[geoduck14]

Let me give you a comparison from my personal experience.

My wife was pregnant. The hospital she chose to give birth in specialized in giving birth. Our health plan was administered by a large company, and was used by over 10k employees at our company.

During the pregnancy, I tried multiple times to determine how much the pregnancy would cost. Neither the hospital nor the insurance could tell me any estimate for the cost. I had no way to price shop or save or budget. I was completely at the whims of the hospital and insurance.

Also. They over charged me for at least one procedure.

[peter422]

My wife gave birth at a hospital in our network, but our daughter needed ICU care (in their opinion). We were given no choice in the matter and our child was taken to the ICU. And surprise, surprise, the ICU doctor we had no choice in selecting was not in network, and a low 5-figure bill was racked up for care we didn't really want and our child almost certainly didn't need. Also a very difficult thing to fight when you've got a newborn.

[Freak_NL]

Man, that kind of experience would really make me lose faith in society. My wife needed a caesarian and was rushed to the operating theatre, but at no point was there any thought about cost — I just trusted that the doctors knew their business (and they did). It's so completely natural that anything that can happen while giving birth is covered by our mandatory healthcare insurance that the thought wouldn't cross your mind in the Netherlands (and obviously no bill came).

Hospitals and pharmaceutical companies do funny stuff with pricing worldwide, but at least patients aren't usually bothered with it.

[peter422]

Well nobody really has faith in the system to begin with.

We went into the process battling the system and ended it battling the system.

The various types of care that were provided were all fine and good but the decisions about which care to do, who does it and how much it is going to cost leaves a lot to be desired. But you know that going in.

[spaetzleesser]

"Also a very difficult thing to fight when you've got a newborn"

Same for people with a serious disease like cancer. They don't have the energy to spend all their time on negotiating with hospitals ind insurance. They either pay up or go bankrupt.

[Chris2048]

> We were given no choice in the matter

How on earth can they charge you then?!

[ridgeguy]

Because they can. So they do.

And when you don't pay, they sell your debt on to collections. Collections will sue to get a judgement against you, which will allow wage garnishment and other types of confiscation. Finally, say goodbye to your credit rating.

They charge because the power in the hospital/patient relationship is so very asymmetric.

[Chris2048]

> Collections will sue to get a judgement against you

Won't they have to see a judge to get this?

[ridgeguy]

Sorry I didn't see your question until just now.

Generally, yes, they'll have to see a judge. Not always, but usually. However, it's really common for debt collectors to present a judge with a stack of cases for entry of judgement. Can be a few hundred at once, it's a scaled process. So going before a judge isn't really a barrier for debt collectors.

Of course for a debtor, it's a different ideal. May have to take time off work, find child care, etc. Very unbalanced power in the debtor/creditor relationship.

[freedom2099]

I live in France… my wife is pregnant and the birth will cost us nothing! Regardless what might happen.