View Full Version : Wifes Recent Accident & Subsequent Hospital Bill
A few weeks ago my wife was on the way to work one morning, hit a patch of ice on an overpass and lost control of her Explorer. She went off the far side of the overpass and rolled the car down a 30 foot embankment.
A good friend of mine and an off-duty fireman just happened to be going by and were the first to reach her. EMS was there inside of five minutes according to my bud. I was at the office when he called me and I was there within 15 minutes of the accident. EMS was bringing her up the hill on a stretcher when I got there.
She had some minor cuts and abrasions, glass all over her and that shocked look in her eyes. She insisted that she was okay and did not want EMS to transport her to the ER. After seeing what happened to her and the completely destroyed car, I couldn't believe she wasn't hurt in some way and I insisted that she go.
Arrive at the hospital ER. ER doctor looks her over, nurse helps her get most of the glass off and out of her hair, gives her half a sponge bath with soap and water, apply ointment and a couple of small bandages. Nothing serious. No x-rays, MRIs...none of that, as thankfully she didn't need it and she's okay. We were there an hour. Maybe.
My wife had no health insurance. (Another story full of female drama that gives me a headache to think about)
I get a bill from the county EMS....$538.00. No problem. Those guys were super.
I get a separate bill from the ER doctor.....$245.00. No problem with that.
Then I get the bill from the hospital......$5,008.00 which they stated already allowed for a deduction of over $3,800.00 for being uninsured.
WHAT!! WHAT THE HELL!!
How? How in the name of all that is holy does some soap, water, ointment, small bandages and an hour of a nurses time cost that damn much? Don’t get me wrong, they gave great care in a great facility but, this is completely absurd! Surely all the bums that don’t pay their bills haven’t caused medical costs to escalate to this height.
Anybody have any insight on this that may calm me down before I crawl a hospital administrator’s ass? Who, I am aware, may not deserve it but…..someone is going to get an earful on this.
Dirk Williams
02-21-12, 10:10
It's an easy check list. You get to pay for those who can't pay. Pretty much every Hosital out there by law has to treat anybody who shows up, indigent or not.
It's a great system for the dopers, the illegals and anybody who just refuses to pay.
It's easier to come after those of us who work or have a steady income, then to waste time and money going after those who don't.
Top down, bottom up, inside out.
Good luck,
Dirk
.
militarymoron
02-21-12, 10:21
maybe ask for an itemized bill from the hospital?
that blows. glad your wife wasn't more seriously injured.
$5,008.00 for what amounts be a basic check-up with no imaging?
You are getting robbed.
I bet your local paper would love to hear that story.
Reagans Rascals
02-21-12, 10:24
Fight it. Plain and Simple. Refuse to pay for that. Eventually they will present you with the actual bill of probably <$400. They will try to get as much from you as they can, just keep fighting it and eventually they will attempt to settle it.
Ask for an itemized list of all charges. And dispute the costs.
Your circumstance is odd though, for me personally the ambulance has usually been the most obscene, 3-4k for a 15 minute unnecessary ride.
A friend of mine was rear ended by an illegal immigrant going about 45. His 82 Suburban was fine, save for a bent tow hitch, the illegals were all banged up. EMS asked him if he wanted treatment, he said "NO"... they left... and promptly 3 days later he received a bill in the mail from EMS for $765 for their responding to the scene, regardless of treatment.
Needless to say... we burned it that night and had a rousing good laugh.
In my experience, you can't squeeze blood from a turnip... at least not as of today.
shit... I had brain surgery in '08... with a 5 day hospital stay.... I have partial insurance, where I am still responsible for 25% after I pay $3000 towards the cap for the year.... In total I paid less than $6000....
ask them to put on some lipstick next time... cause you like to get kissed before you get ****ed...
maybe ask for an itemized bill from the hospital?
that blows. glad your wife wasn't more seriously injured.
This. And once you get it start working through things you think are crazy and mark them off. Once you have a reasonable looking bill to you call the collections department at the hospital. Offer to pay in cash (if you can) the parts that make sense if they write off the rest. Many times they will work with people willing to pay the bill. Growing up with out insurance I saw mom and dad do this more than once.
Did they send you an itemized list for the charges? If not that is the first thing I would ask for. Make sure they did anything that is listed. You may be able to negotiate the price down to a reasonable level. Try to keep all correspondence in writing. The problem with going to the hospital is that no one gets to see the prices up front.
BTW, did you have car insurance?
maybe ask for an itemized bill from the hospital?
that blows. glad your wife wasn't more seriously injured.
Yes, I will be asking for an itemized accounting. Can't wait to see what that will look like.
$750.00 for some liquid soap maybe.
Yes she is okay, thanks. It could have been tragic.
I bet your local paper would love to hear that story.
If push comes to shove....they just might. Terrific idea.
Sorry to hear about your wife's accident and the hassle with the bill. I'm sure that must be frustrating. Thank God she's ok.
I've been there with the exorbitant hospital bills. Check it out before you agree to pay anything. Sometime they'll accept a reasonable middle ground: start paying them on the portions of the bill you DO accept, as a show of good faith, while you're working out the other parts.
montanadave
02-21-12, 11:05
First, focus on what really matters. You're wife is OK and escaped serious injury. Cars can be repaired or replaced. And bills can get settled.
So take a deep breath, count backwards from 100 (then repeat as necessary), and go to the hospital's billing department and request the itemized billing. My guess is the lion's share of the ER bill is a flat "room fee" which is going to seem ridiculously high. That's how they play the game. Just walking through the door and sitting on the table racks up a big initial charge, even before you start buying $5 band-aids and a $25 plastic emesis basin.
Then do as previously suggested and try to negotiate a reasonable settlement. You may or may not succeed. And be grateful (as I'm sure you are) that you're wife is safe and sound.
Reagans Rascals......
Thanks for the insight. I do intend to fight this. There is no way I'll pay this amount. I'm requesting the itemized bill today.
I had a lower back fusion/rods done back in October in the same facility. They billed my insurance, BCBS, $169,000 and some change. BCBS ended up paying less than half that amount. My out of pocket was 3 grand too.
Half of this bill is still absurd and I'll not settle for that.
5pins.....
Yes we had still had collision insurance on the vehicle even though I had paid it off a few months prior to all this.
We've actually already settled with them and they gave us a fair deal.
Guess what I get to hear now? NEW CAR!
Does the hospital name begin with "St." i.e. faith-based?
I had a $16,000 appendectomy when I was 23 with no ins., I wrote them and said I have no money, finishing up college, but will work to pay what I can. They dropped it to 300.00 with no fuss...I agree, fight it.
If push comes to shove....they just might. Terrific idea.
If the local papers printed a story every time a working class (read: not on welfare) person got ****ed by a hospital for no other good reason than because you actually have the ability to pay, there would be very little room left for news.
The hospital in my town won't negotiate at all. They give you 90 days & then they send you to collection, period. You can make payments, sure, but only if your TOTAL BILL can be paid off in 18 payments.
It pisses me off that they are more than willing to eagerly take 50% from a collection agency but not a penny less than full price from you. The medical care situation in this country is so ****ed up it's beyond fixing it would seem.
Does the hospital name begin with "St." i.e. faith-based?
I had a $16,000 appendectomy when I was 23 with no ins., I wrote them and said I have no money, finishing up college, but will work to pay what I can. They dropped it to 300.00 with no fuss...I agree, fight it.
No it is not a faith based hospital.
It does bear the name of a very prominent family in this relatively small town.
If the local papers printed a story every time a working class (read: not on welfare) person got ****ed by a hospital for no other good reason than because you actually have the ability to pay, there would be very little room left for news.
sadmins' post and my reply made me think alittle.
As I said, this hospital bears the name of a prominent local family with LOTS of pull in all areas of this community. Including the local paper.
Any letter to the editor I may write, has a good possibility of getting ignored or "lost".
Reagans Rascals
02-21-12, 11:47
If the local papers printed a story every time a working class (read: not on welfare) person got ****ed by a hospital for no other good reason than because you actually have the ability to pay, there would be very little room left for news.
The hospital in my town won't negotiate at all. They give you 90 days & then they send you to collection, period. You can make payments, sure, but only if your TOTAL BILL can be paid off in 18 payments.
It pisses me off that they are more than willing to eagerly take 50% from a collection agency but not a penny less than full price from you. The medical care situation in this country is so ****ed up it's beyond fixing it would seem.
Like I said.... you can't squeeze blood from a turnip.... if you don't have it you don't have it
whats bullshit is that there is no governing body with oversight into what prices a hospital charges, however there is legislation on the books that states a hospital can sue you, put a lean against your house, possibly foreclose on your house, drain your bank account, garnish your spouses wages, and even obtain a court order to examine your assets.
So essentially... they are running wild. They can charge whatever they like with no legal oversight, and then, when you fail to pay the arbitrary sum, of which you did not agree to before services were rendered, take anything and everything you have....
http://www.hospitaldebtjustice.org/rights.html
pure b/s plain and simple
seems like its better to just give them a fake name and address if you ever need care....
On Christmas night, my mother became deathly ill due to severe onset withdraws (she has an implanted intrathecal pain pump for neuropathic pain). The pump she has ran dry, and we were not alerted for 4 days. The medicine within the pump is not the kind you can simply stop taking, if you do you die... That night at the emergency room, they refused to call the Pain Specialist to refill the pump, and thus also refused to fill the pump because there were no "certified" staff on call. So essentially my mother sat there dying, until they prescribed her oral medication to hold her over until later in the week when the Pain Specialist returned from vacation.... HOWEVER, when we received the bill for that night at the emergency room... guess who wanted their cut? I'm not proud to say that during that situation, I came the closest I've ever been to losing my cool and doing things that can't be talked about.... that's all I'll say about that..
the entire thing is a ****in racket.... if you're in you're a guest if you're not you're a pest...
the only thing we can hope for is eventually we the masses will rise up and smite them all and attempt to start over
Just remember that Emergency care means they are waiting for someone to be hurt. So you get to pay for them to keep the lights on and workers there when you do get hurt.
Same with an ambulance ride, you pay for two EMT's and the truck to sit around waiting for someone who needs it 24/7, weekends, holidays, not just your 15min ride.
While I agree that health care is overpriced, it's hard to put a price on having the emergency room open on a holiday weekend when your child suddenly goes from a runny nose to fever and barely able to breath.
Did they send you an itemized list for the charges? If not that is the first thing I would ask for. Make sure they did anything that is listed. You may be able to negotiate the price down to a reasonable level. Try to keep all correspondence in writing. The problem with going to the hospital is that no one gets to see the prices up front.
Do this. Best of luck.
I work at Duke. I have worked at UNC and other hospitals. Every hospital for which I have worked will negotiate to some degree. It is imperative you get an itemized bill, though...see what you are supposed to be paying for.
Reagans Rascals
02-21-12, 12:13
While I agree that health care is overpriced, it's hard to put a price on having the emergency room open on a holiday weekend when your child suddenly goes from a runny nose to fever and barely able to breath.
I agree 100% with you, where the problem lies is when do need emergency care for your child and the doctor needed to provide you with that specific care is on vacation or not on call, and the hospital refuses to call them...which is all too often the case on weekends and late nights... and thus you sit and wait for a solution. And when all is said and done, you are charged for services you did not receive. At least in my experience.
When you enter a profession such as the medical field you take on the responsibility of civic duty, and when your services are needed, they come first... not golf or watching tv on your day off. If someone is in dire need of specialized care, it is the responsibility of the hospital to provide.
If you were an EMT on your day off and someone had a heart attack at the table next to you while you were eating, you have a moral, ethical and legal responsibility to treat them. There is no "off-duty" in those circumstances.
In the end, the entire process has become convoluted, and at some point has transitioned from a "public service" to a "for profit business"
5pins.....
Yes we had still had collision insurance on the vehicle even though I had paid it off a few months prior to all this.
We've actually already settled with them and they gave us a fair deal.
I take it you did not have medical coverage on the auto policy.
I take it you did not have medical coverage on the auto policy.
My wife is finding that out today. I am hoping so.
I have requested an itemized accounting of this bill and the nice lady on the phone told me I'd have it by Friday.
CarlosDJackal
02-21-12, 14:19
From what I understand, HIPAA requires that they give your wife full disclosure of what she was treated for and their findings. I do believe this includes itemized billing at the patient's request. Request a fully itemized bill from the hospital before you pay them a cent.
As to where the cost comes from I'm willing to bet that they came from two sources: welfare and insurance. You are basically paying for the other uninsured patients who never paid their bill (for whatever reason).
You are also paying for those who chose to sue the hospital for whatever reason (most of whom also probably never paid their bill). A friend of mine has a brother who happens to be a Shock Trauma Surgeon. From what I was told his annual premiums for his malpractice insurance is over $500,000. He's a Shock Trauma Surgeon!? It's not like what he did caused the trauma in the first place. This is like bringing a Combat Medic on charges because he could not save a Grunt who was shot, blown up and bayoneted by the enemy!!
It sucks, but unfortunately it's the type of system we have. Good luck!!
Like I said.... you can't squeeze blood from a turnip.... if you don't have it you don't have it
But they can hound you with letters and phone calls before selling it to a medical debt collector that will haunt you for years.
I agree 100% with you, where the problem lies is when do need emergency care for your child and the doctor needed to provide you with that specific care is on vacation or not on call, and the hospital refuses to call them...which is all too often the case on weekends and late nights... and thus you sit and wait for a solution. And when all is said and done, you are charged for services you did not receive. At least in my experience.
When you enter a profession such as the medical field you take on the responsibility of civic duty, and when your services are needed, they come first... not golf or watching tv on your day off. If someone is in dire need of specialized care, it is the responsibility of the hospital to provide.
If you were an EMT on your day off and someone had a heart attack at the table next to you while you were eating, you have a moral, ethical and legal responsibility to treat them. There is no "off-duty" in those circumstances.
In the end, the entire process has become convoluted, and at some point has transitioned from a "public service" to a "for profit business"
Do we not want for-profit businesses running healthcare in this country with a minimum of government regulation, allowing competition and choice to determine who succeeds?
And are some advocating the OP not pay if he is unable to do so?
Both seem contrary to the prevailing opinions on this site that free markets are good and the nanny state is bad.
Belmont31R
02-21-12, 14:31
Just tell them you would like to pay a fair amount and theres no way 5000+ just for the hospital is reasonable.
I had a CT scan done and they wanted to charge me over 10,000, and then reduced it automatically to about 7500. I called around to ask about CT scan costs for the scan I got and the highest price was at least 5000 less than what the hospital I went to wanted to charge. Told the hospital I would pay a competitive rate and no more.
The doctor at the hospital also wanted to charge me for the highest level of ER visit which when I looked up the code for it was for things like extreme trauma where theres serious risk to life or limb. He spent about 2 minutes in my room, ordered some blood tests and the CT scan. Came back in for about 30 seconds after the CT scan was done and said they didn't find anything. Here's a prescription and a referral to a GI doctor. Called his office and told them I didn't get a level 5 ER visit and it was a 1 or maybe a 2 if you want to stretch it based on their own descriptions.
Avoid the ER at all costs. You can often get the same treatment somewhere else for a fraction of the cost. Our medical industry is so ****ed up these days its hardly worth going unless its a real life or death emergency. In my case I went to an urgent care clinic and like an idiot I followed their advice and went to the ER who did nothing for me and the doctor was not interested in finding out what was going on. I am finally getting somewhere with a GI doc who has a great cash payment plan. $25 office visits and half off any other services. Just have to pay at the time of service otherwise they send you a bill with no discount.
Just remember that Emergency care means they are waiting for someone to be hurt. So you get to pay for them to keep the lights on and workers there when you do get hurt.
Same with an ambulance ride, you pay for two EMT's and the truck to sit around waiting for someone who needs it 24/7, weekends, holidays, not just your 15min ride.
While I agree that health care is overpriced, it's hard to put a price on having the emergency room open on a holiday weekend when your child suddenly goes from a runny nose to fever and barely able to breath.
I don't disagree at all.
I don't mind paying a fair share of the physical facility, power bill, beds, sheets, etc..... Completely understandable.
And to be perfectly clear, this hospital is an outstanding facility. Actually purported to be one of the top cardio medical facilities in the southeast. Both my wife and I have received great service from them. What stinks is their prices and more importantly how they may have derived at them.
I don't think a person should have to pay for services not rendered. It is not fair for someone to have to pay for a share of a MRI unit when they haven't had a MRI.
I certainly don't want to pay for a share of some low lifes medical bills that he can apparently just walk away from with impunity.
lethal dose
02-21-12, 14:38
Having worked in the medical field for years, I'll tell you that they're trying to rape you. My stepfather just spent a night in the hospital for chest pain and trouble breathing. They did a full cardiac workup on him and his bill was less then $8k. As was suggested, get an itemized bill. I've been to the ER for much more severe injuries and my bills never totaled that high. They're overcharging based in the fact that many people don't pay up... next time someone tells you that we need free healthcare, you tell them that we do. The hospital I worked at wrote off about 50% of all medical bills. Anyhow, I hope Mrs. Scoby gets to feelin' better. Got a ton of new parts comin'... wanna sight a rifle in?
Belmont31R
02-21-12, 14:47
Do we not want for-profit businesses running healthcare in this country with a minimum of government regulation, allowing competition and choice to determine who succeeds?
And are some advocating the OP not pay if he is unable to do so?
Both seem contrary to the prevailing opinions on this site that free markets are good and the nanny state is bad.
Free markets are good but thats not what we have now.
What if they billed him 500k? They don't tell you how much things will cost until services are already rendered. If you don't want to tell someone how much a service costs until the service is already completed then you don't have a claim to get paid what you think you should. I can't think of any other industry where this is allowed to take place.
I mean think about getting gas. What if they didn't tell you how much it was until after you filled your tank, and then surprise! $100 a gallon and if you don't pay it we're going to tarnish your name by ruining your credit, maybe garnish wages, seize assets, ect. This system is so ****ing stupid no one should be surprised so many people don't pay their hospital bills.
Having worked in the medical field for years, I'll tell you that they're trying to rape you. My stepfather just spent a night in the hospital for chest pain and trouble breathing. They did a full cardiac workup on him and his bill was less then $8k. As was suggested, get an itemized bill. I've been to the ER for much more severe injuries and my bills never totaled that high. They're overcharging based in the fact that many people don't pay up... next time someone tells you that we need free healthcare, you tell them that we do. The hospital I worked at wrote off about 50% of all medical bills. Anyhow, I hope Mrs. Scoby gets to feelin' better. Got a ton of new parts comin'... wanna sight a rifle in?
Yeah, they're trying to rape me.
Come on down bud...just let me know when.
Belmont
Not only do they have you by the balls by you having no idea what you're going to be charged when you need their services, in our smallish community, they are the only show in town.
What's the word for it? Monopoly?
Do we not want for-profit businesses running healthcare in this country with a minimum of government regulation, allowing competition and choice to determine who succeeds?
And are some advocating the OP not pay if he is unable to do so?
Both seem contrary to the prevailing opinions on this site that free markets are good and the nanny state is bad.
I am 100% against paying 1000% for services so that freeloaders can be covered and because the hospital CAN rape you but give a 70%+ discount to insurance companies. That isn't a free market it is a monopoly, collusion and taking advantage of good folks.
Free markets are good but thats not what we have now.
What if they billed him 500k? They don't tell you how much things will cost until services are already rendered. If you don't want to tell someone how much a service costs until the service is already completed then you don't have a claim to get paid what you think you should. I can't think of any other industry where this is allowed to take place.
I mean think about getting gas. What if they didn't tell you how much it was until after you filled your tank, and then surprise! $100 a gallon and if you don't pay it we're going to tarnish your name by ruining your credit, maybe garnish wages, seize assets, ect. This system is so ****ing stupid no one should be surprised so many people don't pay their hospital bills.
The critical difference between healthcare (especially in emergent situations) and gas is that with healthcare there is really no choice to refuse service if there is no agreed-upon price, and no way to determine what services will be needed before the actual service is performed. This, in turn, means there is no pricing transparency and no way for anyone inside the golden hour to really make any type of logical market-based decision.
To me, this means healthcare sits in a very special category that does not fit well inside a market-driven system.
Belmont
Not only do they have you by the balls by you having no idea what you're going to be charged when you need their services, in our smallish community, they are the only show in town.
What's the word for it? Monopoly?
Same principle hit us but on a smaller scale. My wife has asthma and got a sinus infection. Our usual dr was closed (7 pm) so she went to a open late place that opened. Apparently a very effective drug rep had been there that day. They wrote her a prescription for a antibiotic that was $150 for 4 days. We use an hsa and high deductible plan so it was going to be full price for us. She called the clinic back to ask if a generic would be able to handle the infection. The Dr. switched her to one that was $20 for the same four days.
The whole health care system seems to be about as F*cked as anything I've seen.
Free markets are good but thats not what we have now.
What if they billed him 500k? They don't tell you how much things will cost until services are already rendered. If you don't want to tell someone how much a service costs until the service is already completed then you don't have a claim to get paid what you think you should. I can't think of any other industry where this is allowed to take place.
I mean think about getting gas. What if they didn't tell you how much it was until after you filled your tank, and then surprise! $100 a gallon and if you don't pay it we're going to tarnish your name by ruining your credit, maybe garnish wages, seize assets, ect. This system is so ****ing stupid no one should be surprised so many people don't pay their hospital bills.
Very well stated. Health care does not operate on regular free market principles, so they shouldn't attempt to fall back on those principles in order to gouge their customers. :(
CarlosDJackal
02-21-12, 15:33
...I mean think about getting gas. What if they didn't tell you how much it was until after you filled your tank, and then surprise! $100 a gallon and if you don't pay it we're going to tarnish your name by ruining your credit, maybe garnish wages, seize assets, ect. This system is so ****ing stupid no one should be surprised so many people don't pay their hospital bills.
There is a huge difference between healthcare, especially emergency healthcare and gasoline. By your logic the obamacare plan to pre-specify what type of care and how much we each can receive would be in place.
When someone gets injured, you never know what and how much care they need to receive. it doesn't matter how it looks at the time and site of injury. What matters is how and what it actually is at the ER.
What is ridiculous is the fact that they continuously overcharge so that they can cover the losses they incur from those who end up in their care but cannot afford the cost. If it wasn't for those who shun their fiscal responsibilities and the high cost of malpractice insurance due to bogus lawsuits; we wouldn't have to worry about it as much.
Belmont31R
02-21-12, 15:39
The critical difference between healthcare (especially in emergent situations) and gas is that with healthcare there is really no choice to refuse service if there is no agreed-upon price, and no way to determine what services will be needed before the actual service is performed. This, in turn, means there is no pricing transparency and no way for anyone inside the golden hour to really make any type of logical market-based decision.
To me, this means healthcare sits in a very special category that does not fit well inside a market-driven system.
Obviously in every case saving the PT's life is more important than running through a price list with them while they are in agony or bleeding all over the place. That is a small percentage of all the medical needs our country has...yet its habit for almost every medical care provider I have ever dealt with (outside of the mil) to bill later and not tell people how much services are going to cost until its too late. Then if you don't pay what they billed it can go on your credit report (what does medical billing have to do with a credit report I don't know).
Then they whine they don't get paid every cent they send out in billing. As I said if you don't want to tell people how much your services are before the service is performed then you don't have a right to expect to get paid whatever it is you decide to bill. Threat to life or limb type of situations are different..yes, and not everyone who rolls through the door is even conscious. The hospital agreed to treat people who cannot afford to pay when they accepted Federal medical plans as payment. There are private treatment facilities out there.
They are raping you. When my wife had our daughter she had a 11 hour labor that ended in an emergency c-section (spelling?). After that my wife was in the hospital for four days.
Our bill for five days in the hospital and an emergency surgery was 38 thousand. We have insurance so I didnt pay that much but I dont think an hour in the hospital with no serious medical treatment should be anywhere near 1/6 of that price.
My appendix burst when I was a teenager that required emergency surgery and a four or five day stay in the hospital because of the subsequent infection. That was a little over 20 thousand.
The_War_Wagon
02-21-12, 16:31
Good friend of mine - 50, in excellent health - just had a retina detach.
Doctor's bill to do the micro-laser surgery to re-attach the retina - $6,000. He was casual with that; eyesight is no small thing, and the surgery was incredible detailed and complicated.
Hospital bill for 3 days stay - $19,000+ :eek:
THAT... is some expensive-ass Jello!!! :fie:
Get an itemized bill from the care provider, dispute the stuff that wasn't delivered or what you feel was excessive. Ask for any discounts or write-offs they may provide.
All these price comparisons are pretty useless. "I had a baby for...", "I got chemo for...", "I broke my leg and it only cost me..." doesn't mean a thing. You can call around and find an MRI for cheap, and one that you'll pay through the nose for. However, what do you know about the machine they're using, the operators running it, and the doc that will read the results?
For comparisons, you need to know the particulars of the facility, their docs and staff, the pt presentation, the care rendered, and what the facility does internally to no-insurance cash accounts.
Good luck.
Belmont31R
02-21-12, 18:47
There is a huge difference between healthcare, especially emergency healthcare and gasoline. By your logic the obamacare plan to pre-specify what type of care and how much we each can receive would be in place.
When someone gets injured, you never know what and how much care they need to receive. it doesn't matter how it looks at the time and site of injury. What matters is how and what it actually is at the ER.
What is ridiculous is the fact that they continuously overcharge so that they can cover the losses they incur from those who end up in their care but cannot afford the cost. If it wasn't for those who shun their fiscal responsibilities and the high cost of malpractice insurance due to bogus lawsuits; we wouldn't have to worry about it as much.
Telling conscious and lucid people how much a product or service cost beforehand has nothing to do with ObamaCare, and it would cut down on people not paying their bills. People can sign AMA's and release themselves from the hospital if they don't want to pay 5k to have a nurse clean a cut little cuts up. Im not talking to people who come in and are bleeding like a stuck pig all over the place and are going to die if not treated.
Theres a better way than what we have going on, and almost the entire medical industry operates on the treat first bill later approach. I just think if doctors and hospitals are going to do that they shouldn't bitch when people don't pay the bills because they had no idea a simple treatment would be 5k or 10k or whatever stupid ass sum they are charging these days. Ive had to almost walk out of a family doctors office when we were getting our boys shots because they would not tell me how much the cost would be and if there was a discount for paying in cash on the spot. I don't want to get a bill a week later for twice or three times what we could have gotten the shots somewhere else for. No medical emergency here and its a friggen family oriented practice.
My GI doctor is great, and they have a price list right at the front window. Thats how it should be. I shouldn't be forced to find out later what something is going to cost me. The doctor is great and tries to keep costs down for his patients.
Again honest medical emergencies where the PT's life is in danger or other serious harm is completely different. I think it could be reasonably assumed a person would want their life saved regardless of the cost. Not so much for less major things when people can shop around and get a better out of pocket cost. If Id known how much the hospital wanted to charge me for the CT scan I would have signed myself out and went 20 minutes down the road to the place that charges less than 1/3rd the price the hospital tried to charge me. The place I would have gone to was the one who read the results from the scan anyways. The hospital didn't even have a person on staff during the middle of the day to read a CT scan image.
And people with insurance are going to start to feel this even more. My wife has coverage under 2 insurance policies and the one through her work just doubled all our out of pocket costs as of Jan 1st. Prescription coverage, co-pays, and upped our deductible. Since I don't have coverage I shop around if I need to see a doctor and use a local urgent care for more immediate things. The urgent care will tell you right on the spot how much something is going to be like a urine test for example. They keep a chart with you and tell you its going to X dollars for this or that. When you're done you go right to a person to pay on the way out. If something is too much you decline and thats that.
BS like this is why Obamacare got traction. I got a call about 6 months ago and a hospital bill from 2007 they claim I owe. I was taken to the ER because of the Flu. Fever was high enough they had to cool me down. Eve with insurance I owed way to much and they are saying I didn't pay a couple hundred of it that I did. I can even prove that I did and they won't stop.
This is what I've been saying for years: The problem isn't insurance reform... it's MEDICAL REFORM. While people have been insured hospitals have been quietly increasing their prices to whatever they want because they can. As long as people pay their deductible they don't even look at the bill. Even giving everyone free medical insurance only insures that they will be able to continue increasing the prices and charging for unnecessary tests/fees. Nobody will complain until, even with great insurance, nobody can afford to pay for medical care. We're coming to that point now but still people are focused on insurance which is the bandade for the real problem.
We have learned that we do have $1,000 worth of medical insurance under our auto plan. Our agent just immediately turned this over to an outside claims representative and those jacklegs didn't bother to let us know this.
Thanks 5pins for the heads up on this....I owe you.
This is what I've been saying for years: The problem isn't insurance reform... it's MEDICAL REFORM. While people have been insured hospitals have been quietly increasing their prices to whatever they want because they can. As long as people pay their deductible they don't even look at the bill. Even giving everyone free medical insurance only insures that they will be able to continue increasing the prices and charging for unnecessary tests/fees. Nobody will complain until, even with great insurance, nobody can afford to pay for medical care. We're coming to that point now but still people are focused on insurance which is the bandade for the real problem.
Jer, I couldn't agree more but, you have to take it one step further.
Medical costs are what they are, IMO, because these facilities could not sustain themselves if they were forced to write off the costs of the ones who do not pay. Therefore, they just pass along these unpaid costs to the people who do pay or have insurance.
Are some of these medical facilities making huge profits by doing so? Or, is the operation a break even proposition? These are things I don't know.
How do you impliment reform in this area?
Refuse treatment to those who don't have insurance or can't pay? I don't think so. That to me would be borderline barbaric.
I don't know what the answer is. It seems to be a Catch 22 scenario.
This a very complicated issue...related to politics, economics, science, values. We DO need insurance reform, as well as tort reform, as well as medical reform. You want to eliminate useless or unneeded tests? Reform the legal side and 'defensive medicine'. Do you see medical care as a 'right' or 'product?' A lot of variables.
There are doctors, one locally, who do not take insurance. None. He will set up payment plans, he will barter, he will deal. He has one office worker and one nurse. The man makes money hand over fist, and turns away patients. He has next to no overhead. So you can't say it can't be done.
Doctors do have the right to refuse care to those who can't pay. Barbaric? I work in an ED...if someone needs medical care, there is a way (and believe me, someone does pay, often you and I through taxes). An ED can't turn away people (well, we can, but only under very specific circumstances), but private clinic or doctor can.
How does Duke pay for services? I haven't a clue, but we are building two hospital additions and will be hiring a couple thousand people, so we are doing something right. I also know that Duke puts out mega-bucks in indigent and 'mercy' care. I don't know how they handle it on the business end.
I wish I had one answer, let alone THE answer.
This is what I've been saying for years: The problem isn't insurance reform... it's MEDICAL REFORM. While people have been insured hospitals have been quietly increasing their prices to whatever they want because they can. As long as people pay their deductible they don't even look at the bill. Even giving everyone free medical insurance only insures that they will be able to continue increasing the prices and charging for unnecessary tests/fees. Nobody will complain until, even with great insurance, nobody can afford to pay for medical care. We're coming to that point now but still people are focused on insurance which is the bandade for the real problem.
Insurance does not allow hospitals to raise their charges willy-nilly. Insurance companies make contractual agreements with hospitals and clinics and doctors to only pay X for procedure Y, no matter what the hospital MSRP is on that procedure.
So insurance itself is not the problem. In terms of rising costs of medical care, the problem is using insurance as a service plan instead of insurance, and underpayment by government care programs compared to the actual costs. And the loss on people who don't pay. My wife is a nurse and can tell tons of stories about so-called "frequent fliers" who are in often, don't pay, don't care, and don't take care of themselves since they don't end up paying anyway for going in.
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I wish I had one answer, let alone THE answer.
The answer is actually very simple. However, no politician in their right mind (including Ron Paul) would dare suggest it because every possible solution REQUIRES a significant downgrade in the coutry's standard of living. Here is the brief version:
1) Remove all of the government price controls on medical care or at least send it all to the States. This means ending or severely curtailing Medicare and Medicaid which function as price controls for their respective beneficiaries. That's right folks, Uncle Sam can no longer afford to warehouse Granny (longterm care for the elderly being Medicaid's largest payout in most states). We also can't afford to dump hundreds of thousands of dollars into the debilitated elderly at the request of families that have no skin in the financial game. You want your 80-year old, cancer stricken grandfather with sepsis kept alive on a vent - then you pay for it! That means that our generation will have to come to terms with the notion of our parents using most of their estate to finance their care rather than leaving us a nest egg.
2) Incentivize the consumer by allowing catastrophic-only coverage insurance programs for admissions more than 3 days and select conditions such as cancer treatments. All other routine and minor emergency care will be paid from health savings accounts that function similar to 401K's or private funds. Consumers will then want to shop around to get the best price for minor illness, or forgo going to the hospital to get "checked out" (heaven forbid). This will put downward pressure on healthcare prices as providers are forced to compete. Will some people have bad outcomes due to a delay in diagnosis of serious illnesses when they ration their care? Yes, but people will have much worse outcomes under the inevitable government imposed rationing as the system collapses under our current trajectory.
As we age those health savings accounts will be used, along with our other personal assets, to fund our care after retirement. When those funds expire, you get palliative treatments only.
Bottom line, American Healthcare is a lifeboat built for 5. However, we now have 12 souls on board and sharks swimming around us as we take on water. To make the situation worse, half of the people in the boat weigh more than 300 pounds and want all of the rations. Its time that we lighten the boat before we all drown.
2) Incentivize the consumer by allowing catastrophic-only coverage insurance programs for admissions more than 3 days and select conditions such as cancer treatments. All other routine and minor emergency care will be paid from health savings accounts that function similar to 401K's or private funds. Consumers will then want to shop around to get the best price for minor illness, or forgo going to the hospital to get "checked out" (heaven forbid). This will put downward pressure on healthcare prices as providers are forced to compete. Will some people have bad outcomes due to a delay in diagnosis of serious illnesses when they ration their care? Yes, but people will have much worse outcomes under the inevitable government imposed rationing as the system collapses under our current trajectory.
The doctor of whom I spoke had a great analogy regarding health insurance: "you don't use your car insurance to pay for an oil change or new tires, why should you have to use health insurance to pay for physicals and bloodwork."
Insurance does not allow hospitals to raise their charges willy-nilly. Insurance companies make contractual agreements with hospitals and clinics and doctors to only pay X for procedure Y, no matter what the hospital MSRP is on that procedure.
So insurance itself is not the problem. In terms of rising costs of medical care, the problem is using insurance as a service plan instead of insurance, and underpayment by government care programs compared to the actual costs. And the loss on people who don't pay. My wife is a nurse and can tell tons of stories about so-called "frequent fliers" who are in often, don't pay, don't care, and don't take care of themselves since they don't end up paying anyway for going in.
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I disagree. When people don't have to pay for something out of THEIR pocket then their take on the bill itself changes. People would call around a LOT more if they had to pay out of pocket and as a result offices would have to remain competitive with pricing. Take a look at elective procedures and how the prices have all gone done due to people looking prior to jumping and this has helped decrease to cost of those procedures. People would also scrutinize the bill a lot more and ask a lot more questions about what's being done and why it needs to be done and what the costs are for it. These are all steps that help to keep things in check that currently don't exist when Joe Schmoe just cares what his co-pay is and if he can afford that.
I disagree. When people don't have to pay for something out of THEIR pocket then their take on the bill itself changes. People would call around a LOT more if they had to pay out of pocket and as a result offices would have to remain competitive with pricing. Take a look at elective procedures and how the prices have all gone done due to people looking prior to jumping and this has helped decrease to cost of those procedures. People would also scrutinize the bill a lot more and ask a lot more questions about what's being done and why it needs to be done and what the costs are for it. These are all steps that help to keep things in check that currently don't exist when Joe Schmoe just cares what his co-pay is and if he can afford that.
I don't disagree with what you just wrote. I am all for "consumer directed healthcare" as this is called. I am all for everyone getting so-called high deductible catastrophic coverage combined with an HSA and taking control.
I was merely saying that the concept of insurance itself, as practiced, does not lead to hospitals raising costs since the insurance companies won't just pay the higher costs. They have every single penny accounted for and they negotiate tight contracts to control costs. The insurance does not lead to higher charges for items.
WHAT IT DOES DO, and what you describe would help fight, is people not caring what they consume for healthcare. Because the system is not a first person payment system, people don't think about and self-ration their care and end up using a lot more CARE than they really need which drives overall costs up. When you are only paying a $5 or $20 copay, why not take the kid to the doctor for every little sniffle? Or take yourself in for every little ache? That sort of behavior drives up overall costs.
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Just want to say I appreciate everyone chiming in on this.
Very interesting insight on what is wrong with how the current medical / insurance fields operates.
Also, I haven't heard a thing, as promised, from either my agent or the hospital concerning this matter.
When it is ever resolved, I'll give an update.
Here is an update if anyone cares.
My auto insurance has paid out $1,000 for the EMS and ER doctor bills.
Big thanks to whoever it was that clued me in on this. Really appreciate it.
The hospital, after three calls from me and two calls from my wife, over the span of at least 30 days, has yet to send us a detailed accounting of the ER charges.
Not only that, they are now billing us the full $8,800. Imagine that. :rolleyes:
Going to request an audience with billing next week. Damn people.
montanadave
04-05-12, 10:59
Stay on 'em. The billing departments at hospitals often function just like insurance companies. They delay, deny, throw up obstacles, inundate the consumer with paperwork, anything to wear folks down so they eventually just throw up their hands and walk away.
The squeaky wheel gets the grease. Make enough of a nuisance of yourself that it eventually becomes more cost effective for them to figure out a way to make YOU go away.
You're also paying for every person that was involved with your wife's visit, behind the scenes or otherwise. The steri-kit that the sponge came out of probably cost $1000. We have the guy that invented the steri-kits here in town. A cheap cafeteria tray with $25 in sterilized tools sealed in plastic wrap. The factory is in Ireland and all we get out of him is what little taxes he pays and alimony for his wives. He's a multimillionaire many times over. It's the American way.. The medical business is the largest monopoly we have, the insurance industry is just a "hanger on"..
Pay them $25 per month (after you get it all worked out) and move on.. JMO.. Ron
montanadave
04-05-12, 11:16
^ astute observation.
In our community, we have a couple of brothers. One is an outstanding cardiovascular surgeon (I know, I've seen him work) with an excellent practice. His brother owns a medical equipment supply business.
While neither of these guys is hurtin' for money, guess who's got the fatter wallet.
^ astute observation.
In our community, we have a couple of brothers. One is an outstanding cardiovascular surgeon (I know, I've seen him work) with an excellent practice. His brother owns a medical equipment supply business.
While neither of these guys is hurtin' for money, guess who's got the fatter wallet.
Indeed.. An acquaintance from work is very well off. His wife owns a few small private schools near campus, lots of our faculty won't send their kids to public schools, and make a mint. They used that money to set their son up in a orthopedic partnership (he's just your average bs). He's almost made his first million now. He does nothing other that attend college ball games, entertain and travel.. Ron
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