I very much doubt anyone would catch it until the bill was contested later. What would a court say? Would it be as legally binding as the standard document?
Edit: Or imagine a disgruntled employee in the copy room changing the form?
See also https://xkcd.com/1494/
The most honest behavior would probably be to mark additions or changes on the form they give you, if they'll fit.
Verbatim quote: "I doubt anyone would catch it".
That is not negotiating, that is fraud.
It is absolutely not your responsibility to check for the case that you give someone papers to sign and they give you back something different unless they tell you so.
It's amazing that you people are still arguing this in earnest so far down the thread. Can you think for a second what the implications of this would mean for society, if it were an acceptable form of "negotiation"? It would be even worse for the ordinary little people.
But the comment I was referring to talked about "swapping" the papers and said "I doubt anyone would catch it". That does not sound like negotiating in good faith to me.
The idea above was about "swapping" some random document in for the standard form and presenting it to them as if it was their document. That's not good faith negotiation, that's just fraud.
I don't think it's going to hold up if you surreptitiously modify it in bad faith.
Granted, a court might still see that as fraud, IANAL.
Not sure how well something like this would fly in the states, but it would be interesting.
[1] https://www.nasdaq.com/articles/updated-russian-man-turns-ta...
For example - if someone agreed a contract, changes are made, and they were pressured to sign without reading the document.
If changes are flagged and/or highlighted it would stand a reasonable chance of being valid. Likewise if the patient sent a cover email/letter saying "This is my standard contract."
Because these exchanges are bureaucratic, it's quite likely the changes wouldn't be noted - or might possibly be automated.
It could be argued that's a failure of diligence by the hospital rather than fraud.
And it's also clearly unconscionable to expect patients to sign a literal blank check with an open amount without anything resembling a credible estimate. That's simply unenforceable.
All of this underlines why single-payer is the only viable system. Without it a few people get extremely rich with huge financial and social costs to everyone else - which is not freedom, it's forced tribute and subsidy.
From my understanding, the medical billing system is so fucked precisely because hospitals bought laws making it so they can arbitrarily bill patients without forming a proper contract (otherwise there would be no way to charge someone who was admitted while unconscious). In the absence of such laws they'd have to fall back to an unjust enrichment claim, under which it would be pretty hard to justify charging someone $25 for an aspirin.
If it ended up in court and they produced that form, would my amendments mean anything? Is it a contract when only one part signs it?