

You really could make an entire website just for American healthcare nightmare stories like this. It’d be like ICanHazCheezburger, except instead of cute pictures of cats it’d be, y’know, people having their lives ruined.

Here’s one for those the corporatists basically killed. Not sure the wounded (those who are still alive & suffering) are listed, but who’s got time to go through all those people too, huh?

http://namesofthedead.com/

Anonymous

I noticed that the total payment to the hospital was $1,100.00 for 8 days in ICU.
How can we expect hospitals to keep the doors open on $1,100.00? The insurance company (Anthem Blue Cross Blue Shield) is robbing that hospital blind.
Perhaps medical care would not cost as much if the insurance companies weren’t allowed to simply adjust off %99 of the claim.

Another way to look at this- I pay $100/mo for my insurance. That’s more every year than the insurance payed on this claim. If I was in ICU for 8 days with a $100K bill, would I be allowed to adjust off 99% of the bill and just pay cash? It would cost less than insurance.

DJBudSonic

Yes, where is the gov’t health insurance I have been told I need to buy? I tried to get new health insurance for my family from 6 major providers and none of them would give me a quote “pending the rules changes that are part of the government health care overhaul”. So if I want to buy private insurance I can’t, but there is no public option available? What gives?

In a related story, my wife went to the hospital for a deep cat bite on her hand (against my wishes) and came home with a $2000 bill. A few weeks ago, when I severely cut my finger on a broken glass that fell from a shelf I decided that we couldn’t afford another $2000 bill, so I stitched it myself using pre-strung curved needles I had liberated from the emergency room – if you ever go in for stitches, pay close attention to how they do it – it’s really not that hard. The key is bleeding it out and making sure it is clean first before you sew it up. It healed up great! And free!

peterbruells

You do know that a cat’s bite is quite nasty, much more dangerous than a deep cut made by glass, as the bite will transfer microbes. With a cat you have about a 50% chance of infection, deep in the muscle, hard to get rid of. Only human bites are probably worse.

GeekMan

Being a Canadian, you probably already know my views on this subject.

What I will say is that every even-slightly-liberal American should be praising Barack Obama every morning when they get up and every night before they go to bed for beginning the slow, painful reform of America’s capitalistic health care system.

The man inherited a rough job with rough problems, but getting this one issue rolling was a lot tougher and a lot more important than anyone gives him, and his administration, credit for.

Lobster

As you are a Canadian, you can be forgiven for the mistake. Obama is not fixing anything. He’s rearranging the furniture and calling it reform.

spiderking

Thanks for posting this. There are fellow Canadians I know who thoroughly believe that the way to fix problems like wait times in our healthcare system is to privatize everything. Definite proof that the US has the most expensive, corrupt, and inefficient system on the planet helps me justify my support for the “socialist” status quo. Cheers.

Anonymous

Thats why I go to Mexico for my medications.
I have no insurance, was hospitalized for 3 hours when I had a car accident, had x-rays done and a cat scan of my head. All came out to be over 18grand. No way in hell I could pay all that. But the hospital had an option to pay cash within a month and Id get a 60% discount. Still a lot if you ask me.

narrowstreetsLA

While we’re sharing scary healthcare ghost stories around the campfire, here’s mine:

Once I got sick at the height of the swine flu. I rested, drank fluids, but I wasn’t getting better. So in a mild panic, I went to the emergency room and got a diagnosis: just a regular flu, no worries, take aspirin and wait it out. I eventually got better.

Months later, my healthcare “provider” sends me a denial of claim bill basically saying I shouldn’t have gone to emergency care since the diagnosis wasn’t urgent. I should’ve made a regular appointment with my doctor.

In other words, I should have had the prognosticative acumen to sense my illness wasn’t that serious. I should have played doctor.

Hal

You’re not required to have “prognosticative acumen”.
You just need common sense. Call your doctor’s office, tell them your symptoms. ER care is for emergencies and I agree with your insurance company’s policy.

The issues I have are:
1 Although the doctor’s office is available by phone 24/7 they are not always available to see someone and so send people to ER unnecessarily.
2. We need an intermediate level of care between the doctor’s office and ER (some kind of clinic?) so I don’t have to take kids to the ER for things like stitches.
- Anonymous
  
  Hal:
  
  First, could you tell me more about this doctor of yours whose office makes a live person available to all callers 24/7/365, and is willing to diagnose problems and give advice over the phone? I’ve never seen one of those.
  
  Second, if “common sense” were enough to tell people how sick they are, Jim Henson would still be alive. I recommend that you go hang out at Yahoo! Answers on a Friday or Saturday night, and watch the kind of questions that get posted in categories like “Diseases & Conditions,” “Pain & Pain Management,” and “Alternative Medicine.” You see stuff like “I fell down the stairs and hit my head. Now I have an excruciating headache, and I can’t see out of my left eye. What should I do?”
  
  Some memorable queries:
  
  – A teenage girl who’d been having severe and increasing abdominal pain for days, but didn’t want to go to the ER because she was visiting her grandparents and didn’t want to upset them.
  
  – A woman who’d been increasingly short of breath and exhausted for no evident reason, and had purpura (spots of subdermal bleeding) on all her joints. She’d also been occasionally smoking dope, and wanted to know whether that might be causing her symptoms.
  
  – A guy who’d been having chest pain so severe it dropped him to his knees (sounded like angina) whenever he exerted himself physically, but hadn’t reported it to a doctor because he was afraid they’d make him stop being a Marine.
  
  Here’s a currently open question there:
  
  My sister wa hit at the posterior neck with a closed fist and lost conciousness for four hours, upon awakening she was confused, lost her personality and was desoriented. Was hospitalised and scanning showed no injury.She was discharged and two days later she started hallucinating,complaining of spasm and pain in the affected side icluding left arm and the upper chest. Am confused what should i do?
  
  Do you need to have me explain any of those to you? They’re all potentially life-threatening conditions.
  
  And not to lose site of narrowstreetsLA’s point, severe influenza is also a potentially life-threatening condition. The CDC’s website cites a study that estimates flu-associated deaths from 1976 to 2007 as ranging from 3,000 to 49,000 per year.
  
  Letting healthcare providers refuse to pay claims because the patient “should have known” they didn’t need to go to the ER is bad policy and bad medicine. It doesn’t save lives; quite the opposite. What it does do is reduce their legitimate healthcare payouts, because a patient who dies costs them nothing.
  - chroma
    
    Kaiser-Permanente has a free (for those with KP insurance) advice nurse available 24/7 via phone. Call the number and the nurse tells you if you should go to the ER, make a doctor’s appointment, or just suck it up.
- arp
  
  Don’t other cities have urgent care?? Phoenix does. That would be the in between clinic you’re talking about. Still crazy expensive but not as horrible as the ER.

Dragonflye

I had a discussion about Health Care with a friend of mine who is a psychiatrist. He had just returned home here to Canada from a conference in Florida and he was telling me a story about how he was having some issues in his hotel room. The maintenance guy who came up to fix whatever the problem was started chatting about the state of health care in the US but overall, was non-plussed about the situation. His opinion? “Hey, not my problem, I have insurance.”

This is what is alarming. Those who HAVE health care don’t seem to care about the state of those who don’t…

Thank God I’m Canadian.

Anonymous

I’m sure I won’t be the only one to report a story like this, but almost a year ago my sister (29 years old) had a massive 13 hour surgery to remove a grapefruit sized tumor on her spine. The reason it got that big was due to it being missed on MRIs two years in a row, which is a whole other story…

Anyway, the surgery and hospital stay came out to several hundred thousand dollars and guess what, her insurance, her INSURANCE decided they didn’t want to pay for it. After months of hard work (while my sister was getting radiation and chemo) and appeals they finally agreed to pay for it, but as she says “fighting the insurance was almost worse than fighting the cancer.”

So even if you do have good insurance, (she’s a high school science teacher at a public school where benefits like insurance are a big part of the relatively meager compensation) you aren’t guaranteed anything!

Anonymous

It’s sadly common. My father had two different (quite comprehensive) forms of health insurance. When he got sick, it wasn’t clear if either insurance would pay for his treatments. His *doctor* actually told my parents that the way they should deal with the situation was to wait until my father received the treatments, and then they should sell their house and flee the country, as otherwise they’d be left bankrupt (and on a fixed income).

MsLeading

Unfortunately, the fact that you DO have health insurance, and that your insurance company will negotiate that bill down by about 60%, is largely responsible for the artificially high cost of the care in the first place. Medical procedures don’t actually cost this much; that’s clear from close inspection of the bills and comparison to costs elsewhere. Were we ALL to have to pay our healthcare bills ourselves, rather than just a generally poorer and less-knowledgeable minority, the market simply wouldn’t bear these sorts of costs, and they’d be lower.

We either need a capitalist healthcare system that’s actually allowed to behave as a capitalist system must, i.e. with actual competition and consumer choice and in which certain things are actually allowed to fail, or a government-provided healthcare system that is separate from the rest of our economy. I’d be about equally happy with either, but this wishy-washy noncommittal middle ground benefits only insurance companies.

dragonfrog

MsLeading, I think you’re mistaken about what a true capitalist system looks like.

Consumer choice is not a necessary feature of truly free capitalism – it may optionally be present, if no one supplier has yet managed to crush all its competitors.

Likewise, preferential rates for certain large purchasers are absolutely a feature of free market capitalism – every vendor is free to negotiate rates with every purchaser. Of course, the big vendors only negotiate with the ones that are big enough to have clout (insurance companies), and those big purchasers can then roll their reduced purchase rates in with other services (the insurance itself) and resell them, making the services seem more attractive.

The features you describe as being mandatory – consumer choice, a pricing scheme that extends bulk purchase rates to all purchasers – are exactly antithetical to a free market system. They’re possible only in a heavily-regulated market – a market full of antitrust laws, price controls, and a raft of other regulations, and a heavy bureaucracy to enforce them.
BookGuy

Personally, I can’t see how a so-called capitalist system of healthcare would ever work. Even if there were an ideal state where prices were determined my market forces and absolutely nothing else, healthcare isn’t like buying a new TV. You just can’t shop around for the best price when you’re losing a liter of blood per hour. Anything other than the mildest, non-emergency treatment would leave the patient completely at the mercy of the provider. Even if one could argue that doctors/hospitals that get a rep for high costs will eventually close down for lack of “customers,” they could still financially destroy quite a few people in the process. In fact, I think even the attempt to transition to such a system would destroy people and leave a lot of others to needlessly suffer. It’s not like privatization would immediately cause hospitals to drop prices from $106,000 to $29.99.

The one “good” (?!?) consequence, I suppose, would be that rural areas would get more doctors. After all, why stay in a competitive city environment when you can go someplace more remote and charge anything you want?
Anonymous

MsLeading, a big problem with “consumer choice” is that the outcome of diagnosis and treatment is impossible to predict at the outset, and its cost is even more unknowable. The only patients who are in a position to plan for that are the ones who don’t need to plan: i.e., the very wealthy.

Since we have a far better idea of what our overall medical costs are likely to be nationwide, I vote for the option where we get a government-sponsored health care system that doesn’t pretend to be part of the free market. It’s the same way we handle law enforcement and public safety: we have these costs, we pay these taxes to cover them, and we don’t waste a lot of time trying to figure out exactly where the expenses are going to fall.

After all, it’s not like anyone wants to be a recipient of those services.

redesigned

i think the reason many people in the USA are against government health care and taxes, is they are not used to getting anything good for their tax dollars.

when i moved to Canada from the USA i was amazed. you mean we get good medical care, good roads, my daughters private education is subsidized, my other daughters daycare is subsidized, etc. etc., all for the same level of taxes? whoa! i wasn’t used to getting anything for my tax dollars except for crappy roads. amazing what you can get when the government isn’t blowing all the tax money on the military! suddenly taxes made perfect sense.

Anonymous

I don’t really like Michael Moore that much but I did watch Sicko http://en.wikipedia.org/wiki/Sicko … Even if the documentary is over the top I do not wish to ever live in a situation where I have to seriously debate seeking medicate attention due to cost.

Some wonderful examples from Sicko:
- Patients picking which fingers to re-attach based on the cost per finger
- Parents fighting their insurance company to get known working treatments only for their child to die while waiting
- Insurance companies forcing patients to travel to different hospitals where they have agreements for cheaper service and refusing to pay for services at the closest hospital.

Nadreck

Parents fighting their insurance company to get known working treatments only for their child to die while waiting

Gotta love those Death Panels!
DoctressJulia

That movie made me cry- not just tear up, but weep openly. Those poor people! Argh! What can we do?

sifr

$110,000 for 8 days of intensive care?

I broke my arm this July, and had to have surgery. I’m still waiting for the bills from the surgery, from the anasthesia, for all the drugs they pumped me full of before, during, and after, and so on.

So far, I’ve received 4 $45 bills for some X-rays they took in the ER.

Oh, right. I got the bill for my hospital room, too. $96,639.22, for 3 night stay. That’s not food, medicine, treatment, surgery, or anything else. That’s JUST THE ROOM.

sifr

Here’s a link to a photo of the bill: http://www.bitshift.org/bill.jpg

Chesterfield

GeekMan, the reason so many of us don’t get excited about the changes to health care is that we suspect they are going to go away.

There’s a pretty good chance Obama won’t get a second term. If he doesn’t, most of the changes will be reversed by any republican president.

Anonymous

Glad I live in Europe when I read stories like these.
I understand that the intensive care prices are higher, but I never saw such high prices for an operation like that.

druse

Our healthcare system in the Netherlands is starting to suck as well, since it was privatized. But this is absolutely ridiculous.

I feel sorry for the lives that would be destroyed by this.

Thanks for sharing.

Brainspore

My mother-in-law might be alive today if she and her husband hadn’t put off going to the hospital for weeks due to being their being uninsured at the time. By the time she was taken to the E.R. by ambulance she was too far gone to save, but she lingered long enough to accumulate a hospital bill that my father-in-law will be paying off for the rest of his life (and likely cost him his home).

And somehow he’s still convinced that our nation would be worse off with a Canadian or European-style health care system. Fear of change can be a powerful force indeed.

redesigned

i’m really sorry to hear that Brainspore. Your story hit really close to home. My mother refused to go to the hospital for months after she suddenly developed a fist size swollen lump in her neck almost overnight, because they can’t afford insurance and are barely making mortgage payments. she finally went because the headaches it was causing were making her so dizzy and nauseous that she couldn’t even eat or barely stand up. now they have another debt they cannot afford and might lose their home. they are conservatives and tow the party line against health care. makes me want to cry, especially since i have experienced firsthand how different it can be. :-(

andygates

Seriously, guys, the NHS is great. I highly recommend it for actual, y’know, health care.

j9c

http://articles.cnn.com/2009-06-05/health/bankruptcy.medical.bills_1_medical-bills-bankruptcies-health-insurance?_s=PM:HEALTH

Medical bills prompt more than 60 percent of U.S. bankruptcies (June 2009, CNN)

I suppose next thing we Ammrrkins will be expected to do to trim medical costs is… oh… I dunno, perform our own appendectomies and C-sections? http://en.wikipedia.org/wiki/Self-surgery You shoulda seen the circus I had to deal with when I was 5 months pregnant and my husband’s COBRA was unexpectedly terminated during the late ’90s dot-bust. We contemplated having zero insurance and employing a midwife. Not one insurer would take us–we ended up using our state’s “high risk pool” insurers of last resort (THIRP). The premiums for that were ferociously high. We dropped out of that one the day after our son was born.

Thank Jah I didn’t swallow any dentures during labor. Not that I have any.

You Canadians count yer blessings, every dang day! I’ll be over here takin’ vitamins and prayin’ no one has an accident, steps on a rattlesnake or gets really ill.

Anonymous

Aha! I am French…

At least I get ot tease you Americans for a few years before our health system collapses under misuse/mismanagement.

JulianR

Boy, do the US need socialized health care urgently. Also, somebody needs to look into the prices they’re charging. This is ridiculous!

I’m from Germany, this whole denture episode would have cost â‚¬ 10 for the admission, plus a daily room fee of roughly â‚¬ 15 to 20, which includes the food and the nursing. The rest would have been covered by the insurance, but it would never ever have been over, say, â‚¬ 10.000 for the week. (The patients usually never see the bill and never know the price of the treatment they just got.) I can only urge you to watch “Sicko” (again), because the parts of the film that take place in Europe are absolutely true and as shown.

RenaldoSugarbush

Wow

It is so good to be Canadian for so many reasons.

Anonymous

Sounds about accurate. I spent 4 days in the hospital drinking soup and sleeping until they finally told me on day 3 that I had a kidney stone.

4 aspirins + 3 food trays + 2 ultrasound scans over 4 days = $10,000 apparently.

The only reason why I didn’t faint dead away from the bill is because I’m an unemployed full time student, a very big bonus. They had no income to attempt to collect from me. I worked with the hospital so that all the fees were 100% covered at no cost to me. It’s still astounding how something such as basics of hospital care are so very expensive.

Anonymous

On holiday in a foreign country I’m out taking a walk, on the side walk. Nearby driver makes a mistake, up on the side walk, hits me from behind. Rushed to hospital after first aid on the spot, operated twice, spend two weeks in hospital, get tickets for me and the family to fly back home. Further surgery and therapy until I’m completely recuperated.

I saw countless doctors, spent weeks in hospital, operated on several times, had a personal therapist help me regain my balance. Free use of wheel chairs and crutches, plane tickets for me and my family.

Total cost? 0 USD.

Thank God I was born in Europe!

Datura Greenleaf

I can’t believe such a thing is even possible.

I just had surgery on both my knees at a private hospital in South Africa. I have private medical cover.

The total bill, including the surgeon’s fees, the anaesthetistâ€™s fees, and the hospital stay fees and take home medicines (didn’t stay overnight) came to about R25 000. At the current exchange rate that’s about $3600.

My medical aid scheme paid the entire bill without any questions, and the only thing that wasn’t covered was some random piece of equipment that I had to pay R600 ($90) for.

Medical schemes here are heavily regulated by the government, and cannot refuse to accept members. Costs of cover are based on the package you choose, and not an individual risk profile. Recommended prices for medicines and procedures are set by the government, and although practitioners are allowed to charge more, there are many who don’t.

$106,911.93 medical bill for swallowed denture

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