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Comment by mastef | Hacker News Reader

The differences in the prices you mentioned are astronomical...

I'm already getting angry here to be charged $50 instead of $25 when the doctor "touches" you during some basic evaluation. But at least they tell you about any massive amounts coming up before any treatment happens.

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It's not sane. With insurance, was hospitalized for a heart condition. ~$45,000. Found no problem in testing, so they kept ordering more tests, sending in more cardiologists. Kept hearing "I know you've said this several times already, but please repeat for me...". Each time I repeated the story to a different doctor there was a large bill. Clearly the hospital new how to pad the bill.

I eventually left "against doctor's advice" though there was a doctor there that agreed with me leaving. Pursued lower cost versions of remaining tests recommended on outpatient basis.

The funny part that time was there was a "patient billing advocate" in the hospital, who was magically never available over the three days I was there despite repeated efforts by us each day.

"With insurance, was hospitalized for a heart condition. ~$45,000"

Please tell me you didn't have to pay the ~$45,000 personally?

We had to pay our ~$8,000 deductible, everything above that was covered. We paid by negotiating a one lump sum payment and got 25% off. Had a relative with more cash flow make the payment all at once then paid them in installments. Was told by a doctor later that they only get paid 75% of what they bill by the insurance company, and that considering that, the 25% discount made sense. Tried for a 30% discount but 25% was the best we could do. I pre-negotiated 25%, then had the relative with more experience in negotiating close the deal and try for 30%.

There was a substantial upside. The cardiac event happened early in the year, and everything covered by insurance for the rest of the year was 100% free. We were able to pursue some things we probably wouldn't have otherwise. Simple things like having more cough syrup on hand became a no-brainer as cost of visit and prescription was guaranteed to be $0

> We were able to pursue some things we probably wouldn't have otherwise. Simple things like having more cough syrup on hand became a no-brainer as cost of visit and prescription was guaranteed to be $0

This is one of the big upsides of always free at the point of access healthcare like we have in the UK. Although there is some inefficiency, in practice I beleive it actually lowers the total cost of healthcare as people seek treatment/diagnosis earlier and avoid getting as sick in the first place.

Someone recently pointed out here that in the UK you still have pox parties because the chickenpox vaccine is considered too expensive by NHS. So that's another way to lower costs, of course you now have a 20% possibility of getting shingles and dealing with that pain.

Apparently its not about cost but from a fear (which may be unfounded) of increasing the frequency of shingles:

https://www.theguardian.com/science/occams-corner/2014/may/1...

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