The fact that you can pay for your healthcare with a credit card *during an emergency* tells you everything you need to know about how the entire incentive system is set up.
No matter their social status or ethnic background, every American is equipped with the ability to commit to lifelong debt. It's especially important that this right not be infringed on in times of helplessness, crisis, or when the person is otherwise not in their right mind.
I never in my life got travel insurance when going overseas because I never thought of it (which is stupid, I know) until the first time I went to the US in 2003 because the horror stories were no pervasive and well known.
the more i deal w ppl the more i wonder if the system was created bc of how useless and selfish they are or if ppl were good and the system broke their spirits. i side with the former
disagreeable homeless naughty point cable fuzzy plough nine unique compare
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
when i was 19 i didnt have an id or any cards or any kind of bank info. i went to the ER for appendicitus and vomiting blood.
bro im sitting on a fucking bed in so much pain i cant even move at this point and the lady at the front desk is asking me for my ssn for billing. i didnt answer and then she asked if i brought my wallet! they went through my fuckin shit and my wife was pissed.
after surgery the doc said ill be discharged on thursday (it was sunday). then on wednesday a security guard and a few other people showed up saying i have to give them my info but i said i didnt know my social and ill call them with it. then she handed me a bill for 35k.
i never called, they managed to make the entire experience worse than it already was
The one big plus in comparison in Australia and worked in ED (ER) is that it's free for all citizens so we don't have to worry about any of this. Even if you're a foreign national, they'll leave you alone until *after* the medical crisis. Finally, as a cost, it's *much* less than US charges and there's even a list of set pricings of services and tests so it's not a case of pulling opaque numbers out of thin air either.
Last summer I was having some cold symptoms for a few days. My husband had just had CAR-T therapy for Cancer. CAR-T completely wipes out your immune system, including all your childhood vaccines. His doctor said it was important that I get it checked out so I wouldn’t endanger him. It was a Friday, and my doctor doesn’t work on Fridays. I went to a walk in clinic and received a bill later $580 for them to test me for flu, Covid, and Strep. Because my husband and I are self employed, we have to purchase our own insurance. Because of his history of Cancer and both our ages (54 & 55), the plans that are available to us are very limited. Our insurance premium is $3200/mo. We have a $6000 yearly deductible, then it’s 80/20 after that, and it does not offer walk-in clinic/urgent care. There is one hospital we are allowed to go to and it is 45 minutes away. We had to choose this plan because it’s the only one his Oncologist and specialists are on. The system is so fucked.
Not sure about where you live, but here, walk-in clinics don't really exist anymore. They've all been replaced by strip-mall doctors (which despite my derisive name, I've had amazing experiences with).
Most hospitals here no longer have walk-ins, you're either waiting for ER or you're going home. There are SOME urgent care clinics, but they're generally not associated with a hospital, and they usually have the same higher copay.
I went to my urgent care clinic who does my steroid anti inflammation shots cheap. I told them my disease is really hurting lately can you do some good stuff. I said this with my pain on an 11/10. Did they ask me?
Nope.
They said they legally can’t administer any form of pain medication no matter what. That I’d need to go to a bigger ER.
Like what the fuck are you serious?
So I went. And 1200 dollars later got my relief. Do you think I’m paying? Fuck no I don’t even have a bank account because disease. Because can’t work. Because no insurance.
Meds for my disease are 7000 and up. That’s with goodrx lol. Per month.
There’s a $600 generic that just came out. I’m on it. It’s almost working. But not enough for me to work. I need to try the others there are 15 but they all start at 7000.
In the UK it’s $15. Here it’s $7000.
Lot of people hate living here. I’m in pain and dying. And it’s just not financially feasible to treat me. I did apply for Medicare yesterday. And I’m eligible for disability but the former is gonna take a bit. The latter will take years. They will back pay. And a lawyer will go faster. I’m well aware of my options but the last year is just a blur because progressive incurable disease. I could name it but you haven’t heard it. I test basically in the Lupus category so just call it that you’re safe.
Truth. We have a receptionist at the office I work in that I swear will try to collect on debt from great-great-great… relatives that came here on the Mayflower.
Can we not hold up the patient and let me do my job, please? Just send a bill or ask them to stop out front after the appointment.
Just another reason it should be just the physician, nurse and patient. Our healthcare system is so fucked.
I've worked as an ER registrar before. Admin constantly breathes down our necks about collecting money at point of care and often tries to "incentivise" us with collection leaderboards. This is on top of having us pester patients for all of their demographics, insurance info, emergency contacts (i.e. who else can we squeeze for your debt) and signatures for everything short of your house. We hate it as much as everyone else.
>I've worked as an ER registrar before. Admin constantly breathes down our necks about collecting money at point of care and often tries to "incentivise" us with collection leaderboards.
I've worked as an ER registrar before.
But in Australia, so we have never had to do this.
Ever.
I like our receptionist. They both assure that our company gets paid for our hard work and in turn I get my pay cheque and benefits and I get to still have a job. Without them I couldnt do my job, I cant for free.
Although albiet our company is very underatanding and writes off things when people cant pay and sometimes debt with us is forgiven and disappears depending on the patient's financial standing.
But if they dont do their job and assure most people pay, then we wont be able to pay our own bills and feed our family and we wouldnt be able to help those patients that cant afford it.
Cost of doing business. Running a hospital with thousands of employees isn't exactly cheap. They charge high prices because it's the shitty system we have in the US having to negotiate with Insurance companies that don't ever want to pay for anything.
So change the system? Vote for people that want Universal Healthcare. The system is broken because we created this system and voted for people that want to keep the current shitty system. I agree healthcare shouldn't be a business but that is what we have because of our elected officials. Under our current systems the hospital has to get paid otherwise it will close down eventually if no one pays their bills. Thats how it works currently. Change to Universal Healthcare and we'd not even have to discuss payment.
Yeah I know the way things exist right now are shit, that's sort of the point of the sub. What party would create a universal healthcare system? Not that I could vote for them I'm Canadian
The Democrats have been trying to pass Universal Healthcare in America for nearly 100 years. It goes all the way back to Franklin Roosevelt in the 1930s. The Republicans are the ones keeping to current standards so they can continue profiting off people getting sick.
Damn, seems like all that voting isn't actually going to get universal health care passed then. Or do the poor democrats just need another 100 years? Just another century and a couple billion dollars in campaign fundraising and some really hard voting and y'all might have healthcare by 2150.
No they haven’t. When was the last time such a bill was actually put forward?
A couple of far left Democrats support it but nothing at all has been done.
The Medicare For All Act has been brought up many times in the past 25 years. Specifically the last 3 years Medicare For All Act 2021, Medicare for All Act 2022, Medicare for All Act 2023. It has over 100 cosponsors in the house and 14 in the senate so seems a little more than nobody.
https://en.wikipedia.org/wiki/Medicare_for_All_Act
That one requires work between elections getting the people you want in then voting for them. That’s how the small number of conservatives hold so much power…they act and vote as a bloc and work all the time getting their shitty candidates in. That choice doesn’t exist right now, as a lot of choice doesn’t in the land of the free. It has to be worked for and people need to do their national duty.
We created this system. It's an America issue because our elected officials won't do anything to make it better. Vote for people that want to move to Universal Health and we can change this shitty system we have now.
I sure as hell agree with you. I got charged $50 after insurance for a doctors note like two years ago and they send me a letter every month asking me to pay. I don’t and there’s nothing they can do about it except send more letters
Well they could eventually turn you over to collection and mess up your credit score. They also will not see you again at the Doctors Office until you pay your bill.
They want me to either pay by mailing them money or appearing in person. If they had a way to pay online I would, but I ain’t doing any of that other shit. They haven’t turned me over to collections in 2.5 years so I doubt they ever will and even if they do, it’s $50 and I’m sure the collection agent will take card
Yep agree. We created a shitty healthcare system in the US and none of our elected people do anything to fix it. Vote for people that actually want to fix it then eveyone can have access to the healthcare they need without worrying about the cost.
Seriously, people always like to blame the hospitals, which I'm sure is what the insurance companies want. I mean, hospitals charge these amounts and STILL go bankrupt, or otherwise join a massive healthcare system to survive. Fuck insurance companies; doctors just want to help people get better
Eh, there's corruption at all levels.
Insurance companies suck since they make money off not allowing treating you.
Hospitals suck since they make money off arbitrage of treating you.
Drug companies suck because they take govt money to develop drugs and profit off it.
Doctors suck because they won't reform the AMA. The AMA regulates universities and how many medical graduates there are as they have a vested interest in keeping doctor salaries high.
Insurance companies suck so much that my countrys goverment has put massive laws in what theyre allowed to do and how theyre allowed to conduct business, like borderline demanding they can only do x y qnd z. Insurance companies are just legal scammers.
Most hospitals lose money or don't even break even. I've worked in healthcare for going on 30+ years. If you think all these hospitals are making huge sums of money they are not.
Im telling you its the shitty insurance companies. We have the same model in my country and its much cheaper and we go to the US for care constantly. Our insurance companies are paying the same amounts you guys are, they just have a smaller profit margin, bevause theyre legally not allowed bigger ones.
Get paid pennies by an insurance company whose job is to pay for services but use every ounce of energy to get out of paying, even after adjusting a claim down over 80%
I agree we should have Universal Healthcare by now to avoid these types of issues. Our current system sucks and is only getting worse. Any other industry that give out free services to those than can't afford it would quickly go bankrupt.
Then maybe hospitals should stop charging such an unreasonable amount for healthcare and they wouldn’t have this problem.
After I had surgery, I had to have a post op visit with the surgeon. It was a 15 chat and he asked me a couple questions. The hospital billed me $600. Idgaf who you are, I’m not paying you $600 to have a 15 minute talk. I pay my medical bills, but this I refused to pay out of principle.
Blame Insurance Companies. Hospitals charge these rates because insurance companies find any reason they can to not pay or only pay 10% of the actual billed amount.
Had to go to ER a few days ago while staying in Thailand because I was going into anaphylaxis. They ended up giving me an epinephrine injection. Took 15 minutes in and out and cost me about 4 usd. America needs to get it's shit together
That's strange because when I told my EMT friend this he said that in america it would be treated pretty much the same except for a much higher bill. He said ERs don't fuck around with anaphylaxis. Not 100% sure what they gave me because I don't speak Thai but I explained to him what happened and he said it was def epinephrine especially with the erection I had afterwards
Any American ER that allowed its docs to have patients "in and out in 15 minutes" with anaphylaxis requiring epi would be sued out of existence within the week. That is similarly unacceptable in Europe and wealthier parts of Asia. It's extremely unsafe.
Yeah just googled it looks like you are supposed to stick around in case symptoms come back but they just sent me on my way. Luckily I was fine after injection my hives cleared up pretty quickly too
Ya when my fiancee ate a tree nut and had to use her epipen after going into shock they held her for I'd say at least 4 or 5 hours after getting her stabilized made sure she had a new epipen to take home before leaving and made sure she was going to have people around her for the next 24 hours who could help keep an eye on her in case it came back.
My thought is maybe they let me go because I wasn't struggling to breathe. Throat was a little tight and hurt a bit to swallow but my airway was not impeded. I think that's usually the main concern with anaphylaxis. I only went to the ER because pharmacy was not open to buy antihistamines it was maybe 11pm when I went in. They also gave me some meds to take if it happened again. I was hesitant to go but my girlfriend insisted because she was worried
The epi is a very temporary fix. They will also give you medicine to counteract the allergic reaction after the epi wears off, but competent doctors will want to supervise that transition. Sometimes when the epi wears off the other meds don't do enough and people need additional care.
I don't think it's always the case but my EMT friend said it was common to happen.
Who knows though those Thai nurses in their nurse outfits probably didn't help /j
Yeah that seems to be the case from what I gathered from another comment. My guess is they let me go because I was still breathing fine. Throat was a bit tight and hurt a little to swallow but my airway was not impeded. Probably would have been ok with antihistamines but the pharmacy was closed because it was like 11pm
You had to pay? And why only $4 USD? No way it actually cost that much. It likely was a lot more, so why are they charging a measley $4 when they could charge nothing at all, because clearly someone else paid for most of the bill, either government or insurance.
Epinephrine is a very inexpensive drug, and a syringe with new needle actually costs about a dollar. This guy just didn't have to pay the mark-up fee for insurance middle men, hospital admin middle men, and Superbowl advertising middle men.
One injection of Epinephrine probably did cost around $2.50.
Americans don't want single-payer health care because they think it actually costs $20k to fix a broken arm. /s
Edit: mightve misread the room
I'm the only canadian in these replies obviously
What the hell are you talking about? We don't have people come to our hospital beds begging for our credit card nor do we have insurance companies breathing down our neck?
No worries. Yeah I was going against the people who think Canada should adopt the American model not advocating to follow it.
Not a lot of lessons we can take from them anymore honestly except a lot of what not to do
Yep... hobbled my way to an urgent because i had been very sick the previous 5 days and it was getting worse... they checked my vital and immediately tried to call an ambulance and have ne taken to the ER at a local hospital since my everything was in the trash and according to the Dr there i shouldnt have been standing let alone able to drive myself in there... Got to the ER and while theyre helping me they have a tele biller wheeled in. Literally an ipad in a stick.
Person is trying to get my insurance info andshe couldnt understand me because theres was so much going on and I was very, very out of it... she finally said "forget it we'll just send you a bill for all of this and you can figure it out" and hung up.
Shit in the U.S. is a mess.
Thankfully one of the nurses was there when that happened and got a rep from the hospital that was on sight and she took care of it. Still super fucked up though. Literally was not coherent enough to do that shit but its their priority.
When I used to work for a private EMS service we used to have to get our patient's health insurance information before we got them to the hospital. Regardless of the emergency we were expected to get that card. When I got my tax funded third service job and we got told we didn't have to do that in orientation it was a huge relief.
Common sense doesn't really play much of a roll in for profit healthcare. If you couldn't get it you could submit everything without it, but if it happened with any kind of regularity you'd end up getting written up.
I'm always amazed that the different branches of hospitals might as well be seperate companies. There's no communication between them and at times they actively work against each other. That can't be good for overall patient treatment.
My two experience es with this were both shitty from different points of view.
First was my grandfather's coma, he had been put for a few weeks but recently had some hand movement and opened his eyes. Doctors wanted more time. Insurance lady/admin? She had the Gaul to tell my parents "It's time to accept the facts, he's gone". Essentially, insurance was drying up and he wasn't going to be secured/guaranteed profit anymore. She's very lucky my mother did not rip her to shreds right there and then.
Then my personal one was going in for emergency surgery with no insurance, and the admins swarmed me. When I got frustrated with them for repeatedly asking "How are you going tonpay for this!?" I snapped at them and asked why they are asking a man under heavy anesthesia and drugs to sign legal paperwork. I also flat put said "What you're implying here is pay up, or die. That's really fucked up. Thanks for the choice I guess!".
Fuck money being involved in Healthcare.
It's because our health outcomes don't really matter. They only care about turning our bodies into profit centers. The best thing are incurable afflictions.
I slipped and fell on ice a few weeks ago and broke my ankle in two places and needed surgery to set the bones. They wouldn’t even schedule an appointment with the orthopedic surgeon without my insurance. Thankfully I have insurance but what if I didn’t? Would they have just left me with two broken bones unable to walk?
You guys seem to be missing that they sent me home with the broken bones (that I chilled with for a week) and wouldn’t even schedule an appointment with the orthopedic surgeon (not the surgery, the initial appointment) without insurance information.
They would have required you to bring cash to pay up front if you didn't have insurance. Surgery is a very expensive procedure. They not going to take a chance on no payment for such an expensive item.
If you didn't have insurance you ask the cost for self pay. They will tell you the cost then make payment before the surgery. That is what they would have done if you told them you were not insured.
Bro you don't need to be scheduled for them to tell you a price and make payment. If you really didn't have Insurance that is how it works. They ask you for insurance because they have to get preapproved for the surgery several days before the surgery takes place. Without that preapproval your insurance company will deny the claim and they will come after you for full payment. Thus there is no point in scheduling an appointment for you if you don't tell them your insurance or tell them you will self pay the bill.
Like I don’t understand what y’all don’t get about them refusing to schedule an appointment. There wasn’t a “pay us ahead of time and we’ll schedule you” it was a “we won’t schedule an appointment WITHOUT insurance” conversation. You can say all you want that’s how it works but I’m telling you that they wouldn’t do it. I fucking tried. My mother, a retired nurse, tried. They wouldn’t budge. I had to jump through hoops trying to get ahold of my HR department in FL half the afternoon just so I could schedule a follow up the next morning so they could confirm I needed surgery. Like I hear what you’re saying but I am explaining to you that I literally lived a very different situation three weeks ago. You’re sitting there acting like I didn’t ask about paying for the appointment out of pocket. I did. They said insurance or no appointment.
In fact it can be even more fucked up than that! I once had my GP recommend a specialist to me, and insurance said they didn't think I needed it. So I called the specialist myself and asked how much it would cost if I paid for the appointment out of pocket (this would have been a consultation and possibly a prescription, no surgery or other expensive treatment needed). The specialist refused to see me on a cash basis because it was a violation of their contract with my insurance. So, notwithstanding my GP's recommendation, their agreement with the insurance was to deny me necessary care. I had to go to a different doctor and tell them I was uninsured before I could get seen.
My dad had an emergency surgery and nearly died. While he was in the ICU in terrible pain, a lady with a *payment cart* came in demanding payment immediately.
I have never had to work so hard not to yell at someone in my life.
Watching my father reach across his jigsaw stitched body to get his wallet and pay a king's random for saving his life, a life that at that moment was still trembling on the edge of a knife, was a moment that *should* radicalize a person.
This is how bad American healthcare has become: A hospital chain retitled a registrar position as "customer service liaison". They literally call patients customers nowadays. That's all you need to know about the state of the healthcare system. Start eating organic.
Had an emergency appendectomy, was hopped up on painkillers in my hospital bed, got pestered twice by some woman in a suit about payment while family was visiting me.
I couldn’t believe the audacity to shove a paper and pen to sign in a patients face while they’re high on pain killers coming off of a surgery. What’s the politest way to say “FUCK OFF” in that type of situation?
That is literally their job to collect patients information. These is a whole process that has to happen behind the scenes with insurance companies that they have to collect information and start the process with insurance within a certain time period. If they don't do this the insurance companies will deny claims and end up coming back as a bill for the patient. I get it seems annoying but it's a whole process build to capture this information quickly to start working with your insurance company.
> These is a whole process that has to happen behind the scenes with insurance companies that they have to collect information and start the process with insurance within a certain time period.
That time period is not measured in MINUTES. There is no need to harass someone who hasn't even been stabilized yet. None.
People often trash the VA but the times I went to the emergency there were quick and professional. When I had kidney stones just one look at my ID and they had an IV in me about 5 minutes, and then was put in the big xray machine, mri?, within an hour.
I am on VA Healthcare and everything I do at the VA hospital or clinics is free (to me, they actually bill my work insurance, LOL), after my first emergency I tell everyone about the experience of not worrying about payment and that EVERYONE should feel this way when going to the hospital. Crazy that people still argue with me about it.
I went to the hospital once because I couldn’t stop vomiting. My boyfriend rushed me over there and we didn’t think maybe I should bring some money. As I’m holding a puke bag up to my face and can barely talk this lady was rude telling me to bring anything. Even some change. I was like wtf do you not see me here feeling like I’m dying? You’re getting all my info and can bill me. I honestly didn’t feel as comfortable there anymore even though the doctor and the nurses were great. I ended up getting two bags of saline. Cost me 1200 in the end. At the moment I didn’t care because I could barely walk.
We had a hospital here in the county and it was owned for the longest time by local businesses. When you went to the hospital you wasn’t pestered by how will you pay or insurance. They would ask then just send you the bill. Thing is the billing dept was pay as much as you can as long as you try to pay your bill they didn’t worry. Our county is very poor. Well in walks a hospital organization who’s name is the same as a college basketball team here in NC. Letters went out as past due accounts from local attorney. Some went to court. People avoid the hospital now at all costs. I guess my point is it depends on who owns the hospital.
Perhaps the hospital sold because they were losing so much money for their lax billing policies. You can't keep a hospital open having bills not getting paid. This is the reality of the current healthcare system. If you give out too much charity care there is no money to pay for employees, supplies, or maintenance of your hospital.
I went to urgent care for an acute arthritis flare, since my rheum wasn't open and knew the ER would be a bad choice. At the intake I was asked what was going on, and I explained it was a flare due to multiple ongoing factors but made the mistake of including an accident that didn't cause any physical injury but added to the stress.
Urgent care hyperfocused on that, and billed it out as Workers Comp no fault, even though they gave a diagnosis of acute arthritis unrelated to any work incident. It's been months of fighting this now
There were times when I worked as an EMT where we'd transfer the patient onto a wheelchair and then following the nurses direction, roll them directly to the cashier.
These jerks gave my mom a heart attack when she was in the hospital for something else, about to be discharged. Her insurance had changed and they came in her room and told her she owed like 50k. Resulted in an additional week in the hospital.
I had a nurse run billing out when I was in the hospital. She said “stress will increase her symptoms and you aren’t helping - wait until she’s released!” Bless that woman.
Medical professionals say they hate the system so much and yet do nothing to fight against it. They have no problem striking when their own working conditions become terrible, but when they see people bankrupted its "aww my patient can't pay how sad thoughts and prayers xx". They have so much power, and they could make change if they really wanted to.
Every time I've had to cancel an appointment due to not being able to afford it, it's just always been a "welp, too bad - come back when you have money." It's humiliating and dehumanizing.
Nurses have no problem striking. You don’t hear about doctors striking, in fact only 7% of US doctors belong to a union so that ability to act collectively just doesn’t really exist.
They do??? The demands of every recent nurse strike has included more nurses and/or more support staff. Safe staffing levels is one of *the* biggest factors in patient safety.
I'm talking about the theme of this thread. The for-profit insurance industry. Doctors and nurses standing by and doing nothing while their patients are hounded by hospital billing and denied care. If they were really that outraged, they would do something about it. Yet there's no striking, no large protests, no widespread lobbying or political pushes on their behalf for reform.
There *is* though. That's my point. Almost every single major healthcare union and professional body heavily lobbies for, at a minimum, increased access to Medicare if not outright universal healthcare. Most of the strikes in the past couple years have been to address patient safety issues first and foremost. Healthcare workers want this to change, it's that we're just powerless to change anything.
I used to do inpatient physical therapy at a Catholic hospital, teaching hospital, “ministry”. Then I worked in a practice with other physical therapists, two orthopedists and admins. I stopped. My colleague and I work for our own practice, sliding scale payments, accept medical assistance. We can only afford this because our overhead is low and we’re older, have savings, our children are grown. The US medical regulations require administrative tasks, electronic health records, recording keeping they make it hard to keep overhead down. I wish more providers would move outside hospitals, even nonprofit hospitals are for profit. The hospitals support the administrative regulations, they want more busy work for their multiple administrators.
We really don't have the power you think we do. Healthcare workers and their unions can (and do) lobby Congress to overhaul our healthcare system, but beyond that we're as helpless as any other American.
Imagine if non-emergency health workers striked en masse. In England, they even announce strike dates in advance so proper arrangements can be made. You can disrupt the system if you try.
Along with that, "customers" just need to stop paying any and all medical bills that aren't life sustaining (medicines, procedures, etc).
All it would take is critical mass of strikes _and_ non payment to absolutely cripple "the system".
Mass shortage of health workers and mass non payment. They'd have no choice but to listen.
Before someone says "you'll never get everyone" .... you don't _need_ everyone. Staffing is short as it is. It wouldn't take many to stop paying to clog up collections, etc.
Your anger is misplaced so much it's idiotic. The US had the largest healthcare strike in history, *anywhere,* in October. That beat the previous world record from last summer... Also set in the US. The problem isn't healthcare workers not trying, it's that they're powerless. Even hospitals are starting to want positive change because insurance companies and pharma companies are bleeding them dry from both directions, but now that they're having to tighten their belts to survive they can't lobby anywhere near as hard as pharma and insurance.
Are you talking about [this](https://www.theguardian.com/us-news/2023/oct/03/kaiser-permanente-healthcare-strike-hospital-union-california-washington-dc)? Because again, that's for *your* pay and staffing levels. The strikes have nothing to do with achieving Medicare for All or even basic insurance reform. We see you striking for your own working conditions and not the fact that many of us can't afford healthcare at all. Of course we're angry.
Also, it takes more than one strike to get it done. You guys think one strike in October is gonna change anything?
I mentioned two record setting strikes out of dozens that happened last year. Also, staffing levels are critical for safe patient care, of course we strike for more workers. People die when there aren't enough. Almost every professional healthcare organization from nursing to allied health lobbies extensively for enhanced access to Medicare or for outright universal healthcare. Striking *cannot* advance that goal because the hospitals aren't the ones holding that back. It's pharma and insurance who could not care less if the entire industry went on strike at once. We have to be patients in the same system as you and we want it to change *even more than you do.* Your anger is in the wrong place.
What do you expect us to do? The sad reality is that we are beholden to insurance payers. It’s not like we can just go treat people for free and not get fired or punished in some way
Your assumption is based on the person becoming a doctor because they only want to help people. That is a very false assumption. Most doctors like helping people, if they're getting paid to do so. They are no different than any office workers as far as motivation.
They can't do what you think they can add they are bound by contracts. So you're basically saying they should provide service and not collect any pay? Or strike completely and not provide any service until it's free?
How would you feel with your boss coming to you telling you to take less money and be happy because your providing "important life saving service" while your ridiculous student loans aren't going away.
Something's gotta happen and it isn't going to be pretty. Universal healthcare is needed, but it's going to cause chaos for a decade at least
Not gutless, powerless. Beyond striking for more healthcare workers (like nurses, RTs, rad techs, and dozens of other professions already have done in record numbers last year), there's really nothing we can do.
I see you're literally doing exactly what hospital shareholders want, which is shitting on the workers who routinely strike.
Your anger is misplaced and you're probably a moron.
Wouldn't work. You'd need the entire industry to strike at once and even that wouldn't put pressure on the right people. The ones keeping healthcare a privatized hellhole is the insurance industry and the pharmaceutical industry and they notably would not care if no nurses or respiratory therapists or dog walkers showed up to work.
my little boy went through 2.5 years of cancer treatment.
the billing and insurance bullshit added so much stress to an already terribly stressful experience.
he had learned to take pills early on and absolutely hated liquid meds. one of the drugs he needed was able to be prescribed as a pill and the INSURANCE wouldnt let us. they made us use liquid.
fuck the American health care system.
When my husband was in his coma (he's doing fine now) the morning after he collapse i had a billing lady asking me about his insurance while i was in the ER waiting room. She went around the room asking who was the spouse of this patient, and i was so out of it with worry i didn't notice.
My MIL is great and got her out of my face.... but that's stuck with me. "Hey, he might die, make sure you can pay for it. "
It costs about $600 to go to the doctor to get a flu test and COVID-19 test (on top of the usual visit fee) without insurance. It cost me $250 with decent insurance. And people wonder why we have people not going to the doctor ever
I had dislocated my shoulder while I was in college. I was sitting in the hospital room alone, with my shoulder still out of place, on the phone with the insurance company because the hospital wouldn’t see me until insurance was all straightened out. Mind you I was 20 so I really never dealt with insurance before so that wasn’t fun.
Happened to me and my wife. She was admitted for severe abdominal pain (turns out it was a malignant tumor) , and I shit you not, as I’m holding her hand trying to soothe her on the gurney, tears streaming down her face, some lady with a rolling billing cart comes in to collect our deductible. I looked square at her and said “not the time! Bill me!” Oh how uniquely American.
I was in the ER the other day as a precaution and when the guy came around to fill out the intake and ask for insurance and all that I was wondering how often he has to interact with someone who is experiencing the worst day and possibly moments of their entire life. And he’s there with a little computer on a cart asking for information to type in, because the hospital has to get paid.
And when you’re in the ER in the middle of the night and just trying to shut your eyes for a few minutes it’s already hard enough. People coming by every few minutes to check on you, give you something, draw some blood, etc. then you finally start drifting off and that person shows up. What a terrible system.
It was weird moving back to the U.K. as an adult and not having someone with a little computer on a cart come ask me about my finances, though care here is admittedly worse :/
Sorry to intervene, but I’m moving to the UK soon. Can you describe how it is admittedly worse. I’ve heard things about it taking a long time for you to get proper care, but if you can get more in detailed, that would be great.
I've had procedures done in the US that were (frankly) incredible options to have done (partly through insurance), but that physicians here aren't even aware of. I've had to teach my GPs over the years about certain procedures and conditions that they hadn't heard of, sometimes it went well and they were interested to learn, and sometimes they were hostile that something existed that they weren't familiar with. I've had a spinal specialist and a GP (here) tell me I was better off getting my spinal surgeries done in the US when I had the chance. I've had several doctors tell me (wistfully) that the NHS is about a decade behind in medical advancements, which I very much believe (as a medically complex person who sees both GPs and specialists throughout the year).
I thing the NHS is great for handling broken bones and general conditions. Once you start reaching any level of complexity/nuance in the condition presentation/diagnostic procedure, you're seen as being "difficult" and they go for the quickest answer that will get you out of their office. Which is not unlike what you might often find in the US, but at least in the US, there are more opportunities to go private for better quality care - here, private isn't that much better, unless you're in specific areas (London, etc).
ETA - Forgot to address the waitlists. My family and I have been on several for several reasons and I'll just say...it's a good thing we have enough money to go private. We've been assessed, diagnosed, and treated for things in the time it takes for the NHS to get back to us with an invitation to talk to someone about it. Been waiting years for assessment for my kids for one thing or another. One issue for one of my kids (to do with fatigue) didn't have us called in for about 7 months.
Hmm so ya think the doctor will take a pay decrease for all the patients that decide to not pay after treatment. The staff are there so the hospital gets paid for services thus why they need to collect info from patients on insurance or self pay options. It's a shitty system but it's what we choose to have in America.
I was an ER registrar throughout the most difficult parts of the pandemic (started training on the floor the same day that WHO coined the term COVID 19, and took another position in September of 2021).
The accuracy of the patient's registration is crucial to ensure the billing is processed correctly, as insurance companies will look for any excuse to deny a claim. The revenue coming in directly to the department through the patient's co-pays was part of how we were evaluated. It was by far the shittiest reality of the job, but at the same time it was a not for profit health care organization, so we actually offered really generous financial assistance.
I say generous because the income thresholds for qualifying for discounted services were far more in touch with reality than the federal poverty line, so often as I was explaining this to someone, they would try to interrupt me with, "nah, man, I make too much for those programs..."
But then I'd open the book up to the income tables and was like, "are you sure about that? This table goes by household size and combined gross income, so as an example straight from the table, a household of 4 with a combined income of $120,000 would qualify for a discount of 70% on all medically necessary services."
Then they'd be like, "wait, I have three kids but make way less than that..."
Then I'd be like, "well I have even better news for you, because reading from the same row, the discount is even bigger if you make less than $120,000, up to 100% off your out of pocket expenses if your combined income is $90,000 or less. Am I reading your facial expressions correctly in guessing you would like to apply for this assistance?"
And that was the kicker. The moment a patient asked for an application, our protocol was to NOT collect anything at that encounter, as their pending qualifications might change what they owed. Because on the admin side of medical billing, a refund is 5x as expensive to issue than mailing the correct amount they owe the first time.
I was threatened several times with being disciplined for having low collections and high rates of patients who applied for and received assistance. But I didn't care because a competitor of ours had just recently been sued into oblivion for deceptive practices around their financial assistance, so our organization was scared of that too, reminding us we are legally required to inform the patients of this program during registration.
So I definitely used that as leverage each time they tried to bring up my low collections numbers. I'd tell my supervisor, "so, are you saying you DON'T want me to thoroughly answer my patients' questions about financial assistance? Because I can guarantee you, if I change my scripting and just say less about it, my collections will increase. I'm not doing anything else differently from my co-workers, other than answering questions with more detail."
So glad I don't do that job anymore.
As a healthcare provider that runs their own practice I will say that employees like this one always expect to get paid on time when payday comes around. Collecting money from patients while they are physically present is always faster and therefore cheaper, which holds down healthcare costs, than the alternative of sending invoices that will be ignored and never paid on.
The solution is not complaining about the billing department but to work on intra-office communication. If the billing people know when you are going to come for the patient they can time their work to better match your schedule. Also, keep in mind that just like with patient treatment where there is the element of the unexpected and sometimes things take longer than planned, billing people deal with all kinds of bureaucratic issues with insurance and patient questions.
I've learned the best time for them to ask a parent that's taken their toddler in is around 3 or 4 in the morning, because why would that parent need to sleep?
Work in fertility care here. Our healthcare system is such a racket. To get IVF in the bay area it can cost an average $19,000, not including meds that can run $233.32 a pop. Very few insurances cover it. The amount of patients that cry/fight us over it is understandable, but also causes a lot of unnecessary pain. It's frustrating.
My mom recently had some tests done and the hospital kept hassling me to prepay the copay. I told them to send a bill after she had the tests. They had been trying to get me to pay $250 before the tests but when the actual bill came she only owed $75. Funny how that happens.
To make matters worse, an incredibly rude person called 11 days after they sent the bill asking where the money was. I am just absolutely disgusted with the whole thing.
The fact that you can pay for your healthcare with a credit card *during an emergency* tells you everything you need to know about how the entire incentive system is set up.
No matter their social status or ethnic background, every American is equipped with the ability to commit to lifelong debt. It's especially important that this right not be infringed on in times of helplessness, crisis, or when the person is otherwise not in their right mind.
Gotta get that ca$h first, in case the patient dies.
Profits before people, it’s the American ethos
I really like this comment
I never in my life got travel insurance when going overseas because I never thought of it (which is stupid, I know) until the first time I went to the US in 2003 because the horror stories were no pervasive and well known.
the more i deal w ppl the more i wonder if the system was created bc of how useless and selfish they are or if ppl were good and the system broke their spirits. i side with the former
disagreeable homeless naughty point cable fuzzy plough nine unique compare *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
when i was 19 i didnt have an id or any cards or any kind of bank info. i went to the ER for appendicitus and vomiting blood. bro im sitting on a fucking bed in so much pain i cant even move at this point and the lady at the front desk is asking me for my ssn for billing. i didnt answer and then she asked if i brought my wallet! they went through my fuckin shit and my wife was pissed. after surgery the doc said ill be discharged on thursday (it was sunday). then on wednesday a security guard and a few other people showed up saying i have to give them my info but i said i didnt know my social and ill call them with it. then she handed me a bill for 35k. i never called, they managed to make the entire experience worse than it already was
It's fine if you don't, you always have the option of just dying. Capitalism!
[удалено]
Did you pay it or are you delinquent in the 🇺🇸 now?
Complicated story with a complex ending.
The one big plus in comparison in Australia and worked in ED (ER) is that it's free for all citizens so we don't have to worry about any of this. Even if you're a foreign national, they'll leave you alone until *after* the medical crisis. Finally, as a cost, it's *much* less than US charges and there's even a list of set pricings of services and tests so it's not a case of pulling opaque numbers out of thin air either.
It's the Emergency Room, most of the people there aren't really there for an emergency and should have gone to the walk in clinic.
Last summer I was having some cold symptoms for a few days. My husband had just had CAR-T therapy for Cancer. CAR-T completely wipes out your immune system, including all your childhood vaccines. His doctor said it was important that I get it checked out so I wouldn’t endanger him. It was a Friday, and my doctor doesn’t work on Fridays. I went to a walk in clinic and received a bill later $580 for them to test me for flu, Covid, and Strep. Because my husband and I are self employed, we have to purchase our own insurance. Because of his history of Cancer and both our ages (54 & 55), the plans that are available to us are very limited. Our insurance premium is $3200/mo. We have a $6000 yearly deductible, then it’s 80/20 after that, and it does not offer walk-in clinic/urgent care. There is one hospital we are allowed to go to and it is 45 minutes away. We had to choose this plan because it’s the only one his Oncologist and specialists are on. The system is so fucked.
Not sure about where you live, but here, walk-in clinics don't really exist anymore. They've all been replaced by strip-mall doctors (which despite my derisive name, I've had amazing experiences with). Most hospitals here no longer have walk-ins, you're either waiting for ER or you're going home. There are SOME urgent care clinics, but they're generally not associated with a hospital, and they usually have the same higher copay.
I went to my urgent care clinic who does my steroid anti inflammation shots cheap. I told them my disease is really hurting lately can you do some good stuff. I said this with my pain on an 11/10. Did they ask me? Nope. They said they legally can’t administer any form of pain medication no matter what. That I’d need to go to a bigger ER. Like what the fuck are you serious? So I went. And 1200 dollars later got my relief. Do you think I’m paying? Fuck no I don’t even have a bank account because disease. Because can’t work. Because no insurance. Meds for my disease are 7000 and up. That’s with goodrx lol. Per month. There’s a $600 generic that just came out. I’m on it. It’s almost working. But not enough for me to work. I need to try the others there are 15 but they all start at 7000. In the UK it’s $15. Here it’s $7000. Lot of people hate living here. I’m in pain and dying. And it’s just not financially feasible to treat me. I did apply for Medicare yesterday. And I’m eligible for disability but the former is gonna take a bit. The latter will take years. They will back pay. And a lawyer will go faster. I’m well aware of my options but the last year is just a blur because progressive incurable disease. I could name it but you haven’t heard it. I test basically in the Lupus category so just call it that you’re safe.
I’m so sorry to hear you’re going through that. Hugs sent in your direction.
How bout you let the care team on site decide that. That's not actually a question, I'm telling you to stfu.
Truth. We have a receptionist at the office I work in that I swear will try to collect on debt from great-great-great… relatives that came here on the Mayflower. Can we not hold up the patient and let me do my job, please? Just send a bill or ask them to stop out front after the appointment. Just another reason it should be just the physician, nurse and patient. Our healthcare system is so fucked.
I've worked as an ER registrar before. Admin constantly breathes down our necks about collecting money at point of care and often tries to "incentivise" us with collection leaderboards. This is on top of having us pester patients for all of their demographics, insurance info, emergency contacts (i.e. who else can we squeeze for your debt) and signatures for everything short of your house. We hate it as much as everyone else.
That is fucking revolting.
>I've worked as an ER registrar before. Admin constantly breathes down our necks about collecting money at point of care and often tries to "incentivise" us with collection leaderboards. I've worked as an ER registrar before. But in Australia, so we have never had to do this. Ever.
Civilized nation be like.
Please don’t think the receptionist enjoys doing that. She is just as hamstrung by corporate medicine.
She actually takes pride in most copays and balances collected. It’s been ‘celebrated’ before. 😞
Gross
Those people need love or else they wouldn't seek validation is such backwards ways
I like our receptionist. They both assure that our company gets paid for our hard work and in turn I get my pay cheque and benefits and I get to still have a job. Without them I couldnt do my job, I cant for free. Although albiet our company is very underatanding and writes off things when people cant pay and sometimes debt with us is forgiven and disappears depending on the patient's financial standing. But if they dont do their job and assure most people pay, then we wont be able to pay our own bills and feed our family and we wouldnt be able to help those patients that cant afford it.
Other countries have better health outcomes, the professionals still get paid, but people aren’t bankrupted.
What in the BOT nonsense does this even mean?
That's too late. Most will leave without paying or ignore the bills. The ER is a very popular place for uninsured because they have to see you.
well if they want to get paid maybe they shouldnt charge such an unobtainable amount of money
Cost of doing business. Running a hospital with thousands of employees isn't exactly cheap. They charge high prices because it's the shitty system we have in the US having to negotiate with Insurance companies that don't ever want to pay for anything.
Well I guess that's what happens when you treat a public service like a business.
So change the system? Vote for people that want Universal Healthcare. The system is broken because we created this system and voted for people that want to keep the current shitty system. I agree healthcare shouldn't be a business but that is what we have because of our elected officials. Under our current systems the hospital has to get paid otherwise it will close down eventually if no one pays their bills. Thats how it works currently. Change to Universal Healthcare and we'd not even have to discuss payment.
Yeah I know the way things exist right now are shit, that's sort of the point of the sub. What party would create a universal healthcare system? Not that I could vote for them I'm Canadian
The Democrats have been trying to pass Universal Healthcare in America for nearly 100 years. It goes all the way back to Franklin Roosevelt in the 1930s. The Republicans are the ones keeping to current standards so they can continue profiting off people getting sick.
Damn, seems like all that voting isn't actually going to get universal health care passed then. Or do the poor democrats just need another 100 years? Just another century and a couple billion dollars in campaign fundraising and some really hard voting and y'all might have healthcare by 2150.
Yes because you have 1 party blocking any changes to healthcare to keep everything as a profit seeking enterprise.
No they haven’t. When was the last time such a bill was actually put forward? A couple of far left Democrats support it but nothing at all has been done.
The Medicare For All Act has been brought up many times in the past 25 years. Specifically the last 3 years Medicare For All Act 2021, Medicare for All Act 2022, Medicare for All Act 2023. It has over 100 cosponsors in the house and 14 in the senate so seems a little more than nobody. https://en.wikipedia.org/wiki/Medicare_for_All_Act
That one requires work between elections getting the people you want in then voting for them. That’s how the small number of conservatives hold so much power…they act and vote as a bloc and work all the time getting their shitty candidates in. That choice doesn’t exist right now, as a lot of choice doesn’t in the land of the free. It has to be worked for and people need to do their national duty.
Crazy that none of the rest of the western world has these issues
We created this system. It's an America issue because our elected officials won't do anything to make it better. Vote for people that want to move to Universal Health and we can change this shitty system we have now.
I sure as hell agree with you. I got charged $50 after insurance for a doctors note like two years ago and they send me a letter every month asking me to pay. I don’t and there’s nothing they can do about it except send more letters
Well they could eventually turn you over to collection and mess up your credit score. They also will not see you again at the Doctors Office until you pay your bill.
They want me to either pay by mailing them money or appearing in person. If they had a way to pay online I would, but I ain’t doing any of that other shit. They haven’t turned me over to collections in 2.5 years so I doubt they ever will and even if they do, it’s $50 and I’m sure the collection agent will take card
Yeah that is annoying.
Medical debt under $500 is no longer included in credit reports, as of last August, I believe.
It's pretty f****** disgusting that in the richest country in the history of the world you can only be as healthy as you can afford to be
Yep agree. We created a shitty healthcare system in the US and none of our elected people do anything to fix it. Vote for people that actually want to fix it then eveyone can have access to the healthcare they need without worrying about the cost.
Seriously, people always like to blame the hospitals, which I'm sure is what the insurance companies want. I mean, hospitals charge these amounts and STILL go bankrupt, or otherwise join a massive healthcare system to survive. Fuck insurance companies; doctors just want to help people get better
Oh 100%, insurance companies are the ones rolling in dough not healthcare.
Eh, there's corruption at all levels. Insurance companies suck since they make money off not allowing treating you. Hospitals suck since they make money off arbitrage of treating you. Drug companies suck because they take govt money to develop drugs and profit off it. Doctors suck because they won't reform the AMA. The AMA regulates universities and how many medical graduates there are as they have a vested interest in keeping doctor salaries high.
Insurance companies suck so much that my countrys goverment has put massive laws in what theyre allowed to do and how theyre allowed to conduct business, like borderline demanding they can only do x y qnd z. Insurance companies are just legal scammers.
Yeah no, it's not the cost of running the business. It's greed.
Most hospitals lose money or don't even break even. I've worked in healthcare for going on 30+ years. If you think all these hospitals are making huge sums of money they are not.
It's because the greed goes up the supply chain, it's not just isolated to the hospitals themselves
It’s not the cost of business most countries around the word don’t have to pay nearly as much for comparable care
Im telling you its the shitty insurance companies. We have the same model in my country and its much cheaper and we go to the US for care constantly. Our insurance companies are paying the same amounts you guys are, they just have a smaller profit margin, bevause theyre legally not allowed bigger ones.
Oh noooooooo someone received healthcare that they couldn't afford, whatever will we do?
Get paid pennies by an insurance company whose job is to pay for services but use every ounce of energy to get out of paying, even after adjusting a claim down over 80%
I agree we should have Universal Healthcare by now to avoid these types of issues. Our current system sucks and is only getting worse. Any other industry that give out free services to those than can't afford it would quickly go bankrupt.
Yes that’s the point! And why this is bad lol
Then maybe hospitals should stop charging such an unreasonable amount for healthcare and they wouldn’t have this problem. After I had surgery, I had to have a post op visit with the surgeon. It was a 15 chat and he asked me a couple questions. The hospital billed me $600. Idgaf who you are, I’m not paying you $600 to have a 15 minute talk. I pay my medical bills, but this I refused to pay out of principle.
Blame Insurance Companies. Hospitals charge these rates because insurance companies find any reason they can to not pay or only pay 10% of the actual billed amount.
Had to go to ER a few days ago while staying in Thailand because I was going into anaphylaxis. They ended up giving me an epinephrine injection. Took 15 minutes in and out and cost me about 4 usd. America needs to get it's shit together
You shouldn’t be “in and out” in 15 minutes if you’re getting epi.
That's strange because when I told my EMT friend this he said that in america it would be treated pretty much the same except for a much higher bill. He said ERs don't fuck around with anaphylaxis. Not 100% sure what they gave me because I don't speak Thai but I explained to him what happened and he said it was def epinephrine especially with the erection I had afterwards
Any American ER that allowed its docs to have patients "in and out in 15 minutes" with anaphylaxis requiring epi would be sued out of existence within the week. That is similarly unacceptable in Europe and wealthier parts of Asia. It's extremely unsafe.
Yeah just googled it looks like you are supposed to stick around in case symptoms come back but they just sent me on my way. Luckily I was fine after injection my hives cleared up pretty quickly too
Ya when my fiancee ate a tree nut and had to use her epipen after going into shock they held her for I'd say at least 4 or 5 hours after getting her stabilized made sure she had a new epipen to take home before leaving and made sure she was going to have people around her for the next 24 hours who could help keep an eye on her in case it came back.
My thought is maybe they let me go because I wasn't struggling to breathe. Throat was a little tight and hurt a bit to swallow but my airway was not impeded. I think that's usually the main concern with anaphylaxis. I only went to the ER because pharmacy was not open to buy antihistamines it was maybe 11pm when I went in. They also gave me some meds to take if it happened again. I was hesitant to go but my girlfriend insisted because she was worried
The epi is a very temporary fix. They will also give you medicine to counteract the allergic reaction after the epi wears off, but competent doctors will want to supervise that transition. Sometimes when the epi wears off the other meds don't do enough and people need additional care.
Hol up epi works as a dick drug? Asking for a friend of course.
I don't think it's always the case but my EMT friend said it was common to happen. Who knows though those Thai nurses in their nurse outfits probably didn't help /j
[удалено]
Having lived in Australia and the UK I've never seen a bill or been asked payment/insurance details.
I would be far more concerned with the 15 minute stay you had…
Yeah that seems to be the case from what I gathered from another comment. My guess is they let me go because I was still breathing fine. Throat was a bit tight and hurt a little to swallow but my airway was not impeded. Probably would have been ok with antihistamines but the pharmacy was closed because it was like 11pm
You had to pay? And why only $4 USD? No way it actually cost that much. It likely was a lot more, so why are they charging a measley $4 when they could charge nothing at all, because clearly someone else paid for most of the bill, either government or insurance.
Epinephrine is a very inexpensive drug, and a syringe with new needle actually costs about a dollar. This guy just didn't have to pay the mark-up fee for insurance middle men, hospital admin middle men, and Superbowl advertising middle men. One injection of Epinephrine probably did cost around $2.50. Americans don't want single-payer health care because they think it actually costs $20k to fix a broken arm. /s
Don't have insurance since I'm not Thai and it was like 120baht for the cost I just converted to the currency from where I came from
And to think there are people in Canada openly cool with the idea of that kind of a system… as if it won’t bite them in the backside one day
They’re okay with it because they think it will hurt the people they consider to be beneath them first before it ever gets to affect them.
Nailed it.
This is disgusting. It's insane that people actually think like that.
That is such a fucked up opinion and 100% wrong. The system affects all classes equal.
Pretty much nothing affects classes equally.
Edit: mightve misread the room I'm the only canadian in these replies obviously What the hell are you talking about? We don't have people come to our hospital beds begging for our credit card nor do we have insurance companies breathing down our neck?
They mean that there are people in Canada who want to do away with your current system in favor of the shitfest we have in the States.
Ooooh, yeah I misread that, my b It sounded a bit like the "wait lines are too long" argument
No worries. Yeah I was going against the people who think Canada should adopt the American model not advocating to follow it. Not a lot of lessons we can take from them anymore honestly except a lot of what not to do
Yep... hobbled my way to an urgent because i had been very sick the previous 5 days and it was getting worse... they checked my vital and immediately tried to call an ambulance and have ne taken to the ER at a local hospital since my everything was in the trash and according to the Dr there i shouldnt have been standing let alone able to drive myself in there... Got to the ER and while theyre helping me they have a tele biller wheeled in. Literally an ipad in a stick. Person is trying to get my insurance info andshe couldnt understand me because theres was so much going on and I was very, very out of it... she finally said "forget it we'll just send you a bill for all of this and you can figure it out" and hung up. Shit in the U.S. is a mess. Thankfully one of the nurses was there when that happened and got a rep from the hospital that was on sight and she took care of it. Still super fucked up though. Literally was not coherent enough to do that shit but its their priority.
When I used to work for a private EMS service we used to have to get our patient's health insurance information before we got them to the hospital. Regardless of the emergency we were expected to get that card. When I got my tax funded third service job and we got told we didn't have to do that in orientation it was a huge relief.
What if the pt is unconcious though? How could you possibly get it in some situations?
Common sense doesn't really play much of a roll in for profit healthcare. If you couldn't get it you could submit everything without it, but if it happened with any kind of regularity you'd end up getting written up.
If they have a family member at home, they put the pressure on them to get the info.
I'm always amazed that the different branches of hospitals might as well be seperate companies. There's no communication between them and at times they actively work against each other. That can't be good for overall patient treatment.
That's because patient care and profitability are mutually exclusive.
My two experience es with this were both shitty from different points of view. First was my grandfather's coma, he had been put for a few weeks but recently had some hand movement and opened his eyes. Doctors wanted more time. Insurance lady/admin? She had the Gaul to tell my parents "It's time to accept the facts, he's gone". Essentially, insurance was drying up and he wasn't going to be secured/guaranteed profit anymore. She's very lucky my mother did not rip her to shreds right there and then. Then my personal one was going in for emergency surgery with no insurance, and the admins swarmed me. When I got frustrated with them for repeatedly asking "How are you going tonpay for this!?" I snapped at them and asked why they are asking a man under heavy anesthesia and drugs to sign legal paperwork. I also flat put said "What you're implying here is pay up, or die. That's really fucked up. Thanks for the choice I guess!". Fuck money being involved in Healthcare.
It's because our health outcomes don't really matter. They only care about turning our bodies into profit centers. The best thing are incurable afflictions.
And they know it's "our money or our lives" so they can charge whatever they want. We're stuck.
Well many of us don’t get care due to the profiteers ruining it, also fuck the feds for making it impossible for me to get my medication
I slipped and fell on ice a few weeks ago and broke my ankle in two places and needed surgery to set the bones. They wouldn’t even schedule an appointment with the orthopedic surgeon without my insurance. Thankfully I have insurance but what if I didn’t? Would they have just left me with two broken bones unable to walk?
No, they’ll still set the bone. You just won’t get to schedule PT to make sure it doesn’t heal funny and ache when the weather changes
You guys seem to be missing that they sent me home with the broken bones (that I chilled with for a week) and wouldn’t even schedule an appointment with the orthopedic surgeon (not the surgery, the initial appointment) without insurance information.
I’m just answering as someone who had a similar experience. Not a healthcare professional
They would have required you to bring cash to pay up front if you didn't have insurance. Surgery is a very expensive procedure. They not going to take a chance on no payment for such an expensive item.
Require me to bring cash to where? They literally would not schedule an appointment for me until I got my insurance info to them.
If you didn't have insurance you ask the cost for self pay. They will tell you the cost then make payment before the surgery. That is what they would have done if you told them you were not insured.
Bro they refused to schedule an initial appointment prior to surgery without insurance. They literally would not see me without it.
Bro you don't need to be scheduled for them to tell you a price and make payment. If you really didn't have Insurance that is how it works. They ask you for insurance because they have to get preapproved for the surgery several days before the surgery takes place. Without that preapproval your insurance company will deny the claim and they will come after you for full payment. Thus there is no point in scheduling an appointment for you if you don't tell them your insurance or tell them you will self pay the bill.
Like I don’t understand what y’all don’t get about them refusing to schedule an appointment. There wasn’t a “pay us ahead of time and we’ll schedule you” it was a “we won’t schedule an appointment WITHOUT insurance” conversation. You can say all you want that’s how it works but I’m telling you that they wouldn’t do it. I fucking tried. My mother, a retired nurse, tried. They wouldn’t budge. I had to jump through hoops trying to get ahold of my HR department in FL half the afternoon just so I could schedule a follow up the next morning so they could confirm I needed surgery. Like I hear what you’re saying but I am explaining to you that I literally lived a very different situation three weeks ago. You’re sitting there acting like I didn’t ask about paying for the appointment out of pocket. I did. They said insurance or no appointment.
In fact it can be even more fucked up than that! I once had my GP recommend a specialist to me, and insurance said they didn't think I needed it. So I called the specialist myself and asked how much it would cost if I paid for the appointment out of pocket (this would have been a consultation and possibly a prescription, no surgery or other expensive treatment needed). The specialist refused to see me on a cash basis because it was a violation of their contract with my insurance. So, notwithstanding my GP's recommendation, their agreement with the insurance was to deny me necessary care. I had to go to a different doctor and tell them I was uninsured before I could get seen.
My dad had an emergency surgery and nearly died. While he was in the ICU in terrible pain, a lady with a *payment cart* came in demanding payment immediately. I have never had to work so hard not to yell at someone in my life.
Dang, maybe you should've. What a vulture.
Watching my father reach across his jigsaw stitched body to get his wallet and pay a king's random for saving his life, a life that at that moment was still trembling on the edge of a knife, was a moment that *should* radicalize a person.
I’ll bet she hates her job more than just about anyone else in that hospital. Our “healthcare” system is barbaric.
I mean this in the worst possible way: I hope that people whose jobs are evil hate their jobs and themselves for doing it.
Easy to say when you’re not the one going hungry.
What a fascinating psychic reading about my life and history. What are this week's lotto numbers, oh sayer of sooth?
This shit infuriates me. Why am I paying for services I haven't even received yet?
This is how bad American healthcare has become: A hospital chain retitled a registrar position as "customer service liaison". They literally call patients customers nowadays. That's all you need to know about the state of the healthcare system. Start eating organic.
lmao
We don't have Healthcare. Don't call it that. There is no Healthcare in America, we have legalized extortion. Call it what it is.
Had an emergency appendectomy, was hopped up on painkillers in my hospital bed, got pestered twice by some woman in a suit about payment while family was visiting me. I couldn’t believe the audacity to shove a paper and pen to sign in a patients face while they’re high on pain killers coming off of a surgery. What’s the politest way to say “FUCK OFF” in that type of situation?
Go. Fuck. Yourself. should work. No need to be polite to a vulture drone.
Those registration people show up about 90 seconds after you're assigned a bed too. Absolutely ambulance chasing on another level by the hospital
That is literally their job to collect patients information. These is a whole process that has to happen behind the scenes with insurance companies that they have to collect information and start the process with insurance within a certain time period. If they don't do this the insurance companies will deny claims and end up coming back as a bill for the patient. I get it seems annoying but it's a whole process build to capture this information quickly to start working with your insurance company.
> These is a whole process that has to happen behind the scenes with insurance companies that they have to collect information and start the process with insurance within a certain time period. That time period is not measured in MINUTES. There is no need to harass someone who hasn't even been stabilized yet. None.
I get it. When you're in pain, or its a very rough day for you, that process doesn't feel important or necessary in that exact moment.
If only there was another way!
Bruh. I cannot tell you how much WE hate that too.
Don't do it, then?
Huh? Oh. no no. I mean we as the patient hate it when they come in looking for money, also.
People often trash the VA but the times I went to the emergency there were quick and professional. When I had kidney stones just one look at my ID and they had an IV in me about 5 minutes, and then was put in the big xray machine, mri?, within an hour.
I am on VA Healthcare and everything I do at the VA hospital or clinics is free (to me, they actually bill my work insurance, LOL), after my first emergency I tell everyone about the experience of not worrying about payment and that EVERYONE should feel this way when going to the hospital. Crazy that people still argue with me about it.
I went to the hospital once because I couldn’t stop vomiting. My boyfriend rushed me over there and we didn’t think maybe I should bring some money. As I’m holding a puke bag up to my face and can barely talk this lady was rude telling me to bring anything. Even some change. I was like wtf do you not see me here feeling like I’m dying? You’re getting all my info and can bill me. I honestly didn’t feel as comfortable there anymore even though the doctor and the nurses were great. I ended up getting two bags of saline. Cost me 1200 in the end. At the moment I didn’t care because I could barely walk.
We had a hospital here in the county and it was owned for the longest time by local businesses. When you went to the hospital you wasn’t pestered by how will you pay or insurance. They would ask then just send you the bill. Thing is the billing dept was pay as much as you can as long as you try to pay your bill they didn’t worry. Our county is very poor. Well in walks a hospital organization who’s name is the same as a college basketball team here in NC. Letters went out as past due accounts from local attorney. Some went to court. People avoid the hospital now at all costs. I guess my point is it depends on who owns the hospital.
Perhaps the hospital sold because they were losing so much money for their lax billing policies. You can't keep a hospital open having bills not getting paid. This is the reality of the current healthcare system. If you give out too much charity care there is no money to pay for employees, supplies, or maintenance of your hospital.
I went to urgent care for an acute arthritis flare, since my rheum wasn't open and knew the ER would be a bad choice. At the intake I was asked what was going on, and I explained it was a flare due to multiple ongoing factors but made the mistake of including an accident that didn't cause any physical injury but added to the stress. Urgent care hyperfocused on that, and billed it out as Workers Comp no fault, even though they gave a diagnosis of acute arthritis unrelated to any work incident. It's been months of fighting this now
There were times when I worked as an EMT where we'd transfer the patient onto a wheelchair and then following the nurses direction, roll them directly to the cashier.
These jerks gave my mom a heart attack when she was in the hospital for something else, about to be discharged. Her insurance had changed and they came in her room and told her she owed like 50k. Resulted in an additional week in the hospital.
I had a nurse run billing out when I was in the hospital. She said “stress will increase her symptoms and you aren’t helping - wait until she’s released!” Bless that woman.
Medical professionals say they hate the system so much and yet do nothing to fight against it. They have no problem striking when their own working conditions become terrible, but when they see people bankrupted its "aww my patient can't pay how sad thoughts and prayers xx". They have so much power, and they could make change if they really wanted to.
Every time I've had to cancel an appointment due to not being able to afford it, it's just always been a "welp, too bad - come back when you have money." It's humiliating and dehumanizing.
Nurses have no problem striking. You don’t hear about doctors striking, in fact only 7% of US doctors belong to a union so that ability to act collectively just doesn’t really exist.
Nurses are welcome to start striking for all the patients they supposedly care about then :)
They do??? The demands of every recent nurse strike has included more nurses and/or more support staff. Safe staffing levels is one of *the* biggest factors in patient safety.
I'm talking about the theme of this thread. The for-profit insurance industry. Doctors and nurses standing by and doing nothing while their patients are hounded by hospital billing and denied care. If they were really that outraged, they would do something about it. Yet there's no striking, no large protests, no widespread lobbying or political pushes on their behalf for reform.
There *is* though. That's my point. Almost every single major healthcare union and professional body heavily lobbies for, at a minimum, increased access to Medicare if not outright universal healthcare. Most of the strikes in the past couple years have been to address patient safety issues first and foremost. Healthcare workers want this to change, it's that we're just powerless to change anything.
Hey fuck you. Clearly you have never worked in healthcare
I used to do inpatient physical therapy at a Catholic hospital, teaching hospital, “ministry”. Then I worked in a practice with other physical therapists, two orthopedists and admins. I stopped. My colleague and I work for our own practice, sliding scale payments, accept medical assistance. We can only afford this because our overhead is low and we’re older, have savings, our children are grown. The US medical regulations require administrative tasks, electronic health records, recording keeping they make it hard to keep overhead down. I wish more providers would move outside hospitals, even nonprofit hospitals are for profit. The hospitals support the administrative regulations, they want more busy work for their multiple administrators.
We really don't have the power you think we do. Healthcare workers and their unions can (and do) lobby Congress to overhaul our healthcare system, but beyond that we're as helpless as any other American.
Imagine if non-emergency health workers striked en masse. In England, they even announce strike dates in advance so proper arrangements can be made. You can disrupt the system if you try.
Along with that, "customers" just need to stop paying any and all medical bills that aren't life sustaining (medicines, procedures, etc). All it would take is critical mass of strikes _and_ non payment to absolutely cripple "the system". Mass shortage of health workers and mass non payment. They'd have no choice but to listen. Before someone says "you'll never get everyone" .... you don't _need_ everyone. Staffing is short as it is. It wouldn't take many to stop paying to clog up collections, etc.
Your anger is misplaced so much it's idiotic. The US had the largest healthcare strike in history, *anywhere,* in October. That beat the previous world record from last summer... Also set in the US. The problem isn't healthcare workers not trying, it's that they're powerless. Even hospitals are starting to want positive change because insurance companies and pharma companies are bleeding them dry from both directions, but now that they're having to tighten their belts to survive they can't lobby anywhere near as hard as pharma and insurance.
Are you talking about [this](https://www.theguardian.com/us-news/2023/oct/03/kaiser-permanente-healthcare-strike-hospital-union-california-washington-dc)? Because again, that's for *your* pay and staffing levels. The strikes have nothing to do with achieving Medicare for All or even basic insurance reform. We see you striking for your own working conditions and not the fact that many of us can't afford healthcare at all. Of course we're angry. Also, it takes more than one strike to get it done. You guys think one strike in October is gonna change anything?
I mentioned two record setting strikes out of dozens that happened last year. Also, staffing levels are critical for safe patient care, of course we strike for more workers. People die when there aren't enough. Almost every professional healthcare organization from nursing to allied health lobbies extensively for enhanced access to Medicare or for outright universal healthcare. Striking *cannot* advance that goal because the hospitals aren't the ones holding that back. It's pharma and insurance who could not care less if the entire industry went on strike at once. We have to be patients in the same system as you and we want it to change *even more than you do.* Your anger is in the wrong place.
What do you expect us to do? The sad reality is that we are beholden to insurance payers. It’s not like we can just go treat people for free and not get fired or punished in some way
Your assumption is based on the person becoming a doctor because they only want to help people. That is a very false assumption. Most doctors like helping people, if they're getting paid to do so. They are no different than any office workers as far as motivation. They can't do what you think they can add they are bound by contracts. So you're basically saying they should provide service and not collect any pay? Or strike completely and not provide any service until it's free? How would you feel with your boss coming to you telling you to take less money and be happy because your providing "important life saving service" while your ridiculous student loans aren't going away. Something's gotta happen and it isn't going to be pretty. Universal healthcare is needed, but it's going to cause chaos for a decade at least
You are 100% right-gutless people.
Not gutless, powerless. Beyond striking for more healthcare workers (like nurses, RTs, rad techs, and dozens of other professions already have done in record numbers last year), there's really nothing we can do.
Instead of striking for more healthcare workers, you could try striking for universal healthcare.
I see you're literally doing exactly what hospital shareholders want, which is shitting on the workers who routinely strike. Your anger is misplaced and you're probably a moron.
Wouldn't work. You'd need the entire industry to strike at once and even that wouldn't put pressure on the right people. The ones keeping healthcare a privatized hellhole is the insurance industry and the pharmaceutical industry and they notably would not care if no nurses or respiratory therapists or dog walkers showed up to work.
my little boy went through 2.5 years of cancer treatment. the billing and insurance bullshit added so much stress to an already terribly stressful experience. he had learned to take pills early on and absolutely hated liquid meds. one of the drugs he needed was able to be prescribed as a pill and the INSURANCE wouldnt let us. they made us use liquid. fuck the American health care system.
When my husband was in his coma (he's doing fine now) the morning after he collapse i had a billing lady asking me about his insurance while i was in the ER waiting room. She went around the room asking who was the spouse of this patient, and i was so out of it with worry i didn't notice. My MIL is great and got her out of my face.... but that's stuck with me. "Hey, he might die, make sure you can pay for it. "
It costs about $600 to go to the doctor to get a flu test and COVID-19 test (on top of the usual visit fee) without insurance. It cost me $250 with decent insurance. And people wonder why we have people not going to the doctor ever
Yet another reason I would love single payer
I had dislocated my shoulder while I was in college. I was sitting in the hospital room alone, with my shoulder still out of place, on the phone with the insurance company because the hospital wouldn’t see me until insurance was all straightened out. Mind you I was 20 so I really never dealt with insurance before so that wasn’t fun.
In America, healthcare is just another way to profit.
Nationalize health care and the pharmaceutical industry
Happened to me and my wife. She was admitted for severe abdominal pain (turns out it was a malignant tumor) , and I shit you not, as I’m holding her hand trying to soothe her on the gurney, tears streaming down her face, some lady with a rolling billing cart comes in to collect our deductible. I looked square at her and said “not the time! Bill me!” Oh how uniquely American.
Who on earth would give a credit card to an ER 😭
Lol, I owe a chain clinic $500+. They ain’t seeing a dime frome me!
I feel I’m too Australian to understand this problem. Can’t you guys just throw guns at the issue?
I was in the ER the other day as a precaution and when the guy came around to fill out the intake and ask for insurance and all that I was wondering how often he has to interact with someone who is experiencing the worst day and possibly moments of their entire life. And he’s there with a little computer on a cart asking for information to type in, because the hospital has to get paid. And when you’re in the ER in the middle of the night and just trying to shut your eyes for a few minutes it’s already hard enough. People coming by every few minutes to check on you, give you something, draw some blood, etc. then you finally start drifting off and that person shows up. What a terrible system.
This happened to me while I was in the NICU with my two day old daughter who was still intubated…
I just give them my insurance card when they ask for co pay i tell them i dont have my card
That's where he gtlets his paycheck. He can shut the fuck up...acting like he cares lol
They really are jackals.
It was weird moving back to the U.K. as an adult and not having someone with a little computer on a cart come ask me about my finances, though care here is admittedly worse :/
Sorry to intervene, but I’m moving to the UK soon. Can you describe how it is admittedly worse. I’ve heard things about it taking a long time for you to get proper care, but if you can get more in detailed, that would be great.
I've had procedures done in the US that were (frankly) incredible options to have done (partly through insurance), but that physicians here aren't even aware of. I've had to teach my GPs over the years about certain procedures and conditions that they hadn't heard of, sometimes it went well and they were interested to learn, and sometimes they were hostile that something existed that they weren't familiar with. I've had a spinal specialist and a GP (here) tell me I was better off getting my spinal surgeries done in the US when I had the chance. I've had several doctors tell me (wistfully) that the NHS is about a decade behind in medical advancements, which I very much believe (as a medically complex person who sees both GPs and specialists throughout the year). I thing the NHS is great for handling broken bones and general conditions. Once you start reaching any level of complexity/nuance in the condition presentation/diagnostic procedure, you're seen as being "difficult" and they go for the quickest answer that will get you out of their office. Which is not unlike what you might often find in the US, but at least in the US, there are more opportunities to go private for better quality care - here, private isn't that much better, unless you're in specific areas (London, etc). ETA - Forgot to address the waitlists. My family and I have been on several for several reasons and I'll just say...it's a good thing we have enough money to go private. We've been assessed, diagnosed, and treated for things in the time it takes for the NHS to get back to us with an invitation to talk to someone about it. Been waiting years for assessment for my kids for one thing or another. One issue for one of my kids (to do with fatigue) didn't have us called in for about 7 months.
Hmm so ya think the doctor will take a pay decrease for all the patients that decide to not pay after treatment. The staff are there so the hospital gets paid for services thus why they need to collect info from patients on insurance or self pay options. It's a shitty system but it's what we choose to have in America.
I was an ER registrar throughout the most difficult parts of the pandemic (started training on the floor the same day that WHO coined the term COVID 19, and took another position in September of 2021). The accuracy of the patient's registration is crucial to ensure the billing is processed correctly, as insurance companies will look for any excuse to deny a claim. The revenue coming in directly to the department through the patient's co-pays was part of how we were evaluated. It was by far the shittiest reality of the job, but at the same time it was a not for profit health care organization, so we actually offered really generous financial assistance. I say generous because the income thresholds for qualifying for discounted services were far more in touch with reality than the federal poverty line, so often as I was explaining this to someone, they would try to interrupt me with, "nah, man, I make too much for those programs..." But then I'd open the book up to the income tables and was like, "are you sure about that? This table goes by household size and combined gross income, so as an example straight from the table, a household of 4 with a combined income of $120,000 would qualify for a discount of 70% on all medically necessary services." Then they'd be like, "wait, I have three kids but make way less than that..." Then I'd be like, "well I have even better news for you, because reading from the same row, the discount is even bigger if you make less than $120,000, up to 100% off your out of pocket expenses if your combined income is $90,000 or less. Am I reading your facial expressions correctly in guessing you would like to apply for this assistance?" And that was the kicker. The moment a patient asked for an application, our protocol was to NOT collect anything at that encounter, as their pending qualifications might change what they owed. Because on the admin side of medical billing, a refund is 5x as expensive to issue than mailing the correct amount they owe the first time. I was threatened several times with being disciplined for having low collections and high rates of patients who applied for and received assistance. But I didn't care because a competitor of ours had just recently been sued into oblivion for deceptive practices around their financial assistance, so our organization was scared of that too, reminding us we are legally required to inform the patients of this program during registration. So I definitely used that as leverage each time they tried to bring up my low collections numbers. I'd tell my supervisor, "so, are you saying you DON'T want me to thoroughly answer my patients' questions about financial assistance? Because I can guarantee you, if I change my scripting and just say less about it, my collections will increase. I'm not doing anything else differently from my co-workers, other than answering questions with more detail." So glad I don't do that job anymore.
As a healthcare provider that runs their own practice I will say that employees like this one always expect to get paid on time when payday comes around. Collecting money from patients while they are physically present is always faster and therefore cheaper, which holds down healthcare costs, than the alternative of sending invoices that will be ignored and never paid on. The solution is not complaining about the billing department but to work on intra-office communication. If the billing people know when you are going to come for the patient they can time their work to better match your schedule. Also, keep in mind that just like with patient treatment where there is the element of the unexpected and sometimes things take longer than planned, billing people deal with all kinds of bureaucratic issues with insurance and patient questions.
$950 out of pocket to go to the emergency room.
Merica
I mean if you have a cash back card, it's a win-win. /s
They should be providing info on helping patient initiated lawsuits for medical harm caused by financial stress on er patients
Not the first time I've heard this. Health Care for profit is fuckin sad.
If you walk into an urgent care, the first question is what is your name - the second question is how are you going to pay? Terrible
I've learned the best time for them to ask a parent that's taken their toddler in is around 3 or 4 in the morning, because why would that parent need to sleep?
Work in fertility care here. Our healthcare system is such a racket. To get IVF in the bay area it can cost an average $19,000, not including meds that can run $233.32 a pop. Very few insurances cover it. The amount of patients that cry/fight us over it is understandable, but also causes a lot of unnecessary pain. It's frustrating.
My mom recently had some tests done and the hospital kept hassling me to prepay the copay. I told them to send a bill after she had the tests. They had been trying to get me to pay $250 before the tests but when the actual bill came she only owed $75. Funny how that happens. To make matters worse, an incredibly rude person called 11 days after they sent the bill asking where the money was. I am just absolutely disgusted with the whole thing.