Comment by goronbjorn | Hacker News Reader

Comment by goronbjorn | Hacker News Reader

When I was in college, I couldn't afford health insurance (no parents + financial aid does not cover it). I played rugby (generally not the safest sport) for two years, in addition to playing pickup basketball all four years. I very fortunately did not sustain any major injuries.

Six months after graduating (and getting a job with health insurance), I tore my ACL while playing pickup basketball. The costs were as insane as outlined in this post, but, again, I had health insurance. However, to this day, I'm horrified at the thought of what would've happened if I'd sustained the injury in college when I didn't have health insurance. Shame on me for putting myself in those sorts of situations, but it feels like there's something wrong when the penalty is so harsh.

You wouldn't have paid anything like $68k. As mentioned in the article, those prices are inflated for charging the insurance company, who in turn negotiates a much better actual price. Similarly, the hospital would have likely worked out a better deal with you. Or, if you qualified (and it sounds like you would have), then Medicaid would have initially picked up the tab and they would have negotiated a better deal for themselves.

In none of these scenarios does anybody actually pay the made-up $68k number.

The hospital would have worked out a better deal with you if you asked. However, if you don't ask, and just put yourself horribly into hock to pay them, they'll take the money. Likewise, if you refuse to pay, and they have to go to collections or the like, they'll apply the full, inflated amount.

That's true, though even 10% of that number (more than twice the out-of-pocket cost with insurance) would've been financially crippling.

Possibly, but look at the picture of the sliced out tendon. ACL replacement is an inherently complicated operation, from a highly skilled practitioner. The take-away from that is: you can't afford to play a dangerous sport like rugby if $5-7k is financially crippling.

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