(Z)SFGH is also the only Level I trauma center in
SF City/County and San Mateo County (415 and 650 area codes)
(note: trauma patients in the southern part of SM county
are taken to Stanford Hospital).
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.