My example of how broken the medical system is.

[oldsoftie]

I need to get some surgery done. Its my sinuses; remove polyps, open he cavities better, etc. Since I have sleep apnea, my surgeon said we have to do it in the hospital instead of their surgical center.
So my surgeon is giving me a discount since I have no insurance & do self pay. His bill started at 9400. With the discount, I'll pay 3340. The Anesthesiologist will bill me a bit under 2k.
So I go to the hospital for their check in. They tell me that their "facilities charge" is 41000. But they'll give me a 70% "discount" bringing it down to 12000. I asked what does that cover? They still haven't provided me with a breakdown.
So the man doing the work charges 3340, anesthesiologist 2000. These are the 2 guys who are doing the major work. Its outpatient. They told me that the procedure takes about an hour.
And the hospital wants 4x what the SURGEON wants. For what?

And is there any way that anyone knows to get this ridiculous number reduced to something reasonable?

[MineralMan]

1. Get health insurance?

It would do that negotiating and you'd just have a co-pay.

They're basically giving you the discount they give the insurers, but you're paying the entire amount without any insurance help.

Beyond that, I have no suggestions.

[oldsoftie]

6. I was laid off and my COBRA was canceled last month.

The policies I've looked at (and the one I chose) are all high deductible. So even with the insurance, I'd still have to pay 80% of the charge.
Heres the deal with the COBRA; end of year when I got my statement it had a monthly price increase of 30 dollars. I didnt notice it & paid my regular payment. They notified me of the shortfall & dropped me. I realize it was MY fault for not noticing, but it seems that an email telling me what I did wouldnt have been out of the question. So I had no insurance with no notice.

[Shell_Seas]

2. Nope. Sorry.

Set up a payment plan, and pay them what you can over the next 10 years. That's about all that you can do.


Our healthcare system is totally f#$%ed, but I promise you it's way better than it used to be, before the ACA. When I was a young single mom in my 20s working at jobs that didn't offer healthcare, the cheapest you could find to be self-insured for yourself and a child was maybe $1,500. Unafordable for a young single mom, so the only way to get my child medical care when he was ill was the emergency room. I was $80,000 in medical debt before I was 28 years old without ever having a serious illness. Welcome to America.

[procon]

3. If you are an at risk type of patient

who requires an acute hsp setting then you are paying for everything that faculty can do to save your life if needed. Whether you would need everything available isn't the issue but that they are prepared for any emergency and have the trained staff and all the services and equipment on hand to help you.

[oldsoftie]

7. Fortunately I'm not a high risk patient. SO many are far worse off than I.

[procon]

8. There must be some apparent risk factor

that your MD had to identify to justify admitting you to the acute facility vs a surg center. Breathing problems would make your doc more cautious of your health outcomes.

Best regards.

[oldsoftie]

10. Thank you! Its on Valentines Day. Yay.....

[Ohiogal]

4. I agree, it is ridiculous.

In '09 my husband needed surgery on his hand. (he stuck his hand in the leaf mulcher to clean out some leaves and whacked off a finger tip). I wasn't home at the time. My son rushed him to the hospital ER with his hand and finger tip wrapped up in an ice pack.. The ER staff called the hand surgeon specialist who did a fantastic job of patching his finger together. He went home that night (my older son and I had to practically carry him in the house since he was so groggy from the anesthesia he couldn't stand up). We were told by the outpatient nurse they wouldn't allow the outpatient dept. to remain open just for him, so we HAD to go home. Got the bill -- surgeon's fee $800, hospital fee $21,000. The explanation was, it's expensive to provide a full service operating room with all the technicians, nurses, equipment, electricity, etc. Plus there would be any and all services and personnel at the ready in case something unexpected came up during his surgery. Luckily we had insurance which paid 80%.

[Auggie]

5. Broken? Or rigged?

[ck4829]

22. A little bit from column A, a little bit from column B

[Crunchy Frog]

9. Maybe check out medical tourism.

I believe that there are a number of countries where you can get high quality surgical services for a tiny fraction of the cost of the same services in the United States. You can even combine it with a luxury vacation and and still be vastly better off financially.

[TexasBushwhacker]

11. Rand Paul's hernia surgery in Canada

is only going to cost $8000. That would probably cover a copay here.

Any chance you can put this off until you find a new job and get insurance?

[oldsoftie]

14. It came on quickly and the polyps will only get bigger. Cant breathe at all thru the nose.

the passages are clogged with the polyps. It's miserable. But I know I could be a LOT worse off, so I try to keep that in mind

[TexasBushwhacker]

16. I don't know where you live

But you might check and see if there is some kind of program through your county hospital district. Here in Houston/Harris County, they figured out a long time ago that it was cheaper to cover low income folks' medical care through the county than to have them using emergency rooms for primary care and letting chronic conditions go untreated. It's not free. There are copays at different levels depending on your income. I had a friend who got her treatment for Hep C basically free. Austin had a program for the uninsured too. Anyway, it's worth looking into.

Also, you may be able to get your COBRA reinstated.

https://blog.bernardhealth.com/bid/183786/how-to-reinstate-cobra-in-5-easy-steps

[oldsoftie]

18. Thanks very much!! I'll see what we've got here in GA

[TexasBushwhacker]

19. Good luck!

[area51]

12. I'm so sorry.

We need the Democratic party to stand up and demand single-payer/comprehensive Medicare for All.

For anyone reading this thread, please consider contacting Nancy Pelosi's office to advocate for this.

[TheBlackAdder]

13. How about entering a cardiac care unit, contracting e.coli, not fed for 3 days, no potassium. . .

.

Come down with pneumonia, while doctors state it's chronic lung disease, then 4 days later state is was pneumonia, but treat a viral form instead of the fungal form because they didn't culture it, moves to ICR where kidneys shut down, crashes when attempting dialysis while I'm in waiting room, liver starts to fail. . three days later dead.

Go in for tachycardia at one of the top hospitals in NJ, state of the art. . . leave in a box.

.

[oldsoftie]

15. OMG. Thats awful!! I'm so sorry you had to deal with that.

As I said up thread, I know I could be MUCH worse off!!

[TheBlackAdder]

21. This happened to a relative just a week ago. Prepare to take elecampane with you, if in-patient.

.

Most hospitals now don't practice full sterilization procedures now. Many workers are now contract employees.

I learned that from an in-law who was the chief surgical nurse at Walter Reed. It's all antibiotics now. MRSA, e.coli, and others are now prevalent in hospitals and it's becoming accepted as the norm. Pneumonia festered in him so long that they could not stop it, where half of the lungs were filled. Elecampane cleans out the lungs and has no known drug interations, but is used to resolve anthrax and chronic bronchitis infections. My family and friends use it for bronchitis and to stave off any chest infection when having a cold. It works in just a day or upwards of three for severe cases. His wife trusted the doctors. She's kicking herself from not giving it to him.

Always question the doctor and have others research what is said. Best wishes.

.

[ck4829]

17. K&R

[rgbecker]

20. Mexico?

Since they are not paying for the wall, they have money to keep the hospitals' charges reasonable.

[Act_of_Reparation]

23. It's really cheap to run a hospital, you know.

We don't have to pay for rent or power or water or anything like that. Our hundreds of employees are volunteers. All that spiffy equipment you see everywhere was given to us for free.