Uninsured motorcyclist charged $12K for a broken rib

[Neecy]

Interesting article in the San Francisco Chronicle today - this guy was treated out-of-county and as a result got hit with a huge hospital bill. Someone needs to just dismantle our medical system and build it again from scratch.
-----

There are 47 million people in this country without health insurance. Richmond resident Joey Palmer is one of them.

He learned how costly this can be after fracturing a rib in a relatively minor motorcycle accident and subsequently being hit with a bill for more than $12,000 from San Francisco General Hospital.

...Iman Nazeeri-Simmons, director of administrative operations at San Francisco General, said she sympathizes with Palmer's situation.

"It's not us," she said. "It's the whole system, and the system is broken. We need to look closely at making changes and at how we can deliver care in a rational way."

http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/03/30/BUG1LOTC6T75.DTL

[Donnachaidh]

1. "It's not us," REALLY?

Umm, just WHO set the prices for the care? WHO printed out and sent the outrageous bill? How many hours was he in emergency at 3 to 400 dollars per hour? The world's most expensive nap on a gurney.

OMG -- it IS YOU Imam! :sarcasm:

[slackmaster]

3. The hospital would have billed an insurance carrier the same amount

Here is how the game works:

1. Provider bills twice the going rate.

2. Insurance carrier responds with a statement that the bill exceeds reasonable and customary charges, and pays something less than half the bill. Patient is responsible for the rest (of half of the billed amount).

3. Patient pays deductible. Provider, because of contractual agreement, can't demand more.

Now since this GODDAMN IDIOT didn't have insurance, he doesn't have anyone to go to bat for him. He's shit out of luck, may end up declaring bankruptcy.

[Donnachaidh]

8. even the going rate, per your figures is OUTRAGEOUS.

And perhaps this *idiot* as you call him couldn't AFFORD insurance? There's what, 47 MILLION people out there without insurance?

Are they ALL Idiots in your eyes?

[slackmaster]

10. If he doesn't have motorcycle insurance he cannot legally drive in CA

There's what, 47 MILLION people out there without insurance?

I think this whole discussion is muddied by misunderstandings about terminology. The issue is NOT health insurance, it's driver's insurance which is required by California law.

If the guy had a standard motorcycle insurance policy from State Farm, Geico, etc. his medical expenses would have been covered. This issue has nothing to do with people lacking medical insurance.

[Donnachaidh]

13. just when has the legality of insurance kept Uninsured motorists off the road?

And yeah, the water's got muddied. Although I still think those hospital charges are bullshit.

I didn't carry insurance to cover uninsured drivers until I had a family. But the way things are now, anyone would be totally NUTS *not* to have that provision.

[slackmaster]

15. I pay for UIM coverage as well

But again that is NOT the issue in this particular incident.

This was a solo crash. The motorcyclist didn't have any insurance at all. If he had a basic policy without UIM coverage, it would have covered his hospital bills.

[obaman08]

18. motorcycl

[raccoon]

28. I worked at a hospital once that wouldn't accept car insurance

(and I presume motorcycle insurance as well) because it can take years to litigate. Patient had to pay and then hope for reimbursement.

[slackmaster]

42. The bottom line is someone has to pay

If you can't pay the bills you'd get in a motorcycle wreck, you don't ride a motorcycle.

[RaleighNCDUer]

43. Maybe he couldn't afford a "standard motorcycle insurance policy".

Maybe he had liability only. Is it different with motorcycle insurance than standard motorist insurance in California? The extra 20 or 30 bucks for injury coverage each month could be the difference of eating or not eating with such a low income.

[slackmaster]

47. Looks to me like he couldn't afford NOT to have it either

Medical payment coverage is dirt cheap, and anyone who rides a bike without it is a fool.

If you can't afford to ride, you can't afford to ride.

[LeftyMom]

73. A CA driver is only required to carry liability

If he had liability, it would cover injuries and damage to anybody he hit, but nothing for himself or his bike.

[slackmaster]

97. Medical pay on a motorcycle policy doesn't cost much more than plain liability

Riding a bike without it seems rather foolish to me, and kind of irresponsible.

[brentspeak]

93. Where in the article does it say he didn't have motorcycle insurance?

Can you point it out?

[raccoon]

27. Maybe this "GODDAMN IDIOT" couldn't get insurance because of a pre-existing condition.

Not everybody can get an individual insurance policy, even assuming he/she can afford it.

Or they can insure you and exclude a pre-existing condition forever and ever amen.

[slackmaster]

41. If he had a pre-existing condition that kept him from getting motorcycle insurance

He shouldn't have been riding a motorcycle.

:dunce:

[meldroc]

32. Exactly how was this "GODDAMN IDIOT" supposed to afford insurance?

If you had read the article, you would have noted that this guy wasn't making much money - he was a woodworking contractor that made $7,000 last year. In short, there was no way he could afford insurance, unless he gave up other minor things like food and shelter.

But I guess since he slipped through the cracks, I mean chasms, he's a goddamn idiot. :eyes:

Sometimes I wonder how many freepers slip through the cracks and get posts on DU...

[slackmaster]

40. If he can't afford it, he shouldn't ride a motorcycle

His low income does not excuse him from his legal and MORAL responsibilities.

[Greyhound]

38. See, it's his fault.

Some of these people just make me sick.

[slackmaster]

39. He CHOSE to ride without insurance which is ILLEGAL IN CALIFORNIA

If the guy had either A) had insurance or B) not ridden the bike, he wouldn't have gotten the outrageous bill.

[Greyhound]

50. The outrageous bill is the issue and is the result of the insurance industry's

seizure of our health care system. The fact that you totally missed that and choose to instead rave about what a terrible person he is to get into an accident just shows how completely far gone you are.

[slackmaster]

51. People who can't afford to pay their bills are part of the problem

The amount billed has little to do with the amount that will ultimately get paid. An insurance company is far better able to negotiate payments down to a reasonable level than a broke individual is.

The fact that you totally missed that and choose to instead rave about what a terrible person he is to get into an accident just shows how completely far gone you are.

If the rider was more responsible and either A) had insurance or B) didn't ride, he never would have seen a $12 K bill.

The fact that you choose to excuse his bad behavior shows how completely far gone YOU are.

[Greyhound]

58. Thick as a brick. n/t

[slackmaster]

64. Nice personal attack, but you really don't get it

:nuke:

[Greyhound]

71. You blame the guy that made $8K because he had an accident, you excuse the bill for $12K

for taped ribs and a few pills, you blame the poor for being poor, but I don't get it.
:rofl::crazy::rofl:

[slackmaster]

75. Kindly point out where I ever said the $12K bill was excusable

I won't hold my breath.

[brentspeak]

94. It's illegal to ride without health insurance in California?

Where is it written that it's illegal to ride a motorcycle without health insurance in California? The article says he didn't have health insurance; it said nothing about motorcycle insurance.

[slackmaster]

96. Not illegal, just kind of irresponsible

The article says he didn't have health insurance; it said nothing about motorcycle insurance.

The article describes him as "uninsured". A motorcycle policy with medical pay doesn't cost a whole lot more than a bare liability policy.

[Freddie Stubbs]

44. Hospitals and insurance companies have contracts with specify how much

each particular service will cost. Unless you have a crappy insurance policy which will not pay the going rate, in which case the provider will not contract with them.

[blondie58]

2. that is outrageous!

especially as there is nothing that they do for a broken rib anymore. They have found that when the rib is wrapped, it does not heal as well. Poor guy- I hope that he can work something out.

[slackmaster]

4. I have no sympathy for the stupid son of a bitch

California state law requires people to have insurance. If he couldn't afford it, he should have taken a bus or walked or ridden a bicycle or bummed rides.

He's just going to have to work out the debt somehow. The hospital will almost certainly accept a partial payment and write off the rest.

[fishwax]

6. it requires you to have health insurance?

Or do they require something more than liability insurance on a motorcycle--because liability doesn't necessarily pay for anything you do to yourself, but only damages you cause others while driving, right?

[slackmaster]

7. Mine does

It's standard for California driver's liability policies to include medical pay that applies to your expenses in a solo accident. That's usually how payment gets made BTW - If you and I get in a crash, your insurance takes care of you and mine takes care of me.

If expenses exceed what the policy covers, then liability starts to become an issue.

From the article it seems the motorcyclist had NO insurance.

[raccoon]

29. Do the hospitals accept this, though? I worked for a hospital once that

didn't.

[slackmaster]

37. Yes they do, and in my case they have

A couple of times.

[fishwax]

52. But standard liability doesn't, nor is Personal Injury Protection required by California law

It looks like California law requires death or injury liability and property liability, but not personal medical coverage.

http://www.dmv.ca.gov/pubs/hdbk/pgs66thru68.htm#how

So I don't think we can really tell from the article that he was driving the motorcycle without proper insurance.

[slackmaster]

56. That's right, but medical pay is DIRT CHEAP

If you're too poor to pay YOUR OWN medical bills and too poor to afford medical pay on your insurance, you shouldn't be riding.

[fishwax]

59. Does the same go for driving a car?

If you're too poor to pay YOUR OWN medical bills and too poor to afford medical pay on your insurance, you shouldn't be riding.

I have no idea how much it would cost, in general or for him specifically, to add medical coverage, but that seems a quite different question than whether or not he was driving legally.

[slackmaster]

63. Absolutely!

Being able to cover your debts is a moral responsibility.

I have no idea how much it would cost, in general or for him specifically, to add medical coverage, but that seems a quite different question than whether or not he was driving legally.

I just did a lookup on a hypothetical quote for a 400 cc 1985 BMW motorcycle for a 49-year-old man with 10 years of motorcycle experience and a clean record.

$10,000 medical pay per person increased the annual premium by $232. It's going to be less for a smaller bike, much more for someone with a bad driving record.

I know that's a lot of money for someone who makes $7,500 per year, but it's a tiny fraction of the lowest available rent in the Bay Area.

[fishwax]

69. Millions of Americans, I would guess, drive automobiles in similar situations

I don't think it makes them all irresponsible or careless or goddamn idiots. It makes them typical Americans trying to balance contingencies against the reality of their everyday lives. There are plenty of people who have to drive their automobile to work, but who cannot afford to both feed/house their family and pay for insurance above and beyond the legal limit. That's life--that's how most people get by in America.

[slackmaster]

76. Driving is a privilege, with privileges come responsibilities

Being financially responsible is one of them.

[fishwax]

79. and the law defines that responsibility as carrying a certain amount of coverage

not by carrying enough coverage to address any injury contingency that might come up. If our controversial motorcyclist had carried medical insurance up to $50,000 but came away with injuries costing 250,000, would that still be irresponsibility?

[slackmaster]

81. I frankly don't know

In my case, I don't feel safe riding a motorcycle at all due to my limited visual field, so I don't do it.

[dionysus]

60. wow, what an asshole you are

real big tough guy eh?

[slackmaster]

65. Another nice personal attack!

:nuke:

[Traveling_Home]

5. LIke I'm gonna feel sorry for an uninsured motorist

He can afford a motorcycle he can afford insurance. Uninsured is part of the reason medical costs are so high.

The uninsured guy that rearended my RV in his pickup truck is being sued for $23,000 for my RV damage and if I can get his house for the damage he did to me and the medical bills - it's mine. F**k him.

[slackmaster]

9. Sorry to hear about your crash - Does CO have mandatory insuriance like CA?

I think it's a good idea, but unfortunately too many people get away with driving uninsured.

[Traveling_Home]

31. Yes - CO mandates insurance

[proud2BlibKansan]

67. I am with you on this

My husband had ONE payment left on his truck in November when an uninsured motorist ran a red light and totaled the truck. He has had to take 2 days off of work without pay and had to pay extra for a rental car while waiting for our insurance company to send a check so he could buy another vehicle.

It's just idiotic to drive without insurance.

[zbdent]

11. Why can't poor people just plain die?

<vwhoop>

Whoa, for a second there, I was possessed by a Republican ...

[slackmaster]

12. This particular "victim" would have been better off if he hadn't gone to the hospital

Other than a little Vicodin they really didn't do jack shit for him.

[indepat]

14. Gee, what's the fuss: $12M represents only about a year's pay at minimum wage (is Amurikkka one

fucked-up country or what, all courtesy of 'pukes)?

[slackmaster]

16. The fuss is that the guy didn't have insurance and chose to ride anyway

That puts him in the wrong, rich or poor.

[wtmusic]

21. So what if he had insurance?

$12K for a broken rib, charged to the insurance company, is an expense we all pay.

This case just brings to light the extortion to which medical providers have availed themselves--with little oversight.

[slackmaster]

22. As an UNINSURED motorist this guy is part of the problem

Chances are, at the end of the day the hospital will not have collected enough money from this asshole to recoup their actual expenses. They have to pass that on to everyone else.

12K for a broken rib, charged to the insurance company, is an expense we all pay.

As I posted earlier, the $12K is what they billed, not what they will end up accepting as payment.

[wtmusic]

24. Oh come off it.

The hospital ran some x-rays, sent the guy home, and told him take it easy for a few weeks.

$12K is extortion. $6K would be extortion. $1K would be expensive. Their "actual expenses" weren't squat.

[slackmaster]

26. I don't disagree that the amount billed is outrageous

My problem is with the sympathy-fest for an irresponsible twit riding around on an uninsured, unregistered, unsmogged motorcycle on the roads I drive in the air I breathe.

:argh:

[Hotler]

88. Sounds like you just hate motorcyclist period. eom.

[slackmaster]

91. Well, that has to be one of the lamest posts in the thread

I don't hate the man, but I do find fault with his irresponsible behavior.

[kiahzero]

33. How do you know he's uninsured?

The article is quite clear that the guy doesn't have health insurance... why the leap to assume he's driving without motorcycle insurance?

I can't find the paperwork for the policy on my bike right now, but I'm pretty sure it only covers my damage to someone else or the damage to the bike (since there's a lien on it). I can't imagine my $350 a year gives me medical coverage.

[slackmaster]

34. The article says he's ununsured, and if he DID have momo coverage,

The hospital would have billed the insurance company rather than the rider. When someone has coverage, the insurance company gets to dispute the billed amount and negotiate it down to a more reasonable payment. Then they pay it, so the hospital doesn't get hosed. In this case it's unlikely the hospital will ever see a dime from the motorcyclist. That's a real expense to them, and in order to keep operating they have to make it up by charging people who can pay, more. That is one of many reasons our health care system is messed up - Uninsured people ARE part of the problem. This guy is CULPABLY uninsured.

I can't find the paperwork for the policy on my bike right now, but I'm pretty sure it only covers my damage to someone else or the damage to the bike (since there's a lien on it). I can't imagine my $350 a year gives me medical coverage.

And you don't live in California. Our laws are different than yours. The minimum required coverage will cover the insured's medical (with a policy maximum, of course).

[indepat]

62. And that uninsured sucker could have gotten a broken rib or worse in a mugging

[slackmaster]

66. But that's not what happened, is it?

He chose to ride a motorcycle without being able to pay for an injury that resulted from riding a motorcycle.

[indepat]

70. Seems you are saying the uninsured must do nothing that could

result in injury or sickness, like breathing or eating. Oh, the joy of living in the land of the free.

[slackmaster]

74. Riding a motorcycle on public roads is a privilege, not a right

With that privilege comes the requirement of financial responsibility. If you aren't physically capable of driving safely or are not financially responsible, it's morally wrong for you to drive.

[indepat]

77. Have never operated a motorcycle in part because at no time in my life have I felt

physically capable of driving that sucker safely and I was qualified to be a naval aviator.

[RaleighNCDUer]

25. Bullshit. That is criminalizing poverty.

The article clearly shows that he is a craftsman, a carpenter, who made less than $8,000 last year. He needs to get to work. He cannot afford insurance. So he does what millions do - hopes that nothing goes wrong.

To say he is in the wrong, rich or poor, is unmitigated bullshit because it is a situation no rich person would ever face - choosing between rent or groceries and insurance. and if your income is under $8000, that's the kind of choices you make.

[slackmaster]

36. ROTFLMAO!

The article clearly shows that he is a craftsman, a carpenter, who made less than $8,000 last year. He needs to get to work. He cannot afford insurance. So he does what millions do - hopes that nothing goes wrong.

Being poor does not excuse one from financial responsibility. If you can't afford a motorcycle and motorcycle insurance, you can't afford to ride a motorcycle.

To say he is in the wrong, rich or poor, is unmitigated bullshit because it is a situation no rich person would ever face - choosing between rent or groceries and insurance. and if your income is under $8000, that's the kind of choices you make.

He had all kinds of alternatives, including finding better paying work, riding a bicycle, etc. $8K in the Bay Area isn't just poor, it's dirt fucking poor.

Tell it to the 2/3 Democratic California state legislature. The law requires motorists to have insurance. I'm quite sure that more "civilized" countries like Canada and the UK don't allow motorcyclists to ride around without insurance either, EVEN IF THEY ARE POOR.

[pitohui]

49. sp he chose to ride anyway? how is that relevant?

this happens every day to people who have never set foot on a motorcycle, your argument is only valid if motorcycle riders were the only people who get unexpectedly sick or injured

i know plenty of people who got sick or injured without ever owning or even thinking about owning a motorbike

why focus on that? poor people ($7K a year income is POOR in my book) are also very high risk for diabetes, high blood pressure events, and so on

the same thing would have happened if he had become sick or injured off his bike

the bike is the red herring here, used to distract from the real issue

maybe this is the first time this ever happened in the entire history of california, but it's an every day event in louisiana, so i'm skeptical frankly

forget about the bike, the issue is that the uninsured subsidize the insured

[slackmaster]

54. Had he not ridden, THIS injury would not have happened

the same thing would have happened if he had become sick or injured off his bike

Yes, but that's not what happened here.

...the uninsured subsidize the insured

You've got that exactly backwards.

[pitohui]

85. no i don't have it backwards and you are letting yourself be distracted by the shiny object

the uninsured subsidize the insured, insurance companies by their contract pay a tiny fraction of real costs

we were billed $900 for a test, we were able to prove that the insurance company paid $55 for the test and this was the full amount the lab was entitled to under the terms of their contract with the insurance company -- yet the lab harassed us for almost 2 years, i suppose to try to get our home or into our bank account for money we did not owe

the insurance company and the state insurance commissioner both backed us up and we did not have to pay any more than the $55 paid by our insurer

however, if we had actually been un/underinsured, we would have had to pay the entire $900 -- run the math on $55 vs. $900, that's a hell of a markup

and this happens every day


the uninsured, unless they are already homeless, subsidize the insured because they pay many times more the cost of the care that insurance companies do

this is fact, i've experienced it for myself

if you haven't, count yourself lucky...so far...

it is irrelevant that the guy had a bike, he probably had the bike because on $7K a year he could not afford a car, and if he had to walk to get work in california, he'd not be given any work at all because he couldn't get there reliably

[slackmaster]

95. The uninsured often end up paying $0 regardless of the amount billed

...it is irrelevant that the guy had a bike, he probably had the bike because on $7K a year he could not afford a car, and if he had to walk to get work in california, he'd not be given any work at all because he couldn't get there reliably...

I know this thought is anathema to many DUers view of the world, but the man's situation is very likely at least partly the result of choices he's made in life - Things like finishing high school, getting trained in a trade, working in an occupation where he can get union representation, etc.

If he can't get by in California maybe he should be living somewhere else.

[napi21]

17. A lot of you are saying that $12,000 isway out of line. It's NOT!

I live in Ga. Last Sept, I broke my ankle. I HAVE Health Ins, and MY portion of the bill was $2,500! The ony reason it was "only" $2,500 is that my policy has a cap on my out of pocket expenses for the year.

Truthfully, I didn't total all the bills to see what the full charges were, but $12,000 sounds like that's what the charge is no matter where you live.

[sandnsea]

45. My son broke an arm in 1990, $500

The doctor at the small town clinic took x-rays and set it. We're STUPID for putting up with this.

[pitohui]

53. $2.5K is an order of magnitude less than $12K

you're completely missing the point, the guy is paying over 6 times what you paid for the injury in question

you don't see any unfairness here?

your $2,500 is almost certainly your deductible and the insurance company probably tossed in only a few hundred more dollars after all is said and done if it's anything like how it works in my state

so say the hospital all told collects $3K for your injury and $12K for his injury -- he is still paying 4x the going rate for the insured person

a lawsuit in louisiana occurred where the uninsured woman was billed NINE TIMES the going rate for the same surgery for an insured person, she lost her home, worth all of $25K as a result, do you think this was fair or that she will ever be able to buy another home when she is that low income, she will be on public housing forever

who wins except for the shareholders in the hospital, in other words, creeps like bill frist?

[slackmaster]

83. "...the guy is paying over 6 times what you paid ..."

No.

The guy was billed $12K. He can't afford 1/10 what he was billed, and probably won't ever pay a dime of it.

Because he lacks an insurance company to go to bat for him and get the charge A) reduced to a reasonable level and B) paid, SF General will write off the amount billed, and that chargeoff will get filtered down to those in the form of increased premiums for those do pay for insurance.

[pitohui]

87. you don't know how it works

this man can never get a job now because even if he did find a decent job, it will be garnished by the hospital

the poor in california never have homes, but there are poor people in other states such as louisiana who actually have small houses (inherited from early 20th century) and this is how hospitals can steal a person's home from them also

lots of ways to get blood from a turnip, if the turnip has no defender, i've seen it with my own eyes

your theory only works if the person is already homeless and completely without anything, otherwise they find a way to drain the person or even pressure family members

and if the person does ever come into money, watch out, they will be drained to the last drop

i will give a famous example, of someone who has since passed on so i'm not violating his privacy: george alec effinger, the science fiction writer, had brain surgery in the 1970s and when he finally began to earn some $$$ in the 90s, he was hunted down for the rest of his life by charity hospital trying to get money he simply never had

you are put in a trick bag where you can never, ever climb out by these creative and inflationary bills

if you assume the homeless person will remain homeless forever, then i guess we can assume these bloodsuckers will never get their pound of flesh, but sometimes people do try to climb out, sometimes they even do start to get somewhere -- and then the vultures are on them again

it disgusts me honestly

[slackmaster]

90. I really don't think that's going to happen

At age 49 I've seen enough to be a little comfortable that I know how the system works.

this man can never get a job now because even if he did find a decent job, it will be garnished by the hospital

All the motorcycle dude has to do is file for bankruptcy. Short of that, he can probably get the bill reduced but will likely need the services of an attorney since he doesn't have corporate lawyers like the insurance companies do. The bill is outrageous on its face, and has to be reduced.

...the poor in california never have homes...

I've been poor in California a few times. It is possible to elevate one's self out of it, if you are motivated enough and have either a good skill set or enough raw intelligence. The current market makes it impossible for most people with good jobs to get into the market. It's a cycle, and a buyer's market will come around again as it always has in past cycles.

Not everyone is going to own a home. Some people choose to live frugally, some just don't have what it takes to earn enough money.

[roamer65]

19. Michigan has solved some of these problems by having no-fault auto insurance.

Plus we have a uninsured motorist protection built-in to the policies. If you are injured and require hospitalization, the catastrophic claims part of the policy covers all medical expenses...unlimited time frame. We're no more expensive than states without no-fault.

[slackmaster]

23. California's system is a version of no-fault as well

Plus we have a uninsured motorist protection built-in to the policies. If you are injured and require hospitalization, the catastrophic claims part of the policy covers all medical expenses...unlimited time frame. We're no more expensive than states without no-fault.

All of which means nothing in the case of an idiot who is riding without insurance.

[Wednesdays]

61. That comes with a price tag, though...

Michigan's auto insurance is pretty dang expensive. AAA has a huge lobby in Lansing.

[wtmusic]

20. "It's not us". No, it's never "us" -- and that's the problem. nt

[WI_DEM]

30. I work in a hospital and hopefully this hospital, like ours, has a community care program

or uncompensated care program which can be reviewed to see if he qualifies for a hardship adjustment. Based on his circumstances he would probably qualify for some kind of adjustment on his bill. Hopefully he is looking into that. Alot of time people get their bills adjusted between 50-100 percent.

[ComerPerro]

35. shit, we're still paying off my fiancee's $14,000 appendectamy last May

[proud2BlibKansan]

46. My friend's son had 4 stitches last week and they charged her

$4000, $1000 per stitch!

[pitohui]

48. the uninsured subsidize the insured

insurance companies get these contracts to supply the same services for a much lower price, so the hospitals and doctors feel obligated to bill the uninsured at huge rates to make up for the shortfall

it has already been ruled legal quite a number of years ago in louisiana, an uninsured person might pay up to 9x the same price as the insurance carrier would have paid for the same service to that person

i guess it's called volume pricing and it's legal in other areas but you'd think health care would be different -- when you are sick or injured you are forced to purchase the care whether it destroys your entire future and family financially or not, it is not like you can go shopping, sometimes you are not even conscious when the care is given if the accident is serious enough!

as far as i'm concerned, it should be illegal for insurance companies to be involved in the health care business at all, health care should be a right and some sort of fairly compensating doctors and other medical care workers should come from taxes/government -- and paperpushers should not be allowed to scoop off huge profits at all

well, preaching to the converted here, i'm sure, if only the powers that be would listen

[slackmaster]

57. Hospitals bill insurance companies outrageously high rates too

In every medical "adventure" I've had in the last 10 years, the amount ultimately paid by my insurance company, plus my share, added up to far less than the amount originally billed.

[pitohui]

86. yes, at first they do, and it's an attempt at fraud

in the end the hospital must abide by the terms of the contract they have signed with the insurers, and if need be, bring the state insurance commissioner to enforce this -- it worked for us!

hospitals make up lying stealing fictitious bills all the time and if more CEOs or whoever authorizes this went to jail for attempted fraud (or even one of them did), it would cool the heels of the rest

insurers know they only have to pay what it says in the contract they have to pay

however, the uninsured have no contract and no insurer to protect them from these predators

the issue in this story seems to be that the patient was a victim of a predatory ambulance company and hospital who did a damn good sales job on a man who was hurt and in pain and in no position to argue when they hauled him off for a worthless and expensive treatment

they should all go to jail in my opinion but it won't happen in my lifetime because preying on the sick and injured in this society is how the bill frists of the world make billions

[slackmaster]

98. I agree with your assessment of predation by the ambulance company

The unfortunate man was naive enough to go along with it.

[KAZ]

92. You have a complete misunderstanding of the health care system.

Hospitals survive by cost-shifting, charging high rates to cash paying patients, or those who have insurance with a low-volume, non-contracted insurer. When I was in the biz, Illinois was receiving .90 on the dollar for Medicare services, and .67 on the dollar for Medicaid. Who do you think makes up those differences? BTW, in most IL hospitals, Blue Cross was contractually at 105% of cost, so the cost-shift went to others.

[Gidney N Cloyd]

55. Jeezus, people...

[RamboLiberal]

68. From some of the responses here I thought I was at Free Republic

The damn system of private health insurance and the health system is broken! The way it's going our employers and we are not going to be able to afford to have health insurance. It's past time to fix it.

And don't sit there all smug if you have health insurance. They could find a way to deny coverage for your health problem and you could be one crisis away from facing huge medical debt!

[marzipanni]

78. I wonder how many people who have insurance benefits paid by their employer

know how much their premiums cost.

Read about one horrendous padded bill for hospitalization for a three year old child-
http://www.heynorton.org/blog/2006/06/dr_no_and_the_m.html
and I wonder how much this father's employer paid for HMO coverage so that the HMO would only have to pay ~half, if that, of the charges.

<snip>-
The new mood for reform is coming from employers and state governments struggling under rising health care costs; from policymakers wanting to replace the fragmented system with a unified one that covers everybody; and from the uninsured, a group that now approaches 47 million.

But there is another group that eventually may exert a more powerful impact on the debate: people who have coverage but sense that it's dangling by a fraying thread.

"The core motivation is that for the last few years health insurance premiums have been going up faster than earnings," says Paul Ginsburg, president of the Washington-based Center for Studying Health System Change. "That means there are a lot of people who have insurance but feel vulnerable to losing it."

The stark realities of U.S. coverage

* About 18,000 people a year die prematurely because they lack insurance.
* People file for bankruptcy at a rate of one every 30 seconds because of medical bills.
* The average employer-based family premium rose 87 percent from 2000 to 2006, to $11,500.
* Fewer than 60 percent of people under 65 have employer coverage, down from 70 percent in 1987.

In Pennsylvania, for example, family health premiums increased by 75.6 percent from 2000 to 2006, compared with a 13.3 percent increase in median wages.
more:
http://www.aarp.org/bulletin/yourlife/healingoursystem.html

[slackmaster]

82. My employer spelled it out for us last December

Pay raises were capped at 3% for even the most productive employees because the parent company's premium increased by over $1 million for this year. I get excellent care on a PPO plan, but the system is very broken.

[KAZ]

84. It's mostly from one particular poster.

And I agree with you.

[Neecy]

72. well....

First of all, I have no sympathy for uninsured motorists. I was broadsided by one a few years back and he drove off and left me in a totaled car with broken ribs, neck and shoulder injuries.

But there's no indication in this article that he was an uninsured motorist. Who knows whether or not SF General accepts vehicle insurance for medical services? We don't, and judging him for this is really pointless.

What was interesting is that at first he refused care - no doubt because he doesn't have health insurance. It was the ambulance driver who insisted that he be transported to SF General. In his place, I might have insisted on waiting until I returned to my own county for treatment but people tend to trust medical professionals and in any event he was probably a bit shaken up at that point and likely in pain (broken ribs, I can attest, are excruciatingly painful).

I'm not sure why all this venom is being directed at the guy. Walk a mile in somebody elses' shoes for a damn minute...

[KamaAina]

80. We interrupt this flame war to bring you this important announcement...

the guy got hosed because he happened to have a wreck in the wrong county.

Palmer said he told the paramedics that his ribs felt banged up, possibly broken, but that he was basically OK. He said he preferred to be treated in Contra Costa County, where he lives and would probably qualify for reduced hospital rates because of his income level....

Palmer said the paramedics were concerned that he may have sustained internal injuries and insisted that he be treated immediately at a hospital. So he was driven by ambulance to San Francisco General, the only trauma center in the city.

So listen up, all you poor people out there, be extra careful as soon as you set foot across the county line, 'cause if you have a wreck or get sick or sumthin', you'll be billed just like some rich tourist (except that the rich tourist has health insurance).

One final thought from BushAmerika:

Palmer is a woodworker who specializes in the decorative touches on wealthy people's yachts.

Any guesses as to how much sleep the wealthy yacht owners will collectively be losing over this?

That's what I thought. We now return you to your regular flame war.

[pitohui]

89. i agree 100 percent w. this post

the yacht owners won't even know it happened, they'll just figure the dude is unreliable because he didn't show up for work and they'll hire someone else

i think the ambulance driver did a real sales job on that guy, i hope he got a damn commission!

[slackmaster]

99. APOLOGIES to anyone I've offended, except those of you who called me names

I bristle at the word "uninsured" partly because I have been the victim of uninsured motorists twice.

Peace to everyone except you who indulged in ad hominem attacks. You can go fuck yourselves.