What is it that does cost $5k? Keeping a mostly-unused tomography machine and crew ready in case someone at the ER needs it? Insurance premiums charged per patient who walks in the door?
We get these complaints in Germany too (where I currently live) BTW. "A five-minute drive with an ambulance shouldn't cost €500!" someone complained to the newspaper here recently. It doesn't, what costs €500 is keeping enough ambulances ready that one can arrive within x minutes with y% probability, for IMO overcautious values of x and y.
€500 is still something many people can pay in Germany, 5k isn't something the average American can foot (with no treatment to boot). It's not at all a comparable complaint.
IIRC an ambulance ride in the US is 10-20k, that's indicative of just how much more medical care costs over there.
I have never heard of an ambulance ride costing anywhere _near_ $10K-$20K. The average, out-of-pocket price of an ambulance ride is much closer to $1000 - and often less. New York's 2012 fee schedule offers a good example: https://www1.nyc.gov/assets/fdny/downloads/pdf/about/fee-sch...
Sure, there's an extra digit. Much US healthcare seems to suffer from Extra Digit Syndrome.
What might be similar that the billable item is not the costly item. Of course I don't know the first thing about US health care costs (as opposed to billable items).
> a mostly-unused tomography machine and crew ready in case someone at the ER needs it
No hospital administration would allow this: they would refer you to a separate medical imaging clinic, or run one on hospital grounds that all departments would refer patients to.
eh in germany driving the ambulance is free - if you really need one. of course there are people who call the ambulance without too much reasons and even than as long as the amublance doctor will allow you to take the drive to the hospital you would still be on the safe side.
Some of the PKV companies offer cheapish plans that effectively do not, or that make you pay the first €x00/month yourself. Things like that. They're marketed as insurance against big problems for a small price.
As far as I know, point of the exorbitant fees is the weird process of collective bargaining between the care-providers and insurers.
I.e. you, as the hospital, inflate your price, by X00% margin over what you actually plan to charge the insurance. Then you let the insurance negotiators negotiate, and you negotiate down to the reasonable price.
This looks really good on the paper. Unfortunately, you as a patient, if you don't have good coverage, you end up paying the inflated price, that you didn't really have the chance of negotiating (and wouldn't really have the chance even if you hadn't been unconcious ;)
Like, if I compare it to Czech Republic, where I live (or even Germany), the prices seem much more reasonable (i.e. you would be able to get a complication-free birth in hospital for ~400$, more complicated, i.e. cesarean section ~1500$, including hospital stay, in US it seem to be 5-10x as much)
> that you didn't really have the chance of negotiating
Not American, but from what I've read in these types of news articles, you often CAN negotiate it down a lot, but when you get a huge bill in the mail, the first thing you think isn't "I'm going to try to haggle down my $5000 bill with this huge hospital" you think "I'm so screwed. Time to google 'personal bankruptcy', was it 7 years?". Pharmaceutical companies are also always saying that they will subsidize prescription medications for those who can't afford it, but I dunno how much that is BS or not.
Oh, good to know. From the horror stories you usually read in the news it seemed that "try to haggle down my $5000 bill with this huge hospital" is something you just don't get to do, if you are a patient, I will remember that if that ever comes up (even though I hope it doesn't :)
If you use insurance they are less willing to negotiate.
(but you are getting the negotiated price anyway; the paranoid part of my brain thinks they run a scam here by recoding bills that come after the deductible has been met, which is a different sort of negotiation than agreeing on prices for services)
I wonder what the result would be of the US government requiring all hospitals to have a public, fixed, non-negotiable price list the same for all insured and uninsured.
We get these complaints in Germany too (where I currently live) BTW. "A five-minute drive with an ambulance shouldn't cost €500!" someone complained to the newspaper here recently. It doesn't, what costs €500 is keeping enough ambulances ready that one can arrive within x minutes with y% probability, for IMO overcautious values of x and y.