Bay Area couple shocked by $200K hospital bill for rabies shots
abc7news.com
abc7news.com
In Redding CA, I ran across a woman with a nasal infusion pump tube taped to her face in a coffee shop. She was hurriedly collecting paperwork for a hearing across the street. It turns out she was preparing to go through bankruptcy proceedings while she was dying from incurable Stage IV cancer. That the doctors and hospitals were vultures picking her life apart for money while she was dying but still alive and making her end-of-life as miserable as possible was adding insult to injury. Some hippocratic oath. More like hypocritical chisels out to monetize misery.
So when someone is out of money and dying in America, they are treated like criminals with court proceedings. At their hearing, they get a chance to justify their existence requires clothes, transportation, and housing while everything else goes to creditors.
The trouble is even if the price list says $500 for something, they'll charge you $8000 for "general classification" and $2000 for a Tylenol.
I have a remote heart monitor at my bedside that, upon pressing a button, wirelessly retrieves data about arrythmia incidents from my implanted defibrillator and sends any incidents to the hospital. Every time I hit the button, even if there are ZERO incidents for them to review, I get hit with a $300 bill for some "general classification". So I hit the button less often than I'm supposed to.
Come in unconscious and bleeding out from a car wreck: "No, no, no.. take me to the other hospital with lower prices. And I don't want $100 acetaminophen."
Also, a car wreck should not be a reason to nickel-and-dime someone unreasonably. And if I knew they were giving me acetominaphen for $1000 and I could wait it out for an hour I'd 100% refuse it and ask a family member to bring me some from Walgreen's for <$10. I'm not exactly swimming in money here.
These hospitals posting their prices reminds me of this classic section of "The Hitchhikers Guide to the Galaxy":
"But the plans were on display..."
"On display? I eventually had to go down to the cellar to find them."
"That’s the display department."
"With a flashlight."
"Ah, well, the lights had probably gone."
"So had the stairs."
"But look, you found the notice, didn’t you?"
"Yes," said Arthur, "yes I did. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying 'Beware of the Leopard.'
https://www.cms.gov/nosurprises/consumers/understanding-cost...
20 emails later it's now at debt collectors, and I've contested the debt twice.
I'm ready to appear in court if I have to. I'm ready to pay $8K in lawyer fees to get rid of this $5K bill because it's wrong. I just don't want this to impact my credit score because it's not my debt.
I hate you, Stanford Healthcare.
2018, I was on Medi-Cal (Medic-aid) and had a stress ECG, right heart catheterization, and 12-lead EKG when admitted to their cardiac unit for 3 days. Cost $0.
Like a third-world country: in America, you're better off being either totally penniless or a billionaire. If you don't have a balance sheet of $5 megabucks, your life will be miserable.
The advantage most European and other countries have under socialism is it means there's a minimum average quality of life everyone. Pay more in taxes but get a lot more in terms of a more dignified, healthier, and longer life free from the slavery of "gotcha!" gangster capitalism.
I live in a "third-world" country. My family and I have insurance and only use private hospitals -- the capitalist portion of the system. Never had as bad an incident as the ones you guys are reporting here. Just some minor annoyances.
Not even the crappiest insurance companies do stuff like that, and they get terminated by the regulatory body if they start to mess up consistently.
Although I don't use it directly, I'm overall well-informed about the realities of the public health system. It's bad, but not even close to what I've seen posted here. One can even obtain overly expensive meds for rare diseases -- it requires some legal effort, but it eventually works.
Then I'd say that, when it comes to health systems, the USA is definitely way worse than some third-world countries -- and one of the main reasons I declined an invitation to work and live in there.
My first “adult”/non-parental healthcare insurance policy had a yearly maximum and a lifetime maximum. This was pre-Affordable Care Act.
It will sound like a nitpick but it's not: there's no socialism in Europe. Socialism is an economic system, not a synonym for "socially-focused policies" through societal-level welfare.
European countries are capitalists, completely. What we do have is a better support system for welfare, more labour protections and regulations to protect against the massive power imbalance that untamed capitalism creates but it's not socialism. Not even close.
If Europe has no socialism they've still somehow managed to end up with a lot of European Socialists (https://en.wikipedia.org/wiki/Party_of_European_Socialists). Some words are basically meaningless because everybody has their own definition for them and socialism is certainly one of those words. It's probably better to avoid the term entirely and just describe what you mean because some people get so emotional just hearing it that they seem to lose the ability to think.
> Socialism: a political philosophy and movement encompassing a wide range of economic and social systems, which are characterised by social ownership of the means of production, as opposed to private ownership.
That is the meaning, it's not meaningless. It becomes meaningless when people just accept that it can mean anything they want, it can't. Socialism has a very specific characteristic: social ownership of the means of production.
If people misuse the term they need to be corrected. At least until the meaning completely shifts to something else, like what Americans try to do with the term "liberal" which does not, at all, mean "progressive" as is the usage in the USA.
It's the one of the most defining characteristics of socialism, if Keir Starmer is not defending that the ownership of the means of production should be socialised it is not socialism.
That's where you build your argument that they acted inappropriately and did not disclose prices (did they?). The next question is are you on a State plan or a corporate EIRSA plan? If State they you can file a complaint with the California department of insurance. If you have a corporate plan, which is likely self funded, then I would ask your HR to talk to your insurance rep. You might find things get retroactively covered at that point. Or you can talk to the news. They love to report on these things.
Stanford has pattern of inflated charges. Hearing tests in audiology for example are ridiculously overpriced without insurance and they don't pre-authorize. And most insurers don't cover hearing tests anyway. Stanford could fix this by not being greedy.
Outpatient. Routine preventative care, I have a heart condition so echocardiograms are done every 2-3 years as a preventative measure. Insurance plan claims 100% coverage of preventative care with no deductible or coinsurance. I tried to dispute with insurance but they insist that it wasn't preventative (it's my body, my health, I know better than them that it was preventative) and they consistently would put me on hold for VERY long times on the phone until 5pm and then say "whoops, we're closed"
> The next question is are you on a State plan or a corporate EIRSA plan?
Self-purchased out of marketplace plan (HealthNet). I was self-employed at the time.
> Or you can talk to the news. They love to report on these things.
I would absolutely love if someone can put me in touch with a contact.
I imagine an expert from the DMHC can advise on your specific situation.
Her medical costs ended up bankrupting her. That was where the scales fell from my eyes and I learned that what we're taught about the purpose of insurance (to protect us in the case of a catastrophic expense) is just pure BS.
And they knew it. That's why they fought paying out every nickel. Evil bastards.
If it doesn't show, I have literally nothing good to say about the insurance industry.
She also has little to no visibility into cost incurred by the patient, and often times there isn't a menu of options to pick from. She's not incentivized to perform extra testing/etc, and keeps patients costs in mind while providing care. I don't think that's rare among doctors. The whole system is frustrating, but yes mostly so for the patient.
Like sure, they aren't solely to blame, and it would probably be hard for individual doctors to successfully push for systematic changes, but the flip side to that is that they don't get to say "Oopsie doopsie, it sure isn't great".
To be clear, I believe at least that section of Taft-Hartley is arguably unconstitutional, and worthy of getting civil disobedienced hard. I just don't see it as likely to happen in such a way as to be effective in facilitating change. Add on top of that the onerous burden of medical school debt, and I don't exactly see many being willing to make that choice.
After all, a care facility can probably be reasonably confident that if a patient needs help, doctors will feel compelled to care for them.
Put another way, would you want to walk into a hospital/ER/your doctors office for something acute and get an apology that care is unavailable because the doctors are on strike?
In the short term, I know it's a tall ask for a provider to be able to tell a patient how much care from other providers might cost. But providers could certainly start by knowing the prices of services that they themselves perform. And if that's too hard because their billing departments have made it opaque with a whole slew of prices depending on who might be paying, then providers need to work on reforming their own houses before pointing fingers at the other half of the problem.
This doesn't get a lot of attention because, well, what media outlet could write a positive article about Trump & get away with it, but healthcare price transparency was a big issue of his and during his administration the Hospital Price Transparency Final Rule was established.
The rule was issued by the Centers for Medicare & Medicaid Services (CMS) in November 2019 and requires hospitals to post prices.
The Trump administration argued that the rule would help to empower patients by providing them with more information about the costs of healthcare services, and that it would promote competition among hospitals and other providers, leading to lower prices and improved quality of care.
The rule was initially challenged in court by a group of hospital organizations, but in June 2020, a federal judge upheld the rule, clearing the way for it to take effect on January 1, 2021.
Even that "normal" cost is absolutely crazy.
Even in Zurich, Switzerland, one of the most expensive places and healthcares in the world, it's 85 CHF / shot:
https://reisemedizin.uzh.ch/en/pre-travel_advice/rabies
Emergency room is 50 CHF extra in non-emergency cases:
https://www.thelocal.ch/20210617/emergency-room-visits-to-no....
We read horror stories like this one, but say "Whew, glad that won't happen to me." We imagine that because of capitalism, if our insurance company screws us over, we'll change to the next one -- freedom we wouldn't have if we had a national health care.
It never seems to occur to us that all of the private insurers have a capitalism-driven goal of maximizing profits, and national insurers don't.
If I hired someone to fix my plumbing and they wouldn't give me an estimate and then decided to charge me $20k/hr I don't think a court would honor that contract.
To me it just seems like fraud. Forget about patient choice because in this situation the patients conceivably could have shopped around for rabies shots, AFAIK you aren't going to die because you got your rabies shot a few hours later the you needed to. The problem seems to be that even if they were able to shop around and find the lowest price apparently the hospital can just charge whatever they want regardless of the expected or quoted cost.
Going back to the example of the plumber; Imagine if my house is flooding and I get into contact with two plumbers, one tries to price gouge me and quotes me $5k/hr and one is seemingly honest and quotes me $80/hr. I go with the plumber that quotes me less but then he ends up charging me $50k for the teflon tape he used anyways. We can see this isn't a breakdown in being able to shop the market and the normal competitive dynamics that arise from that, the breakdown occurs because of the fraud.
Whoever has the most money in America captured the regulators and politicians through money conveyed to them by lobbyists.
You live without plumbing by making different arrangements but you can't live with a fatal lyssavirus.
They make money as a % of care paid out (max profit is capped).
More costs == more profits and the costs are just passed onto the people paying for insurance (both employees and employers)
Pay, or pay and die.
It's the weakness and disorganization of the consumers who emboldens them.
Money goes mostly to the salaries of healthcare administrators and dividends for shareholders, with enough going to doctors and nurses to keep them from striking out on their own.
There was a security guard at the front with a grey keypad. The would not speak to you unless you entered your Social Security Number. I made the mistake of entering it but thought nothing would happen because I didn't see any live human. Guess what? $800 bill for the pleasure of seeing exactly no service provider. This is how they work.
So many anecdotes end with "they sent me a bill", without saying what happened next. Just because someone sends you a bill does not mean you have to pay, especially when that bill seemingly isn't based on a contract or other form of legal liability. Did you tell them to go screw, they took you to court, and they actually managed to substantiate the debt? Or if you were worried and strapped for time and just gave in to the extortion, please let us know that.
I'm glad I don't live in the US.
https://www.healthsystemtracker.org/chart-collection/health-...
My insurance is fighting me on a $450 test (that I could have gotten done with an Amazon kit for $80).
Because here where I live, if you walk into an emergency room and walk out a few hours later with two shots and a $200k bill, ... well it's unthinkable, but if it happened anyway and the hospital tried to defend it, the judge would just laugh their lawyers out of the door.
https://en.wikipedia.org/wiki/Sistema_%C3%9Anico_de_Sa%C3%BA...
The USofA has an unbelievably shitty healthcare system.
A woman crashed her car into my vehicle there. She didn't stop. A cop was right there and did nothing. I called 911. The county or city didn't have E911 properly configured with Verizon and couldn't get my location. This is how America works. Broken, lawless, and dysfunctional.
The hospital should be subpoena'd to get the actual cost of treatment - both the vaccination, the amount paid to the ER staff during the time the patients were there, etc.
Also this BS where they can just say "out of respect for patient privacy we don't discuss billing matters", when the patient has provide explicit documentation and consent saying the hospital can discuss billing can also get shafted.
But this isn't really relevant when discussing healthcare, because the problem is precisely with providers not dealing in specifics that would be necessary to create a printed receipt. It would be a terrible system if hospitals demanded full payment ahead of treatment and price gouged patients on the spot, but it would be significantly more legitimate than what we currently have!
They can't put a lien on property without a court case and I want to see someone stand in front of a judge and justify an un-itemized 100k bill when their own public charge sheet shows that the service should cost <1000.
They will force you into bankruptcy when you should've declared bankruptcy to begin with.
"I've been asking for 2 years for a breakdown to explain how what is listed on their website as a $600 charge became a 120k charge."
https://www.npr.org/sections/health-shots/2022/12/21/1144491...
Or is this a case of bad insurance?
That the US can spy on the entire world but can't get its own people basic healthcare is shocking.
I looked up the cost, and found out the household would be bankrupted by the shots and we would end up homeless. I calculated the danger from homelessness outweighed the risk of rabies. I guess the bet paid off, as we're now well past the 99th percentile of incubation period.
"The Aguilars wound up paying $3,546.64 out of pocket. The insurance company told us Wednesday that they "are reaching out to NorthBay Healthcare... to address these excessive charges.""
The shot normally costs ~$600 USD. There is no way the insurance in the end will pay the $54k the hospital tried to get away with.
They did.
Just FYI, it's possible to get bit by a bat while sleeping and not realize it. Most bats are small and a bite mark may not be painful or immediately noticeable. There was a case in 2021 in Illinois of a man being bitten by a bat in his sleep; in his case, he realized he'd been bitten, but declined treatment (cost, probably...) and died of rabies a month later. Not a fun way to go.
I've heard the advice before to get a prophylactic rabies shot if you find a bat trapped in your house while you were sleeping. ...in civilized countries, anyway.
edit: https://www.npr.org/sections/health-shots/2016/06/02/4804145...
That's rough though, lucky you didn't get sick. It's not a choice I'd like to make.
NorthBay Healthcare is a non-profit hospital.
This is a very, very obvious billing mistake. And while I have zero evidence for what I am about to say, I would be willing to bet that ABC7News did not even share the case they were preparing to discuss with the hospital. They just wanted to run the story, and so they asked the hospital for generic comment about a patient's large bill.
I've looked for follow-up to this two-month old story, and I can't find any. But I am sure it's a billing mistake.
So there is more to the story.
That's an epic understatement. I'm of the opinion that the root cause is the insurance companies.
Sure, in some other countries, for-profit health insurance is illegal.
There are many more for-profit hospitals in the US than there were 40 years ago. Many not-for-profits sold out to for-profit companies. I believe John Oliver or VICE did a piece on this years ago.
Then there are the doctors. Only in the US is being a doctor insanely lucrative. Not all US doctors are out to financially abuse patients, but there are enough who are complicit in the hospital and outpatient practice system who enable mass exploitation.
Single-payer wouldn't end this. Medicare for all wouldn't even be close to fixing the problem. Most of Medicare is administered by for-profit health insurance companies. Medicare pays, but doesn't cover 100%. It still requires paying for one of a laundry list of letters Medicare supplemental and prescription plans. Also, the US doesn't have a functional mental healthcare system. And that's not covered either. Dental and vision also aren't covered.
And only for some doctors. Most aren't making crazy money at all.
> Single-payer wouldn't end this.
I never said it would. But this is a thing that most other modern nations have figured out (imperfectly, sure, but orders of magnitude better than we have in the US). It's insane that the US can't seem to resolve this situation, especially considering that it kills people.
But then, we here in the US don't seem to prioritize actually helping people. The US is the wealthiest, most powerful nation in the history of the planet. That we allow anyone to go without a roof over their head, food in their belly, and adequate medical care is criminal.
> Even with plan discounts, United Healthcare still paid more than $58,000 for the couple's rabies treatment.
Wow, look at the Stockholm Syndrome on this guy!
As if that's an acceptable normal process for anyone to be subjected to...