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Comment by rvo | Hacker News Reader

Does your blood not boil that the original charge is of 12 thousand dollar?

> The doctors in the emergency room did multiple tests including a CT scan and ultrasound. They determined that Cloyd had ovarian cysts, not appendicitis. They gave her pain medications that helped her feel better, and an order to follow up with a gynecologist.

> A few weeks later, Cloyd received something else: a $12,596 hospital bill her insurance denied — leaving her on the hook for all of it.

For a few tests, the hospital charges 12,000 dollars. How is this sane? People should be rioting over this.

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The worst thing in all of that is how accepted it became in US culture.

Emergency visit or medical treatment requiring remortgaging, debt or spending otherwise life savings are used as a background plot mechanism.

When I was younger, money was the plot (and that was already depressing enough): valiant doctor fighting to avoid their patient to have crippling debts, but now, often it is part of the background. Of course cancer is going to ruin you, everybody knows that, so let's build drama on top of that. Doctor are uninterested in making it cheaper, all is based around choosing health or money.

I would guess that it’s actually that staff are more interested in avoiding the liability when they don’t order a required test. Like all big problems there are many parts to it.

So we all agree we should be rioting. Good. But, um, I'm afraid I can't take the risk of being injured in a riot - I don't have $12k to blow on a trip to the ER (I spent all my money on premiums). So, y'all go ahead without me.

The most crazy thing I find, outside of the cost, is the doctors were uncertain and ordered those tests, but then the insurer say : the tests were negative so we will not pay.

It's not like she decided herself to administer those tests ...

We recently had to do an ER visit. Simple stitches + observation for 3.5 hours. 4 hours in total. $7,900 billed to the insurance. Looks like they will pay most of it.

What pisses me off is they have some bureaucrat walking around the building, walking into various ER rooms, does absolutely nothing, stays for a minute, leaves, and then it shows up on the bill as $1000 with some nonsensical description.

The bill was based on what insurance company would pay, or as the opening gambit in a round of negotiations to get the insurance company to pay a reasonable amount. An individual could probably get the hospital to knock a '0' off, but even $1,200 for an emergency room visit is too much to expect a person to pay.

It's been demonstrated that when people have to pay for ER visits, they stop going to the ER. And, from past experience, anytime there is pain in the gut, even doing the "right" thing and going to an urgent care clinic first will get you turned around right away and pointed at the ER.

For the record, I don't agree that it's the "right" thing, but it's required by some insurance companies.

>>How is this sane?

Its just one of those functional test cases, capitalism fails as a system.

Hospitals/Doctors/Clinics look at purchased equipment as something they need to make money on. So they have to keep them working. Its really no different than workers doing in 24x7 shifts to keep machinery in the textile mills working all the time. Human labor is cheap, and money gets made by putting in energy into the machine and selling the output of the machinery for profit. So in this sort of a system, you can only make profit by keeping the machines working, as the human labor required to make them work is cheap, and the profit is made by selling the output, keeping the machines idle means loss.

Its just that when you apply this to a hospital the model breaks down. But most of us are ok with this model if we get to buy jeans pants at Costco for $14.

Insurance as a work around doesn't fix anything in this system as you are just passing around the burden of paying for non-productive output of a process around until some one can bear the loss. And no one will.

My wife had exactly the same issue. We went to ER with pain that looked like appendicitis, but after the tests and a night at the hospital (they checked her in for the night) they found out it was just a cysts and we could go home with some painkillers. The twist to that story is that this happen in UK and on the end of the day we just said a big "Thank you" to whole staff that took care of her and that was it.

Couple days ago there was discussion here on HN, how we, Europeans, are so braging about our health and support for citizens systems but we still earn peanuts in comparison to US. Well this is exactly the reason why I prefer to earn £50k in UK rather than $150k in SV. This $12k bill from the article is not that bad, but it could easily end up with $120k if she would have something that require surgery.

They really should. My wife had a similar issue - charges were not nearly _that_ much.

Albeit, one of the larger ones is STILL in negotiations between the hospital and the insurance company.

Yes, absolutely, this too is insane.

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