Something is wrong with healthcare: ridiculous emergency room cost

ThanksObama wrote:

I was in AZ at the time. I'm actually from Vermont and checked with my insurance that no prior approval was needed for out of network in emergencies. The bill doesn't actually include an itemized list just the total cost. I'll have to call my insurance and find out why the paid such a small portion of the bill (only about 20%).

I don't really understand how the health care insurance system works but this convinces me the current one isn't working. Not sure what the right answer is though, but more competition for insurance companies and hospitals sounds like a good idea to me.

Luckily recovery is going well and I'm back to running and biking and he shoulder is fine. Just hope it doesn't happen again and if so I'm not going to the emergency room.

If you've ever been on the other end, i.e., getting paid by health insurance companies, you find that they use any pretense they can think of to withhold payments. You end up making phone calls, resubmitting forms and so on. Often you'll get paid eventually. Sometimes you won't. But as long as the company hangs onto the money they have it invested somewhere and are making a bit more interest than if they paid it promptly, or at all. And on the consumer end they do the same thing. Why pay your claim when they can deny a lot of it and hang onto the money even if just temporarily?

This went on before, during, and after Obama. If you have an accident or major medical episode you may not be able to get a prior approval and in your case you weren't supposed to need one anyway. Health insurance companies are scum. Maybe they'll make this right if you fight them on it and maybe not but they'll try their best to get you to give up and pay it yourself or pay some of it yourself.

Vermont will have an insurance commissioner and maybe an office of consumer affairs or something along those lines. You need to get in touch with one or both of these offices and file a complaint. I've done that in the past and it's worked like magic, but it too is a pain in the sitting part.

asdfasfads wrote:

Problem is figuring out a system that remotely lets competition happens because without competition, capitalism doesn't work. Health though has a huge drive towards monopolies. Providers have realized that competing with one another is stupid. It is a lot better to form a monopoly and gouge the insurance companies. Insurance companies realize that they don't have the leverage to control costs and the state boards don't let them set rates that make things work.

Monopolies in healthcare are a result of the massive overhead costs, which are caused by policy along with the huge number of different insurance plans that providers have to work with. You need massive economies of scale in order to support the necessary army of pencil pushers.

Most providers I know would rather this not be the case. Many physicians would much rather work in private practice and not be part of a corporate structure. Unfortunately, this is just really tough to do in most cases.

This is a part of the reason that "socialized medicine" delivers cheaper care. There's no need for office staff to support every physician when the billing is simple and streamlined.

Canadian Here wrote:

Canadian here. All my hospital and standard doctor visits are fully paid for by government. An ambulance ride is like $250 with no insurance.

Only thing we get gouged on is dental work.

You also get gouged on taxes. When you consider higher taxes vs higher medical costs it's probably a wash. In fact, if you are a healthy person it's much cheaper here in the USA.

Egads! A calm, intelligent, and informed response on a Letsrun forum! What is the world coming to?

I agree on all points.

Canadian Here wrote:

Canadian here. All my hospital and standard doctor visits are fully paid for by government. An ambulance ride is like $250 with no insurance.

What province are you from? I'm in the Toronto area.

I've taken several ambulance rides over the past 10-15 years, and the cost has always been between $35 - $50. And what do you mean by "no insurance?" Don't you have a health card?

I get on YouTube instead of going to the emergency room. Serious. It's free.

John Utah wrote:

You also get gouged on taxes. When you consider higher taxes vs higher medical costs it's probably a wash. In fact, if you are a healthy person it's much cheaper here in the USA.

That's a myth. Canadians pay less or comparable in taxes to Americans:

Also Canadian wrote:

Canadian Here wrote:

Canadian here. All my hospital and standard doctor visits are fully paid for by government. An ambulance ride is like $250 with no insurance.

What province are you from? I'm in the Toronto area.

I've taken several ambulance rides over the past 10-15 years, and the cost has always been between $35 - $50. And what do you mean by "no insurance?" Don't you have a health card?

In Alberta here. Yes, I have an Alberta Health Care card but ambulance rides are one of those things not paid for by Alberta Health Care. $250 is what I paid for an ambulance ride. Probably Toronto charges different rates. Still, $250 Canadian is really cheap compared to what Americans pay.

That's Obamacare. It's designed to tax the healthy to pay for the unhealthy. Your high premium and large deductible pays for the intensive use of health care by the uninsurables. Somebody has to pay - it would probably be better just to put them all into Medicaid and let the taxpayers do it. Then you could choose to opt out of BCBS altogether since your so unhappy with the insurance.

As to whether $1900 is an exorbitant bill, I remember the day a newly minted driver with her friend in the car rear ended me in a parking lot at about 5 miles per hour. Very minor damage, but it cost $2000 to make the bumper and rear end of the car whole at the collision shop. I think we pay doctors and ER nurses a bit more than automobile mechanics.

Trumpcare means 23 million out of insurance. Obamacare allowed for those to get insurance and subsidized insurance for many, while providing for Medicaid coverage from the states. Unfortunately, too many Republican states, including big ones like Florida and Texas, were content to let their millions go uncovered when the Feds were paying for the Medicaid expansion. The costs of the system and insurance long predate Obama, who only helped moderate the costs and make far fewer go bankrupt and allowed people with pre-existing conditions--which the companies were making extend to vast #'s of people--to get coverage without being bankrupted. The system as a whole is horrendous. It requires a vast shakeup that Republicans aren't approaching in any way and which Democrats in the past didn't have the stomach to do. Single payer is just the start of it. 24/7 staff in emergency rooms is somehow affordable through Europe but not here. Go figure.

Those Canadian tax charts are worthless in comparing US to Canada. You can't compare US taxes and Canadian taxes without looking at the total package....sales taxes, state taxes, allowable exemptions from gross income etc.

If an oil change at Jiffy Lube was managed by our medical system it would take 5 hours and cost 600 dollars.

Old timey guy wrote:

Those Canadian tax charts are worthless in comparing US to Canada. You can't compare US taxes and Canadian taxes without looking at the total package....sales taxes, state taxes, allowable exemptions from gross income etc.

Sales tax in Alberta is 5%. In California it is 7.25% - 9.75%. As I said before, it is a myth created by Americans that Canadians pay more in taxes.

Canadian Here wrote:

Old timey guy wrote:

Those Canadian tax charts are worthless in comparing US to Canada. You can't compare US taxes and Canadian taxes without looking at the total package....sales taxes, state taxes, allowable exemptions from gross income etc.

Sales tax in Alberta is 5%. In California it is 7.25% - 9.75%. As I said before, it is a myth created by Americans that Canadians pay more in taxes.

Well, I guess you should be happy in Canada. You do you and we will do us.

Also Canadian wrote:

Canadian Here wrote:

Canadian here. All my hospital and standard doctor visits are fully paid for by government. An ambulance ride is like $250 with no insurance.

What province are you from? I'm in the Toronto area.

I've taken several ambulance rides over the past 10-15 years, and the cost has always been between $35 - $50. And what do you mean by "no insurance?" Don't you have a health card?

Canadian, eh. Try $2000 for an ambulance ride in the US. Wish I was joking.

notrump wrote:

That's Obamacare. It's designed to tax the healthy to pay for the unhealthy.

No that's just what insurance is.

BRB, I'm going to see my doctor and not worry about having to take out a second mortgage. Ahhh, bliss!

Canadian Here wrote:

Old timey guy wrote:

Those Canadian tax charts are worthless in comparing US to Canada. You can't compare US taxes and Canadian taxes without looking at the total package....sales taxes, state taxes, allowable exemptions from gross income etc.

Sales tax in Alberta is 5%. In California it is 7.25% - 9.75%. As I said before, it is a myth created by Americans that Canadians pay more in taxes.

Go ahead and list all the exemptions you are allowed to deduct from your yearly income.

Take it from someone who works deep in the bowels of the health care system, politicians can't fix the problem of high health care costs. Modern health care is complicated, it relies on multiple levels of people and technology that you never see from just going to the hospital. Health care costs a lot because it costs a lot.

Could ER costs be lower? Probably. But the hospital probably uses the ER fees to make money that they loose in other areas. I do think that a health insurance market that is more competitive could force insurance companies to streamline their processes and take a smaller chunk of the profit. But any efficiency improvements in this area can only "lessen" the cost of health care, they can't really "fix" it.

We want world class health care, but want it to be dirt cheep. It just doesn't work that way. You can't buy a yacht for the price of a canoe.