[vision-master]

$this->bbcode_second_pass_quote('', 'N')ext time book a plane ticket and travel to Thailand for your medical care. You'll get American trained doctors, bargain prices due to no government interference, a nice vacation, and thousands of dollars left in the bank.

[mattduke]

$this->bbcode_second_pass_quote('vision-master', '')$this->bbcode_second_pass_quote('Prince', 'T')hanks for the advice so far. I passed the info along to my sister and already she's making progress (she's a bigger hard-ass than I am . After getting the run-around from the gash at the hospital admin office, she called me back and we came up with a game plan and a concise list of exactly what to say to them.

She asked for a single itemized list without cryptic hospital codes, rather than the cryptic invoice she's gotten so far, spread across 10 separate invoice sheet. First they said no, and then maybe, and after ripping the lady a new one and mentioning that she had talked to a lawyer (which was a lie), you'd be amazed how quickly the woman was left speechless and "him-hawed" and worked in my sister's favor. Turns out that they "accidentally" overbilled the procedure under the wrong (read, more expensive) code and asked my sister to keep quiet and calm while they figured things out (which is another way of them saying that they want to cover their ass).

This is going to be a long process, I'm sure, but she's making progress. Appreciate it.

[mattduke]

I think that what this country needs is lower quality care. Sometimes you just need the Hyundai service, but all the various training requirements ensures only Ferrari engineers are allowed to see you.

[Prince]

$this->bbcode_second_pass_quote('mattduke', 'I') think that what this country needs is lower quality care. Sometimes you just need the Hyundai service, but all the various training requirements ensures only Ferrari engineers are allowed to see you.

[frankthetank]

Right on Prince...

I think part of it is just where you live. Up here it seems like the quality of care is really high. I've never had any problems other then a doctor or two being a drug pusher

**not saying this is the reason for every illness/etc...i just know a lot of cost is associated with lifestyle choices**
People still have to know that when you eat McDs, drink cola, and never physically do anything, and expect doctors to fix you up for nothing...well that just doesn't make sense either.

[smallpoxgirl]

It is outrageous that a 15 minute surgery costs $18,000. Clearly. The whole blame the doctor/hospital bit is pretty lame and uninsightful though. IMHO, veterinary medicine in the US provides an excellent example of what human medicine could and should be. You could probably have a 15 minute surgery done on your dog for $500 bucks. That's a pretty reasonable expense to me. The difference between the ENT and the veterinarian isn't that the ENT is a malign character who wants to see you declare bankruptcy. People have hugely different expectations between what sort of medical care they expect for their child and what they want for their dog.

I think the basic reasons why US health care is so expensive are these: 1. Risk aversion. People are unwilling to accept a 1 in 500,000 chance of something bad happening and avoiding such freak occurrences is difficult and expensive. Almost all of what the medical profession fronts as "quality improvement" falls in this category. 2: bureaucratic overhead. A direct result of #1. You can not begin to imagine the amount of paperwork and paper pushers that it takes to keep a hospital operating suite going. Probably at least a third of your bill can be directly attributed to the costs of regulatory compliance. 3; Malpractice expense again a direct result of #1. A huge portion of that bill is either the direct costs of malpractice insurance or the indirect costs of things the doctor or hospital did trying to avoid getting sued. 4: Technophilia. Our entire society has a pathological obsession with technology. Better believe all the whiz bang monitors they hooked your kid up to, the brand new fancy anesthesia machine, all the fancy expensive drugs, the latest generation inhalational anesthetic agent, all the fancy expensive emergency equipment that was sitting in a corner in case your kid had a problem, all that stuff is expensive. If you want high tech, it's gonna cost. 5: Professionalization. This is a pervasive problem in society, but it's particularly acute in health care. Every time the qualifications to do something are raised, it raises the cost of doing that thing. Becoming an ENT surgeon is a long, grueling, poorly paid process. If you expect someone to spend fourteen years in school, put in 80 hour weeks for years on end just learning how to put tubes in your kid's ears, that costs money. Likewise, the anesthesiologist, the RNs, all those people put in long hours training. They spend weeks every year maintaining their education. It costs money to train those people and maintain all their certifications. Down at the vetrerinary clinic, when fluffy gets tubes, there's the one vet. Not a veterinary ENT surgeon. Just a vet. He went to school for 8 years then opened the office. His assistant is a vet tech, a one year training program. She takes care of the anesthesia, monitoring the dog, and assisting the surgeon. Obviously a much cheaper personnel structure. 6: Third party reimbursement. This one is a double edged sword. First off it fosters in people the idea that they aren't responsible for their own medical expenses, so they demand services they can't afford. The lowliest homeless person assumes they have an inalienable right to a heart transplant. Secondly, it costs the hospital and the doctor a ton of money, time, and hassle trying to get paid at all. They've got to file and fight with the insurance company trying to get paid. Half the time the insurance company finds some reason to deny the claim. Then they've got to try to fight with the patient to try to get paid. The patient assumes that since they've got insurance they're not responsible, so they get pissed off when they get the bill. Some of them legitimately can't pay, so it ends up getting written off as bad debt. Others, after a significant harangue finally pay, but the expenses of collecting the bill are enormous. Fluffy, OTOH, ain't getting tubes unless you pay up front. The veterinarian deposits your check, fixes your dog, and doesn't have to spend the next year wondering whether he's going to get paid, how much, or how he's going to make payroll and pay his rent in the mean time. He also doesn't have a whole department in his office devoted to billing, claims, and collections.

In answer to the OP, the amount of options you have really depends on how much money you have. If you have the money to pay the bill, perhaps in installments, then the hospital is probably going to be pretty insistent on getting paid. If you push it far enough, they could even end up suing you. OTOH, if you are low income and can't realistically pay the bill, then they will probably work with you on paying what you can and write off the rest.

Here's the one that kind of ticks me off right now. I finally got myself some health insurance. I didn't have any for several years. I saw an ophthalmologist about my eye. My insurance is a high deductible plan so I was just planning to pay the bill. The thing that floored me is this: When I got the bill, even though the insurance company didn't pay anything, about half the bill was written off. Apparently my insurer has a contract with the doctor setting the max amount they can charge. Medicare, medicaid, and many insurance companies have tables of maximal allowable charges and the doctor is required to write off any charge above that. So why am I pissed? I'm pissed because basically it means they're screwing the uninsured. They're setting their nominal charges high so that they get as much money as possible from the insurance companies, but in the process they're totally screwing any uninsured patients that get caught in the crossfire. I actually think it would be a very helpful move if the government would require that providers not charge the uninsured any more than the medicare allowable for a service. It's ridiculous that they should go to all the trouble of billing my insurance, wait three months for the claim to be rejected, and then give me a 50% discount for it.

[Pretorian]

$this->bbcode_second_pass_quote('drew', 'W')hat I'm suggesting is that off the cuff racism is bullshit. Not every honkey is a straight up character either. Prince's statement smacks of bigotry, and I called him on it. Either that or he's not very thoughtful about what he writes.
What about you, Pretorian? Are all blacks lazy no good 'negroes', in your books? What about the 'spics' ? Can you differentiate, or do they all suck? Pray do tell.....

[Livewire713]

My ex-wife had 3 major operations and all the after care and doctor visits you could think of about 2 years ago. I had insurance at the time but it wasn't very good. I had to call them all the time to get them to pay their portion which was 80%. We still had about 30k in hospital bills after insurance paid their part. I tried to pay at the start but they were difficult to work with. I had 4 or 5 different offices billing me besides the hospital that did some sort or radiology or lab test that were separate from the hospital bill. One office wanted $50 dollars a month and at the time I could only send $40 with our other bills so they turned us in to some collection office. After that I said f%ck it and I stopped paying all of them. I still get bills and letters from collection agencies and I have a box that I throw all that crap in. One collection agency tried to threaten me and I told them that Ill just have to file for bankruptcy and I never heard from them again.
Im not proud of the fact that I havent or can't pay them. They are my ex-wifes bill its just that the insurance was in my name. She ran off after I was laid off from Caterpillar so I don't feel I should have to pay for her health care anyway. My unemployment runs out in 2 months so happy times ahead for me.

[Aaron]

This reminds me of an old joke.

A dishwasher comes home one night & tells his wife he has some bad news. She asks what the bad news is, and he replies, "Well, I was fired today." "That's terrible" she replies, "what will we do now?" "No problem", he says, "tonight. I'll take you out to dinner... refuse to pay, and I'll be working again."

The brutal nature of US health care is pretty evil IMO.

[billbrasky2]

this tidbit today from Business Week:


Medical problems caused 62% of all personal bankruptcies filed in the U.S. in 2007, according to a study by Harvard researchers. And in a finding that surprised even the researchers, 78% of those filers had medical insurance at the start of their illnesses, including 60.3% who had private coverage, not Medicare or Medicaid.

Medically related bankruptcies have been rising steadily for decades. In 1981, only 8% of families filing for bankruptcy cited a serious medical problem as the reason, while a 2001 study of bankruptcies in five states by the same researchers found that illness or medical bills contributed to 50% of all filings.

This newest, nationwide study, conducted before the start of the current recession by Drs. David Himmelstein and Steffie Woolhandler of Harvard Medical School, Elizabeth Warren of Harvard Law School and Deborah Thorne, a sociology professor at Ohio University, found that the filers were for the most part solidly middle class before medical disaster hit. Two-thirds owned their homes, and three-fifths had gone to college.

But medically bankrupt families with private insurance reported average out-of-pocket medical bills of $17,749, while the uninsured's bills averaged $26,971. Of the families that started out with insurance but lost it during the course of illnesses, medical bills averaged $22,658.

[Aaron]

$this->bbcode_second_pass_quote('billbrasky2', 't')his tidbit today from Business Week:


Medical problems caused 62% of all personal bankruptcies filed in the U.S. in 2007, according to a study by Harvard researchers. And in a finding that surprised even the researchers, 78% of those filers had medical insurance at the start of their illnesses, including 60.3% who had private coverage, not Medicare or Medicaid.

Medically related bankruptcies have been rising steadily for decades. In 1981, only 8% of families filing for bankruptcy cited a serious medical problem as the reason, while a 2001 study of bankruptcies in five states by the same researchers found that illness or medical bills contributed to 50% of all filings.

This newest, nationwide study, conducted before the start of the current recession by Drs. David Himmelstein and Steffie Woolhandler of Harvard Medical School, Elizabeth Warren of Harvard Law School and Deborah Thorne, a sociology professor at Ohio University, found that the filers were for the most part solidly middle class before medical disaster hit. Two-thirds owned their homes, and three-fifths had gone to college.

But medically bankrupt families with private insurance reported average out-of-pocket medical bills of $17,749, while the uninsured's bills averaged $26,971. Of the families that started out with insurance but lost it during the course of illnesses, medical bills averaged $22,658.

[drew]

$this->bbcode_second_pass_quote('Prince', '
')In this PC-correct, liberal world, anything--ANYTHING--can be found offensive to somebody. With that, why do you care? This isn't about you.

[threadbear]

$this->bbcode_second_pass_quote('Prince', 'S')o my sister and her husband have a son (my adorable nephew) who has had some medical problems--mostly minor stuff such as colds, ear infections, bronchial infection, sinus problems. After being in and out of the pediatrician's office, they decided to put tubes in his ears and remove his adenoids--very minor and routine surgeries. Since then, he's pretty much been healthy, but to my sister's shock the hospitals bills are coming in much higher than expected. Some of the fees are absolutely criminal ($1100 to see a doc for 5 mins, in addition to the doc they had with him during surgery). This routine 38-minute surgery had a total tab of $18,000. Even Goldman Sachs can't pull off a scam like that.

My sister has insurance, but it is only paying 60%, and although they make a decent living, they don't have the money to pay for these bills. She expected such a routine and simple surgery to cost no more than $8000 (which is still criminal, but at least manageable). I told her to get firm and negotiate. Tell them you're only paying 'X', similar to how you would handle a credit card company. I figure if the average illegal spic or negro can get their healthcare for 'free', then I figure she should work to get her costs down. She's concerned that she'll be taken to court if she refuses to pay the full tab,but I don't see it happening.

She's really upset and I'm looking for advice to give her... anyone been in this situation?