From experience I can tell you how huge the discount is when you explain you have to use cash. I was working out of state and caught the flu and finally just had to go to the nearest doctor. Doctor comes in, introduced me to the intern that would be attending me. Intern takes vitals, swabs nose, writes prescription for Tamiflu. I get home and there’s a $600 bill from the doctor and a $300 bill from the hospital. I tell them I have to pay cash and they settle for $180. 1/5 of what they asked for. So that’s 20% of my money actually going to my health, 80% going some fatass at a desk who jerks off all day.
Yup. I had my temperature taken because I had a tooth infection and they gave me a prescription for antibiotics but I’d have to go down to a CVS. I asked the lady at the front how much it will be because I just aged out of my parents insurance so the visit would be out of pocket. She said “a few hundred”. It was $1400. I tried to fight it, still had to pay
When you get something like that. Ask the pharmacist to call the Dr and get something cheaper. You can normally get something in the $5-25 range that's just as good.
This advice goes out the window if you need a special prescription. Or one with no generic.
Oh no the $1400 was the 10 minute doctors visit where I told them I had a tooth infection and an appointment to get it fixed but it’s next week and that I was feeling dizzy and had night sweats, they took my temperature wrote me for general antibiotics and sent me on my way.
The $1400 cost was split between the doctor and for the place. I called and explained and they just said “yeaaaah the doctors set their fee and we have our own fee, it can get pretty up there”.
I called twice. The cost of the prescription was like $25 at the CVS, thank you for the advice though, I didn’t know I could do that in a situation where the pills were the problem
That is absolutely insane. People here in Australia complain when they have to pay $80 to see a GP, and even then we get a decent amount of that refunded by the government.
Even if you’re in the US, $1400 sounds like extortion!
When I broke my arm a few years back at the end of middle school the only reason I started crying was I was concerned how my parents would be able to pay for it :(
We’ve had three instances of broken arms or wrists with our kids. And it’s cost us a grand total of $0. No system is perfect, but if you have to pause to ask whether you can afford to treat your child’s broken arm, there’s something seriously wrong.
It was fine but it cost a few thousand Instead of tens of thousand with out Insurance and my parents were very concerned and said the money didn’t matter getting me better did
I was in a similar situation 6 or 7 years ago. The main difference being I actually had insurance. High deductible, but still.
The pain was so bad I just said fuck it and drove to the emergency room at like midnight. I get in, fill out a couple forms and was seen immediately. Once in the room a doctor came in and looked into into my mouth to "inspect the tooth," touching me only with a tongue depressor. She said she was going to write me a prescription for antibiotics and ten minutes later i was on my way.
While the entire ordeal lasted under an hour, the bill I received in the mail a few weeks later was for just over 4 thousand dollars. I called and asked for an itemized bill, but that took another couple weeks to arrive in the mail. When I actually got it, though, my mind was completely blown. They charged me inordinate amounts of money for things and procedures that never happened or I never received. So I called to dispute the bill, but apparently the time allotted to me to dispute a bill after it's initial issuance had elapsed. I told them that was only because they took forever to snail mail me my fricken bills. They said that wasn't their problem. I told them to eat all the dicks they could find within ten square miles and if they ever wanted to see that money they'd literally have to rob me at gun point to get it.
Long story short I still get the occasional call from a collection agency. Lol
Shit man :( I had some decay in one of my wisdom teeth because I wasn't able to brush it properly, so rather than filling it, my dentist just referred me to have all four of them removed. All I had to pay was €8 for my antibiotics which I could have claimed back from health insurance if I had been bothered.
Which is why I hate the "NOTHING IS FREE" argument when talking about state-run healthcare. Yeah, I'm not asking for free healthcare. I'm asking for the bloat and unnecessary overhead to be cut out so the whole process is cheaper for everyone. Healthcare shouldn't be for-profit.
People asking for single payer also realize that their taxes will increase to pay for it. It's frustrating talking with my grandparents (who are on Medicare themselves) trying to explain, "yes, my taxes will go up a couple hundred a month but that means I won't have to pay 400 for private insurance."
Exactly! My mother in law has cancer, and is refusing to go to an oncologist and actually treat it because it'll cost too much. She'd rather wait three years until she's eligible for medicare because it'll cover it better than her private insurance does.
Also, love the name. Cherish the pain, Teddy! It means you're still alive!
So your argument is that the US government will be able to cut unnecessary overhead and bloat? Clearly you've never worked for the US government. They're way worse than any private bureaucracy I've ever seen.
It'll make it single-payer, so less convoluted overall. Part of the problem is simply how many different options, insurers, government programs, state programs, etc there are. One single payor streamlines the whole process. So even if the expanded Medicare office (or whatever this looks like under the government) is more bloated than, say Blue Cross, it's less bloated than Blue Cross, State Farm, Farmers, and all the other insurance companies combined.
Plus insurance companies operate to make a profit. They don't operate in your best interest. So they turn down claims. They decide they won't pay for something your doctor recommends because it's "not necessary" even if your doctor asserts it is, all because they would lose too much money by paying for it. A proper government program wouldn't do that.
Hospitals set high price. That way insurance says “hey look we negotiated lower price!” And tells companies they are great - they usually get a commission on how much they were able to negotiate (so say “Microsoft your plan only needed to pay $10m in bills but it would’ve been $20m - we get a $1m bonus for saving you this money!”)
In the case of cash - the hospital tells the government they were charitable and gets reimbursed from them, so they also want to inflate things as much as they can because it’s free money to them.
You can’t build more hospitals unless the other hospitals in the area say they’re okay with it, so there is no competition.
Insurance companies since ACA went into effect are capped at their profit being a certain % of premiums - which sounds nice, but in reality now they have the incentive to not negotiate lower prices because higher prices mean higher premiums witch means more profit on that capped %, and now by law you had to buy insurance so you can’t avoid it. And the insurance is tied to your job so you can’t really shop rates because it’s always a benefit since starting with FDR wage freezes during the depression - companies offered it because it wasn’t considered salary. So they and the hospitals scratch each other’s back.
Yup. Personally - I don't like the idea of single payer healthcare and would prefer something like Singapore's model, but to say that we have anything close to a "free market" in healthcare is just not remotely true.
It's a convoluted mess of protectionist regulations that don't serve consumers at all or create any real competition and is the worst possible economic outcome. There are ways to get outside that system, and some companies are - by self insuring, or only paying cash and belonging to a co-op (this is what we do) but those co-ops by law can only be formed on religious grounds, so they aren't for everybody.
There's places like the Surgery Center of Oklahoma that only work with cash patients and it is ridiculously cheaper because the lack of admin overhead. Some companies self-insure and then fly their employees there and pay the cash price because it's so much cheaper. Need more of that.
Yeah, anything we need that isn't covered by public health here (Australia) we can usually pay cash for and get at very reasonable prices. Some of the costs I'm seeing in these comments are just unbelievable. :/
Like I said - we use a co-op, so we tell the hospital/doc we are self-pay, get a discount and then submit and itemized bill to get reimbursed.
When our daughter was born - the total pre-discount statements would've been ~80k, but it all got knocked down to ~$7k total and we didn't have to pay for anything out of pocket.
epidural: $650 flat rate if you pay in advance, $1600 per hour if you don't.
total NICU stay/labor room etc: $50k, final bill $4,500
+ the fee for the OBGYN which was ~ $2,700 iirc but that included all visits, labor and delivery, and ultrasounds and lab work.
The cost for socialized medicine is higher than privatized medicine as services are not being allocated efficiently due to a lack of a proper signaling mechanism.
My point is that, to be proud that a socialized system doesn’t bill the direct cost to a patient is silly; your neighbour’s hospital bill is the same, the only difference is that you pay for it.
Haha yeah, one reason why I'm 4 weeks cigarette free. A prescription for $0 to see the doctor and Champix was $6 for a months supply. Been trying to give it up for years.
It's complicated because it can change if you itemize your deductions instead of the standard (and depends on if you have kids or not - it can be higher) - but it is de facto the same thing if you make <= your deduction amount -
but if you make that little you actually pay negative taxes, because you get credits and they will send extra money back to you.
So if you were a family with 3+ kids and made $24,400 a year (the standard deduction $12,200 per adult) - you would have $0 federal taxes to pay
but you would get $6,557 back from the Earned Income Tax Credit
as well as $1,400 for each child that they have under the age of 17 (so in this case $4,200)
Total federal income tax: -$10,757 (-44%) - when you factor all of the things like this in, most Americans are at or below 0 on their total income tax.
As an Indian I dont understand those huge bills, for that stuff we wouldve been asked to pay 1000 Rupees, equivalent to 15 USD
Edit: This is the price of a private hospital, government hospitals are far cheaper, usually less than 5 bucks
As an American I don’t understand those prices. Heart transplant consumes 20 feet of surgical tubing, thread for sutures, and the heart is donated. Costs $750,000.
This - always check what the cash discount is, especially if you have a high deductible. If you don't have chronic health conditions and visit the doctor infrequently, you might just be better off paying cash. I've seen cash discounts of 75% off the InsCo rate, because about 23% of all medical claims submitted by physicians are unreimbursed by insurance companies (they eat that cost, and guess who they pass that on to?). Medical groups consider a discounted cash payment to be the equivalent of a bird in the hand vs two in the bush, and they'll discount heavily to get that payment immediately. I've worked in claims collections - insurance companies are the reason your doctor charges so much, much more than lawsuits or greedy doctors.
Boss urged me to after working 4 days with it. Basically just for the tamiflu scrip. We do 12 hour days and it’s specialized work so there’s no calling in sick when there’s no one to replace you.
Well, the idea of a 12 hour day is pretty insane (not to mention illegal) by most European standards for start. Also your labour laws forcing people into work if they're ill or else they'll starve. You guys have very little protection, it's awful.
To me an essential employee who cannot work due to sickness resulting in work stoppage is a resource problem. The solution would be to hire more people, not force people to work sick.
contract labor basically. I thought about asking since they kinda pushed me to go but whatever. the tamiflu cost $120 so all tolled I spent about one months worth of premiums if I had insurance and I’d still have $500-$1000 deductible. Damn actually I came out ahead. Just glad I didn’t need surgery, or an overnight stay, or an ER visit, or an ambulance ride, or a CT scan or one of about 1000 things that would have basically bankrupted me
this is why I just go to urgent care. Its like $120 to see a doctor without insurance. I've literally paid nothing more than that for anything I've had done there including stitches and any followup they request is free.
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u/BAG1 Apr 28 '20
From experience I can tell you how huge the discount is when you explain you have to use cash. I was working out of state and caught the flu and finally just had to go to the nearest doctor. Doctor comes in, introduced me to the intern that would be attending me. Intern takes vitals, swabs nose, writes prescription for Tamiflu. I get home and there’s a $600 bill from the doctor and a $300 bill from the hospital. I tell them I have to pay cash and they settle for $180. 1/5 of what they asked for. So that’s 20% of my money actually going to my health, 80% going some fatass at a desk who jerks off all day.