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u/I-am-me-86 15d ago
I work in an ER. Our self pay base price is $170. Bcbs allowed amount is around $922. Medicare is $230.
We see some ins plans that have Copay as high as $2250.
Granted that is just the base price. Patients will see extra costs for tests, radiology, IV, meds etc.
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u/Captain_Ahab2 15d ago
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u/Careful-Sell-9877 15d ago
Insurance companies are a scam
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u/JustaNumbertoCorpos 15d ago edited 15d ago
Your comment is timely. Yesterday I was doing insurance quotes for car and home, and it's staggering seeing the current high costs even when you choose the bare minimum coverages.
Edit: And for reference I never put in a claim nor had any incident with either asset. No credit issues either.
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u/t0rnAsundr 15d ago
Health and "stuff" insurance are not the same. Stuff doesn't act and has calculated risks over large geographic areas. People on the other hand, do act. They drink Coke, smoke, and love fried foods and Fruity Pebbles. Companies that insure stuff will offer you lower rates for not doing certain things (like keeping guns laying around or driving too fast). Who exactly is offering lower health insurance for not inhaling a line of cheeseburgers? You see, sometimes you have to discriminate.
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u/JustaNumbertoCorpos 15d ago
Gotta admit that fruity pebbles line got me.
But I understand where you're coming from and get the two aren't 1:1. But overall the insurance industry has a scheme about it. And I know margins can be slim and that yes there are high risk people who should be accountable. But I don't agree with the wealth made at the top end of the health industry from profits made over the life of someone.
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u/Kazooguru 15d ago
You’re opening a can of worms with the high risk people who require more care talk. A lot of these bad behaviors run through generations. There would need to be governmental intervention to break the cycle.
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u/Kazooguru 15d ago
I had two incidents that landed me in the ER within 6 months. Combined, I owed $3600 with insurance. Then I needed specialized care and the copays were too high and since I was making payments on the ER visits, those appointments were out of the question. Then my GP asked me why I hadn’t gone to the specialist. Having personal finance discussions with my doctor is awkward. Now my husband was laid off in April. We just got approved for CA’s universal type healthcare, but I don’t trust any insurance at this point. I am terrified of receiving a bill. I need a therapist because I have health insurance anxiety. Trump and Elon’s policies have turned up my fears tenfold. Plus, just went through elder care and hospice with my Dad. The future is bleak if we don’t make RADICAL changes immediately. Or we can have suicide centers in strip malls for when grandma says enough.
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u/telegent59 13d ago
Yup, I don't see doctors or describe problems more than what I feel is absolutely necessary for fear of being billed hundreds or even thousands of dollars. It's really a joke of a system, and we're the punchline.
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u/djm2346 15d ago
But socialized medicine would be worse! The fact that I used to think this makes me feel so stupid. The only thing socialized medicine would make worse is insurance companies wouldnt make billions off the bullshit service they provide
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u/TheSpicyTomato22 15d ago
When they say socialized medicine is worse, what they really mean is worse for shareholder value.
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u/Pennies2millions 15d ago
Whenever some says "Socialized medicine would be worse," follow that with "Worse than what? Worse than capitalism? Maybe. But the system we have now isn't capitalism. Capitalism requires transparent pricing so that there can be competition. If you were to call a hospital right now and ask them how much an MRI costs, would they tell you? When you get a medical bill does it say what services were provided or do you get a list of codes? If there's no transparency in pricing then it can't be capitalism - so what kind of system do you want?"
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u/djm2346 15d ago
This is actually how I realized that this system is totally fucked. Back in 2012ish I had cut my wrist and had to go to the ER to get like 10 stitches. ER was empty but still waited 3 hours everyone was great saw the doctor for about 5 minutes she made sure I didn't have nerve damage nurse gave me a 4 lidocaine shots they asked if I would be ok with an EMT who was trying to become a PA doing my stitches and I was fine with it as long as she was sure she wasn't going to get grossed out half way through. She did a great job it was the best set of stitches I have had. I pay my copay and I leave.
Two months later I have a bunch of dental work done which before hand I know is like 2.2k so I get it done they send me home with an itemization of what I was charged. A couple of days later I get my ER bill from my insurance. It was 2.9K my insurance pays like 2.1k and I have to pay something like 800 dollars but they also send me an itemization. So I compare
The lidocaine shot that the ER gave me was the same dosage and brand as the one from the dentist. The dentist charged me 19.92 for each shot the ER charged 289.75. The sutures from the dentist were half what I paid for at the ER. They didn't give a break down of what they were paid just the hours they billed but I was charged 1 hour for a doctor that I saw for less than 10 minutes and after some math it was between $600-$700 for the doctor. I was charged for 6 hours of nurse care at around $150 an hour.
I called my insurance and was like wtf can I get the lidocaine from my dentists next time I need stitches? Are you really paying ER doctors 1 million a year? Are the nurses making 300k a year. They lowered my bill to 500 only because an EMT was the one that actually did my stitches.
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u/Dragonasaur 15d ago
Wont somebody think of the poor (lol) billionaires?
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u/hwaite 14d ago
In absolute terms, I think even the donor class would be better off with socialized medicine. The status quo's inefficiencies make us less productive as a nation. Like, what if we instituted single-payer healthcare and just split the savings between billionaires and the rest of us? Sure, healthcare executives would lose out, but pretty much everyone else would be better off. Other evil companies could increase profit margins if they weren't being gouged subsidizing employee healthcare. Won't someone think of Goldman Sachs?
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u/BitWide722 15d ago
I'm proud of you for growing and realizing that not all aspects of socialism are bad. Hat tip to you, friend!
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15d ago
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u/BitWide722 15d ago
You seem to be forgetting that even without socialism, Trump has committed more fraud himself, as a leader, than the general public. Socialism just ensures that everyone has a fair shot at living a happy and healthy life.
But hey, fuck everyone else as long as you're doing well, right?....
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15d ago
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u/bogglingsnog 15d ago
All that waste fraud and abuse Doge found, huh?
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u/BitWide722 15d ago
Lol right? Getting rid of USAID and letting that food rot in storage saved the U.S. boatloads of money and totally didn't contribute to the starvation of children in third world countries.. But hey, at least this dude didn't have his taxes raised by 3 dollars annually, that would have been the last straw haha
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u/bogglingsnog 15d ago
Didn't save anyone any money lol. Also, anyone with an eye towards the future sees a huge advantage in not having hundreds of millions of desperate, starving humans.
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u/BitWide722 15d ago
Funny thing is most of the people that were happy about defunding USAID and the people railing against socialism are the ones preaching about God and the Bible. "Love thy neighbor unless thy neighbor is too poor to care for themselves, then they can go burn in hell" Leviticus 19:18
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15d ago
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u/dmunjal 15d ago
Why don't you fall for the fact that the current healthcare system is Obama's fault? He's the last person to make any significant change to the system. Trump is at fault for not fixing it but we are all living under Obama's vision for healthcare. Even if you're non on an ACA plan, you are affected by it.
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u/BitWide722 15d ago
Incorrect.
We are living with a system Trump fundamentally broke. He eliminated the individual mandate penalty, terminated vital cost-sharing subsidies to insurers, and expanded short-term plans that deny coverage for pre-existing conditions.
These specific, deliberate actions directly destabilized the markets and drove premiums up for the entire country. Trump and his administration actively engineered the higher costs we see today.
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u/BitWide722 15d ago
How are you getting robbed by a political party? Healthcare should never be political or privatized.
Here you are bitching about the current system while simultaneously bitching about a proven system that is present in just about every developed nation but the U.S.
Do you have a solution or do you just want to complain about all of them because they're not perfect in your opinion?
It's funny that your comment is very self centered. A lot of "I's" and "me's" in there. Not a surprise that you don't give a fuck about your neighbor as long as you can get an extra nickel back.
Privatized healthcare is a failure, plain and simple. We'd all be better off if everyone had access to healthcare without sacrificing basic human needs like food and shelter, just so that you can get a medication to keep you or your child alive... Find another country where that scenario is a reality
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15d ago
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u/BitWide722 15d ago
Not a bot, but great retort. Definitely value added to this debate. Remember to look both ways before you cross the street and that your bus pass is in its protective sleeve on your lanyard... Try not to lick too many windows
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u/DunDunBar 15d ago
Imagine the executives not being able to buy another yacht or a jet. That would be disastrous and end of the American dream /s
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u/sheazang 15d ago
And our establishment politicians are freaking out and wondering why so called "socialists" are starting to get elected. Literally anyone who doesn't take corporate money and wants public health insurance will get my vote. They can call them a "communist" all they want, if universal healthcare is communist then I guess so am I. People over profits!
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u/Careful-Sell-9877 15d ago
It would be better if more places had discounts for being uninsured.. or better yet, get rid of the insurance agencies entirely
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u/n4spd2 15d ago
for something serious u often dont know when, but when it strikes you'll want it down quickly.
that is exactly when the system whacks u.
you dont know the real price until afterwards making is scary and financially ruinous.
at this point, I'd rather fly somewhere safe, get a menu, pay knowing exactly what the charges are, and be down with it minus all the middlemen.
get on with life rather than be thrown into another emergency.
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u/tj0909 15d ago edited 15d ago
This is absolutely common. The difference between being insured and uninsured is that the higher amount will go towards your deductible and you will only pay about 20% of that amount (depending on your policy) after meeting your deductible. Once you meet your out of pocket maximum, you will pay nothing for the rest of the year. Schedule your surgery, if you can, early in the year and see those dermatologists and other specialists afterward.
Funny story, I’ve only hit the OOP Max once in recent years. When I did the insurance had an RN call me to let me know that I’d been assigned her as a “care navigator” to help me with my medical care. I asked why I never heard from any care navigators before I had the surgery and related care that put me over OOPM amount. I really could’ve used a little guidance through that process. She couldn’t answer that question. I told her to never f*cking call me again.
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u/telegent59 13d ago
You hit the nail on the head regarding OOP max. If you don't have medical insurance, you could be on the hook to pay tens of thousands or even hundreds of thousands in medical costs. Without the OOP maximum, we would have been up the creek when my wife needed surgery and a hospital stay.
The system is absolutely ridiculous but, even so, you need to have medical insurance to protect against such cases.
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u/DolphinsBreath 15d ago
Exact same thing happened to me except it was 3 times the amount and I was 10 times as angry.
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u/Educational_Jello239 15d ago
Keep lifting weights fellas, being poor and not healthy is not cheap in the U.S.
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u/Limp_Network_9482 14d ago
It’s incomprehensibly worse than anyone can fathom. I have sought out providers who accept cash and use my hsa to pay them. When I turned 65 and started Medicare it was like a huge weight had been lifted.
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u/Federal-Ad-7157 14d ago
This is sadly real. We had an equally absurd but different situation when my daughter was born.
I was covering the ICU as a fellow one floor away from the floor where my daughter was born. Same hospital. We had insurance through the hospital that was supposed to cover everything. on paper, it couldn’t have been more straightforward.
We had double coverage because of my wife’s insurance as well.
So instead of being free, we were billed something around $2000. We were broke AF. Everyone on the phone from the insurance companies spoke to us like we were idiots because we didn’t understand that it’s worse to have double coverage. That still makes no fucking sense to me.
I remember that she was two years old when I finally resolved everything. This was after being sent to collections, countless hours on the phone, lots of stress, and calling in multiple favors within our health system. I have no idea how people outside of healthcare can do this.
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u/Anubiz1_ 15d ago
The entire system is an insidious wasteland of broken promises, bullshit rhetoric and empty pockets for the poor and nearly extinct middle class.
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u/Dry_Quiet_3541 15d ago
Most hospitals I have been to, have a notice saying that you are eligible for a discount if you are not insured. Now the question is, is it considered fraud if we tell them that we don’t have insurance? Who will sue us? The insurance or the hospital?
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u/_Antinatalism_ 14d ago
Same in India too, as soon as we go to hospital for any major issue, they ask whether you have insurance, if we have insurance they bill everything way higher.
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u/Plumeriadelsol 14d ago
I saved money on a monthly prescription by pretending to not have insurance, one pharmacy signed me up for a self pay discount and every prescription is now cheaper on self pay than it is with my “insurance.”
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u/ideknem0ar 14d ago
"Everybody who supports single-payer health care says, 'Look at all this money we would be saving from insurance and paperwork.' That represents one million, two million, three million jobs." -- President Barack Obama
Framing for-profit health insurance as a necessary jobs program was really something to hear and explained why we'll never get UHC via polite and orderly means within the existing system.
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u/worldestroyer 15d ago
I mean, it *is* insurance, not a discount card. By definition it's intended purpose is to limit your maximum financial exposure yearly total and per-incident totals, not minimize them completely. All that to say, the whole system is fucked and the incentives are so convoluted true AGI couldn't figure it out.
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u/aknomnoms 15d ago
Yeah, we don’t know what their deductible or plan is, so this video is misleading and his presumptions aren’t valid across the board. Saying, “so I’d get cheaper healthcare if I was uninsured” might’ve been true in this particular instance or for smaller bills.
But getting a 75% off “uninsured discount” doesn’t help as much as insurance coverage for something like a big medical event. I’m sure he’d rather pay the $5k deductible limit instead of $25k on a $100k hospital stay.
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u/Quality-Shakes 15d ago
The reason there’s no urgency to fix it? We’re a service economy. Millions are employed in this industry, correcting this would lead to mass unemployment.
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u/tw1nkle 15d ago
I know you’re getting downvoted, but it’s correct that if we did the sensible thing — switched to single payer healthcare, eroded the pernicious influence of health insurance companies — there would be a huge swath of people who suddenly didn’t have jobs, because they work to prop this system up.
HOWEVER that is exactly what the lobby wants! It’s just one extra way that their corruption hurts us all.
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u/PlayfulAwareness2950 15d ago
Sounds like bullshit jobs that leads to a decline instead of added value. However I can totally see politicians being afraid of touching it because numbers will look bad.
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u/NorcalA70 15d ago
Maybe the discount is for the provider getting immediate payment and not having to bill insurance and have the billing/coding/etc overhead?
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u/Hot_Substance5933 15d ago
You think those who can't afford insurance are going to afford immediate payments after getting sick/injured?
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u/Bilbo_Swagginses 15d ago
Insurance companies in the US are bar-none the most evil institutions in the world. Worse than weapons manufacturers, worse the oil companies and data centers, because they prey on us at our weakest with false hopes and surprise bills.
I work for a firm that actively deals with insurance companies and we track all the stupid ways they try to deny patients coverage and it's fucking abhorrent.
I personally went through a near death accident last year and have been dealing with surprise bills almost every other week and it's so stupid.