Toddler's backyard snake bite bills totaled more than a quarter-million dollars | Hacker News Reader

Toddler's backyard snake bite bills totaled more than a quarter-million dollars

sandiegouniontribune.com

33 pointsteleforce30 comments

It's wild to see people in this thread defending that the family "only" had to pay either $7K (or $18K with the ambulance).

Stockholm syndrome at its finest.

If you’re wondering what the national cost of delivering an average of 18 doses (article’s figure) of this stuff, sans other expenses, at the rate paid per dose in this case, is against the low-side estimate of 7,000 venomous snake bites, it’s about $900,000,000/yr.

[edit] Well actually 18 is the median, so technically the figure could be way higher or way lower than that. Probably a decent ballpark figure, still.

For profit-driven "health care" org's, Pay Or Die products with a natural monopoly are the Holy Grail.

No one is stopping government leaders from spending money to develop, trial, manufacture, and sell medicine.

Yet not a single candidate campaigns on this initiative.

Also, patents are not a “natural” monopoly.

The article makes it clear the crazy-high rates for these drugs aren't because of the price hospitals pay for the drugs, but hospital mark-up.

Does the medicine expire quickly? Or does the cost of storing it/administer it differ from other medicine?

Hospital profit margins don’t seem particularly high (~10%).

https://www.macrotrends.net/stocks/charts/HCA/hca-healthcare...

The other publicly listed company I could find is Tenet, which doesn’t do so well:

https://www.macrotrends.net/stocks/charts/THC/tenet-healthca...

> Why the high price? One explanation is that hospitals can — and do — mark up products to balance overhead costs and generate revenue.

This is something all businesses do. Some products/services are sold at higher margin than other products/services, for a variety of reasons.

Edit: CHS is the other large publicly listed hospital company, also has very low profit margins.

https://www.macrotrends.net/stocks/charts/CHSCP/chs-inc/prof...

More and more hospitals are owned by for-profit corporations that own many rather than administered by municipalities and non-profits. They're all about profits, rarely outcomes, as the evidence shows.

This doesn’t seem to be true, at least as of 2013:

https://www.statista.com/statistics/824788/total-number-of-f...

The numbers seem like they trend downwards, with 1,219 in 2024.

https://www.aha.org/system/files/media/file/2024/01/fast-fac...

The two hospitals in the linked article are government owned.

https://en.wikipedia.org/wiki/Palomar_Health

https://en.wikipedia.org/wiki/Rady_Children%27s_Hospital

Then you haven't been paying attention or your sources are inadequate.

> From 2013 to 2017, nearly 1 in 5 of the nation's 5,500-plus hospitals were acquired or merged with another hospital

https://www.usnews.com/news/healthiest-communities/articles/...

https://www.pbs.org/wgbh/frontline/documentary/the-healthcar...

https://hms.harvard.edu/news/what-happens-when-private-equit...

My experience (SE Michigan) is that a large "non-profit" hospital can be every bit as horrible as a for-profit one. There ain't no "be nice" requirement in the legal definition of nonprofit. And once you're talking billions of dollars, with big-ego executives and income streams that are independent of the org's actual do-good cred...yeah. Things get very feudal.

What do you mean "no one is stopping"? The "ones stopping" are lobbiests and their associated bribes.

They can try to influence, but they are not successful all the time. I would bet the American public does not have the stomach for government spending on risky trials that more often than not fail to result in a medicine.

I don’t think any government in the world does.

The US government does most of the hard work on medicine. Pharma takes over from there. It's quite literally privatizing the successes and tax payer funded failures.

If that was true, then it should be a slam dunk for a party to win elections on reducing the cost of medicine by obviating pharmaceutical companies, the businesses with the highest or second highest profit margin in the healthcare delivery chain. I assume healthcare software (like Epic) perhaps has higher profit margins.

However, I suspect the reality is that the clinical trials cost a ton of money and politicians don’t want to be associated with the failures.

You don't think that Pharma and Insurance aren't paying off both sides? That's rule number 1 in lobbying - you work both sides.

The title is somewhat misleading, since it implies the family paid that much. From near the bottom of the article:

>Brigland’s family paid $7,200, their plan’s out-of-pocket maximum.

Plus have been billed another $11,000 for an ambulance that insurance decided not to cover.

Surprise! Gotcha capitalism and unexpected risk of bankruptcy, homelessness, and poverty is America's defining feature that's not a bug.

Judging from the photos I’m guessing these folks can take the hit and at least be OK, if not somewhat scuffed-up, financially speaking, but almost $20k in medical bills because your kid had one could-happen-to-anyone mishap would ruin a lot of families’ entire decade.

It remains baffling to me that almost any other topic gets attention in this country when we have this problem.

Of course, because us poor people don't have access to journalists or large social media presences. The burden for most families falls on them and nonexistent, power-law distribution ad-hoc charity drives like GoFundMe that are more like the lottery rather than receiving a consistent amount of help comparable to their condition.

The whole point of society is to share risks and costs that would be difficult or impossible to share alone. When a society doesn't do that, it becomes a degree of a failed state by definition. Anything shared today in America is privatized, eliminated, or disparaged as "communism" by the ignorati and by the greedy rich.

What photos did you see that I didn’t?

Maybe it’s different in San Diego, but mismatched sunken slab walkways and large poured concrete landscaping features would only occur on new or recently heavily-made-over well-above-median-cost houses in trendy areas, place I’ve lived. The photos read “money” to me, at least enough that they might not be ruined by an unexpected $20k outlay in a year (though I’m sure it stings, at least).

It’s not really misleading, doesn’t say the parents paid that. The actual costs outside OOP maximum is spread across the insured, so high bills affect many.

> Insurance did not pay all the claims, including one ambulance bill. And Lindsay said the family received a letter this summer suggesting they owe an additional $11,300 for Brigland’s care. While the landmark No Surprises Act protects patients from many out-of-network bills in emergencies, the law controversially exempted bills for ground ambulances.

And still the headline is silly. 18,500 total is far less than what "totaled more than a quarter-million dollars" implies.

Since a lot of people don't have insurance, I think the number is useful. Also what the actual fuck with that markup?

If you don't have that much, you can always negotiate down. So ultimately, you are really looking for an intersection of: those who do not have insurance, those who get snake bites, those who cannot negotiate for whatever reasons and thus face death/medical bankruptcies. My gut feeling tells me that it is a very small number, but happy to learn from actual data if it is readily available.

Not sure why you are downvoted. The title is indeed misleading. It literally says "totaled more than a quarter-million dollars". Sorry, but the "total" should include discounts induced by out-of-pocket maximum, which was 7,200 in this case[1]. "total" should also include discounts negotiated by the insurer with the hospitals, which will be a lower cost than the title implies. Sensationalist headline indeed, to pray on "murican healthcare silly... hahaha" biases.

[1] afterwards, the article says they got an additional bill of 11,200 but not sure if they paid it or negotiated something else.

Welcome to America!

(Also don't sign-up for Medicare Advantage because it has lifetime limits.)

Previously: https://news.ycombinator.com/item?id=42013478

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