Thread Article: Why Medical Bills Are Killing Us

Sarcasmo

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For those of you who aren't my FB friends:

I don't recall the number of times I've asked the doctors I know for an explanation about how medical bills are computed, but I do know that not one of them has ever had an answer. No one seems to have the slightest idea where the actual numbers come from.

I remember when I was billed several thousand dollars last year after my son had a few stitches in his forehead, for example. A very quick and simple visit to the ER, followed by a bill so outrageous I immediately questioned the legitimacy of the entire medical field. (Most of that bill was eventually written off, but the questions about how those initial, seemingly arbitrary numbers were derived remained.)

I think we've all lamented about this at one time or another. "Yes, but WHY does a 10-minute doctor visit cost $4,000? He didn't even do anything!" This Time article is a very long and very interesting read about that same issue, and the toll it's taking on our country. Take the time to read it and increase your understanding of how things happen and why. The markups for medical instruments and procedures at hospitals is absolutely staggering. $18 diabetes test strips that sell for 55 cents a piece on the open market, for example.

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/

When medical care becomes a matter of life and death, the money demanded by the health care ecosystem reaches a wholly different order of magnitude, churning out reams of bills to people who can’t focus on them, let alone pay them. Soon after he was diagnosed with lung cancer in January 2011, a patient whom I will call Steven D. and his wife Alice knew that they were only buying time. The crushing question was, How much is time really worth? As Alice, who makes about $40,000 a year running a child-care center in her home, explained, “[Steven] kept saying he wanted every last minute he could get, no matter what. But I had to be thinking about the cost and how all this debt would leave me and my daughter.”

By the time Steven D. died at his home in Northern California the following November, he had lived for an additional 11 months. And Alice had collected bills totaling $902,452. The family’s first bill — for $348,000 — which arrived when Steven got home from the Seton Medical Center in Daly City, Calif., was full of all the usual chargemaster profit grabs: $18 each for 88 diabetes-test strips that Amazon sells in boxes of 50 for $27.85; $24 each for 19 niacin pills that are sold in drugstores for about a nickel apiece.

There were also four boxes of sterile gauze pads for $77 each. None of that was considered part of what was provided in return for Seton’s facility charge for the intensive-care unit for two days at $13,225 a day, 12 days in the critical unit at $7,315 a day and one day in a standard room (all of which totaled $120,116 over 15 days). There was also $20,886 for CT scans and $24,251 for lab work. Alice responded to my question about the obvious overcharges on the bill for items like the diabetes-test strips or the gauze pads much as Mrs. Lincoln, according to the famous joke, might have had she been asked what she thought of the play. “Are you kidding?” she said. “I’m dealing with a husband who had just been told he has Stage IV cancer. That’s all I can focus on … You think I looked at the items on the bills? I just looked at the total.”
 

Amstel

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I read this this morning. The pricing is wildly variable, and totally shocking.

this is the part I found most shocking,

Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Stephanie got her mother to write her a check. “You do anything you can in a situation like that,” she says. The Recchis flew to Houston, leaving Stephanie’s mother to care for their two teenage children.

About a week later, Stephanie had to ask her mother for $35,000 more so Sean could begin the treatment the doctors had decided was urgent. His condition had worsened rapidly since he had arrived in Houston. He was “sweating and shaking with chills and pains,” Stephanie recalls. “He had a large mass in his chest that was … growing. He was panicked.”

Nonetheless, Sean was held for about 90 minutes in a reception area, she says, because the hospital could not confirm that the check had cleared. Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card.


Read more: http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/#ixzz2LZjGUDBz
 
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DJBrenton

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I just don't get this. Is it not possible to get whatever medical treatment you need for free in America? Do you have to pay or die? If you get cancer and can't afford the bills what happens?
 

Mr. Argumentor

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I just don't get this. Is it not possible to get whatever medical treatment you need for free in America? Do you have to pay or die? If you get cancer and can't afford the bills what happens?
There's a reason Health care is a huge political football in this country, and that reason is that it's broken
 

DJBrenton

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But do people genuinely just go without treatment because they can't afford it?

I mean we have lots of issues with our NHS. It's inefficient, it doesn't always get you treated as fast as you'd like etc. But at least we are guaranteed free treatment and always have the option of paying to go private.
 
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Sarcasmo

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There are a lot of shocking revelations in that article. The gargantuan profit margins of hospitals, for example. Billing someone $134 numerous times in one visit for "supervising oxygen inhalation," i.e. making sure they're breathing, or charging them $35 for the blanket they keep warm with in the hospital bed, which the hospital washes and reuses. The article contains dozens of examples of this behavior (one person was charged for the shade on their examination lamp) and it fills me with rage. And no one takes anyone to task over it. The leaders of these hospitals shrug and smile and say they aren't allowed to talk about it and life goes on.

RAGE.
 

DJBrenton

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So can I ask why people seem to be against socialised health care? Is it really just a case of 'I'm alright. I can afford health insurance so I don't care about others who can't'?
 

JAXvillain

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So can I ask why people seem to be against socialised health care? Is it really just a case of 'I'm alright. I can afford health insurance so I don't care about others who can't'?

It's some sort of bizarre "let them eat cake" mentality that pervades the entire US.

"Socialism never took root in America because the poor see themselves not as an exploited proletariat but as temporarily embarrassed millionaires."

John Steinbeck
 

Sarcasmo

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I just don't get this. Is it not possible to get whatever medical treatment you need for free in America? Do you have to pay or die? If you get cancer and can't afford the bills what happens?

Hospitals cannot refuse emergency medical treatment due to the Emergency Medical Treatment and Active Labor Act (EMTALA). In non-life threatening situations, however, there is often no obligation to do anything if you have no insurance.

Treatment isn't the issue, however. It's the bill that comes later. Even if you cannot afford the emergency treatment, you will be billed for it. And it will probably be for a staggering amount. That's when the financial nightmares begin, like being sued by the hospital and having a judge order you to pay, somehow, some way.
 
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DJBrenton

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It's some sort of bizarre "let them eat cake" mentality that pervades the entire US.

"Socialism never took root in America because the poor see themselves not as an exploited proletariat but as temporarily embarrassed millionaires."

John Steinbeck

I think it's believeing the bullshit that all things are possible despite the fact that if you are born poor in the USA you will almost certainly spend the whole of your life poor. There's a dangerous view that if you are poor it's your own fault because you could always just have made different decisions and got rich, or done without food or rent to afford medical insurance. Personally I believe you can judge a country by how it treats it's less fortunate inhabitants.
 

Domon

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I would say that a litigious society, malpractice and the fact that hospitals are businesses is the problem more so than the government
 

Sarcasmo

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Socialism never took root in America due to the unabashed pride of our preceding generations and concepts like liberty. It is generally unacceptable in America to engage in practices that involve taking something from someone and giving it to someone else who did not earn it. Even in situations of charity, under the umbrella of which universal medical care (socialized medicine) could be grouped. It will happen at some point. I guarantee it. And this article points to a huge reason why.
 

JAXvillain

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I think it's believeing the bullshit that all things are possible despite the fact that if you are born poor in the USA you will almost certainly spend the whole of your life poor. There's a dangerous view that if you are poor it's your own fault because you could always just have made different decisions and got rich, or done without food or rent to afford medical insurance. Personally I believe you can judge a country by how it treats it's less fortunate inhabitants.

That's a paraphrase of a Roman or Greek philosopher whose name is escaping me at the moment but I couldn't agree more.
 

DJBrenton

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Socialism never took root in America due to the unabashed pride of our preceding generations and concepts like liberty. It is generally unacceptable in America to engage in practices that involve taking something from someone and giving it to someone else who did not earn it. Even in situations of charity, under the umbrella of which universal medical care (socialized medicine) could be grouped. It will happen at some point. I guarantee it. And this article points to a huge reason why.

But you already take taxes from people and then spend them on otehrs who haven't earned it.

Imagine for a moment that education was run along the same lines as health. You had to pay for schools and if you couldn't afford it, then your children only got to learn to read and write till, say, the age of 10. After that, it was up to you to afford education for them. Of course you do ( and so do we to a lesser extent) have that situation but at a higher age. What percentage of Americans would be proud of their country if universal free education wasn't considered a part of the social contract? What about refuse collection? Or police? You see you already have lots of socialised services i.e. services that, as a society, you agree should be available to all and should be paid for on an 'ability to pay' basis. What we Brits find hard to understand is how you don't see medical care as falling under that blanket.
 

Sarcasmo

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America is too pesimistic to believe that. We know that many of our poor would simply live off the system and take advantage of the handouts and because of that we choose inaction. Those people would exist that way, forever, being enabled (and paid for) by the rest of us. That's why we get so angry at the prospect of handouts. Work hard and give your earnings to the people who choose to do nothing? How unAmerican! Let's sit on it for another 20 years and maybe a better alternative will present itself.
 

Sarcasmo

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But you already take taxes from people and then spend them on otehrs who haven't earned it.

Imagine for a moment that education was run along the same lines as health. You had to pay for schools and if you couldn't afford it, then your children only got to learn to read and write till, say, the age of 10. After that, it was up to you to afford education for them. Of course you do ( and so do we to a lesser extent) have that situation but at a higher age. What percentage of Americans would be proud of their country if universal free education wasn't considered a part of the social contract? What about refuse collection? Or police? You see you already have lots of socialised services i.e. services that, as a society, you agree should be available to all and should be paid for on an 'ability to pay' basis. What we Brits find hard to understand is how you don't see medical care as falling under that blanket.

I'm not saying I disagree with you. But we are currently busy spending that tax revenue on other countries for ambiguous reasons. And also wars.
 

fly

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So can I ask why people seem to be against socialised health care? Is it really just a case of 'I'm alright. I can afford health insurance so I don't care about others who can't'?

If socialized medicine could improve efficiencies here, it would be a no brainer. Only what we're offered is the same system with another layer of bureaucracy (and added expense of that) layered on top. I'm not saying that good social health care can't be done, but our socialized health care plan certainly isn't doing that. And that's why myself, and plenty of other people, don't support it.
 

DJBrenton

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I'm not saying I disagree with you. But we are currently busy spending that tax revenue on other countries for ambiguous reasons. And also wars.

Well at least the wars offer employment opportunities for the less fortunate. And even some medical coverage when wounded. I guess war is one solution.