Not paying for ER visit

[halethsonofhama]

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So on this forum I see a bunch of people cracking jokes about people using the ER for free healthcare, and then I see people getting ripped on for coming into the ER for a $1000 bandaid. I figured it was about time I learned how ER billing works.

What makes it so these people get "free" healthcare? Is it just that they are homeless or undocumented so they have nothing to lose? Or do they just use a fake name/address so they can't be traced. I'm assuming that hospitals contact collections for any unpaid bills.

 

[Apollyon]

A lot of the "no pay" are frequent fliers, so they can't/don't use a fake name. Rarely, people will do that (I had the amazing luck to see a guy in South Carolina that used two different names, birthdates, and social security numbers - which were all similar, though - but had the exact same chief complaint - he didn't recognize me, which was weird, considering I'd just seen him 3 months ago, and, for as elaborate was his deception, to not recognize me didn't jibe), but most aren't that sharp.

I say "no pay" because most "self-pay" won't. If you have nothing, you can pay nothing. When you don't worry about your credit rating, then you take from others when it is legal (as is in this case), and don't worry about not paying (which is not legal).

Stuff gets sent to collections, but this isn't hounded into oblivion. Again, what is 10% of nothing?

 

[GeneralVeers]

It's funny but people who are amoral and poor actually have the best access to care. They can come to the ER for every complaint, and by my hospital's policy get every test, treatment "necessary" completely for free, and if I misdiagnose them or they have a complication they can sue me.

This is why I'm a big fan of the medical screening exam, followed by a co-pay before treatment. My hospital won't do this for "customer service" reasons, nevermind that the "customers" have no intention of paying.

 

[lilsheba]

New person here, not a medical professional in any way, I am just reading stuff 🙂

However I disagree with a hospital bill going to collections is not hounded to death. I have insurance but haven't always had the money to pay the 150.00 copay, and had a couple of bills from that in the past for my daughter. Plus some random left over charges from procedures I had done. The collection agency came after me so fast it made my head spin and garnished me.

I don't understand why it's so vicious when they get 80 percent or more of the money from the insurance already.

 

[EctopicFetus]

I don't understand why it's so vicious when they get 80 percent or more of the money from the insurance already.

Is it ok to pay 80% of your mortgage or car payment? How about your credit card bill? Just asking why you think this should be different?

Would you be ok if your job paid you 80% of what you earned?

 

[Arcan57]

You have to have some skin in the game or the game will break. If you feel like paying 20% of your bill is too much, then what in your mind is a reasonable amount?

 

[dsoz]

Now I am just a volunteer in the ER, but I have seen one of the "frequent flyers." I only volunteer every Thursday evening and every other Saturday evening, which I consider to be not very much. I started in January, and have accumulated 100 hours. I have seen one woman in there three times. She will bring both kids, one is autistic and screams and yells every time he is in there. According to the receptionest, this gal does not have insurance. The last time she was in the ER was because her precious baby (not the one with autism) had PINK EYE!!! What the heck! Pink eye in the ER? That is something that should be seen by a PCP or at most urgent care. But this gal uses the ER as a form of free primary care.

Talk about abuse of the system.

dsoz

 

[Rendar5]

just because collections calls doesn't mean these people will pay anything.

 

[Doctor4Life1769]

just because collections calls doesn't mean these people will pay anything.

Could be like this one dude who dropped his number for another one.

I joined Sprint, picked up a new number (this random dude's) and now I get calls from collections agencies up the wazoo, all for the same dude, and I tell them it's not me and to quit calling.

😡

 

[deleted65604]

To care about a bill, you have to care about law and/or your credit score. These people never intend on buying cars, or houses, or anything of significance. They don't few law as applicable to them. They are all about gaming the system and extracting the maximum from it. They welcome bankruptcy.

 

[GeneralVeers]

To care about a bill, you have to care about law and/or your credit score. These people never intend on buying cars, or houses, or anything of significance. They don't few law as applicable to them. They are all about gaming the system and extracting the maximum from it. They welcome bankruptcy.

Actually they don't even care about bankruptcy. These people have no "official" income, and often derive their income from government programs. They often are paid in cash so they have no assets for any creditor to go after.

IMO we should be protected from lawsuits under the "good samaritan" laws if something happens to these people who are clearly out to abuse the system.

 

[malpractician]

IMO we should be protected from lawsuits under the "good samaritan" laws if something happens to these people who are clearly out to abuse the system.

well come practice in TX, an attending told me there has to be proven malignant intent for them to be awarded anything. But that doesn't mean they won't waste your time and money trying.

 

[Doctor4Life1769]

well come practice in TX, an attending told me there has to be proven malignant intent for them to be awarded anything. But that doesn't mean they won't waste your time and money trying.

I likely will come to TX and practice.

 

[GeneralVeers]

well come practice in TX, an attending told me there has to be proven malignant intent for them to be awarded anything. But that doesn't mean they won't waste your time and money trying.

I did my residency there. The Texas language is some of the strongest pro-doctor language in the country. To win a malpractice suit you have to prove:

Wanton disregard or
Negligence or
Intentional harm.

Those are tough legal standards to meet in many cases.

 

[DeLaughterDO]

I did my residency there. The Texas language is some of the strongest pro-doctor language in the country. To win a malpractice suit you have to prove:

Wanton disregard or
Negligence or
Intentional harm.

Those are tough legal standards to meet in many cases.

Willful and wanton FTW!

And in addition, Gov Perry just signed a law that dictates that loser pays in the tort system. Not sure yet if it will apply to the medical tort cases, though, as all the mentions I saw were to business torts. Will have to wait and see.

 

[EMRAGE]

I did my residency there. The Texas language is some of the strongest pro-doctor language in the country. To win a malpractice suit you have to prove:

Wanton disregard or
Negligence or
Intentional harm.

Those are tough legal standards to meet in many cases.

My dream come true!

TORT is BS. I just wish, as physicians, we could all come together and agree to use the power we have. Most physicians are so passive. We have more power than we appreciate, let alone utilize.

RAGE

 

[microscp2]

Now I am just a volunteer in the ER, but I have seen one of the "frequent flyers." I only volunteer every Thursday evening and every other Saturday evening, which I consider to be not very much. I started in January, and have accumulated 100 hours. I have seen one woman in there three times. She will bring both kids, one is autistic and screams and yells every time he is in there. According to the receptionest, this gal does not have insurance. The last time she was in the ER was because her precious baby (not the one with autism) had PINK EYE!!! What the heck! Pink eye in the ER? That is something that should be seen by a PCP or at most urgent care. But this gal uses the ER as a form of free primary care.

Talk about abuse of the system.

dsoz

I had one mother bringing her 2 year old son because she saw some worm in her son's diaper one week ago.

 

[Colbert]

I had a mom bring in her 6 children, all under the age of 9, at midnight, because the one-month old had a diaper rash. Then she was yelling because, of course, she has all these children with her and it's the middle of the night, she doesn't have time to wait around for us to get around to her. Can't wait to start residency next month.

 

[Fiveoboy11]

I went to the ER about 6 months ago, twice, for what ended up being a kidney stone. Required minor surgery and an overnight stay. Guess how much it cost me? Close to 30,000 dollars. Don't have insurance.

Let me ask this, is it fair that I have to pay that amount of money for a kidney stone? Give me a break. About 3 months ago I had to max out 4 credit cards to avoid having it go to collections and ruin my credit.

 

[EctopicFetus]

I went to the ER about 6 months ago, twice, for what ended up being a kidney stone. Required minor surgery and an overnight stay. Guess how much it cost me? Close to 30,000 dollars. Don't have insurance.

Let me ask this, is it fair that I have to pay that amount of money for a kidney stone? Give me a break. About 3 months ago I had to max out 4 credit cards to avoid having it go to collections and ruin my credit.

2 points. Why dont you have insurance? If you had a family and you were the sole bread winner and you had a horrific accident and you died if you didnt have life insurance and your family was screwed financially whose fault is that?

Why would it be "unfair" that you have to pay a bill for services rendered? Hopefully you were smart enough to talk to the financial dept of the hospital cause most of them work well with people.

Who should pay the salary for the Urologist, Er Doc, Anesthesiologist, nurses, techs, lab, kitchen staff, maintenance, IT, janitors etc. Who should pay for the gauze, IV equipment and meds?

 

[EctopicFetus]

I had a mom bring in her 6 children, all under the age of 9, at midnight, because the one-month old had a diaper rash. Then she was yelling because, of course, she has all these children with her and it's the middle of the night, she doesn't have time to wait around for us to get around to her. Can't wait to start residency next month.

This behavior never ends. the "family plan" is my least favorite complaint. Somehow people with a copay dont do this as it costs too much.

 

[DrVanNostran]

Is it ok to pay 80% of your mortgage or car payment? How about your credit card bill? Just asking why you think this should be different?

Would you be ok if your job paid you 80% of what you earned?

👍👍

 

[Winged Scapula]

I went to the ER about 6 months ago, twice, for what ended up being a kidney stone. Required minor surgery and an overnight stay. Guess how much it cost me? Close to 30,000 dollars. Don't have insurance.

Let me ask this, is it fair that I have to pay that amount of money for a kidney stone? Give me a break. About 3 months ago I had to max out 4 credit cards to avoid having it go to collections and ruin my credit.

You live in a state with a Medicaid program. Why haven't you applied or why didn't the hospital apply for you? Could it be that you make too much money or have assets which exceed the limit (which is fairly generous) or simply chose not to apply or to pay for insurance?

I see the latter in my office at times - someone who claims not to have any money, cannot afford insurance, yet when the state program is applied for, they are denied because they have a 6 figure income. My own mother went without health insurance for years as a self-employed person, claiming it was too expensive, but yet drove a new Mercedes. 🙄

I've had plenty of jobs which did not offer health insurance and fortunately, never had any medical problems but as an allied health care worker (at least by your status), you should know that paying for insurance or applying for state aid is YOUR RESPONSIBILITY. I'm sorry you had a kidney stone, but why should someone else (ie, me and everyone else here) pay for your medical problems, especially if you are otherwise healthy and gainfully employed?

2 points. Why dont you have insurance? If you had a family and you were the sole bread winner and you had a horrific accident and you died if you didnt have life insurance and your family was screwed financially whose fault is that?

Why would it be "unfair" that you have to pay a bill for services rendered? Hopefully you were smart enough to talk to the financial dept of the hospital cause most of them work well with people.

Yes, the OP should have applied for the state Medicaid program and I'm suprised the hospital did not do it for him which leads me to believe that he is not eligible for some reason (which usually means he makes too much money). At any rate, financial departments will work with you and often greatly discount the bill if you ask.

Who should pay the salary for the Urologist, Er Doc, Anesthesiologist, nurses, techs, lab, kitchen staff, maintenance, IT, janitors etc. Who should pay for the gauze, IV equipment and meds?

Exactly. He wants *us* to pay for it.

 

[Fiveoboy11]

2 points. Why dont you have insurance? If you had a family and you were the sole bread winner and you had a horrific accident and you died if you didnt have life insurance and your family was screwed financially whose fault is that?

Why would it be "unfair" that you have to pay a bill for services rendered? Hopefully you were smart enough to talk to the financial dept of the hospital cause most of them work well with people.

Who should pay the salary for the Urologist, Er Doc, Anesthesiologist, nurses, techs, lab, kitchen staff, maintenance, IT, janitors etc. Who should pay for the gauze, IV equipment and meds?

I never implied those people shouldn't be paid, what I was trying to make clear was how inappropriate the actual bill was. Thirty thousand dollars is a lot of money. It obviously was a big mistake of mine to not have health insurance. Only was 29 at the time, had started a new job, they had a standard probationary period and I was not eligible for health insurance until that was over. By the way, I did try to negotiate with the hospital, they would not negotiate at all. I even hired a healthcare bill advocate who helped me get the separate Dr. bills cut in half. The hospital bill still stood at about 24k though. That is way too much relative to what I received if you ask me.

 

[Fiveoboy11]

You live in a state with a Medicaid program. Why haven't you applied or why didn't the hospital apply for you? Could it be that you make too much money or have assets which exceed the limit (which is fairly generous) or simply chose not to apply or to pay for insurance?

I see the latter in my office at times - someone who claims not to have any money, cannot afford insurance, yet when the state program is applied for, they are denied because they have a 6 figure income. My own mother went without health insurance for years as a self-employed person, claiming it was too expensive, but yet drove a new Mercedes. 🙄

I've had plenty of jobs which did not offer health insurance and fortunately, never had any medical problems but as an allied health care worker (at least by your status), you should know that paying for insurance or applying for state aid is YOUR RESPONSIBILITY. I'm sorry you had a kidney stone, but why should someone else (ie, me and everyone else here) pay for your medical problems, especially if you are otherwise healthy and gainfully employed?



Yes, the OP should have applied for the state Medicaid program and I'm suprised the hospital did not do it for him which leads me to believe that he is not eligible for some reason (which usually means he makes too much money). At any rate, financial departments will work with you and often greatly discount the bill if you ask.



Exactly. He wants *us* to pay for it.

Wow, you guys really project a lot. I never said I wanted someone else to pay for my bills. Hospitals really bend people over and give it to them when they don't have insurance.

If I did have insurance the hospital would have been reimbursed something between 4-5k to 10-15k per my healthcare advocate, but magically since I don't have insurance the hospital brilliantly thought I should pay twice as much (30k). No wonder why nobody pays their bills, perhaps hospitals should jump on the bandwagon and grasp the concept of fair pricing.

 

[justaregularmed]

What I find completely disgusting is this: Friend goes to hospital, gets 5 sutures, hospital charges them for supplies which could but them an ENTIRE BOX of sutures at RETAIL.

That is completely disgusting and reprehensible.

One packet of sutures, one vial of lidocane, one needle and syringe, one chuck, one betadine swab and some gauze. For the low low price of $100 dollars!

This stuff costs maybe 15 bucks retail, including hospital collective bargaining, I would estimate cost them maybe 5-7 bucks.

So only a 2000% markup.

 

[Apollyon]

Wow, you guys really project a lot. I never said I wanted someone else to pay for my bills. Hospitals really bend people over and give it to them when they don't have insurance.

If I did have insurance the hospital would have been reimbursed something between 4-5k to 10-15k per my healthcare advocate, but magically since I don't have insurance the hospital brilliantly thought I should pay twice as much (30k). No wonder why nobody pays their bills, perhaps hospitals should jump on the bandwagon and grasp the concept of fair pricing.

Hold on there bud. When I was admitted to the hospital 4 years ago, my four day stay was billed at $14000. However, the Blue Cross/Blue Shield capitated rate was negotiated to $3600, which means, in other words, BC/BS paid $3600, no matter what the hospital charged. However, I had to pay 10% of the bill - the whole bill ($1400, not $360). I didn't get any discount for being a staff physician.

It's not that the insurance rate is calculated, then they double it for everyone else. It's the opposite. Hospital sets price "x". Then insurance says "We won't pay 'x', but this percentage (40, 50, 60, whatever)".

At the same time, that the hospital wouldn't budge? Really? But, then, the physician charges were cut, but not the hospital side? Who's the thief there? The doctors? Really? That would mean you got less than the going rate - that sounds like fair pricing (or at least equitable, as fair is the weather).

 

[EctopicFetus]

A few things for those who think hospitals are raking in the cash. Hospitals are shutting down in the US. The reason is simple they ARE NOT making money. There are exceptions but there is a reason there arent tons of for profit hospitals out there.

Also to the OP who said he didnt get his money's worth. Your option is to simply not have gotten the care or at 29 years old be a little more responsible.

You make it sound like being 29 you shouldnt be a responsible adult. I can see 18 or even 21 but at 29 you should be responsible.

 

[Fiveoboy11]

A few things for those who think hospitals are raking in the cash. Hospitals are shutting down in the US. The reason is simple they ARE NOT making money. There are exceptions but there is a reason there arent tons of for profit hospitals out there.

Also to the OP who said he didnt get his money's worth. Your option is to simply not have gotten the care or at 29 years old be a little more responsible.

You make it sound like being 29 you shouldnt be a responsible adult. I can see 18 or even 21 but at 29 you should be responsible.

I actually am a responsible adult, sorry to enlighten you but a person's insurance having status does not determine that. There are many things that go into making a person responsible, and your biased affection for people with health insurance given your job does not change that. Sh&t happens.

And the other poster prior to this...

So are you saying that since health insurance companies only pay a percentage, you are advocating for the hospital to bill the patient the remainder?

I think it would make a lot more intelligent sense for the hospital to bill a non insured person the maximum amount they would get from an insurance. At least that would be fair.

 

[EctopicFetus]

I actually am a responsible adult, sorry to enlighten you but a person's insurance having status does not determine that. There are many things that go into making a person responsible, and your biased affection for people with health insurance given your job does not change that. Sh&t happens.

And the other poster prior to this...

So are you saying that since health insurance companies only pay a percentage, you are advocating for the hospital to bill the patient the remainder?

I think it would make a lot more intelligent sense for the hospital to bill a non insured person the maximum amount they would get from an insurance. At least that would be fair.

Chill the the demeaning tone. If you dont think carrying health insurance relates to your responsibility then you are mistaken. Unless thats the difference between getting food for your family you are wrong. See something happened and you complain. Is the system perfect, nope, is it good nope but there are costs and you are responsible for your portion. Health insurance is CHEAP if you are healthy. If you arent its even more reason to have insurance. I take care of plenty of uninsured people and thats fine. I knew that when I CHOSE to go into this field. Its one of the reasons I chose it. But dont complain when you have a bill that needs to be paid.

regarding advocating the hospital bill the patient for the rest it is called balance billing and I am 100% for this. Without it what would stop an insurer from paying $5 for every visit?

Keep them fair and it keeps pressure on the insurers to pay a fair rate.

 

[Fiveoboy11]

Hold on there bud. When I was admitted to the hospital 4 years ago, my four day stay was billed at $14000. However, the Blue Cross/Blue Shield capitated rate was negotiated to $3600, which means, in other words, BC/BS paid $3600, no matter what the hospital charged. However, I had to pay 10% of the bill - the whole bill ($1400, not $360). I didn't get any discount for being a staff physician.

It's not that the insurance rate is calculated, then they double it for everyone else. It's the opposite. Hospital sets price "x". Then insurance says "We won't pay 'x', but this percentage (40, 50, 60, whatever)".

At the same time, that the hospital wouldn't budge? Really? But, then, the physician charges were cut, but not the hospital side? Who's the thief there? The doctors? Really? That would mean you got less than the going rate - that sounds like fair pricing (or at least equitable, as fair is the weather).

If I were you in those circumstances (assuming I was uninsured), paying 3600+1400 or 5k for a 4 day stay would be fair. Paying 14 thousand would not.

I had two separate ER visits about 24 hour separation. Was D'C obviously after the first to follow up with a urologist. I had to go back due to severe pain and vomiting, couldn't eat/drink anything. So I was admitted with an infection, fever, bla bla, stayed overnight and had a minor surgery the next day, and left that day.

Is thirty thousand dollars really appropriate? Every single doctor I saw in that hospital has been paid long ago and at the negotiated rate. So no, I don't think they were crooks at all. The hospital and the doctors billed separately where I was at. The doctors negotiated down to a reasonable price, the hospital did not. The hospital bill was about 24k, the doctors about 6k. I think it is obvious who is and who is not a crook.

 

[EctopicFetus]

Also, fwiw someone coming after the balance of the bill happened to me to. With insurance I had a completely healthy kid, wife did well and my total cost was $5000. Kick ass insurance👎

On another note, after this bit I moved my wife and kids to a different policy which cost me 1/2 as much and works out much better for us with a slightly higher deductible but no coinsurance.

So far I have saved almost 5k.

I left my insurance as is since my group pays the whole cost of my insurance.

 

[EctopicFetus]

If I were you in those circumstances (assuming I was uninsured), paying 3600+1400 or 5k for a 4 day stay would be fair. Paying 14 thousand would not.

I had two separate ER visits about 24 hour separation. Was D'C obviously after the first to follow up with a urologist. I had to go back due to severe pain and vomiting, couldn't eat/drink anything. So I was admitted with an infection, fever, bla bla, stayed overnight and had a minor surgery the next day, and left that day.

Is thirty thousand dollars really appropriate? Every single doctor I saw in that hospital has been paid long ago and at the negotiated rate. So no, I don't think they were crooks at all. The hospital and the doctors billed separately where I was at. The doctors negotiated down to a reasonable price, the hospital did not. The hospital bill was about 24k, the doctors about 6k. I think it is obvious who is and who is not a crook.

Name the hospital for us. In arizona and chicago the docs would cut a break no prob for about 2/3 of the charge. The hospitals would go 50% or more.

 

[Fiveoboy11]

Chill the the demeaning tone. If you dont think carrying health insurance relates to your responsibility then you are mistaken. Unless thats the difference between getting food for your family you are wrong. See something happened and you complain. Is the system perfect, nope, is it good nope but there are costs and you are responsible for your portion. Health insurance is CHEAP if you are healthy. If you arent its even more reason to have insurance. I take care of plenty of uninsured people and thats fine. I knew that when I CHOSE to go into this field. Its one of the reasons I chose it. But dont complain when you have a bill that needs to be paid.

regarding advocating the hospital bill the patient for the rest it is called balance billing and I am 100% for this. Without it what would stop an insurer from paying $5 for every visit?

Keep them fair and it keeps pressure on the insurers to pay a fair rate.

Yes I agree that having health insurance is a responsible move, not having it doesn't make you irresponsible. I'm not complaining that I have a bill that needs to be paid, or that I have to pay my "portion." Perhaps you and I should redefine the word "portion" in all dictionaries to mean "every possible penny." I'm complaining that the bill is inappropriate for services rendered. I'm perfectly fine paying a reasonable bill.

What would stop an insurer from paying 5 dollars for every visit? No hospital or clinic would ever contract with an insurance company for that level of reimbursement.

So you're saying when you get Medicare patient's in your hospital and after Medicare gets billed, you send the balance to the patient as if you were billing an uninsured person? Doubtful

Just so you know, they hospital has already received every penny. The credit cards are just waiting for their "portion." I've got about 1 1/2 years of interest free payments to get 'R done.

 

[Fiveoboy11]

Name the hospital for us. In arizona and chicago the docs would cut a break no prob for about 2/3 of the charge. The hospitals would go 50% or more.

As I said, the doctor's did cut me a break. I'm not exactly sure how much off it was, but they still got a good portion of it. This was fair.

The hospital was Yavapai Regional Medical Center in Prescott, AZ. The hospital refused to negotiate the price down. They have a standard offer of 20% off if you pay in full, within a month of the bill. How was I supposed to know the medical billing advocate I hired would be unable to negotiate lower? By that time the month had long expired and the hospital would not offer the 20% off or any other price negotiation. So....I was left with paying it in full.

What does the hospital expect. They send a patient a bill for 24 thousand dollars. It takes a while for the shock of that to wear off. Then, do they expect a person to just say, ok, here's 80% of 24 thousand dollars. Do you accept cash or check?

 

[ccfccp]

Yes I agree that having health insurance is a responsible move, not having it doesn't make you irresponsible. I'm not complaining that I have a bill that needs to be paid, or that I have to pay my "portion." Perhaps you and I should redefine the word "portion" in all dictionaries to mean "every possible penny." I'm complaining that the bill is inappropriate for services rendered. I'm perfectly fine paying a reasonable bill.

I'm not going to argue about insurance making your responsible. I tend to think it does, but I'm obviously not changing your opinion on that. Most kidney stones suck. No doubt about it. But most pass on their own with pain meds, fluids, antiemetics, etc. Unfortunately, it sound like you fall into the small section of people where the stones don't pass and some intervention needs to be made. I look at it like this:

The two most catastrophic complications of kidney stones are obstruction and infection. Unrelieved obstruction can lead to kidney failure and put you one step closer to dialysis for the rest of your (very) shortened life. It sounds like (from what you said... admitted with a fever) you may have had an infection. Infected, obstructed stones tend to lead to sepsis (infection in the bloodstream) which starts off with a mortality of about 20% and goes up depending on the severity. Does it happen to everyone? NO. But the risks are high. Not to mention relieving the pain, nasuea, etc. It sounds like you have completely recovered and you should be thankful for that. You're 29 and (back to being) reasonably healthy.

How much is that worth to you?

 

[docB]

What I find completely disgusting is this: Friend goes to hospital, gets 5 sutures, hospital charges them for supplies which could but them an ENTIRE BOX of sutures at RETAIL.

That is completely disgusting and reprehensible.

One packet of sutures, one vial of lidocane, one needle and syringe, one chuck, one betadine swab and some gauze. For the low low price of $100 dollars!

This stuff costs maybe 15 bucks retail, including hospital collective bargaining, I would estimate cost them maybe 5-7 bucks.

So only a 2000% markup.

We've covered this one before. You're not just paying for the supplies. You're also paying for the right to sue if there are ever any problems that you claim were due to those supplies. You are also paying the facility charge to have the nursing assessment, bed, linens, etc. and, of course, the right to sue for any of those things as well. And you are paying for the cost of maintaining an ER to respond to critical emergencies which you didn't have but might have since we are required to suspect one in every patient who walks in. Finally you are paying for your supplies and everything else for you and the guy in the next bed who won't pay anything but who we are required to treat by federal law.

 

[Fiveoboy11]

I'm not going to argue about insurance making your responsible. I tend to think it does, but I'm obviously not changing your opinion on that. Most kidney stones suck. No doubt about it. But most pass on their own with pain meds, fluids, antiemetics, etc. Unfortunately, it sound like you fall into the small section of people where the stones don't pass and some intervention needs to be made. I look at it like this:

The two most catastrophic complications of kidney stones are obstruction and infection. Unrelieved obstruction can lead to kidney failure and put you one step closer to dialysis for the rest of your (very) shortened life. It sounds like (from what you said... admitted with a fever) you may have had an infection. Infected, obstructed stones tend to lead to sepsis (infection in the bloodstream) which starts off with a mortality of about 20% and goes up depending on the severity. Does it happen to everyone? NO. But the risks are high. Not to mention relieving the pain, nasuea, etc. It sounds like you have completely recovered and you should be thankful for that. You're 29 and (back to being) reasonably healthy.

How much is that worth to you?

Good points.

Yes I did have an infection. And dilaudid is the best medication ever. For me, it was definitely worth it, even at that price. As you've said, it's not a TV set. That doesn't mean I can't think it's too much money, or unreasonable when you can get the same care in a different hospital, or with health insurance and pay half that.

 

[RustedFox]

I'm going to jump in here to say that yeah, while I'm sure that the OP is very happy with his outcome, I tend to think that a hospital visit lasting a few days shouldn't cost more than I make in a YEAR (take home) as a resident.

Just sayin'. Kill all the lawyers, maybe things will get a lot cheaper.

 

[hemoglobincell]

I tend to sympathize with the guy that got the $24,000 bill. It's not fair that some people pay NOTHING and this guy gets the shaft. Health insurance should not be an obligation. It's like insurance for anything else: it's only needed for things that cost a lot. Bring down the costs and there will be little to no need for it.

There should be ONE RATE, listed as prices when you walk in the door. 25% due UP FRONT. So instead of $24,000 and nearly bankrupting the guy, have it be $4,000 (the rate they'd pay an insurance company), $1,000 paid up front. I guess I see an inherent unfairness that a hospital charges different prices to different people.

$24,000 is unreasonable.

 

[RustedFox]

Health insurance should not be an obligation. It's like insurance for anything else: it's only needed for things that cost a lot. Bring down the costs and there will be little to no need for it.

$24,000 is unreasonable.

Auto insurance is obligatory no matter what.

 

[EctopicFetus]

Awesome.. we are going into the mandatory discussion.

I dont think you should be mandated to buy insurance. See Auto insurance isnt obligatory no matter what. There are tons of new yorkers who dont have auto insurance. Same for the people in other cities who dont drive. You choose to drive you need auto insurance.

Regarding the one price for all scheme. Sounds good in theory but much like Walmart. They get better prices cause they have what economists call scale. Get us a better deal and we will put 100k customers in our plan and they will come to your hospital.

Regarding 25% up front, there are 2 problems with that. 1) EMTALA and 2) no one knows what the up front cost is.

Also, the OP had the option of not paying like all the other people. You pay the price for not paying. Also, do I think some of the costs are insane? Yep. When my wife was getting care they charged us $80 something for a bag of LR, I know those things cost about $6 a piece. Freakin nuts. I should have run down to the ED myself and got one.

In the end there are problems and big ones but your best bet is to get you and your family insured. This is your OPTION if you chose not to then YOU take the responsibility.

I think hospitals should post prices of things but not some discounted rate. The full monty whatever that is and then they can work with people to give discounts if they want.

 

[RustedFox]

I stand corrected on the auto insurance. I did mean to include "if you want to drive"; thought that was assumed, but you know what happens when you assume.

 

[EctopicFetus]

Yep.. The devil is in the details.

 

[halethsonofhama]

Just to be clear; when people say "OP" they aren't referring to me

 

[Fiveoboy11]

So... what is a good health insurance anyway? From the standpoint of the patient I mean. Who cares how much the hospital or doctor get.

 

[justaregularmed]

We've covered this one before. You're not just paying for the supplies. You're also paying for the right to sue if there are ever any problems that you claim were due to those supplies. You are also paying the facility charge to have the nursing assessment, bed, linens, etc. and, of course, the right to sue for any of those things as well. And you are paying for the cost of maintaining an ER to respond to critical emergencies which you didn't have but might have since we are required to suspect one in every patient who walks in. Finally you are paying for your supplies and everything else for you and the guy in the next bed who won't pay anything but who we are required to treat by federal law.

So none of that was included in the 300 dollar ER fee? I'm pretty certain this extra 100 dollar fee was purely for supplies.

 

[hemoglobincell]

Regarding the one price for all scheme. Sounds good in theory but much like Walmart. They get better prices cause they have what economists call scale. Get us a better deal and we will put 100k customers in our plan and they will come to your hospital.

Walmart has competition to drive down the costs, hospitals do not. The same rules do not apply.

Collective bargaining and wholesale prices are great when you're dealing with a wholesaler, but Walmart and hospitals are not wholesalers. Walmart has posted prices and charges everyone the same.

Again, I would repeal EMTALA, because no one should be required to work/provide a service for free. Most expenses should be paid up front with FIXED PRICES for all-comers (insurance companies and individuals alike). Now competition between hospitals could occur.

 

[EctopicFetus]

So... what is a good health insurance anyway? From the standpoint of the patient I mean. Who cares how much the hospital or doctor get.

Thats naive. Good insurance is insurance that contracts with the docs and specialists YOU want to see. It also relates to what you have to pay.

Here is a REAL life example for you. I had kid #1 my TOTAL out of pocket cost.. $10. Kid #2 no real problems my out of pocket cost was about $5,000.

Do you see the difference now? I hope that made it clear for you.

Another example is when patients come to the ED becuase their insurance wouldnt pay for something (happens all the time).

5oboy11, I hope that helps you.

 

[EctopicFetus]

Walmart has competition to drive down the costs, hospitals do not. The same rules do not apply.

Collective bargaining and wholesale prices are great when you're dealing with a wholesaler, but Walmart and hospitals are not wholesalers. Walmart has posted prices and charges everyone the same.

Again, I would repeal EMTALA, because no one should be required to work/provide a service for free. Most expenses should be paid up front with FIXED PRICES for all-comers (insurance companies and individuals alike). Now competition between hospitals could occur.

We can debate Emtala but say you are having a giant heart attack. Who should be doing the wallet biopsy before we decide to intubate and activate the cath lab?

Hospitals do compete for business. You might not realize it but they do. I dont know where you live but just about anywhere they advertise their services. Why do you think they do this if they dont have competition?

Using the post prices model (which I am for) would be great. I dont think everyone should be charged the same. If you did that wouldnt you just put the hospitals in the poorest areas out of business? Think about that.