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The $23,000 bug bite

sgtbaker said:
That's fine, like I said, I wouldn't even call the US healthcare system satisfactory, in terms of meeting the needs of it's citizens. Hell, people with insurance still die because they don't always cover the cost of expensive but life saving treatments. The only point I was making was that there is no need to resort to being dishonest about how the system works.
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Who was being dishonest about the way the system, such as it is, works?
 
sgtbaker said:
I think the bankruptcy or death is a bit misleading. The American Healthcare system isn't perfect, it isn't even satisfactory but I have never been turned away from an emergency room, even in nonlife threatening situations, because I couldn't write a check, on the spot. My other experiences with not having insurance include a) never paying what they would charge an insurance company. When I gave birth to my first daughter, the cost of uninsured is almost half of what is charged to the insurance company by both the OB and the hospital. B) As long as you keep an open line of communication with the hospital, they are willing to accept payments of what you can afford to pay, monthly.
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Well I can at least agree with you on the “never paying what they would charge an insurance company.” part, sgtbaker. One of the medications I’m on can do quite nasty things to ones liver. So every three months I get a series of blood tests to ensure things are still working as expected. Without insurance these tests cost me about $87. However the same provider charges my insurance company $367 for these tests. My insurance company, in its diligence for me and others, has set a maximum fee (by negotiation with the provider) they will pay for this service at about $190. This leaves me with a co-pay of about $33 every quarter for these tests. Still less then I’d pay uninsured but even the negotiated minimum the insurance company pays is twice what I would have to pay without insurance. What a mess.
 
The Man said:
Well I can at least agree with you on the “never paying what they would charge an insurance company.” part, sgtbaker. One of the medications I’m on can do quite nasty things to ones liver. So every three months I get a series of blood tests to ensure things are still working as expected. Without insurance these tests cost me about $87. However the same provider charges my insurance company $367 for these tests. My insurance company, in its diligence for me and others, has set a maximum fee (by negotiation with the provider) they will pay for this service at about $190. This leaves me with a co-pay of about $33 every quarter for these tests. Still less then I’d pay uninsured but even the negotiated minimum the insurance company pays is twice what I would have to pay without insurance. What a mess.
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Hiuh? Usually it's the exact opposite, insurance companies pay less than uninsured individuals do for the same treatment.

eta: And I'm not making any sense of your math, $190 + $33 does not equal $367.
 
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Sorry I can’t speak to “usually” just this one particular set of tests that agreed with what sgtbaker was saying about the prices insurance companies are charged. As to the math, the insurance company negotiates a maximum fee they will pay for the service, about $190 in this case. Based on that fee my co-pay is around $33 (paid directly to the provider) leaving $157 paid by the insurance to the provider. The $367 is what the provider would bill the insurance company without the negotiated maximum. It all comes as an explanation of benefits with big bold letters saying the insurance company has saved me “92%” from what the provider would have charged (the $367) when actually it is just like 60% from what I was paying without insurance. It’s just a song and dance and that’s about the only way it really adds up. They bill the insurance companies way more but the company has negotiated a lower maximum for the service that still was more then I paid without insurance.


ETA:
As for the most expensive drug I take ($1500 a month) the cost (billed to to the insurance company) with the issuance of the old company, the new and what I paid when I was uninsured are all comparable with some slight increase over the past few years.

Also when I was first uninsured and due for the blood tests I called around the area for how much the two major labs would charge without insurance for those tests. I went with the lower cost one (same one I’m still using with the insurance) while the higher cost one was a bit closer (like $120 if I remember correctly) to but still lower than the current stated insurance negotiated maximum for those tests.
 
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Aepervius said:
Replace the child by an adult being bitten by a bug if you prefer. The reasonning would be the same without SCHIP.
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Happened to a friend of mine who is a self-employed dog walker about 8 weeks ago. Small insect bite on her thigh on a Wednesday afternoon, felt "fluey" on Friday, rushed to high dependency unit Saturday afternoon after going to A&E, developed septicaemia and it was touch and go for a week whether she would lose her leg. Thankfully she didn't but they did have to remove a lot of muscle from her thigh and there was talk about her needing skin grafts. Thankfully she is back working again, but still having physiotherapy and regular check-ups. Total cost to her at the point of need = £0.

Obviously she has lost a lot of income because she couldn't work but she didn't have the added stress of wondering how she would pay for her treatment. And all from one insect bite.


(The current government is currently making changes to our NHS that will significantly reduce our coverage. :( )
 
Cain said:
Yeah, that's a great idea. Let's just turn over a huge part of our economy to government health-care. No, sorry. I can think of nothing more apropos than the phrase "better dead than Red."
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For everything that your government provides you? Or just healt care? Are you happy to be red in respect to say, a fire service? Or the police and security services? Or any number of thousands of things that are funded from taxes. Are you going to give all of those up?
 
Jarlaxle said:
I suspect London is one of those places!
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I suspect gross ignorance on your part.

As this is a place of evidence and critical thinking, then I'd ask you to present a little of both to show where you came up with that statement.
 
Jarlaxle said:
I suspect London is one of those places!
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Having lived and worked close to London for many years, I can say you absolutely suspect wrong. London has several of the largest and highest-quality teaching hospitals in Britain, which means in the world. They are literally world famous. You could maybe google "Great Ormond Street". And they're all absolutely free at the point of delivery.

Here's a thought. If you are rich, in London, and considering having private medical or surgical treatment in a swanky private hospital, do you know how you find out who the best surgeon is, to make sure you get the best? You ask what his NHS job is. You make sure you get someone who is a senior consultant at one of the best NHS hospitals, then you go to his Harley Street private consulting rooms and see him there. He'll attend to you wearing a Savile Row suit, and book you into the Cromwell or one of the other private hospitals, and you can have your hip replacement or whatever in luxurious style, and he'll charge you a lot of money.

Then he'll change out of the Savile Row suit and go to his day job at Charing Cross or St. Thomas's or somewhere, and do the same operation on Joe Bloggs the Heathrow baggage handler. Who will pay not a penny.

And in the event of something going horribly wrong with your swanky private surgery in the swanky private clinic, an NHS ambulance will be called to rush you to the NHS teaching hospital for emergency and intensive care. Because that's where the expertise and facilities are. And if you're a British resident, you won't pay a penny for that either.

Rolfe.
 
dirtywick said:
You're reading things into my statement that aren't there.
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Just because that amount of debt wouldn't bankrupt you, you fail utterly to put yourself in the place of someone who would be bankrupted by that amount of debt.

'It's not a lot of money to me, therefore it's not a lot of money to anyone.'

It would bankrupt me pretty easily.

I think you're lacking empathy for those less well off than yourself, what's your explanation?
 
3point14 said:
Wow.

No, really, just wow.

Not big on the whole empathy thing, huh?
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Come on - you'd have to be totally feckless and irresponsible if you don't have the odd $25,000 tucked away! And why should everyone else* have to pay out just because you are feckless?




(*Note: Argument doesn't apply to pooling risk through purchasing insurance because that's different!!)
 
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Rolfe said:
Having lived and worked close to London for many years, I can say you absolutely suspect wrong. London has several of the largest and highest-quality teaching hospitals in Britain, which means in the world. ...snip...
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You mean the socialist-liberal-fascist health nazis force people at gun point to use unqualified medical professionals. Plus of course the old saying "..those who can't teach".

(I think I'm getting the hang of this.)
 
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dirtywick said:
You're reading things into my statement that aren't there.
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Please explain how a family with crappy income that doesn't provide health insurance, living in rented housing because they can't afford to buy, running a beat up car because they can't afford a new one, finds $25,000 to pay a medical bill, and how it doesn't bankrupt them.

Please, I'd love to hear this.
 
Rolfe said:
Having lived and worked close to London for many years, I can say you absolutely suspect wrong. London has several of the largest and highest-quality teaching hospitals in Britain, which means in the world. They are literally world famous. You could maybe google "Great Ormond Street". And they're all absolutely free at the point of delivery.

Here's a thought. If you are rich, in London, and considering having private medical or surgical treatment in a swanky private hospital, do you know how you find out who the best surgeon is, to make sure you get the best? You ask what his NHS job is. You make sure you get someone who is a senior consultant at one of the best NHS hospitals, then you go to his Harley Street private consulting rooms and see him there. He'll attend to you wearing a Savile Row suit, and book you into the Cromwell or one of the other private hospitals, and you can have your hip replacement or whatever in luxurious style, and he'll charge you a lot of money.

Then he'll change out of the Savile Row suit and go to his day job at Charing Cross or St. Thomas's or somewhere, and do the same operation on Joe Bloggs the Heathrow baggage handler. Who will pay not a penny.

And in the event of something going horribly wrong with your swanky private surgery in the swanky private clinic, an NHS ambulance will be called to rush you to the NHS teaching hospital for emergency and intensive care. Because that's where the expertise and facilities are. And if you're a British resident, you won't pay a penny for that either.

Rolfe.
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This. Especially the bolded bit. Of the 21 NHS hospital trusts with the lowest mortality rates, 14 of them are in London. [Linky]

If you're in the UK and in a bad way medically, you want to be in London.
 
wollery said:
Please explain how a family with crappy income that doesn't provide health insurance, living in rented housing because they can't afford to buy, running a beat up car because they can't afford a new one, finds $25,000 to pay a medical bill, and how it doesn't bankrupt them.

Please, I'd love to hear this.
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You don't even need to go that far. I'm earning a little over $50k a year, I have a nice car, but it's 17 years old now (a 1995 Toyota Corolla) so isn't worth more than a few thousand if I am lucky. I am renting, though I probably could afford to be paying a Mortgauge, though even if I was, I might not have the equity in it to afford to get a further loan of $25k. A bill of $25,000 would bankrupt me easy.
 
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