This has to become a national effort to curb these exploitative and unfair billing practices. It’s simply outrageous.
About 80 percent of its patient population either receives publicly funded health insurance (Medicare or Medi-Cal) or is uninsured. SFGH also cares for the homeless, who make up about 8 percent of its patients.
They effectively use the high rates for privately insured folks to subsidize their public mission. Of course this all speaks to a really broken health care system, but it's not like uninsured people would have been charged even more than $20k.
Regulation can help here.
So, under their billing practices, if you suffer major trauma, say in a vehicle collision, and are taken to SFGH, you may win multiple lotteries: major injury, recovery time, major medical bills to pay, and the chance to pay some other people’s medical bills as well, depending on the hospital policy, and whether you have an HMO or PPO (details are complicated.)
The thing that most US Americans stumble over here is their general expectation that goods and services have a price, and that bargaining for a better price is not an option.
We do not expect to bargain over groceries in a supermarket, or gasoline when fueling, or most other goods. In a professional setting, like a medical office, trying to negotiate a price seem inappropriate. But behind the scenes, a vast network of third parties are negotiating on behalf of other patients, and the uninformed or naive consumer not only pays “retail” but is asked to pay a wildly inflated price that all the third parties know is merely an initial offer.
(415 and 650 area codes)