[woofyman]

I was badly bitten by a dog. The ambulance took me to a trauma center that was out-of-network. The retail cost of my 6 hour stay was $11,800. This didn’t include the ER doctor and radiologist.

My insurance covered only $2800 of the $11,800 (what they considered reasonable). I have a $7900 deductible.

Since they were out-of-network, the hospital could have billed me for the entire amount (balance billing).

Happily they reduced the charge to $1000.00

[igravious]

And you call yourself woofyman because of that? Or you always called yourself that and it's a terrible coincidence?

[woofyman]

Terrible coincidence. The upside is I’m a werewolf now.

[igravious]

That is good news. Glad things worked out for you.

[conductr]

I once paid $1000 because my wife had to basically go to the ER for an antibiotic prescription. You know, when you already know you have a upper respiratory infection, but you required to see the doctor. They wouldn’t negotiate with me. So don’t rely on this in the future.

[jilles]

As someone who moved to the US from the Netherlands, this scares me.

[chrisjc]

Don't worry. It doesn't make any difference where you're from.

[madengr]

We’ll if you are stuck with a giant bill, you can always move back. I don’t see how they would collect on it.

[CSactuary]

Under the ACA, in and out of network must have the same cost sharing for ER care. It’s the risk you run having such a high deductible plan. But I’m sure you’ve saved monthly by paying lower premiums for such a low coverage plan.

[red-indian]

You are responding to a post where he paid $7,900 for a $11,800 procedure.

Under ACA Bronze, the worst plan, his copay should have been 40%.

Is it your assertion that $7,900 is 40% of $11,800?

[CSactuary]

? When you pay a % of the allowed amount that’s called coinsurance (not a copay). This is paid after deductible in most cases. So he would owe up to his deductible ($7,900) before his coinsurance would kick in.

A minimum value ACA plan must have > 60% AV and cover the essential health benefits. The coinsurance % is irrelevant so long as it meets those requirements.

[zepolen]

This is honestly ridiculous and typical sales tactics.

In the end you're happy to pay $1000 for a 6 hour stay...

Anywhere else in the world if they tried asking $1000 for that they'd get laughed out of the room, $11,800? Heads would roll.

[woofyman]

The bite was to my abdomen so they had to do a CAT scan in case an internal organ was damaged.

My care included a tetanus shot, intravenous liquids and antibiotics.

So yes, I considered the $1000 reasonable.

The ER doctor and radiologist were in-network so I paid the insurance negotiated price.

All-in-all, the dog bite cost me $5000. The ambulance was $1800.

[ceejayoz]

My wife had a three day stay in hospital and pins surgically placed in her shattered foot while we were on vacation in Australia in the early 2000s. $700 - and that was the non-resident price.

[zepolen]

A 6 hour stay plus a few bios for $1000 is not reasonable.

For that money you can get a week's care at a premium private hospital in Europe.

An emergency ambulance costs 100 euro.

I think America has been with an extortionate health care system for so long you guys are starting to consider it 'reasonable'

It isn't.

Let me put it another way. You can fly from America to Europe three times for $1800.

[buzzerbetrayed]

Why is how many times you can fly between two places relevant to how much medical bills cost? All you did was choose a metric that makes your argument appear more reasonable, even though they are entirely unrelated.

You also seem to be arguing that Europe healthcare is cheaper and therefore better, even though it obviously is not that simple (I'm sure you know it isn't that simple. That's just how your reply comes across). For example, if I get cancer I would much rather be in the United States, despite the problems with their health care system, simply because I have a higher chance of living.

[zepolen]

Except the US has a much higher cancer mortality rate than almost all of Europe: https://www.wcrf.org/dietandcancer/cancer-trends/data-cancer...

[dtwest]

That doesn't prove anything about hospital quality.

From your source: "Around 40% of cancer cases could be prevented by reducing exposure to cancer risk factors including diet, nutrition and physical activity".

Americans live a lifestyle (fast food, less walking) that leads to a much higher risk of cancer than Europeans, the difference in mortality rate is mostly explained by this.

Another way of thinking about this, looking at your data, do you really think Australia has the worst hospitals in the world because they have the highest cancer rate?

[red-indian]

And as a critical care patient he dies during the flight. Now what.

Also, emergency last minute round trip flights to Europe are absolutely not $600 as you claim.

[floatingatoll]

The estate is billed, and the collectors do anything in their power to block inheritance until paid.

[zepolen]

I didn't claim emergency flight though, I said you can fly to Europe for less than $1800.

Also no wonder healthcare is so expensive in the US - you're actually arguing for it...

[red-indian]

Fine. Last minute round trip flights to Europe from the US are not $600. PROVE ME WRONG.

[RHSeeger]

To be fair, a $111 (100 euro) ambulance ride would not be a reasonable amount if you were paying for it outright. You're paying for the time of 2 EMTs, your share of the supplies in the ambulance, your share of the ambulance vehicle, gas. Plus you're not just paying for the time it took for your ride, you're paying for your portion of the entire day (since not all their time is utilized). Even without considering profit, that's well over $111.

The fact that you're paying 100 Euro for the trip means is subsidized. Which is great, and it should be, but don't pretend 100 Euro is a reasonable price if you're actually paying for it.

[zepolen]

No subsidy, these are for private ambulances and a result of real competition.

Using an average wage in the US to be double of Europe I'd say $200 for an ambulance ride in the US is a reasonable price.

Also an ambulance ride is like 20-30mins tops and within a day there can easily be 4-5 calls in a larger city - that's more than enough to be profitable.

[mlguy456]

Wait, are you saying that 30k/mo gross is enough to run an ambulance service?

[FireBeyond]

> You're paying for the time of 2 EMTs

For a fun little exercise, look up the average salary of an EMT.

When I did it on the side, six years ago, starting salary was $9.60/hr. (Thankfully I was doing it for experience, not a living).

[woofyman]

I considered it reasonable given our current horrible medical system.

I want a single payer system.

[zepolen]

That requires ethical people to run and heavy enforcement otherwise it turns in to a corruption fest where doctors run their own private practices in addition to state funded and waiting lists run rampant forcing you to go private.

What is needed is real competition in the health care sector - because at the moment the whole thing in America is a coalition/monopoly between insurance, pharma and health care companies with the sole intent of giving you no choice but to pay and say thank you.

[red-indian]

> where doctors run their own private practices

The supposed evil sole individual human you postulate as the source of dire evil is not the problem usually, rather the evil collective corporation or other organization calls the shots when we see these sorts of industry wide systematic abuses.

[conductr]

The sales tactic is to price things so high the insurers have not idea who is getting what discounts on what services. So the article here would actually come into play in this case