[dheera]

I got charged $5000 for a 30-minute preventative echocardiogram (basically an ultrasound) that insurance was supposed to pay 100%.

20 emails later it's now at debt collectors, and I've contested the debt twice.

I'm ready to appear in court if I have to. I'm ready to pay $8K in lawyer fees to get rid of this $5K bill because it's wrong. I just don't want this to impact my credit score because it's not my debt.

I hate you, Stanford Healthcare.

[theGnuMe]

Why didn't the insurer pay? Was it not covered? And what setting was it in, outpatient or ER? If ER then you should be able to dispute with your insurer to get it covered. If outpatient you might be able to negotiate with the Financial Services folks that they (the doctor) did not submit for pre-authorization appropriately per industry standards.

That's where you build your argument that they acted inappropriately and did not disclose prices (did they?). The next question is are you on a State plan or a corporate EIRSA plan? If State they you can file a complaint with the California department of insurance. If you have a corporate plan, which is likely self funded, then I would ask your HR to talk to your insurance rep. You might find things get retroactively covered at that point. Or you can talk to the news. They love to report on these things.

Stanford has pattern of inflated charges. Hearing tests in audiology for example are ridiculously overpriced without insurance and they don't pre-authorize. And most insurers don't cover hearing tests anyway. Stanford could fix this by not being greedy.

[dheera]

> Why didn't the insurer pay? Was it not covered? And what setting was it in, outpatient or ER?

Outpatient. Routine preventative care, I have a heart condition so echocardiograms are done every 2-3 years as a preventative measure. Insurance plan claims 100% coverage of preventative care with no deductible or coinsurance. I tried to dispute with insurance but they insist that it wasn't preventative (it's my body, my health, I know better than them that it was preventative) and they consistently would put me on hold for VERY long times on the phone until 5pm and then say "whoops, we're closed"

> The next question is are you on a State plan or a corporate EIRSA plan?

Self-purchased out of marketplace plan (HealthNet). I was self-employed at the time.

> Or you can talk to the news. They love to report on these things.

I would absolutely love if someone can put me in touch with a contact.

[theGnuMe]

Look into https://www.dmhc.ca.gov/fileacomplaint.aspx

I imagine an expert from the DMHC can advise on your specific situation.

[1letterunixname]

Oh my word.

2018, I was on Medi-Cal (Medic-aid) and had a stress ECG, right heart catheterization, and 12-lead EKG when admitted to their cardiac unit for 3 days. Cost $0.

Like a third-world country: in America, you're better off being either totally penniless or a billionaire. If you don't have a balance sheet of $5 megabucks, your life will be miserable.

The advantage most European and other countries have under socialism is it means there's a minimum average quality of life everyone. Pay more in taxes but get a lot more in terms of a more dignified, healthier, and longer life free from the slavery of "gotcha!" gangster capitalism.

[myth2018]

> Like a third-world country: in America, you're better off being either totally penniless or a billionaire. If you don't have a balance sheet of $5 megabucks, your life will be miserable.

I live in a "third-world" country. My family and I have insurance and only use private hospitals -- the capitalist portion of the system. Never had as bad an incident as the ones you guys are reporting here. Just some minor annoyances.

Not even the crappiest insurance companies do stuff like that, and they get terminated by the regulatory body if they start to mess up consistently.

Although I don't use it directly, I'm overall well-informed about the realities of the public health system. It's bad, but not even close to what I've seen posted here. One can even obtain overly expensive meds for rare diseases -- it requires some legal effort, but it eventually works.

Then I'd say that, when it comes to health systems, the USA is definitely way worse than some third-world countries -- and one of the main reasons I declined an invitation to work and live in there.

[seanmcdirmid]

When I was living in China working for Microsoft, our company provided insurance had a cap on claims paid ($100k), so while everything was cheap enough via the private system, I wondered if I was screwed if I ever got cancer or something really bad.

[dheera]

Yeah that doesn't sound like insurance to me at all.

[TheNewsIsHere]

It used to be common here in the US too, to have a cap on the amount an insurance policy would pay out.

My first “adult”/non-parental healthcare insurance policy had a yearly maximum and a lifetime maximum. This was pre-Affordable Care Act.

[piva00]

> The advantage most European and other countries have under socialism is it means there's a minimum average quality of life everyone. Pay more in taxes but get a lot more in terms of a more dignified, healthier, and longer life free from the slavery of "gotcha!" gangster capitalism.

It will sound like a nitpick but it's not: there's no socialism in Europe. Socialism is an economic system, not a synonym for "socially-focused policies" through societal-level welfare.

European countries are capitalists, completely. What we do have is a better support system for welfare, more labour protections and regulations to protect against the massive power imbalance that untamed capitalism creates but it's not socialism. Not even close.

[autoexec]

> It will sound like a nitpick but it's not: there's no socialism in Europe.

If Europe has no socialism they've still somehow managed to end up with a lot of European Socialists (https://en.wikipedia.org/wiki/Party_of_European_Socialists). Some words are basically meaningless because everybody has their own definition for them and socialism is certainly one of those words. It's probably better to avoid the term entirely and just describe what you mean because some people get so emotional just hearing it that they seem to lose the ability to think.

[piva00]

Words have meaning, socialism has a meaning:

> Socialism: a political philosophy and movement encompassing a wide range of economic and social systems, which are characterised by social ownership of the means of production, as opposed to private ownership.

That is the meaning, it's not meaningless. It becomes meaningless when people just accept that it can mean anything they want, it can't. Socialism has a very specific characteristic: social ownership of the means of production.

If people misuse the term they need to be corrected. At least until the meaning completely shifts to something else, like what Americans try to do with the term "liberal" which does not, at all, mean "progressive" as is the usage in the USA.

[autoexec]

Words do have meanings, the word socialism has so many meanings that using the term just makes things less clear. Even your preferred definition is so overbroad that it strains usefulness. Any definition that lumps together the political philosophy of Keir Starmer with that of Joseph Stalin is one of questionable utility.

[piva00]

That's the thing, it does not lump Keir Starmer's political philosophy and Stalin's. To be defined as socialism it needs to encompass the social ownership of the means of production, Keir Starmer's economic-political philosophy does not encompass that and hence it's not socialism...

It's the one of the most defining characteristics of socialism, if Keir Starmer is not defending that the ownership of the means of production should be socialised it is not socialism.