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Comment by agotterer | Hacker News Reader

I was doing consulting for a few months and considered not getting insurance. I decided to take the safe route and payed $550 a month out of pocket for personal coverage. I eat healthy and exercise (on and off). Long story short, I ended up hospitalized for a week with some crazy stomach infection. To this day, no doctor knows what it was or how I got it. The bill would have been 50 or 60 thousand dollars if I didnt have insurance. Better to be safe then sorry, accidents do happen. I will always get the best coverage possible now.

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if you didn't have insurance, that bill would have been 5-10K, with the hospital willing to give you 10-15 years to repay it.

Can you explain your logic? 50 sounds crazy high, but 5-10k seems like a wild extrapolation.

hospitals mark up their costs for insurance. If you are paying cash they will always lower their bills big time to accomodate you.

hospitals mark up their costs for insurance

No they don't. Hospitals mark up for people paying cash. This is because they know most of the people paying cash won't pay at all. The markup for people paying cash is about 3 times that what they bill the insurance company.

If you are paying cash they will always lower their bills big time to accomodate you.

This can happen but it's arbitrary. I needed to be hospitalized without insurance and the hospital wouldn't budge on the bill. Likewise I had a roommate who had a $40,000 concussion once and the hospital wouldn't negotiate that bill, either.

An anecdote about hospital negotiation: I just got a bill for $7,000 for a two-hour visit to a San Francisco hospital emergency room. The bill arrived with a letter offering me a 20% discount if I paid directly (and claimed it back from my insurance or not, either way) versus if I asked them to submit an insurance claim, and another 20% discount for payment within 30 days. So the opening offer on the bill was to pay 40% less. This is probably in the neighborhood of what an insuror would pay, but the hospital saves a fortune in claims processing.

I actually just tried to find the papers, but don't want to put much more time hunting them down :) I was able to find the lab bills though, those alone came out to around $3000. I stayed 7 nights in the hospital, got a ton of tests and received a shit load of medication. Not to mention this was in NY, which has notoriously high medical costs. Maybe 50K was an exaggeration, this was a while ago. But it was in the tens of thousands for sure. There may be discounts when paying in cash, I'm not sure. Either way, its worth the money for coverage. Even if you don't get the top of the line, get something, especially if you have a family and little kids. Go watch John Q if you arent convinced...

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