Stop pretending. It's fucking stupid. Do you agree with them? You clearly don't hence your bitchy response. If you agreed with them saying they're grossly exaggerating what the mod said, you wouldn't be saying "badass alert duuuuurrrr". If you agreed to the idea that blindly following advice online is wrong, you wouldn't have said what you said. You get on somebody's ass for objectively calling somebody out for lying. Read what the fuck you write. Or pay attention to the thread. Oh good idea right? You people are so fucking stupid. Wow.

Just imagine reading this thread and saying your main attention was on "fucking champ". Lol ok champ.(Let's see them do it again)

Fuck i laughed too hard at this. I used to be in charge of a call center and that job robbed me of all humanity. I totally made demanding requests of my employees and while i never asked them to be racist, its a hilarious play on the demanding nature of a boss’ requirements.

That phone call grants you a fresh bucket, Larry.

Yeah I had someone calling me for 2 months about paying something and I told them over and over I will not pay with bank info on the phone and to send me a paper bill...they told me they don’t do business that way so I told them they aren’t getting paid. Went on every other day for two months or so before they finally stopped calling me. Never hit my credit so they may have just been trying to scam me.

Yep, I've owed a lot of money in my life, and at this point, I ask for verification from any agency contacting me-- "for security purposes" I always say. I will NOT give them one iota of info about me, whether I'm employed, what my pay is, when I expect to pay, my address, anything-- I do not give them anything. They leave me alone pretty quick. The level of online scams has hit collection companies hard, because most of us don't even answer our phones, let alone confirm who we are.

It makes me wonder how these companies even make a profit. They must be borrowing against the promise of future payment from a population that will never be able to get out of debt.

even better is to ask for proof of the debt itself. Often they don't even have it, and therefore, can not legally collect anyway.

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This is what we mean when we say Capitalism is inhumane and unethical

The company does. The shlub on the other end of the phone probably makes Jack shit & is mad at the world his life didn’t work out the way he or she expected

Furthermore, they don't get any money until the account is closed, which is why they harass so hard to try and get you to pay it off faster.

No, the collections agency gets that money, the agents do not. The agents get a fraction of the value they produce for that company. Then again, that’s implying collections agencies actually produce any value lol

They typically buy the debt for pennies on the dollar. So if they sucker you into paying the whole bill they make bank.

Right? A lot of people seem to not realize they have leverage, at least in the conversation. They want something from you, not the other way around.

Quick question - if a collections agency says they are suspending their collecting on an account because a person is disputing it (me) — is that code for something? Wait 6 months and we’ll get back to you? Screw this, we are throwing it in the trash? I’m going on 3 months and haven’t heard anything.

Watched this YouTube video (https://youtu.be/ryTn81fJUko) that was floating around and this reminded me of something that was stated...

First off, if your ever called from an unknown number and that person asks for you or anyone you know, BEFORE you confirm you are/know that person, ask “who’s speaking?” to find out their identity before giving up your own.

With that knowledge, next time a collections agency asks for you, you tell them wrong number and hang up.

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Seems like you got lucky, I was unlucky or a combination because I had my Verizon bill sent to collections four days after paying $90 of a $240 bill. Which in turn increased my debt tenfold due to my device payments being canceled. Scumbags.

I can’t tell you the legality of it, but it’s been their practice for years and is not only the only hospital system for many rural counties, but is the largest in the state. It’s dumb but they do it 🤷🏻‍♀️

it does but no one wants to pay for it. just pointing out that costs are high because broke/uninsured get free treatment when they dont pay.

no u stupid

It's honestly fucking ridiculous someome with a ruptures appendix has to care about the morphine costing extra...

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Oh bro, I totally get what you went through! I had to finish a shift at work because my coworker wouldn't cover me. He had other plans, so I muscled through it and went to the ER aftwards/the next day. Acute appendicitis, bingo bango 14k and a surgery later I'm all fixed up and back to work a week later.

I was in the same boat and refused everything. Except the fluids as my dad told me to not be stupid. I didnt stay overnight because I didnt want to pay for a 2nd day.

Mind you I didnt rupture and they got it out in time time

how the fuck? mine was on the verge of bursting about six months ago and i could barely speak even after they whipped up the dilaudid

Sure. As I went through the hospital, a case worker met with me in my room to start the process.

People with good health insurance. If your OOPM is 2k, then you pay 2k and go on with your life.

Exactly. More meds = more money = more debt

By far the most controversial part of Obamacare was the Medicaid expansion, which not-coincidentally is also the part that does anything for the lower middle class.

...and yet they’re always the ones who fuck us all over by voting against their own interests.

This makes no sense.. there wouldn't be a middle class if you weren't in the US. The fact that you (i'm assuming) can stay middle class WHILE being fucked from all directions is testament to how great it is to be middle class in the first place. Also everyone is getting fucked from all directions, not just the middle class. It's all about perspective.

Not quite. Every band-aid is eventually paid for. Maybe not by you but by someone. Hence the $10.00 Tylenol. Niece is a Medical Biller.

Made me laugh out loud

*sigh *

It is known...

Don't have to be sorry, don't have to speculate. It's el fucko la suprema here. Unless you're independently wealthy. To be clear, anyone who's independently wealthy, cmon over because it's titties and beer here if you don't ever have to worry about money.

Been broken for a long time. We can have the ultimate healthcare system but when it comes to the next global crisis, North Korea, burning oil fields, we would have to sit it out and let Canada, Sweden, Australia and Wales have a go at it. War is big business for us and unfortunately, this is where our medical dollars always go.

Think?

Well...they are. We have a couple small advantages over them--speed is sometimes one of them, but not reliably so.

Yep

Not necessarily if you're single without dependents. Federal Poverty Level is $12,490* for a single person household. Minimum Wage with full time (40h) employment (could be from more than one job) is $15k, meaning you're still stuck out-of-pocket. The extended parental-coverage window is generally going to be more helpful than Medicaid for these people, and even then it relies on you having a good relationship with your parents, which is not assured.

*Technically that's Adjusted income, but if you're under the poverty level you're probably not itemizing deductions.

not currently no, but just 3 years ago you were in a constitutional crisis heading for a dictatorship and eviction from the EU: https://en.wikipedia.org/wiki/2015_Polish_Constitutional_Court_crisis

We used to think we didn't have that risk here either

Not sure where you live, but I've had to wait somewhat absurd times to get both routine healthcare, mental healthcare and urgent healthcare (biopsies, etc.).

We shouldnt have to wait, given what we pay. But the only time I routinely have luck with not waiting is late December, when the people who are trying to cram their care into a year in which theyve met their deductible have already been seen, and all the people who got nowhere near are delaying even serious procedures til after Jan 1.

You're a bit off base...

I have fantastic insurance and I still wait a month or so to see a specialist. I'm in the United States, for the record.

Medicaid/Medicare also absolutely have waitlists, because the issue isn't source of payment but availability of providers.

You ignorant europoors are adorable :)

And trashy Americans like you make the rest of us look bad.

Go spread your nationalist bullshit somewhere else.

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Lmao it sounds like you have no idea about American private insurance or Medicaid... 3 month wait to see a specialist(with Bluecross/Blueshield silver plan) or find the one specialist who takes Medicaid in the county, and wait 4 months(since again only specialist takes medicaid) and drive 50 miles(once again, only specialist...) to go to poor doctor.

Also it's funny you ignore the Dane who said "yeah ours really isn't that bad," but still call him "Europoors?" You've gotta be a troll...

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Oh boo-hoo.

(i.e. having a government official dictate what you can/cannot get for treatment).

You mean.. having a corporation dictate what you can/cannot get for treatment.

Citizens have no power to change corporate policy, but citizens have the power to change government policy. It's very obvious which is better. (Hint: It's the one we the people control.)

there's no guarantee you will personally be able to get said treatment

Preposterous claim. Private insurers frequently deny legitimate claims, because they know the patient probably won't live long enough to see the completion of a civil suit.

You can add up all the "socialized medicine" countries together...the amount of expenditure on development of new drugs still doesn't match the US.

And this matters why?

They pay less for the identical American made drugs that we pay more for. They pay LESS than us. Think about that. Whatever they're doing, they're doing it a lot better than us.

Just a point if you put > in front of the line

it makes it like this so its easier to distinguish the quotes from your points.

.

having a government official dictate what you can/cannot get for treatment

Yeh except almost all treatments are still available as the Doctors and hospitals don't have to worry about money and just give you the best option no matter what.

Also, Private is still an option. Very few countries disallow private healthcare.

the amount of expenditure on development of new drugs still doesn't match the US.

How much of that is actually valuable though? How much of that "research" is just changing the medication slightly so it renews the patents?

Either way, theres no reason you have to stop doing that R&D afterwards. How about your government puts the extra you spend on healthcare comparatively into health research...

https://www.bbc.co.uk/news/uk-42950587

So Uk spends $2892 Per person per year Thats 190 Billion Dollars.

US spends $7617 dollars per person per year so thats 2.4 Trillion if you cut your spending to UK levels thats 924 billion so you'd have 1.4 trillion dollars to either improve your healthcare and/or increase research funding.

We still have private healthcare as well. So if the NHS doesn't cover it or we can go private for relatively cheap also. The NHS covers pretty much everything bar cosmetic. It's honestly the best thing the UK has done post-WWII.

However, there are consequences to availability of treatment options (i.e. having a government official dictate what you can/cannot get for treatment)...so while your government may be able to procure the drugs for less, there's no guarantee you will personally be able to get said treatment, either.

As opposed to some random executive at Cigna or Aetna when designing the plan for my employer. The incentive argument for development also breaks down when you run into patent shelving and evergreening.

So as opposed to a government official, who is neutral in deciding for your care - you would prefer a for-profit insurance company deciding whether to pay for your care? The for-profit insurance company is incentivized to decline your care and will try as much as possible to enhance their bottom-line.

I don't get your point here. You can always elect to pay for your care in either case, even if the govt or the insurance company decline your care.

So you'd rather have an insurance company make that choice knowing that they get to keep any of the money you've paid in and not used?

We are already the World Police. We shouldn't be on the hook for being the World Researchers, too.

Nice 27 dislikes tard

Yes we do have great coverage, she works for the local sheriffs office. Can't complain at all.
Maybe I phrased it incorrectly, but we didn't spend anything over her out-of-pocket maximum for the year.
We sat down and looked through our bank records, the bills and it all totaled up perfectly to $2500.

Her insurance has a $300 emergency room copay +30% coinsurance, childbirth is deductible + 30% coinsurance.
She went to the emergency 3 times and this is what her deductible shows:

You have spent $137.56 towards your In Network Individual deductible of $300.00

Yet the out-of-pocket maximum is capped :

You have spent $2500.00 towards your In Network Individual Out-of-Pocket Maximum of $2500.00

So you being an insurance biller might understand why her deductible is not maxed out and the out-of-pocket maximum is? I'm not complaining as financially it's better for us but it's still kinda weird right?

That's not how deductibles work. Unless the total bill was less than $2500, you have to pay the full deductible and insurance covers the rest.

I do think this post is directed to those that don't have great insurance, though

No, the $2500 is an annual maximum of what we have to pay for covered services.
Any covered service after that amount is covered 100% by our insurance.

Hospital bill for delivery was around $27000, her doctors delivery bill about $7000, 3 emergency visits over $5000 each.
After "member discounts" (basically for having insurance lol) all bills were roughly halved.
So "member responsibility" would have been around $25000. Using /u/MrRabinowitz example we could have theoretically gotten that down to around $12500.

However, due to our out of pocket maximum being $2500, we would never spend a penny over that unless there is an out-of-network or non-covered service being performed.
The $27000 hospital bill we literally paid $0 because her out-of-pocket maximum had already maxed out at that point due to the emergency visits earlier on in the pregnancy.
Like /u/chrissyv54 says, this post is more towards those that either don't have insurance or crappy insurance.
And as some people have pointed out in this thread (who work in billing apparently) this LPT isn't even accurate in most cases.

It's doubtful they tacked your wifes bills onto your daughters.
Our son had some bills too, but those were only related to the services rendered on him such as lab work and a few hours in the NICU due to complications following shoulder dystocia.

Your source says that less than 5 percent of American citizens struggle to eat a complete diet year-round, and will be forced to eat less food as a result. Meanwhile another 6% are forced to modify their eating habits in order to still get the nutrients they need. This means that slightly more than 10% of Americans are so affected by poverty that they are forced to modify their eating habits (although starvation in the US is so rare that I literally could not find a statistic after ten minutes of googling). That is a considerable number of people.

However, that does not mean that a majority (or even a large minority) of Americans are incapable of feeding themselves or their families. That means that a minority of Americans struggle to feed themselves for part of the year. Those are two very different things. There is a world of difference between occasionally skipping lunch because you can't afford it (as awful as that might seem to many an American or European) and suffering from chronic malnourishment. One of those things involves mild discomfort and embarrasment, the other involves the genuine threat of death.

Never said good, said not low income. It's not poverty. Not even close.

And that would surprise you? Look at you with all the effort you put into your comment with evidence to prove me wrong.

This is messed up. Wealthiest most developed nation in the world...

There is an element of hatred of the poor that is surprising in its intensity and outright frontality.

the money does not go to healthcare, it goes to insurance companies, HMO's, and office workers.

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It's not just maternal mortality though: https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-amenable-mortality-measured-by-healthcare-access-and-quality-index-2016

Also: not sure why a woman dying from a c-section is any better than one dying from natural childbirth.

The worst part, however, is the fact that if you have a 20% copay in this scenario you're going to pay that whole $900 and the insurance is on the hook for $0. If this isn't a scam I don't know what is.

Healthcare provider here. I do vaguely recall there being a rule about having to file with insurance if patient does have insurance. Hospitals seem to be the only places where this is actually sometimes potentially relevant, so it hasn't come up for me personally. I need to look into this more, admittedly.

Ah! Good to know!

The way my therapist was talking about it made it sound like it was fraud (and the version we went with was the least fraudulent) so good to know there was a misunderstanding.

hospitals can be little more hectic and you dont want Drs and nurses to have to scan everything in an emergency, or have to try and go back and remember to scan them after.

I think the majority of the issues come from HIPPA and thats why no one has tried to use a technology solution, hospital data has a butt load of regulations.

When my daughter was born, everything had a barcode and was scanned. No one ever mentioned what was going on until I put 2 and 2 together (I didn’t think this particular hospital was that tech savvy).

Btw, 2 and 2 equals 12,000.

Piedmont hospital in Atlanta just scans barcodes on everything. All of my pills come in a pill per packet, all drug IVs, everything. They scan my wristband, scan the medication, and dispense it into a cup for me to take. The one time there was a med not meant for me? The scanner notified the nurse. (It was another patients pill). Same thing happened when I was almost given a med early.

My tests are labeled with my individual barcode that matches my wristband as well right at blood draw. Saves time, automatically charts, keeps chain of custody, sets up billing, and allows my main doc to keep tabs on everything I’ve been given. I’m shocked more hospitals aren’t using this??

I saw that used once at a hospital don't remember where. They scanned my hospital band and whatever they were giving me. It's probably much easier for records to know what has low stock and such

The government has more negotiating power than Joe Shmoe who's dying and needs medical care now.

No one wants to say it, but hospitals are price gouging people who are in desperate straits. They aren't the paragons of goodness that they pretend to be.

All single payer does is change who pays for your bill (everyone), not how much is being charged.

You don't know what you're talking about. It provides the single insurance provider a tremendous amount of bargaining power to negotiate prices down to a reasonable level. There's a reason why countries with these systems pay 1/2 to 1/3 the amount per capita that we in the states do.

You're definitely right. It has more to do with immediate skin to skin, rather than total-stay time. It's the period of time between birth and the lot of medical examinations. There's definitely a cap time on it, but yeah, it's extortion.

It's probably not just $40 a minute for that one extra nurse. It's $40 a minute for that extra nurse as well as for the extra time in the delivery room with all the doctor(s), nurses, and hospital staff that are just standing around twiddling their thumbs while mom and baby's skin-to-skin is going on.

I'm not defending the charge. I'm just trying to figure out their justification for the accounting.

Plus there is usually no need for supervision

I think the thing is that you can't always know when there isn't a need for supervision, and the consequences for being wrong can be absolutely dire.

One explanation, that I've heard, is that the $40 charge is for after c-sections when mothers are usually nauseous, disoriented, and need assistance with their baby so the extra nurse is actually needed to help assist the mother.

Plus there is usually no need for supervision

Immediately after the birth, when mom is still anesthetized and likely quite groggy (especially for a C-section) and baby has just taken their first breaths and may develop problems adjusting, it would be incredibly negligent to not supervise.

I am a vehement opponent to the cost of healthcare in this country, and especially the insurance companies' hands in creating this system, but the argument that supervision isn't really required is very uninformed. Medical staff constantly have 100 things on their plate and they aren't going to decide to stand around to milk money out of a patient. Now I realize it may not be a personal decision; policy may dictate they stick around. But that policy is sound.

Plus there is usually no need for supervision

Babies that were just born need to more observation than being held by the woman that just birthed them. The room is so busy and emotional that nobody is paying attention to the baby's airway. We've had babies become completely apneic without anybody noticing, because Mom was getting sutures for her laceration and nobody was watching baby get smothered in her gown and blanket.

The first few minutes after birth is a crucial time period, and disasters can happen if you're not watching.

What a person gets paid is always inherently lower than the actual value contributed by their work, otherwise capitalism doesn't work. The capitalist owns the means of production, meaning that their employees will always get paid less than the value of their services, otherwise there would be no profit for the capitalist.

That's a problem (not informing patient until bill arrives), but I think another problem is that they are actually getting charged for that.

Yeah , while I still can!

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Let’s assume you’re correct. In what world can a hospital charge out their nurse, who is being paid MAYBE $20 an hour (being generous) at $2400 an hour, without ASKING FOR CONSENT FOR THE CHARGE AND/OR SERVICE, and that be reasonable? It’s absolutely absurd.

Any court in any decent country would throw that charge out immediately.

Enjoy the film everyone, here we are

My "not for profit" hospital is building a specialty clinic on every corner in town and the CEO is inching toward a cool million a years.

No hospital can operate "not for profit" in the privatized US health care system

I agree.

If it's meaningless then why doesn't every major corporation restructure as a non-profit?

For nonprofits , I've heard of using a foundation as an intermediary between the cash cow non-profit and other entities. Money can pass back and forth, I believe, or even stay within the foundation. I don't understand it as a non-accountant and I'd venture to say few accountants understand it either. It reminds me of the practice at the top of the housing market where homebuilders set up charities to help people make the down payments on their homes (5-10%) - they were making so much money off the sale of the home that the 5-10% they lost was just cost of doing business.

Agreed. Votes matter.

You're confusing some terms here. Coinsurance is your percentage of the bill (20%, 30%, 50%, whatever it is). There is no part of the coinsurance that is the insurance company's responsibility - that is all the patient.

I'm not entirely sure exactly what you're asking, but here's how it basically works. Doctor's office bills (for example) $100 for a service. Insurance Company A's contracted rate for that service is let's say $60. So they take a $40 write-off before anything else happens - that is $40 that no one is paying. Then let's say the plan provisions say the patient is responsible for a 20% coinsurance. You would pay $12 (of the $60 - we call this $60 the "allowable charge"), and the insurance company would pay $48. All of this is assuming you haven't met your OOP max yet.

Insurance Company B may have a contracted rate (allowable charge) of $75 for that same service, and maybe their patient is responsible for a different coinsurance amount. It all varies based on the company and the plan.

tbf, a significant part of the reason why so many countries are able to be run in the way that Canada is is that the US Navy is there to prevent piracy in most major shipping lanes. People seem to underestimate just how important military force is for protecting global trade, but if the US weren't footing the bill, everybody else would have to up their military spending or suffer serious hits to their economies due to more dangerous international trade.

edit: not saying this situation is ideal, just that it makes perfect sense if you take a step back and actually look at all of the factors.

i believe we tried 🤦🏽‍♂️

I moved before the 15 mos date of surgery arrived, so never had it done.

Very much this, but God I don't mind paying taxes and waiting if it means my family doesn't go broke when something is seriously wrong. I had to wait in the hospital for 6 hours when I thought I broke my ankle and it was only a sprain, it probably would have been less if I had screamed as much as the lady in the next room. But, when we found out I had a brain tumour and required surgery to relieve the pressure in my head, the only waiting was the time it took us to drive to the city with the specialists.

And, after 4 days in the hospital and a surgery, there was no half million dollar bill waiting for us after.

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It's cheaper (overall) mostly because Americans are generally unhealthier, use less preventative care, and use more expensive healthcare (and/or more of it). The per capital cost of healthcare has little to do with the payment structure from what I've read in the past from healthcare economists.

The reason to support universal healthcare is because poor and often middle class people can't afford those costs, but the collective funds of everyone can. All I push back against is the idea that other OECD countries do this through straight single payer. Most do not. Obamacare, if the mandate had been stronger and the public option had made it through, would have been roughly equivalent universal coverage to most continental European countries like Switzerland or Germany

I mean I don't care that much between single and multi payer in a vacuum, I just think for America going to multipayer universal would be much easier. Easier is better for me since there's not much reason to care one way or the other, doubly true since people are going bankrupt right now

I think you are just really wrong about how much things costs at the hospital and how much time is spent.

For example, 5 minute physician time may actually be 20 minutes because of back end duties like record taking, making the order, consultation, etc. I don't know about hospitals, but at an average engineering firm the cost of labor is easily 2x to 3x the actual salary of the person when burdened. And you aren't counting any costs of things you simply don't know about (culture may have hazardous waste disposal costs for example). Not to mention that all these things include the cost of rent on the building, lights, administrative staff, etc.

So I'd bet that the actual costs of the thing you are talking about is quite a bit higher than you are estimating. Add on to that it was an ER visit. You and your wife paid the bill. Some people don't or can't. You are also paying for those costs.

You can check for your specific hospital, but in general, hospitals are not swimming in cash. Median operating margins for non-profit hospitals is around 2%. Primary cause of reduced margins? Drug costs and labor costs. Primary labor costs for a hospital? Mostly drs and nurses, admin staff usuall less so.

Your bill was high because hospitals are expensive to run. They are expensive to run mostly because drugs costs to much, Drs and nurses get paid too much, and payments are overly complicated. But the hospital isn't getting rich in most cases.

It is fine to get mad about high prices in healthcare, but let's not pretend hospitals are soaking us. They are passing their costs on to the customers as required to stay in business. Just like burger king. Except burger king as operating margins between 20% and 50%.

"Imagine getting a restaurant bill"

Okay, its kinda like how a restaurant "costs" are about 12 cents for a glass of coke and then 3.50 on the menu for a 2916% increase...

Sorry, what? You were spitting Doritos everywhere.

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Yup, that's about it. It's an 'unsecured' debt meaning it's not tied to any asset other than your credit score really. It's the same tactic many use when in loads of credit card debt.... Have 20K in cc debt? You can pay the minimum payment for decades OR just stop paying... give it some time... eventually it'll go to collections and you can pay off for pennies on the dollar... at the expense of your credit score but most don't care at that point. What's more important, your cash or your credit? No brainer for most.

It will impact your credit scores but, on their own, medical collections rarely, if ever, would impact your ability to get a mortgage.

This should be a national scandal.

Kinda shitty how you're getting punished for something you don't really have control of.

Is it an ongoing issue still for you? Double check that the collections information actually matches the debt in question.

I had a scan done a few years back that was pre-approved as preventative care for 100% coverage with both the hospital and insurance company, which the "care group" billing dept then refused to bill as preventative (because, according to one rep, my grandmother had once had breast cancer and therefore I was disqualified from preventative cancer screenings). After I had already paid $600 for the "100% covered scan", I got a third bill for the use of the room for the scan (I had already paid one from the hospital and one from the care group) for about $120. While I was disputing the bill, someone sent it on to collections. Who reported it to the credit bureaus, and then bumped the date up to the current year. I filed a dispute, they were unable to verify the debt, and it dropped of my credit.