Seamaster said:

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Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

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"Hey, Mr. Builder, I want a house. How much will it cost?"

"I don't know. How big do you want it? What do you want it made of?"

"I can't tell you. Just give me a price and let's sign a contract."

*Dial Tone*


It's not broken. Doctors, ER's, and hospitals simply can't give you a price for something they know nothing about when you walk in the door the same way a builder can't give you a price for a home he knows nothing about. My son went to the pediatrician last year because he was sick and having trouble breathing. His oxygen was low and didn't come up enough with different steroid treatments, so he ended up in the hospital and staying overnight. Could they have quoted me a price for seeing him at the pediatrician's front desk? What are they supposed to do, eat everything after the $120 for the pediatrician visit or charge everyone $5k for every visit just in case they end up admitted? Medicine is simply filled with unknowns and often very short and hard timelines. There are certainly games played with billing and insurance, but the cash price afterwards can't be given to you upfront for something like an ER visit, and it's going to be way more than an urgent care or GP purely because you're paying for the existence and availability of the facility to treat almost anything.

If you go get an elective procedure, most of the time they're going to work with your insurance beforehand and give you a ballpark or exact price.

Quote:

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1) Doctors and hospitals can charge whatever they want because they know insurance will pay for it.

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This, as stated, is absolutely untrue. It's actually the insurance companies (and other 3rd party payors) that can pretty much "pay whatever they want". The billing code and associated contractual rate is all they look at. They don't really care what number the provider charges.

Watermelon Man said:

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Seamaster said:

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Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

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What has broken it so badly is an economic system that is so amoral that it believes that making a profit from saving someone's life is a good thing. Take the profit motive away, and the nutty parts go away.

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Take the profit away and everyone providing service then becomes a government employee. Tell me how good government is at doing these things.

$250,000 for a ***** reduction that my wife had been begging for me to get for years! Did insurance cover it? Hell no!

Watermelon Man said:

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Seamaster said:

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Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

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What has broken it so badly is an economic system that is so amoral that it believes that making a profit from saving someone's life is a good thing. Take the profit motive away, and the nutty parts go away.

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Take the profit motive away and the knowledge, advancements, research, etc. go away and we become Cuba.

There is no incentive to do something if you cannot make profit, and there is nothing inherently wrong with profit. The system got screwed up when medical insurance figured out it could manipulate the system and contort it to the state we see it now.

IIIHorn said:

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Psycho Bunny said:

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This is why I carry dismemberment insurance, 13k per finger. Just need to find away to lose a few "accidentally"

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Hook 'em!

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Rather lose 4 on the same hand and have a permanent Gig'em

Psycho Bunny said:

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This is why I carry dismemberment insurance, 13k per finger. Just need to find away to lose a few "accidentally"

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Make a $13k bet on the Ags with a loan shark.

Probably about a 50-50 shot of winning $13k, and if you lose, work something out with the muscle.

AJ02 said:

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Weird. I went to urgent care for stitched and it was nowhere near $15k billed to insurance.

Best bet is to NEVER go to an ER for something minor that can be handled by urgent care.

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I went to my local urgent care last winter to have severe Covid symptoms treated. My out of pocket was going to be almost the same price OP paid out of his pocket for his E-room visit. I left without treatment and told my wife to keep a close eye on me in case I deteriorated.

I have the worst insurance I've ever had in my life. They have repeatedly denied meds prescribed by my primary and my cardiologist. Interestingly the CEO of the insurer is a former student. I guess new army doesn't abide by the code of honor.

In the last five years do you have more respect or less respect for the medical profession?

I had four stitches put in my hand after an incident with a glass Mexico Coke bottle and stitches were put in and removed at one of those storefront 24 hour Emergency clinics. Both procedures were done by the same lady and I think she was just some type of Nurse and I only paid a deductible. Were there tendons involved in your stitches?

ABATTBQ11 said:

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Seamaster said:

---

Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

---

"Hey, Mr. Builder, I want a house. How much will it cost?"

"I don't know. How big do you want it? What do you want it made of?"

"I can't tell you. Just give me a price and let's sign a contract."

*Dial Tone*


It's not broken. Doctors, ER's, and hospitals simply can't give you a price for something they know nothing about when you walk in the door the same way a builder can't give you a price for a home he knows nothing about. My son went to the pediatrician last year because he was sick and having trouble breathing. His oxygen was low and didn't come up enough with different steroid treatments, so he ended up in the hospital and staying overnight. Could they have quoted me a price for seeing him at the pediatrician's front desk? What are they supposed to do, eat everything after the $120 for the pediatrician visit or charge everyone $5k for every visit just in case they end up admitted? Medicine is simply filled with unknowns and often very short and hard timelines. There are certainly games played with billing and insurance, but the cash price afterwards can't be given to you upfront for something like an ER visit, and it's going to be way more than an urgent care or GP purely because you're paying for the existence and availability of the facility to treat almost anything.

If you go get an elective procedure, most of the time they're going to work with your insurance beforehand and give you a ballpark or exact price.

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This is crap.

When you go to a restaurant, you don't ask for a price for dinner upfront before you order. You order, and then you pay for what you get, and the prices are provided prior to your order.

There are zero reasons why medicine can't be the same way. Sure, you don't know how much your stay is going to cost you when you go to the ER, but you will know how much you are going to get charged for every service you consume.

B-1 83 said:

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NavyAg92 said:

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Did you take an ambulance to the hospital for 4 stitches? That may be why the $15K.

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Only The Wife in her car

She may be in on this

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wait, is she Somalian?

Burrus86 said:

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$250,000 for a ***** reduction that my wife had been begging for me to get for years! Did insurance cover it? Hell no!

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Teamsters aren't cheap.

Burdizzo said:

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Watermelon Man said:

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Seamaster said:

---

Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

---

What has broken it so badly is an economic system that is so amoral that it believes that making a profit from saving someone's life is a good thing. Take the profit motive away, and the nutty parts go away.

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Take the profit away and everyone providing service then becomes a government employee. Tell me how good government is at doing these things.

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Typical RW lie/deflection.

In the not too distant past (like, within my lifetime, yours too, probably), very few healthcare providers were government employees. Hospitals were non-profits, as were clinics.

It wasn't until insurance companies found out there was money to be made in people getting sick that greed became the driving force.

Turns out, people will pay a lot of money to stay alive. Our system is designed to maximize the amount of money brought in while reducing the costs of the services provided. What do you expect to happen.

I just assume the hospital bills the insured to cover their losses from those without insurance. I have no proof, but it makes sense as to why your stitches cost so much.

I had an accident with a pocket knife this Christmas that all but cut off the tip of my middle finger. Only partly hanging on my some loose skin. I immediately pushed it back together & applied pressure, wrapped and bandaged the thing and ignored it for about a week (only applying new gauze and bandages after the old ones were blood soaked through.

Probably should have gone and gotten stitches but didn't want to deal with the hassle of all that on Christmas Day & the price of it all. Almost two weeks removed from the event, the wound is still healing but surprisingly a lot reattached and has begun to heal. The human body is pretty remarkable on wanting to heal itself, I didn't think this would be able to heal with how deep it was cut, but I have been pleasantly surprised. Lot of nerve pain that first week, but now just skin irritation as the new skin comes in.

Quote:

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When you go to a restaurant, you don't ask for a price for dinner upfront before you order. You order, and then you pay for what you get, and the prices are provided prior to your order.

There are zero reasons why medicine can't be the same way.

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There are reasons. They're just not good. It's like the student loan scam. Universities charge unrealistic rates and banks get rich by getting students to mortgage their future...The system is broke, but the lawmakers keep doing what they're told by the univer$itie$ and bank$ to keep the scam going.

ABATTBQ11 said:

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Seamaster said:

---

Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

---

"Hey, Mr. Builder, I want a house. How much will it cost?"

"I don't know. How big do you want it? What do you want it made of?"

"I can't tell you. Just give me a price and let's sign a contract."

*Dial Tone*


It's not broken. Doctors, ER's, and hospitals simply can't give you a price for something they know nothing about when you walk in the door the same way a builder can't give you a price for a home he knows nothing about. My son went to the pediatrician last year because he was sick and having trouble breathing. His oxygen was low and didn't come up enough with different steroid treatments, so he ended up in the hospital and staying overnight. Could they have quoted me a price for seeing him at the pediatrician's front desk? What are they supposed to do, eat everything after the $120 for the pediatrician visit or charge everyone $5k for every visit just in case they end up admitted? Medicine is simply filled with unknowns and often very short and hard timelines. There are certainly games played with billing and insurance, but the cash price afterwards can't be given to you upfront for something like an ER visit, and it's going to be way more than an urgent care or GP purely because you're paying for the existence and availability of the facility to treat almost anything.

If you go get an elective procedure, most of the time they're going to work with your insurance beforehand and give you a ballpark or exact price.

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I call BS. The Doctors/ERs/Hospitals don't want to tell you because they first want to see how much money they can get out of you and your insurance. That's why you see your insurance statements about doctors asking for X amount and only getting paid half. Do you owe the other half? Sometimes they'll try to make you pay, but usually they just write that off and you magically owe nothing else. They always ask for more than they expect because they can and sometimes they get that full amount. Its a system that works its hardest to feed and benefit itself, not the people who need the help.

B-1 83 said:

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NavyAg92 said:

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Did you take an ambulance to the hospital for 4 stitches? That may be why the $15K.

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Only The Wife in her car

She may be in on this

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A veterinarian could have done it for a grand or less.

A staple kit on Amazon https://a.co/d/2cBOg66

Four stiches: $100 each x 4 = $400
Two Ibuprofen 200mg tablets: $14600

Next time tough it out.

Did you cut a nerve or tendon? That would make it much more expensive and need reconstruction even if just 4 stitches (I would think)

My son hurt his foot playing football, so we took him to urgent care for an x-ray and they saw a very small fracture. Put him in a boot and told him to take it easy for about 6-weeks.

Got the bill yesterday for the boot. $374.91.

A similar one on Amazon is ~$50

T-Shirt Ag!!! said:

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Four stiches: $100 each x 4 = $400
Two Ibuprofen 200mg tablets: $14600

Next time tough it out.

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Those hospital Ibuprofen are no joke.

Ol Jock 99 said:

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Quote:

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I GUARANTEE they didn't send back the insurance payment.

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Your insurance company did not cut them a $15k check.

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No, the removal guy was a separate bill 10 days after the first visit

Do you have pics you can post of this cut to your finger, before or after stitches? I'd genuinely like to see what knife cut that expensive looks like.

I'm an ER doctor and I agree the system is broken. I hate my own insurance.

Here's some realities though:

1) Health care is getting more and more expensive to provide. Administration costs are through the roof, not what it costs to pay doctors, nurses, etc. It is costing more because it costs that much more to give it to you.

--still don't agree with the $5000 stitches though

2) In the ER, you are definitely paying for those that don't. People think the government magically reimburses the ER for those that don't pay. While some charity reimbursement happens, it's not much. It is better in larger cities where there are hospital districts, in those cases, your property taxes help offset the costs. But yes, in the ER, it really is socialized medicine.

3) As long as EMTALA exists, you will NOT get up-front prices in the ER.
- EMTALA is the "you won't get denied care in the ER because you can't pay law."
- As a consequence of EMTALA, anyone turned away from the ER for ANY reason is considered "horrible" and "should never happen."
- Even if John Smith is being reasonable and says, "Hey, I'm having chest pain, how much is this visit going to cost me." If someone even mutters that it could be $_______ , and that comment makes John Smith not receive emergency care, and he dies from a heart attack, that's the sort of thing that could shut a hospital down.
Again, ER up front pricing will not happen with EMTALA in its current state.

You should have been an illegal alien - it would have been free

I'd like for some accountant to tell me about something. Given the sometimes HUGE difference between the price billed to insurance, and the actual amount paid by insurance for any given "procedure" or action, are medical companies able to deduct the difference between billed and received--as a "loss" for tax purposes?

Went to the ER 3 times last year that resulted in 5 or 6 nights in the hospital. No idea what any of it cost. I imagine all in my medical total was north of $1MM. I also had a PFO closure that was $107,000 out patient.

Quote:

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I'd like for some accountant to tell me about something. Given the sometimes HUGE difference between the price billed to insurance, and the actual amount paid by insurance for any given "procedure" or action, are medical companies able to deduct the difference between billed and received--as a "loss" for tax purposes?

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I don't know the answer to that, but I routinely use the grocery store analogy to explain a small factor of how I think this mess started.

Imagine that you own a grocery store. It's your livelihood, not that you work for HEB, Kroger or Randalls, but your own.

Someone comes up to the register with $100 worth of groceries and only decides to pay $35 for it. You're not allowed to do anything about it. You just have to take the $35 and accept the losses.
Let's just say that's what food stamps pays for.
More and more people get on food stamps, and you lose more and more money.

Eventually, you raise your prices to where it's now $200 for that same basket of groceries, and now "the program" will pay you $100. Eventually they reimburse you less and you have to raise your prices more to stay "whole."

This is essentially what Medicare and insurances have been doing for decades now, causing things to spiral out of control.

Not the whole story, but definitely a factor.

Highway6 said:

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Thanks Obama

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But everyone is healthier, saving money, and can keep their doctor, right?!!!

Muy said:

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Highway6 said:

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Thanks Obama

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But everyone is healthier, saving money, and can keep their doctor, right?!!!

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and by digitizing everything we always have access to all of our records. Except you don't own them. The hospital system does. And they don't talk across systems because you are their proprietary.

Psycho Bunny said:

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This is why I carry dismemberment insurance, 13k per finger. Just need to find away to lose a few "accidentally"

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Maybe convince them you were born with five extra fingers on each hand. Tell them you accidently cut the extras off, keep your originals, and pocket $130,000

One of my fellow track mates ripped a gash in my thigh with his spikes. I deadened the area with alcohol and stitched it together myself with a needle and thread. It healed nicely.