[mobilene]

Something similar happened to one of our sons. Unfortunately he has a history of drug use that landed him in legal trouble. The local police recognize him. He had a minor fender bender. The police tested him for alcohol there, clean. But then given history they detained him and took him to the nearest ER for a battery of drug tests -- for which the hospital billed our son, and for which our son is on the hook. It's bonkers.

[OptionOfT]

I'm surprised the police doesn't have to pay for them. It's not that the tests were medically necessary.

[hwillis]

> After being chased by police for stealing clothing from a Walmart, Seacat barricaded himself in a house at 4219 South Alton Street in Greenwood Village, Colorado. By the time Seacat was finally extracted from the premises, the house had been destroyed by law enforcement in their efforts to flush him out. The homeowner—Leo Lech—filed a lawsuit against the municipality for compensation, but was ruled against by the United States Court of Appeals for the Tenth Circuit; he appealed to the Supreme Court of the United States, but the court declined to hear the case.

https://en.wikipedia.org/wiki/Arrest_of_Robert_Seacat

[xvokcarts]

The same wiki article also describes the absurdness of the whole thing:

> At 10:38 pm, SWAT entered the house and used a stun grenade to conceal their movements [...] During the next 10.2 hours, a Lenco BearCat was driven through the front door, tear gas[1] and 40 mm grenades were repeatedly launched inside, shots were fired upon the house, and explosives were detonated to destroy several exterior walls.

Just amazing multiple people (the authorities) were present and none of them stopped to think "gee, that house is somebody's home".

[Ajedi32]

That's a different situation, because at least there it could be argued the damage was ultimately Seacat's fault for engaging in a shoot out with law enforcement on someone else's private property; the police were just doing their job apprehending an armed suspect. With a drug test that comes back negative, the person being tested clearly isn't at fault.

That said, I think it does probably make sense for there to be some sort of financial incentive for police to not create more collateral damage than necessary. Like maybe the damages should come out of the department budget initially and then they could get a judge to decide how much of that was the suspect's fault and recover that amount from them, assuming they can pay? Policing is a social service and I don't think externalizing the costs of social services onto innocent bystanders is a good idea; it makes the agency less accountable for the monetary costs they incur if those costs aren't tracked as part of their budget, and it's bad PR.

[hwillis]

> At 10:38 pm, SWAT entered the house and used a stun grenade to conceal their movements, but were driven back outside by gunshots (though criminalists would later establish that they were not fired upon). During the next 10.2 hours, a Lenco BearCat was driven through the front door, tear gas and 40 mm grenades were repeatedly launched inside, shots were fired upon the house, and explosives were detonated to destroy several exterior walls.

Whether or not police have any imperative to consider the impact of their actions, this situation was clear incompetence and reckless destruction. They're just as much doing their job by forcing drug tests on random people. The person may not have been on drugs, but all police would have to do is say they saw "erratic behavior".

> Like maybe the damages should come out of the department budget initially and then they could get a judge to decide how much of that was the suspect's fault and recover that amount from them, assuming they can pay?

This is just a different bad incentive; it incentivizes police to completely ignore situations or to find someone to hold accountable. Just extend the logic to the other expenses of an investigation- hourly pay, overtime, materials, forensics. Making a criminal pay for their own arrest is a terrible idea.

Police should pay for all the drug tests they demand, and for all the damages incurred in the process of investigating or arresting a suspect. Those things are not related to the crime itself, like a fine is. They are part of the cost of investigation and operation.

[Ajedi32]

> This is just a different bad incentive; it incentivizes police to completely ignore situations

If the societal cost of enforcement exceeds the societal cost of non-enforcement, then perhaps they should ignore the situation.

> or to find someone to hold accountable

This is why it would have to be decided by a judge as part of sentencing. If they're actually accountable then why shouldn't they be held to that?

> Just extend the logic to the other expenses of an investigation- hourly pay, overtime, materials, forensics. Making a criminal pay for their own arrest is a terrible idea.

I don't necessarily disagree, but just to play devil's advocate: why? It's their fault the public had to spend money on this, so why shouldn't they pay for it? (One argument I can think of is that for small crimes the cost of enforcement may greatly exceed the bounds of reasonable punishment for the offense, but what about when that's not the case?)

> Those things are not related to the crime itself

I'd argue exchanging gunfire with police is definitely a big part of the crime committed in this case. The shoplifting that started the encounter is practically irrelevant compared to that.

[fc417fc802]

Broadly agree with you and would like to add that if in this particular case the department had expected to foot the bill for their destruction I imagine they would have readily found a slower but cheaper approach. They went with the fast, expedient, and above all exciting (for them) approach precisely because they knew they wouldn't be the ones paying for the aftermath.

> It's their fault the public had to spend money on this, so why shouldn't they pay for it?

How about transparency and uniform enforcement of the law? Fines should be formally codified, not implicit and variable depending on incidentals internal to that particular investigation. The legislature is always free to direct those proceeds wherever they would like.

[hwillis]

> > or to find someone to hold accountable > This is why it would have to be decided by a judge as part of sentencing. If they're actually accountable then why shouldn't they be held to that?

I am more insinuating that it will lead to much more falsified evidence- something that is already a problem even while completely shielding them from consequences.

> why? It's their fault the public had to spend money on this, so why shouldn't they pay for it?

Because that isn't really accountability, practically speaking. The department funding is very distantly coupled to personal impact. When a division of a company does badly, they don't cut its funding as a form of incentive or punishment. Individual performance is done through the system of management and personal incentive. You don't want to fund the police based on how many crimes they solve- you do it based on how much crime exists. Likewise you shouldn't cut funding for bad policing- it's something that can also just be actively managed instead of simplified to a budgetary concern.

[ty6853]

In my case they tried to bill the federal government first, they then denied the claim and put me as the guarantor instead.

[Ajedi32]

Are you actually legally on the hook to pay? Or are they just going after you because they think they have a better chance of getting you to pay than the government?

[account-5]

I'm assuming you and the son of the other commenter are US citizens? Quite frankly the way the US operated on most things absolutely baffles me. In the UK were the same thing to happen to you the police would be paying the bill, but obviously we have the NHS so it actually pays. The NHS might be broken but I am thankful every time I hear an American health story!

[eru]

Well, the NHS might be better than what the US has, but that doesn't mean it's good.

So Britain as a whole spends roughly half (in terms of percentage of GDP) on healthcare as the US. That includes both public and private expenditure. At similar health outcomes.

Now Singapore spends roughly half of what Britain spends (in terms of percentage of GDP), and our population is no worse off for it.

[amiga386]

You need to look at PPP-adjusted per-capita stats, and also accept that there are limitations in a simple measure of "health outcomes" (e.g. average life expectancy)

https://ourworldindata.org/grapher/life-expectancy-vs-health...

What you can see though, is a cluster that vaguely fits "spend more, better life expectancy", with two outliers:

1. The USA, massively outspending every other country, but having same life expectancy as China spending a tenth of what it does

2. South Africa, spending roughly as much as Mexico or Columbia, but 10 years less life expectancy. I suspect it needs more targeted spending with its HIV crisis, rather than measuring average spend vs average life expectancy

[myrmidon]

Another thing to consider about South Africa is that wealth inequality is insanely high; it seems very plausible to me that most money is spent on like the rich 30% of population, and the majority of the country is basically on Namibian levels of care.

Public healthcare expenditure is also likely to be wasteful; governmental corruption and languishing infrastructure is a comparatively big problem there (compare power infrastructure, rail network, postal service), so the pure dollar value spent on healthcare is systematically off.

Thanks for the link btw-- I would not have expected such a clear trend in this, especially given how noisy metrics like life expectancy are; very interesting.

[randerson]

South Africa's poor life expectancy is more a function of poverty, violence, and HIV, than anything to do with their healthcare system.

[eru]

Interestingly, if you plot disposable income against healthcare spending, the US falls squarely on the trend line.

See https://www.econlib.org/is-the-us-an-outlier-on-health-care-... for a discussion.

[cma]

You can also get cheap dental and haircuts in Mexico: what's Singapore's purchasing power parity compared to the UK? Maybe not an extreme difference since Singapore has has such a high GDP or even worse, but if it is more that can explain a lot even for advanced services.

[eru]

Purchasing power parity depends a lot on what basket you compare.

Eg owning a car or cigarettes are very expensive here. But eating out starts much cheaper than in the UK. (There's no upper limit in either place, of course.)

[supermatt]

The GDP per capita in Singapore is roughly double that of the UK, so health spending per capita is similar. I cant find latest figures, but it seems it is somewhere around 20% higher spend in UK.

On the other hand, there are EU countries such as lithuania and estonia, that spend less than half per capita of Singapore, and are ranked with a higher healthcare index.

[eru]

Depends on how you measure. Lots of health spending is labour costs, and our labour costs are higher. So percentage of GDP relatively closely tracks percentage of total working time.

Also perhaps our more enlightened policies are helping us achieve that higher per capita GDP?

[DFHippie]

I sometimes think the US exists as a cautionary tale. We suck so you don't have to!

[cscurmudgeon]

But somehow you can use us as the world’s ATM!

https://www.statista.com/statistics/275597/largers-donor-cou...

Imagine a fraction of that going back to citizens!

[mpweiher]

Hmm...there are other countries on that list...who spend more relative to their GDP. So not exactly "the world's ATM".

And of course the rest of the world finances the US economy and US debt by virtue of the US dollar being both the currency of international trade and reserve currency. And it is reserve currency by virtue of being the currency of international trade.

That is a far, far greater monetary value than the aid given out.

Which you can also tell by what happens to you if you start to use another currency for trade. "Would you like some regime change to go with that?" Or how the US fights the Euro tooth and nail, including sabotage.

[ssalazar]

You dont have to imagine! Thats less than a sixth of a percent of the entire US federal budget :)

[eru]

> Imagine a fraction of that going back to citizens!

You know that US citizens mostly donate to charities that help other US citizens?

[ashoeafoot]

There must be a whole bootleg health system by now in the shadows , that is single payer and non-hostile/helping. Wait till the debtdoctor passes then go to the real one in some back alley .

[astrange]

"Single payer" means the government pays it. Hard to do in a back alley.

[potato3732842]

Nobody has gotten their life ruined enough over it to go postal in a hospital so it's in hospital's interests to keep playing along.

[anon7000]

This is why we need constitutional amendments to make the police better. I mean there’s shit like this, and then asset forfeiture (legalized theft). Shit like this should be non-partisan.

[fasa99]

>I'm surprised the police doesn't have to pay for them. It's not that the tests were medically necessary. If only it were so simple. Medicine can be quite nasty politically at times, internally and externally, and these mandatory examinations are the currency of really screwing someone if that's what you want. Psych especially, part of the theme of the original catch-22 book.

A lot of the laws are at first pass related to psych - "harm to self or others". That earns you a free non-voluntary trip to the hospital. The part where it gets nasty is when words get twisted, when ulterior motives exist, when the accuser possesses some authority - such that an "unsafe to self or others" argument is put forth. Situations where the person needs help, but perhaps won't seek it out on their own, thus the state must intervene. In this narrative, our police officers said, "harm to self, drugs in digestive tract, may rupture and cause death, not willing to seek medical care for fear of losing drug transport and/or prosecution, please treat so they don't rupture"

The victim of such a crime now has a choice - pay a bunch of money to the hospital to clear the bill, or pay a bunch of money to a lawyer to get the police to pony up responsibility. It's happened to me too along the lines of "the government made big mistake and caused problems for you, you can take ownership of the false accusations, or pay a bunch of money to a lawyer to have them wiped". Often in our society there's the suffering of being a victim, then the victim tax on top of that

[prawn]

I read the piece on your blog viewing your life story from various perspectives. This story about your son seems a good example of those facets for him; in this case, the hospital situation piling on top of existing challenges. What a scam. Best of luck to both of you.

[FireBeyond]

One day I got a call at work from my (now previous) partner. "What's up?" "You need to come home, we need to talk."

I duly do.

"So I went to the doctor earlier today. Had an issue. They swabbed me and told me I have an STD. So they did a full STD and blood test, we'll see how that goes. In the meantime, who did you cheat on me with?"

"Uh, nobody."

Back and forth, arguing, etc. Me insisting I'll go get tested.

The doctor rings back the next day. "We reviewed and looked again under the scope, and you do not have an STD, just a yeast infection."

Relationship relief.

A month later, get a call from the clinic: "So about this bill for $290 for a full workup and testing, can you pay that today?"

No. Not a chance. You not only misread a test, but you also gave my girlfriend factually inaccurate information that you knew was going to be controversial. On the strength of that, you told her, "If it wasn't you, you really need to get fully tested if you don't know where he's been."

And then you want to send me the bill for the battery of tests you ordered because you misread a culture? No.

[giantg2]

Did they actually waive it then?

[thaumasiotes]

Doesn't matter. It's not like they can make you pay.

I refused to pay for medical "services" I never asked for. They sent the debt to collections. Collections had no argument other than that they would really like it if I paid. My credit score was unaffected.

[gwd]

This is what confuses me about so many of these "horror stories" about cancelling things like gym memberships or NYT subscriptions. You can't just say to someone "you owe me X because my policy says you do". You only owe someone something if you are legally or morally obliged to do so, and there are certainly lots of cases where (it seems to me) you are neither.

[freedomben]

That's despicable. What a clearly grotesque thing for a cop to be able to do, forcing people to involuntarily spend their own money to accomplish police business. If they want the tests, the least they should do is pay for them!

Mind if I ask what area he lived in?

[wongarsu]

It's pretty bizarre. Surely if spending money is free speech as per Citizens United, then the right to remain silent also includes the right not to spend money on an investigation against yourself.

Apart from all the other common sense reasons why this is absurd

[34679]

Ah, but you not only have the right to remain silent- since a 2013 supreme Court ruling, you also have to know that you have the right to remain silent, and you have to say that you know and that you wish to remain silent.

https://reason.com/2013/06/17/supreme-court-rules-fifth-amen...

>In a 5-4 decision the Supreme Court ruled today that a potential defendant's silence can be used against him if he is being interviewed by police but is not arrested (and read his Miranda rights) and has not verbally invoked the protection of the Fifth Amendment.

[earnestinger]

Is this legal? Everything is done by the book?

[ty6853]

Yes see Ashley Cervantes v US, nearly identical case to my circumstances and same people but even worse abuse. She lost as doctors were considered acting as non medical pseudo police for the purposes of challenging the care and considered purely medical actors when challenging the police search.

Catch 22 you lose. She was sent bill by same hospital. I contacted her lawyers for my own purposes, they said they'd given up these cases.

https://holdcbpaccountable.org/wp-content/uploads/2018/08/ce...

[nickff]

Here's the court's decision on the case:

https://storage.courtlistener.com/recap/gov.uscourts.azd.985...

The result wasn't what you're describing. The plaintiff was suing in federal court, with a constitutional cause of action. The defendants argued, and the court decided that the plaintiff has a medical malpractice cause of action in state court, which is appropriate for her to pursue (at least before a federal court will rule in her favor).

[mindslight]

What are the actual legal theories by which they're trying (/succeeding) at enforcing these bills? Anybody can send anybody a bill for anything, that does not mean it is valid or legally enforceable.

In general I find discussions of this topic very frustrating because everybody stops short of visiting the if and how of the fraudulent bills actually having an effect. I can certainly believe there are corrupt or dubious ways they get collected on, but those mechanisms need to be focused on and then eliminated as an obvious first step of healthcare reform.

[throwway120385]

Usually the hospital has you sign something during intake that says "I acknowledge that if the insurance fails to pay this bill then I am the final guarantor." And so without that signed documentation the detainee shouldn't be on the hook for the bill. So asking the hospital to present your signature on that document or escalating until someone can provide that or indicate that they don't have it should be enough. This is a situation where personal legal insurance might be beneficial because for about $30 a month you get a law office you can call and ask questions, for example about the legality of the local hospital's billing practices for detainees.

[ty6853]

Yes I refused to sign anything so they just send it to a carousel of debt collectors who give up with resistance but then resell it to someone else whom hasn't received a cease and desist yet, then I must start over fighting it. This happens roughly annually for several years now.

[mindslight]

The thing they have you sign is a single-party "consent" and not a two-party "contract", implying it's merely informing you about what they are able to do to you, rather than asking you to assent to a purportedly mutual agreement.

I cross out all that unilateral nonsense about being financially responsible (as well as other types of nonsense), and have never been balked at. Worst case is these days when they ask me to sign a contextless touchpad, and then they roll their eyes like it's some big imposition when I ask for a hard copy instead so I can "review".

So I don't think that paperwork is directly involved with how the medical industry has come to run on billing fraud shakedowns. Hence asking for actual mechanics / outcomes of what happens when people are "sent a bill" and don't do the implied thing of just paying it.

Also, have you ever talked to an attorney - especially asking them preemptive or against-the-status-quo questions? In my experience they generally tell you to just go with the flow. If they advise you to do anything else and it blows up, then they themselves could be on the hook.

[cornholio]

> doctors were considered acting as non medical pseudo police for the purposes of challenging the care

What does that mean? They are either providing the services on behalf of the police, so their pseudo employer needs to pay them, or they are medical professionals providing a care you did not consent to or requested, in which case they should charge the party that requested the services, again, the police.

In both cases, you were not the contractual beneficiary of the services, so you own nothing. The fact that your blood and orifices are involved is purely incidental, any evidence resulting from this unnecessary medical act can only be used against you, so you would have no reason to want it.

[potato3732842]

It lives in one of those grey areas of "nobody has been murdered over it brutally enough to make national news so it persists" just like all the other abuse the police do. At least they don't suffocate people as much anymore...

[potato3732842]

What do you think the cops do all day?

Handing out civil infractions is basically the same thing but without the unnecessary extra party and steps.

[Egret]

In medicine, for minor procedures such as blood tests or ECG, there is the notion of implied consent. Just holding out your arm for the blood test is implied consent. To refuse, you might say, I am of sound mind and I do not consent to this procedure. Or, you are performing this procedure without my consent and against my wishes. I'm not a lawyer,and not in the US, but this is how it generally operates for practical reasons. Written informed consent is required for more invasive or significant procedures.

[justinclift]

"America! Fuck Yeah!"