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Comment by sbov | Hacker News Reader

We had a similar experience about 8 months ago, but only one night in the hospital. Raise hell with everyone.

The out of network doctors were resolved the fastest for us, and the longest was the hospital stay itself, which our insurance didn't agree to pay until 8 months after the stay. It was a seriously draining experience, and luckily my wife doesn't work so I didn't have to take time off for all the phone calls and following up that was required.

I don't fault our insurer. The hospital charged more for our one night stay than another slightly further hospital recently charged us for three nights stay. It was completely ridiculous. But completely out of our hands.

I've had to deal with that and more in the last couple years. In my experience there are no "good" or "bad" guys in this fight. It's a bunch of individually rational entities that when taken as a whole are completely fucking over the rest of us.

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I think there are "bad" guys. I've pointed out to a doctor that their agreement said that I would agree to pay any charge they decided to bill me for. I pointed out that I was in their office because they were in network for my insurance and that I couldn't agree to pay literally anything they decided to bill. So, I asked them to tell me what the maximum they might bill would be. And, they kicked me out of the office.

So, yes, if you refuse to be transparent in your billing and you extort money from your patients by refusing them treatment unless they agree to pay literally anything for service, you are a "bad" person.

> So, I asked them to tell me what the maximum they might bill would be. And, they kicked me out of the office.

Sounds like dental care in Canada.

The funny thing is that dental care in the US is the exact opposite. If you ask $RANDOM_DENTAI_CLINIC what the cost for $RANDOM_PROCEDURE will be, they can quote you a price that will generally be pretty accurate.

I'm told this came about because historically more people had to pay for dental services out of pocket, so dental offices were used to having standard fees that they could just look up.

Also most dental insurance will only pay up to $10-5k total per year, so its not some unlimited spout of money you can abuse like medical insurance in the USA. Some dentists offer a direct subscription plan that costs around the same amount of costs as a dental plan directly as a result.

> so its not some unlimited spout of money you can abuse like medical insurance

Apropos of outliers, this type of attitude is problematic and emblematic of issues in the US.

"Needing healthcare" is not "abusing medical insurance".

I'm pretty sure your parent comment was characterizing the doctors and hospitals, not the patients, as abusing the system.

I think he means the hospitals abusing it by billing inflated charges - not patients using healthcare.

Yes I meant that, thank you :)

A major area of Canadian health care which is not covered by the socialized system ends up looking a lot like the US system? How expected.

>>So, I asked them to tell me what the maximum they might bill would be. And, they kicked me out of the office.

There are of course shitty doctors, but playing devil's advocate for a minute: you were arguing about theoretical billing scenarios while there were other patients in line waiting to be seen. So it's not exactly surprising that he got fed up and kicked you out.

wrong. I was asking about a specific procedure that I made an appointment for. They gave me a form -- after I got to the office -- which said I agreed to pay any amount they decided to charge. When I asked for clarification, they refused to quote me a price.

> luckily my wife doesn't work so I didn't have to take time off for all the phone calls and following up that was required

This.

This is so horrifically true, it takes call after call after call (and emails, and faxes, and snail-mail claims forms that take "30 days" to "process") to get anything changed, and by then you have collections companies harassing you and your credit goes down the drain. Meanwhile you must keep working and taking care of family and dealing with the actual illness/issue that led to the medical visit in the first place. It is insane.

A friend of mine was in a sports accident almost two years ago. He had a good medical insurance plan for exactly this possibility.

He fractures his pelvis into 14 pieces, and broke another dozen major bones including both femurs.

The surgeries are still ongoing although he is mostly himself again. But even two years later, he is facing a daily barrage of calls, being put on hold, no callbacks, paper shuffling, records from hospital to hospital, faxing permission sheets, fighting with the insurance company (who has threatened to drop his insurance multiple times) and on top of it all, his landlord is trying to evict him.

It's been horrible to watch. It's like the insurance company is trying to kill him with stress.

These stories have me at 'WTF USA'. Like seriously, how does the US society think this is ok? Can anyone explain this to me?

Is it a 'won't happen to me' sentiment? Preferring the freedom of literally landing on the streets with one accident since you're presumably fully in charge? I do not understand, though there must be an understandable reason.

It's unbelievably horribly fucked up.

I think the only reason anyone can think it's OK is (1) they haven't had a major medical expense yet and (2) their political tribe tells them capitalism is the answer for everything.

Honestly, healthcare in the US is so broken I don't see how we avoid a crisis in the next few years because of it. Maybe it will somehow pop like a real estate bubble (sad when that's the most optimistic thing you can hope for).

It's becoming increasingly obvious that the political tribalism is insanely strong. Enough to prop up things that might've seemed outrageous a year or two ago.

> He fractures his pelvis into 14 pieces, and broke another dozen major bones including both femurs.

That sounds horrific. What sport was this?

Paragliding. He competes at the top level, and the accident occurred in competition. Think Nascar crash.

> It's like the insurance company is trying to kill him with stress.

A health insurance company, no less.

Also, don't forget that you'll frequently need to deal with multiple bills, each potentially requiring separate work to resolve.

If you take an ambulance to the emergency department, see a doctor, they order a scan, the scan shows appendicitis, and your appendix is subsequently removed, this can easily lead to six different bills:

  - Ambulance
  - Facility
  - ED doctor
  - Radiologist
  - Surgeon
  - Anesthesiologist

And that's assuming that the ED and hospital are under the same company (not always), and that no off-site labs are used. You may not have ever heard of the radiologist or anesthesiologist. I once had bill collectors calling me re: a radiologist I'd never heard of, who managed to ruin my credit for a good six months until I figured out what the bill was actually for.

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