[mercutio2]

In the US, patients should go to urgent care for minor health issues that are unlikely to require a fully outfitted trauma and surgical unit. Conveniently, they’re also much easier to get to in urban areas.

Urgent care would have had something closer to a $100 markup than $2,000, because you’re only paying for a few nurses and doctors to be on call, not for having used the resources that are meant for trauma and acute crises.

That hospitals are required make up fictitious itemized explanations for their very real costs is indeed broken, but it’s a very small part of the overall issue.

If you called the hospital billing department and offered 20% of the overall bill, they would likely have immediately accepted; uninsured hospital billing has expected value on the order of 10% of outstanding balances, so if you give them more than they can get from sending you to collections, they’re usually happy to compromise much more steeply than the 60% “discount” they offered you.

[amluto]

You mean how the Bay Area, which is fairly urban, has precious few urgent care clinics open until 10 pm and, I believe, literally none open after 10pm? I went to one of these urgent care clinics once and got charged $650 for about 5 minutes of doctor time and a single DermaBond stick. The latter costs something like $20.

Oh yeah, I asked how much I would be charged before the doc saw me and they refused to answer.

$100 markup my arse.

[uberduber]

In LA, Hispanic neighborhoods have 24 hour urgent cares but the doctor quality is all over the place though usually bad.

Urgent cares used to be pretty upfront. I went to an urgent care a couple of years ago, $99 advertised in the window. I go in, fill out all the paperwork and they tell me it's going to be $150. When I point to the window, she says it's expired. I start to walk out and she tells me to come back and gives me price. This is not the only time I've had to walk out over various health things, it's ridiculous. They think you won't do it because you're ill and act that getting angry over this is some sort of insane response. So now I just pretend not to have the extra money.

Anyway, I use Heal now. So happy that the VCs are funding this, hope it lasts.

[stuff4ben]

You went to the doctor for a bandaid? Seriously? Could you not apply said bandaid yourself? Why would you waste a doctors time and your money for that?

[jacquesm]

I don't like the tone of your comment at all. It's very well possible for a person to end up in the hospital where the right treatment is to 'stick a bandaid on' on one end of the treatment spectrum and a much more invasive or complex procedure on the other when going in with roughly the same symptoms.

For instance, if you work a lot with tools and dirt then there is a fine line between blood poisoning and a mere scratch, they will both start out the same but you won't be able to tell what's in your bloodstream until it is too late if you're going by symptoms alone. By the time the choice is amputation above or below the knee or you've gone into septic shock you've lost the window where you might have been ok. More people die from this stuff than from heart attacks or strokes.

So in some cases, when the exact contaminant is not known it can be a good decision to go to the hospital to have something looked at, and it shouldn't cost an arm and a leg (pun unfortunately not intended) to do so.

Nobody goes to the hospital for fun except for a very few individuals that have something wrong with their heads rather than with their bodies, and that's before we get into things like people with compromised immune systems.

[amluto]

DermaBond is not a bandaid. I personally did not have a container of sterile saline, a pack of sterile gauze, a DermaBond cartridge, and the expertise to evaluate exactly what was needed.

And yes, I have bandaids.

[borkt]

Agreed and the real costs support major bloat. A friend of a friend who's previous job was a phone salesperson for a small, local sign shop got a job in the sales department for hospital software. Within months she was being flown across the country to the companies headquarters monthly and traveling around selling a product she clearly had no understanding of but was following the pitch which was taught to her. Not that she isn't a great person, but I cannot think of another industry where I've seen so many resources going to an entry level, zero experience position that could be handled locally or even remotely rather than sending this person out and paying for nicer hotel rooms than my friend who is a major airline captain stays in.

[heavyset_go]

Outside of large cities, urgent care facilities operate on the standard 9-5 and are very selective when it comes to which insurance plans they take.

It's entirely possible that you're insured, but no facility within an hour's drive will take your plan, and if your kid becomes ill outside of business hours, tough luck. For liability reasons, they'll refer you to the ER anyway if you have symptoms beyond a sore throat.

The last time I had to go to an urgent care clinic in a state where no one took my insurance plan, I had to pay $700 out of pocket to talk with a doctor for 10 minutes and get prescribed a z-pack. I then paid $90 for 6 pills at the pharmacy.

[nytesky]

In theory urgent care would be useful, but for anything non-obvious you have to go to ER. Abdominal pain? ER. Head injury? Dislocation requiring pain management? ER.

Urgent care can get you antibiotics and test for strep, and I think x-ray and set simple fractures, and stitches of course. What else is within their scope, I find it fairly limited.

[isostatic]

> In the US, patients should go to urgent care for minor health issues that are unlikely to require a fully outfitted trauma and surgical unit

Just looked up the one near to my hotel. Closes 6PM. Not much use at 2330.

[mercutio2]

If your symptoms are acute enough that you really can’t wait until the morning, then yes, you’re going to pay for access to round the clock in person medical professionals in the US.