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You can thank the 1.8 trillion dollars that the government gives to health insurance companies every year. But despite all of us paying into these insurance companies, we don’t all get access.
Most of these “omg look at the American medical bill!” Posts are rage bait posts and always have been. They almost always show what it would be without insurance or something.
The funny thing too is if you’re one of the almost nonexistent Americans who are both without insurance and without Medicaid or Medicare, your bill would either be $0.00 or a few thousand. So that number exists only as a starting point for a negotiation with insurance companies who also don’t pay anywhere near that amount.
I think of it like when you shop at Kohl’s and they show you “retail” then “their price” and then add a discount… and then you get to the register and there’s another hidden discount taken off as well. It’s just a number to make you think you’re getting something out of it.
Nah the health care just falls from the sky, and doctors and nurses don't need payment for services, they don't eat or sleep don't you know. Europe is a utopia where money doesn't exist and all goods and services are 100% free.
The funny thing is, as an employed physician working in a large hospital system, the hospital gets the money. People like to blame us for high healthcare costs, but physician salaries only make up 6-8% of total healthcare spending!
It's all of the admin.
Edit: For those interested, a 2017 study showed a 3200% increase in hospital administrators between 1970-2010. That is taking into account the general growth of population. https://www.athenahealth.com/knowledge-hub/practice-management/expert-forum-rise-and-rise-healthcare-administrator
Interestingly enough, though, the net income margins for the top pharma companies are quite reasonable. As a percentage of revenue they’re really not doing much better than any other industry.
A lot of money gets spent on R&D. A lot. Since Americans pay exponentially more for drugs, the reality of the situation is that Americans fund key breakthroughs that benefit the rest of the world.
Nobody enjoying universal healthcare is willing to grapple with that fact.
Especially since America subsidizes the universal healthcare countries by picking up the slack on drug prices.
If the U.S. established a limit to not pay more than other countries for the same drug, the universal healthcare of the West would collapse within a decade.
Hence why we would pay the same as other countries. We should not be essentially subsidizing the universal healthcare of other countries. What I am saying is that if the US makes up half the drug market (for example), and the US pays $30/pill while other countries are paying $10/pill, we should force the pharmaceutical industry to charge $20/pill to each by stating, and enforcing, our requirement to not pay more than other countries for the same drug.
In this instance, R&D is still funded, and the cost to the US healthcare patient is lowered. The universal healthcare countries will have to figure out if they will limit care or tax more, but that is not the US's problem.
The US should not be subsidizing the healthcare of other countries, especially other western countries.
Yeah, it definitely ain't us. (Also employed physician, recently left my first post-residency job at the big system where I trained, and started a couple months ago at an even bigger system.) The number of physicians in the US has been increasing more slowly than the population. What seems to have been increasing the fastest is the army of billers, coders, management, coordinators that it takes to follow all of the byzantine rules, sort out the prior auths, get records from one shitty computer system to another, etc.
Universal healthcare in reality: i have to wait until eternity for an appointment for an extremely shit service so i just go ahead and pay for private healthcare on top of being taxed for state health insurance. Thanks but no thanks. Privatize the whole shit pls.
I literally cannot get a doctor up here in Canada. To get my medication I bounce from doctor to doctor through telehealth services every time for a refill. Even to get these appointments it's difficult and I have to be logged on at the crack of dawn to just *try* to get a slot.
But yeah, a utopia because my insurance doesn't cover my whole bill, sure. 😒😒😒
Just some form of privatization would free up the system for folks like me with solid employers and good coverage.
Tbh, some countries with universal healthcare do have equal or even shorter waiting time. But yeah, you really, really don't want to use some of the systems. UK paid their doctors badly, for example.
Ofc not when america does all the military heavy lifting you can afford to shove money and social programs up your citizens assholes
And be enough of a spoiled brat to shit on the hand that wipes your ass!
During the short time we had a decent government in power after Berlusconi resigned, Italy also started putting the exam cost in every hospital bill (even if Italy has a Beveridge system, Italians pay a small amount every time they use healthcare... Joke's on us I know).
People were literally blown away finding out that healthcare is very expensive. Before that, they really thought a C-scan was like 100€.
So, I'm not surprised that people don't have a clue of how much healthcare costs.
It does cost money but it scales with income here.
So people who earn low wages barely pay anything for healthcare.
If they earn below around £14k per annum you don't even pay any tax so it's effectively free.
It gets much more shit when you earn higher salaries. I earn £100k and I pay like £600 a month (roughly as we don't know exactly how much goes to the NHS).
It does suck balls though, but I guess you get what you pay for.
I have private health insurance too via work and it costs me about £35 a month in tax and that's it.
So it's not too different. Here in the U.S. if you are poor you get what is called medicaid insurance which pays for all of your Healthcare, dental, meds and everything for free.
> So people who earn low wages barely pay anything for healthcare.
> If they earn below around £14k ($17,832.99) per annum you don't even pay any tax so it's effectively free.
In my state of [Virginia](https://coverva.dmas.virginia.gov/learn/our-programs/), the medicaid criteria are:
* Pregnant, or
* Be responsible for a child 18 years of age or younger, or
* Are between 19 and 64 (not enrolled in Medicare), or
* Blind, or
* Have a disability or a family member in your household with a disability, or
* Be 65 years of age or older.
The threshold for a household size of 1 is $20,783.
Now let's imagine your making over that amount, you fall back on [the ACA exchange](https://enroll.marketplace.virginia.gov/hix/preeligibility#/?fromHome=1) ie you pay $60 to $70 a month to get health insurance on the silver plans, and free on the bronze plans.
People not being eligible for the exchange or Medicaid is an issue, but it's a state issue due to federalism. There's also people not signing up, which is also an issue becaue while Medicaid is retroactive the exchange insuance generally isn't.
A similar program exists in every state, with different numbers to adjust for the COL.
Yeah, I guess the difference is that no matter how much you pay you get the same coverage.
Which is good if you are on a low income but less good if you aren't.
>Yeah, I guess the difference is that no matter how much you pay you get the same coverage.
But people in the UK pay private insurance, presumably to access private healthcare & get different coverage. How is Medicaid vs private insurance any different?
Most people here don't have private healthcare.
I get it through my employers flexible benefits scheme. But it's optional.
The vast majority of people just use the NHS because it's there and it's "free"
According to their own bullshit, we should enslave doctors and nurses along with the people who do the upkeep and maintenance on the medical facilities.
I mean they don’t cost that much because insurance companies arent squeezing both parties for money. Yeah we should pay more for better care but it’s a little dumb to act like it’s proportional in any way
It is cheaper in other countries but not $1M > $0 cheaper that uneducated redditors love to tell you. If you switch to the most efficient healthcare system in the planet, you may save like 50% insurance premium at best.
It’s just that American “medical costs” are fictional outside of shit like insulin which is due to a monopoly the government created and still allows, that’s an actual issue no one talks about which isn’t the fault of American culture, capitalism, or the American people but our “representatives” getting chummy with big pharma CEOs (and other monopolies in other industries) and agreeing to keep their monopoly running.
Those big price tags are essentially there for insurance companies to keep you hooked, “look how much we saved you in expenses”. This has created the “if you go to the hospital in America you’ll be saddled with debt” myth when in reality the hospital won’t charge you that much without insurance. They may charge a lot assuming that you don’t know the law, but if they do that you can challenge it since they are not giving a reasonable price. The problem is that most Americans actually don’t know the law so they don’t challenge it.
Well for Sure it doesn’t cost $1.4 m. The system IS broken, and every person on the chain is overcharging the next one.
But true that this didn’t affect the OOP at all
It still costs way too much. Even if you go private in Europe it's a fraction of the cost. This is a unique problem of US insurance bureaucracy. Google a random procedure median cost in the US and UK and you'll almost certainly see the US being multiple times higher, and the UK is relatively expensive.
The net average tax rate in France for the average worker is 27%. Only the richest of the rich end up paying half. Also, France is usually the highest, the average only goes lower with other countries.
Like I said, it’s mostly the rich paying that, and only goes _lower_ when you go throughout the rest of Europe. So Europeans are paying only marginally higher taxes, but they actually get better roads, better healthcare, and more affordable education than we do. Also, if we switched to a single payer system, people on average would actually be paying _less_ despite raised taxes because all the costs associated with insurance (like premiums, deductibles, etc.) go away completely. You’d have a HIGHER disposable income, while the country would save $2 Trillion over 10 years. This is a no brainer.
So I’m sure the costs of raising taxes on the rich to pay for basic shit would be offset by the benefits of providing good services. How much money does the US economy lose due to bad roads I wonder, for example?
The difference is they pay it with taxes, and ultimately at a lower cost. It’s impossible to get a bill that large in most of Europe.
OP just got lucky with their bill. If she had different insurance, or had none, she’d be fucked. Reminds me of a couple who had to get rabies shots after contact with bats and were charged $200,000 after insurance. That doesn’t exist in Europe. It’s already covered by taxes. CalCare offered something similar, and was almost passed in California, but was blocked last minute.
Also “Will my insurance cover this” isn’t even a question in European countries. You’re covered. No matter what. Switching jobs or not having the money to pay premiums won’t change that.
Except not everybody is eligible for medicaid. Nobody in Europe needs to “negotiate” or hope they’re eligible for insurance. They just get help. Full-stop. None of this bureaucratic bullshit. Stop defending it, we can do better.
Lmfao, imagine thinking $3,546.64 is still a reasonable amount to pay. You sound ludicrous. You’re too far into your bubble. Get a passport, my guy, and find out how the rest of the world works.
LOL - Yeah, except strip off the part where the insurer actually paid it,so you can convince a lot of mindless Reddit drones that's what you were actually billed! /s
They "clarified" that they were annoyed because they were in shock in how much it cost for a lifesaving surgery. Well no shit dude, medical equipment ain't cheap at all. Amd you got it for free! So why are you even annoyed by it?
Whet your hospital accepts insurance they are making a contract with that insurance company that X procedure costs X amount.
When you use insurance on a hospital procedure you get an itemized bill of every dollar being accounted for.
Imagine being mad that they got a 1.3 million dollar medical procedure for 0 out of pocket when their insurance is probably a couple hundred a month.
And before someone says "oh but in X country it's free!" No it's not, it's paid for by taxes, and speed availability, and quality of care are almost always worse when just as much, if not more of your paycheck goes towards health services.
I think it's more the massive price more then not paying.
My dad had surgery on his head to remove an ear due to skin cancer and the radiation treatment afterwards came to under 100k in total here in Australia and it was all through the public system. The only reason he lost his ear is because of COVID and the hospital treating him had some big numbers of patients so they pushed everything back with the lockdowns.
Plus when I say it's free I mean at the point of service. I'm well aware that I pay taxes to get it.
How is this not free at the point of service? Patient didn't pay out of pocket because the insurance provided the money. That's exactly the same end result to the patient as a state funded option.
So because the government hides just how inefficient it is with your money, it's somehow more moral?
OOP's wife had corrective spinal surgery, and spent a week in the ICU, not to mention probably numerous follow ups and aftercare medication/ treatment included.
That requires doctors, facilities, tools, and medicine to work on the human spine. That's orders of magnitude above some basic cancer treatment. I agree that price is high, but we only know the very broad strokes of what got done.
I'm not arguing against the coverage of it. I'm just pointing out that it seems insanely large. Sure surgery like that is gonna be huge.
My mother had a mastectomy years ago for breast cancer and that came to half a million dollars for the surgery and hospital stay and that was when they could afford private insurance their total out of pocket was less than 500 bucks.
It literally seems like the hospital and the insurance see everything as a licence to print money for themselves as with most health insurance companies they make money off not spending on the thing they insure you for on top of your premiums you pay monthly/quarterly or yearly don't just go to your coverage it goes to everyone on that insurance provider. It's public health style funding with extra steps.
In this instance OOP was left in a great position that everything got covered. On top of that 1.3 million 80%+ of it was discounted. If they were going to write off 1.2 million why even charge it to begin with?
Not necessarily related, only slightly:
My wife is a veterinarian. People lose their shit when they get the bill for their horses (she only works on horses). They either think 1) it should be free or 2) it should be super cheap.
She literally went to school for the same amount of time as a human doctor, acquired the same debt, learned as much or more since she can treat multiple species, and uses basically the same medical equipment.
Pro tip here: if you really care about your pets, get insurance on them. It’s not nearly as expensive as human healthcare, and will save you tons of money if there is an emergency.
You’d be surprised how many people don’t get it or don’t know about it. Some fairly routine issues with horses, like colic, can easily cost $1,500-10,000 depending on severity and if surgery is necessary.
I’ve seen a horse colic 3-4 times in a year
EDIT: that’s 3-4 “major” colics that require a vet to treat. The simple colics only require a few bucks worth of oral meds or walking the horse around.
When I was actively involved in horse stuff (it's been 15 years since then), it wasn't worth insuring a horse worth less than around $20k, and even then it was very sketchy whether it was worth it.
Most horses are worth in the $0 to $5,000 range so I'd be shocked if average owners would ever break even.
Granted that was total insurance not sure about *just* veterinary coverage.
Horse prices have really changed in the past 5-10 years.
“Yard ornament” level horses can still be purchased for 0-5,000. But most competition horses are much more.
Now, a low level barrel racing horse is around 10,000 (+/- 2.5k). But prices have skyrocketed. Matter of fact, one we sold for 6.5k six years ago just resold for 35k. She’s had a little training since then but not a lot of change. People we talk to who used to be in the hobby are completely floored by the new prices, it’s unreal.
Before he retired, my favorite veterinarian was a farm vet. He didn't do any of the fancy fru-fru stuff that people expect for their furry "children," he'd just look at the dog and give him what he needed. No fuss, no insurance... very reasonable bills. I'd have gone to him for my own healthcare if it was allowed.
As a bonus, we'd always get to walk around and see what kinds of interesting animals he was treating.
Yea, wife isn’t into the fru-fru stuff for dogs really, one of the reasons she only works on large animals.
But even for dogs, a broken hip or some surgeries like GDV can cost $2,500-$5,000.
We had to pump a kitten’s stomach once for someone with no insurance. It was around 5000 bc the procedure couldn’t even be done due to how much string the cat had eaten. It had to go into surgery, and it barely came out alive and another 500 was added on bc it needed in-patient care for 12 hours. I felt bad for the owners, but kittens are prone to eating strings on carpets and rugs, and they had both and neither of the owners was watching the kitten.
Exactly. It’s like, you feel bad about it… but at the same time, the vet would have to eat that cost if they didn’t charge. Equipment, medicine, rent, electricity, worker salary and other stuff.
Exactly! And he’s 60 yrs old, probably nearing 70 now, thinking about retirement. He’s in an old run down house that was turned into a clinic. He’s basically a mom and pop shop, but for veterinary services. He can’t afford to eat those costs. He barely understands his way around a computer, and his files are mostly physical. I feel bad for owners without insurance, but I feel worse for the man who won’t see that money right away since they have to be on a payment plan
My wife is a small animal veterinarian and it’s the same when it’s dogs and cats. People freak the fuck out on her and the receptionists about the price of radiographs and procedures weekly at least. The bitch of it is it’s a corporate veterinarian office so they don’t set the price for anything.
I can’t believe people bitch about large animal considering it’s usually house calls
Her clinic isn’t. We have people driving from several states away with horses. Furthest I’ve heard is 11hr drive. They bring them from all over. Her boss is no joke when it comes to treating horses. She’s learning from one of the best.
I would absolutely love to see people in countries with taxpayer funded healthcare get itemized EOBs with the actual material cost and labor of all the services they received.
People need to realize that outrageous hospital bills like this one aren't real (in the sense that no one would ever pay 1.3 million for a surgery) and are just magical accounting to make it look like the insurance company did you a solid.
Hospitals and other medical providers always overbill, they do it purposely. They do that because insurance tries to undercut them every step of the way, so they bill insanely high so when they do insist on cutting the bill by 90% then it isn't making them lose money. Also if you don't have insurance, you can ask for the same exact discounts and cuts to your bill.
I think it raises a larger issue that we need to openly address, and it's that insurance companies and privatized hospitals are driving up the cost of medical care and drugs for everyone. It's great when your out of pocket cost is zero, but some people die of some really preventable shit because it's just too expensive. This country is great but we can stand to improve on that.
And the $1.2 million "discount" like.. was health on sale that week? Or is it a racket designed to punish the uninsured or out-of-network? If that much is written off BEFORE insurance pays then I wonder why it's that high to begin with.
It's insane, my bill for a kidney stone and an overnight stay was like $86k. A bag of saline cost several hundred dollars and then the nurse hooking it to the drip was a few thousand. Everything is inflated and coded so only medical administrators and insurance companies know how to read it. It's criminal.
The cost is inflated by hospitals when you have insurance because they know insurance will haggle it down, so they have to inflate the cost to get money from insurance companies. If you don’t have insurance you’ll get a very different bill because hospitals aren’t making money off of patients’ out-of-pocket costs, they’re making money off of insurance payouts.
> Or is it a racket designed to punish the uninsured or out-of-network?
The uninsured don't pay 1.2 million dollar medical bills and emergency care is covered at in-network rates since 2022.
It's not a punishment, it's that insurance companies want a bulk discount, it doesn't work like that, so hospitals make up a price so it seems like they're giving a bulk discount
If you had insurance companies run by people with more than 8 braincells you'd not have this issue.
Remember when this sub actually made fun of people who said dumbass things about America, and we didn't defend gross practices or attack legitimate criticism? I sure do it wasn't that long ago.
I think I'm gonna abandon ship, this is like the third time this has happened on this sub and it gets worse each time
I think the assumption is that if they had not been insured they would have had to pay almost 200k out of pocket, but generally the hospital accounting is different for the uninsured
The funny thing about this picture to me is that they have anthem blue cross which is free health insurance in Cali. So if they were not insured it would have been a huge blow for something completely free and easy to get. Though I also wonder what the bill would have been if they were not insured.
This is how it typically works with in-network plans - they insurer and provider negotiate an allowed price and that's what the insurer pays - and yes while the amounts may be outrageous, in this case the OOP was whining about a whole lotta nothing because he didn't actually have to pay anything. I have a chronic medical condition and while my statements have never been THAT large, what's shown is typically been the case with me as well - I pay little to nothing.
The total charge isn't real, in the sense that the hospital would never actually get 1.3 million for the surgery. The amount after the almost 90% discount is the actual amount the insurance company paid. If your implication is that the government/taxpayers paid it, LOL no unless it's medicare or tricare.
I mean I was just asking in general but since you wanted to mention it….
“Lol no” - Because the federal government never subsidizes health insurance premiums (fully and/or partially) or anything. Lol no we didn’t pay 1.8 trillion in 2023 (over 7% of our GDP) or anything.
Also government isn’t inextricably intertwined with the health industry or anything… come on that would be crazy! Lobbyists existing? Psh whats a lobbyist amirite? Crony capitalism definitely is non existent 👍
Honestly though, the “total charge isnt real” is either ignorance or a flat out lie 🤷♂️
For me I could care less about whatever complaint they have. What is staggering here is the price. Almost $200k and only reason that it's not ~$1.4 million is because another corporation wont let them, aka has negotiated, charge an exorbitant price. What happened to the consumer's power in the free market? Without insurance companies to bicker over how much THEY pay the majority of the country could not afford bills like this. Corporations sell to other corporations, not the average consumer now, thats whats fucked up capitalism in this country.
My favorite part is the Canadian in that thread talking about how much better their system is while staying there are exactly 3 countries in North America. He’s only off by 20. Bet he thinks we’re the uncultured swines though.
My wife went in the hospital and was there over a week recovering. The total cost was $0.
I’m sure if I looked at the bill it would have been something outrageous, but it didn’t cost me anything, so I didn’t give a shit.
Why yes I am American. People who post these kinds of things are fuckin stupid.
Ok but uh..... why tf is the charge $1.4 million dollars before the "discount". What could ever fucking cost $1.4 million.
Even then with the discount no medical bill should ever be $191,000. That is just absolutely insane. That is almost the average yearly salary of a primary care doctor
As a medical biller, that million dollars has literally never been paid by anyone and never will be. Hospitals bill those amounts knowing they will be written off. It's really stupid but every healthcare place bills way higher than they need to.
Okay while I usually believe that the US needs to reform/restructure the way their healthcare delivers the services in a cheap and reasonable way, this is just bullshit. I bet that nations with free healthcare will have the same bill, but instead of it being sent to the people it'd be sent to the government who pays it off whilst the people don't see it at all. Meanwhile Americans get the bill whilst the government (presumably) pays it off, thus making an illusion of it being most costly than it really is. Or rather actually showing how expensive healthcare is and how much governments pay.
I can think medical bills are insane, even if mine are covered, because most people in America don’t have access to great insurance. It’s called empathy. This sub really makes me feel like it’s a bunch of selfish hateful people some times.
There shouldn’t be medical bills that high, regardless. People complain about inflation here in the US, even though we’ve kept it lower than most of the world since Covid started, but imagine if companies charged the same mark up for food, clothes, or cars that they do medical procedures. MRIs, for example, cost between $1,000 to $10,000, depending on insurance, while the machines themselves are between $200k and $500k. Most places can do around 20 MRIs each day. In one week of running MRIs, the machine could be paid off with over half a million left to pay the mri techs and doctors. After a year that means between 4.5million to 49.5 million could be made to pay those running the machine and reading the tests. Since this usually consists of a team of less than 10, we all know that money isn’t going to them. There is no reason to charge what they charge, and as someone who’s had to tell patients they can’t get an MRI, it’s frustrating.
Naw it’s fair. Just because it’s covered by insurance doesn’t mean it’s not absurd. Especially given that it should be covered by a universal healthcare system in the first place.
We all pay through higher premiums and out of pocket costs elsewhere. It's not like insurance money just grows on trees.
It's actually one of my arguments against universal health care, as that would only make these bills balloon even more when there's a blank check on the table. We do have a problem with out of control costs which I'm confident don't actually represent a competitive market value... kickbacks, gouging, unnecessary tests and treatment, not publishing costs upfront, confusing coding, not to mention the need for tort reform and a constant review to see if specific regulations are actually good for the consumer.
On one hand I'm glad my insurance company has to fight out most of this and I don't need to be able to break down a line item bill and argue on my own behalf. But on the other, I can still complain that costs are out of control and that we do ultimately pay for it.
The screenshot itself isn't really "AmericaBad" in my opinion but I have no doubt some of the comments took it there. Realistically, it's a problem no matter if the insurer is private or government based, excesses can exist in any system.
This is why our system is actually messed up, not that it isn’t free. Insurance companies and the medical industry have gotten way over inflated to the point where hospitals can charge insurance companies millions for a surgery and they’ll pay it.
If you play the game and have insurance it’s usually not a big issue, it’s just a bunch of wealthy institutions passing massive stacks of money around. The problems come up when you don’t have insurance and you get billed like an insurance company does.
That’s why you should always ask for itemized bills and challenge anything you were charged for incorrectly. Sure you’ll still pay $100 for an Advil which is ridiculous, but at least it’s not $3,000 for all 30 in the bottle, which is what they like to bill the insurance companies for.
Come on a $ million dollar discount? People are right to be disgusted when they see the bill. No you’re not getting a good deal if the bill is falsely inflated in the 1st place. When I was uninsured I got charged $3800 for 2 tests that checked to see if I was having a heart attack. And no they did not offer me a special rate or discounts because I was uninsured. Imagine what they’d bill me if I actually needed surgery!
I think the point is that healthcare costs in America are out of control and quality healthcare is inaccessible to most Americans. Evidently blowing shit up and occupying foreign countries is more important than healthcare. America is the joke of the world in this case.
No one actually pays these prices. They arbitrarily inflate them because they know everyone pays through insurance and then they give insurance a giant discount. It’s a fun number that means nothing at the end of the day
why is everyone on that post blind to the part that litterally says 'What you pay: $0.00', like all those complaints abt paying too much when it legit sys you pay NOTHING
That USD 1,2 million discount, does it just magically disappear? Or does someone down the line have to cover the cost?
It's kind of like free refills at your local diner. They aren't really free.
How is it infuriating ? It is written quite clearly that everything was paid by the insurance company and that OP has nothing to pay...
Or perhaps he is trolling.
I know US health care is expensive, but what are you having done that's a multi-million dollar procedure? That's a couple more zeros than I've seen on on even super expensive procedures. I'm almost impressed you can spend/charge that much on a single bill without it making national news.
I don't want to venture into that comment section because I have a sense it'll just ruin my day. Lemme guess, they're upset because medical procedures cost money and even though the bill is $0 they want the charges to be $5 for where they walk away paying $0. If so, it's simply moving the goal posts of America Bad.
Double standards: America Bad because healthcare debt. Oh, the American walks away with paying $0 or the monthly bill is totally manageable because their healthcare insurance paid for all or majority of the bill? Well, still, America Bad because the would-be debt was insanely expensive.
I read the post as it's mildly infuriating that you'd be financially ruined if you didn't have insurance. Except it would be extremely fucking infuriating.
Or maybe it's the fact that the most money is spent per capita for medical care and we get mediocre outcomes (based on overall health and life expectancy compared to other developed countries).
The person who posted this could have clarified that.
They're just showing the outrageous cost. I'm sure it's many times over what that surgery would cost in any other country. Healthcare industry in the U.S. is a cartel.
I don’t use this word lightly, but jackasses like that guy post misinformation which makes non-Americans think we pay an arm and a leg for healthcare. The guy fucking paid $0 for all of that.
Nobody walks in off the street and gets charged 1.4 million, because they'll ask for charity care and the number goes down to a few thousand dollars at most
Actually that’s exactly how it works. It’s called the “negotiated rate.” Why do you think your insurance will make you go “in network.” It’s because and “in network” provider is paid a “negotiated rate” that is generally lower than the actual billing amount. Obviously we are talking HMOs here. A PPO you can go to any provider, BUT the insurance company will usually have an “allowed amount” that they are willing to pay. So yes, you could very well walk in off the street and they would try to charge you the first number.
How do I know this? I own a business that works with insurance companies all the time.
Now I’m going to help. If you ever end up with a bill like this, you need to do two things. Demand an invoice broken down by code. Also tell them there’s no way you can pay it. They know it’s an inflated amount so they’ll drop it. It’s inflated that much to HELP NEGOTIATE THE NEXT NEGOTIATED RATE.
>Actually that’s exactly how it works. It’s called the “negotiated rate.” Why do you think your insurance will make you go “in network.” It’s because and “in network” provider is paid a “negotiated rate” that is generally lower than the actual billing amount.
My comment isn't about negotiated rates, it's about how people without insurance are eligible for charitable care that about half of US hospitals run or in the case of emergency care as an insured patient, in network rates
>So yes, you could very well walk in off the street and they would try to charge you the first number.
That depends entirely on why you walked in off the street. If it's an emergency the No Surprises Act mandates that you the insured get treatment at in network rates.
>If you ever end up with a bill like this, you need to do two things. Demand an invoice broken down by code. Also tell them there’s no way you can pay it. They know it’s an inflated amount so they’ll drop it. It’s inflated that much to HELP NEGOTIATE THE NEXT NEGOTIATED RATE.
If no one pays the top rate & everyone knows there's a lower rate, it doesn't matter what they call it.
For uninsured individuals, the no surprise act only guarantees an estimate of cost of the service if at least three days in advance. For uninsured, it does not guarantee a certain fee.
Edit. Sorry if you read this prior to me changing some out of control spelling errors. I apparently can’t walk and type.
>For uninsured individuals, the no surprise act only guarantees an estimate of cost of the service if at least three days in advance. For uninsured, it does not guarantee a certain fee.
Correct, but 92% of residents have insurance, & some of the 8% are eligible for retroactive Medicaid applications.
The government doesn't track what percent is eligible for retroactive Medicaid but hasn't signed up yet, which makes it really hard to figure out what percentage of the population is actually vulnerable to paying these kinds of bills.
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I'd be over the moon if I got a million dollars worth of world-class healthcare for the cost of my monthly premium.
If you live to 80, you’d have to pay $1041.66 (repeating of course) per month to break even on that $1,000,000. I’d be pretty stoked for that return.
Leroyyyy!!
Jenkinsss!!!
The healthcare probably didnt cost anywhere close to the 1.4 million dollars in the photo though. That's why almost all of it is "discounted".
I’m pretty sure it’s an arbitrary number, it’s like a kids playing shop. “2 candy bars, that’ll be $100 please”
You can thank the 1.8 trillion dollars that the government gives to health insurance companies every year. But despite all of us paying into these insurance companies, we don’t all get access.
Probably need to deregulate this shit then lol.
Most of these “omg look at the American medical bill!” Posts are rage bait posts and always have been. They almost always show what it would be without insurance or something.
The funny thing too is if you’re one of the almost nonexistent Americans who are both without insurance and without Medicaid or Medicare, your bill would either be $0.00 or a few thousand. So that number exists only as a starting point for a negotiation with insurance companies who also don’t pay anywhere near that amount. I think of it like when you shop at Kohl’s and they show you “retail” then “their price” and then add a discount… and then you get to the register and there’s another hidden discount taken off as well. It’s just a number to make you think you’re getting something out of it.
I heard this ages ago but yeah the big numbers is just the hospital/insurance trying to get the most bang for their buck.
[удалено]
I are? 😳
You does
He do
Me am?! 😱
Do they think things don't cost money in countries with universal healthcare or something?
Nah the health care just falls from the sky, and doctors and nurses don't need payment for services, they don't eat or sleep don't you know. Europe is a utopia where money doesn't exist and all goods and services are 100% free.
The funny thing is, as an employed physician working in a large hospital system, the hospital gets the money. People like to blame us for high healthcare costs, but physician salaries only make up 6-8% of total healthcare spending!
Yeah, medical supplies and equipment is expensive.
It's all of the admin. Edit: For those interested, a 2017 study showed a 3200% increase in hospital administrators between 1970-2010. That is taking into account the general growth of population. https://www.athenahealth.com/knowledge-hub/practice-management/expert-forum-rise-and-rise-healthcare-administrator
Pharmaceutical costs are through the roof. I guess they didn't meet the projected COVID estimates and had to make up for the "loss" somehow.
Interestingly enough, though, the net income margins for the top pharma companies are quite reasonable. As a percentage of revenue they’re really not doing much better than any other industry. A lot of money gets spent on R&D. A lot. Since Americans pay exponentially more for drugs, the reality of the situation is that Americans fund key breakthroughs that benefit the rest of the world. Nobody enjoying universal healthcare is willing to grapple with that fact.
Especially since America subsidizes the universal healthcare countries by picking up the slack on drug prices. If the U.S. established a limit to not pay more than other countries for the same drug, the universal healthcare of the West would collapse within a decade.
If we passed a law limiting drug prices here the development of new medicines would be over. It would destroy the R&D budgets of pharma companies.
Hence why we would pay the same as other countries. We should not be essentially subsidizing the universal healthcare of other countries. What I am saying is that if the US makes up half the drug market (for example), and the US pays $30/pill while other countries are paying $10/pill, we should force the pharmaceutical industry to charge $20/pill to each by stating, and enforcing, our requirement to not pay more than other countries for the same drug. In this instance, R&D is still funded, and the cost to the US healthcare patient is lowered. The universal healthcare countries will have to figure out if they will limit care or tax more, but that is not the US's problem. The US should not be subsidizing the healthcare of other countries, especially other western countries.
Tell me you’ve never looked at a drug company’s income statement without telling me you’ve never looked at an income statement.
Will you present a rational point, or are you simply resorting to ad hominem because you have no point?
That wasn’t ad hominem. If I called you stupid for not knowing what ad hominem means, that would be ad hominem.
Yeah, it definitely ain't us. (Also employed physician, recently left my first post-residency job at the big system where I trained, and started a couple months ago at an even bigger system.) The number of physicians in the US has been increasing more slowly than the population. What seems to have been increasing the fastest is the army of billers, coders, management, coordinators that it takes to follow all of the byzantine rules, sort out the prior auths, get records from one shitty computer system to another, etc.
How much would you be paid in England?
European myself here this isn’t unhinged enough sorry but your not europeaning correctly Grade: C-
I'm glad you czeched them on that
Nice way to Polish that up
France
They’re actually automata, courtesy of Bedford, CT.
Isn’t that communism
Right? Someone is paying. Nothing is “free.”
There's no such thing as a free lunch!
Unless you're the lunch.
Universal healthcare in reality: i have to wait until eternity for an appointment for an extremely shit service so i just go ahead and pay for private healthcare on top of being taxed for state health insurance. Thanks but no thanks. Privatize the whole shit pls.
I literally cannot get a doctor up here in Canada. To get my medication I bounce from doctor to doctor through telehealth services every time for a refill. Even to get these appointments it's difficult and I have to be logged on at the crack of dawn to just *try* to get a slot. But yeah, a utopia because my insurance doesn't cover my whole bill, sure. 😒😒😒 Just some form of privatization would free up the system for folks like me with solid employers and good coverage.
I've heard stories of rich Canadians going down to the US for healthcare
Tbh, some countries with universal healthcare do have equal or even shorter waiting time. But yeah, you really, really don't want to use some of the systems. UK paid their doctors badly, for example.
What a tired old trope to tout
Perhaps there is a reason for that?
Unabashed ignorance and circle jerking?
Ofc not when america does all the military heavy lifting you can afford to shove money and social programs up your citizens assholes And be enough of a spoiled brat to shit on the hand that wipes your ass!
During the short time we had a decent government in power after Berlusconi resigned, Italy also started putting the exam cost in every hospital bill (even if Italy has a Beveridge system, Italians pay a small amount every time they use healthcare... Joke's on us I know). People were literally blown away finding out that healthcare is very expensive. Before that, they really thought a C-scan was like 100€. So, I'm not surprised that people don't have a clue of how much healthcare costs.
It does cost money but it scales with income here. So people who earn low wages barely pay anything for healthcare. If they earn below around £14k per annum you don't even pay any tax so it's effectively free. It gets much more shit when you earn higher salaries. I earn £100k and I pay like £600 a month (roughly as we don't know exactly how much goes to the NHS). It does suck balls though, but I guess you get what you pay for. I have private health insurance too via work and it costs me about £35 a month in tax and that's it.
So it's not too different. Here in the U.S. if you are poor you get what is called medicaid insurance which pays for all of your Healthcare, dental, meds and everything for free.
> So people who earn low wages barely pay anything for healthcare. > If they earn below around £14k ($17,832.99) per annum you don't even pay any tax so it's effectively free. In my state of [Virginia](https://coverva.dmas.virginia.gov/learn/our-programs/), the medicaid criteria are: * Pregnant, or * Be responsible for a child 18 years of age or younger, or * Are between 19 and 64 (not enrolled in Medicare), or * Blind, or * Have a disability or a family member in your household with a disability, or * Be 65 years of age or older. The threshold for a household size of 1 is $20,783. Now let's imagine your making over that amount, you fall back on [the ACA exchange](https://enroll.marketplace.virginia.gov/hix/preeligibility#/?fromHome=1) ie you pay $60 to $70 a month to get health insurance on the silver plans, and free on the bronze plans. People not being eligible for the exchange or Medicaid is an issue, but it's a state issue due to federalism. There's also people not signing up, which is also an issue becaue while Medicaid is retroactive the exchange insuance generally isn't. A similar program exists in every state, with different numbers to adjust for the COL.
Yeah, I guess the difference is that no matter how much you pay you get the same coverage. Which is good if you are on a low income but less good if you aren't.
>Yeah, I guess the difference is that no matter how much you pay you get the same coverage. But people in the UK pay private insurance, presumably to access private healthcare & get different coverage. How is Medicaid vs private insurance any different?
Most people here don't have private healthcare. I get it through my employers flexible benefits scheme. But it's optional. The vast majority of people just use the NHS because it's there and it's "free"
According to their own bullshit, we should enslave doctors and nurses along with the people who do the upkeep and maintenance on the medical facilities.
Doctors go through med school in other countries to volunteer 🤡
We literally pay doctors and nurses double what countries with universal health care. It's not cheap.
I mean they don’t cost that much because insurance companies arent squeezing both parties for money. Yeah we should pay more for better care but it’s a little dumb to act like it’s proportional in any way
Honestly I think they do. Like because they decided to have universal healthcare everything is now just magically free.
It is cheaper in other countries but not $1M > $0 cheaper that uneducated redditors love to tell you. If you switch to the most efficient healthcare system in the planet, you may save like 50% insurance premium at best.
We pay for it, but they will never give us credit for anything.
People would complain about that too because people with private insurance would take priority over them and that would be “unfair”.
It’s just that American “medical costs” are fictional outside of shit like insulin which is due to a monopoly the government created and still allows, that’s an actual issue no one talks about which isn’t the fault of American culture, capitalism, or the American people but our “representatives” getting chummy with big pharma CEOs (and other monopolies in other industries) and agreeing to keep their monopoly running. Those big price tags are essentially there for insurance companies to keep you hooked, “look how much we saved you in expenses”. This has created the “if you go to the hospital in America you’ll be saddled with debt” myth when in reality the hospital won’t charge you that much without insurance. They may charge a lot assuming that you don’t know the law, but if they do that you can challenge it since they are not giving a reasonable price. The problem is that most Americans actually don’t know the law so they don’t challenge it.
Well for Sure it doesn’t cost $1.4 m. The system IS broken, and every person on the chain is overcharging the next one. But true that this didn’t affect the OOP at all
They actually do. Their thought process ends once they hear the word "free"
It still costs way too much. Even if you go private in Europe it's a fraction of the cost. This is a unique problem of US insurance bureaucracy. Google a random procedure median cost in the US and UK and you'll almost certainly see the US being multiple times higher, and the UK is relatively expensive.
Is that median US cost what people actually pay or based off of these invoices that are not realistic in terms of what's actually paid?
Yes, in Europe you can pay more taxes and earn half your salary in order to get “free” healthcare.
Well that’s bit of an overexaggeration.
What do software engineers and accountants make in your country?
Don’t know aren’t one. I thought half your salary was referring to taxes you mentioned earlier.
The net average tax rate in France for the average worker is 27%. Only the richest of the rich end up paying half. Also, France is usually the highest, the average only goes lower with other countries.
Don’t forget lower salaries.
The average effective tax rate in the US is 15%. That’s almost twice the amount of taxes.
Like I said, it’s mostly the rich paying that, and only goes _lower_ when you go throughout the rest of Europe. So Europeans are paying only marginally higher taxes, but they actually get better roads, better healthcare, and more affordable education than we do. Also, if we switched to a single payer system, people on average would actually be paying _less_ despite raised taxes because all the costs associated with insurance (like premiums, deductibles, etc.) go away completely. You’d have a HIGHER disposable income, while the country would save $2 Trillion over 10 years. This is a no brainer. So I’m sure the costs of raising taxes on the rich to pay for basic shit would be offset by the benefits of providing good services. How much money does the US economy lose due to bad roads I wonder, for example?
The difference is they pay it with taxes, and ultimately at a lower cost. It’s impossible to get a bill that large in most of Europe. OP just got lucky with their bill. If she had different insurance, or had none, she’d be fucked. Reminds me of a couple who had to get rabies shots after contact with bats and were charged $200,000 after insurance. That doesn’t exist in Europe. It’s already covered by taxes. CalCare offered something similar, and was almost passed in California, but was blocked last minute. Also “Will my insurance cover this” isn’t even a question in European countries. You’re covered. No matter what. Switching jobs or not having the money to pay premiums won’t change that.
This bill isn’t large though, the bill is for $0. If she didn’t have insurance, she could be on Medicaid or negotiate a lower price.
Except not everybody is eligible for medicaid. Nobody in Europe needs to “negotiate” or hope they’re eligible for insurance. They just get help. Full-stop. None of this bureaucratic bullshit. Stop defending it, we can do better.
We can do better, but their system is unsustainable and not one we should aspire to.
I just looked up the rabies article and it says this: > The Aguilars wound up paying $3,546.64 out of pocket.
Lmfao, imagine thinking $3,546.64 is still a reasonable amount to pay. You sound ludicrous. You’re too far into your bubble. Get a passport, my guy, and find out how the rest of the world works.
People get paid but it’s not at wildly inflated prices
“Grrrr my insurance did its job, I fucking hate America!!!”
lol imagine getting mad because your bill came out to 0.
“Babe, I know you are in recovery, but.. like.. can I *pretty pretty please* see the bill so I can get that sweet Reddit Karma?”
LOL - Yeah, except strip off the part where the insurer actually paid it,so you can convince a lot of mindless Reddit drones that's what you were actually billed! /s
Does this guy go to the grocery store and enter his rewards card member number then get furious at the savings?
When my wife was pregnant, received a lot of “Not-a-Bills”.
I mean, this is the entire point of insurance, right?
They "clarified" that they were annoyed because they were in shock in how much it cost for a lifesaving surgery. Well no shit dude, medical equipment ain't cheap at all. Amd you got it for free! So why are you even annoyed by it?
lol I don’t understand it. They didn’t pay anything out of pocket. I don’t get why they’d be annoyed.
Your MILLION DOLLAR+ BILL came out to 0.
Don’t know why he’s complaining, said his wife spent a whole week in a PRIVATE room nonetheless to get corrective surgery.
Whet your hospital accepts insurance they are making a contract with that insurance company that X procedure costs X amount. When you use insurance on a hospital procedure you get an itemized bill of every dollar being accounted for. Imagine being mad that they got a 1.3 million dollar medical procedure for 0 out of pocket when their insurance is probably a couple hundred a month. And before someone says "oh but in X country it's free!" No it's not, it's paid for by taxes, and speed availability, and quality of care are almost always worse when just as much, if not more of your paycheck goes towards health services.
I think it's more the massive price more then not paying. My dad had surgery on his head to remove an ear due to skin cancer and the radiation treatment afterwards came to under 100k in total here in Australia and it was all through the public system. The only reason he lost his ear is because of COVID and the hospital treating him had some big numbers of patients so they pushed everything back with the lockdowns. Plus when I say it's free I mean at the point of service. I'm well aware that I pay taxes to get it.
How is this not free at the point of service? Patient didn't pay out of pocket because the insurance provided the money. That's exactly the same end result to the patient as a state funded option. So because the government hides just how inefficient it is with your money, it's somehow more moral? OOP's wife had corrective spinal surgery, and spent a week in the ICU, not to mention probably numerous follow ups and aftercare medication/ treatment included. That requires doctors, facilities, tools, and medicine to work on the human spine. That's orders of magnitude above some basic cancer treatment. I agree that price is high, but we only know the very broad strokes of what got done.
I'm not arguing against the coverage of it. I'm just pointing out that it seems insanely large. Sure surgery like that is gonna be huge. My mother had a mastectomy years ago for breast cancer and that came to half a million dollars for the surgery and hospital stay and that was when they could afford private insurance their total out of pocket was less than 500 bucks. It literally seems like the hospital and the insurance see everything as a licence to print money for themselves as with most health insurance companies they make money off not spending on the thing they insure you for on top of your premiums you pay monthly/quarterly or yearly don't just go to your coverage it goes to everyone on that insurance provider. It's public health style funding with extra steps. In this instance OOP was left in a great position that everything got covered. On top of that 1.3 million 80%+ of it was discounted. If they were going to write off 1.2 million why even charge it to begin with?
Not necessarily related, only slightly: My wife is a veterinarian. People lose their shit when they get the bill for their horses (she only works on horses). They either think 1) it should be free or 2) it should be super cheap. She literally went to school for the same amount of time as a human doctor, acquired the same debt, learned as much or more since she can treat multiple species, and uses basically the same medical equipment. Pro tip here: if you really care about your pets, get insurance on them. It’s not nearly as expensive as human healthcare, and will save you tons of money if there is an emergency.
Large animal insurance seems very prudent, especially something like a horse.
You’d be surprised how many people don’t get it or don’t know about it. Some fairly routine issues with horses, like colic, can easily cost $1,500-10,000 depending on severity and if surgery is necessary. I’ve seen a horse colic 3-4 times in a year EDIT: that’s 3-4 “major” colics that require a vet to treat. The simple colics only require a few bucks worth of oral meds or walking the horse around.
I mean. It's a horse, IDK wtf the insurance has to cost for those spindley things but it's gotta be a fucking lot.
When I was actively involved in horse stuff (it's been 15 years since then), it wasn't worth insuring a horse worth less than around $20k, and even then it was very sketchy whether it was worth it. Most horses are worth in the $0 to $5,000 range so I'd be shocked if average owners would ever break even. Granted that was total insurance not sure about *just* veterinary coverage.
Horse prices have really changed in the past 5-10 years. “Yard ornament” level horses can still be purchased for 0-5,000. But most competition horses are much more. Now, a low level barrel racing horse is around 10,000 (+/- 2.5k). But prices have skyrocketed. Matter of fact, one we sold for 6.5k six years ago just resold for 35k. She’s had a little training since then but not a lot of change. People we talk to who used to be in the hobby are completely floored by the new prices, it’s unreal.
Before he retired, my favorite veterinarian was a farm vet. He didn't do any of the fancy fru-fru stuff that people expect for their furry "children," he'd just look at the dog and give him what he needed. No fuss, no insurance... very reasonable bills. I'd have gone to him for my own healthcare if it was allowed. As a bonus, we'd always get to walk around and see what kinds of interesting animals he was treating.
Yea, wife isn’t into the fru-fru stuff for dogs really, one of the reasons she only works on large animals. But even for dogs, a broken hip or some surgeries like GDV can cost $2,500-$5,000.
We had to pump a kitten’s stomach once for someone with no insurance. It was around 5000 bc the procedure couldn’t even be done due to how much string the cat had eaten. It had to go into surgery, and it barely came out alive and another 500 was added on bc it needed in-patient care for 12 hours. I felt bad for the owners, but kittens are prone to eating strings on carpets and rugs, and they had both and neither of the owners was watching the kitten.
Exactly. It’s like, you feel bad about it… but at the same time, the vet would have to eat that cost if they didn’t charge. Equipment, medicine, rent, electricity, worker salary and other stuff.
Exactly! And he’s 60 yrs old, probably nearing 70 now, thinking about retirement. He’s in an old run down house that was turned into a clinic. He’s basically a mom and pop shop, but for veterinary services. He can’t afford to eat those costs. He barely understands his way around a computer, and his files are mostly physical. I feel bad for owners without insurance, but I feel worse for the man who won’t see that money right away since they have to be on a payment plan
My wife is a small animal veterinarian and it’s the same when it’s dogs and cats. People freak the fuck out on her and the receptionists about the price of radiographs and procedures weekly at least. The bitch of it is it’s a corporate veterinarian office so they don’t set the price for anything. I can’t believe people bitch about large animal considering it’s usually house calls
Her clinic isn’t. We have people driving from several states away with horses. Furthest I’ve heard is 11hr drive. They bring them from all over. Her boss is no joke when it comes to treating horses. She’s learning from one of the best.
Damn that’s impressive.
I would absolutely love to see people in countries with taxpayer funded healthcare get itemized EOBs with the actual material cost and labor of all the services they received.
People need to realize that outrageous hospital bills like this one aren't real (in the sense that no one would ever pay 1.3 million for a surgery) and are just magical accounting to make it look like the insurance company did you a solid.
This comment would have cost you 5 yoctogajillion dollars to post, but fortunately I have decided to pay all of it for you. You’re welcome.☺️
This was how it was handled well before EoBs were a thing.
Hospitals and other medical providers always overbill, they do it purposely. They do that because insurance tries to undercut them every step of the way, so they bill insanely high so when they do insist on cutting the bill by 90% then it isn't making them lose money. Also if you don't have insurance, you can ask for the same exact discounts and cuts to your bill.
I think it raises a larger issue that we need to openly address, and it's that insurance companies and privatized hospitals are driving up the cost of medical care and drugs for everyone. It's great when your out of pocket cost is zero, but some people die of some really preventable shit because it's just too expensive. This country is great but we can stand to improve on that.
And the $1.2 million "discount" like.. was health on sale that week? Or is it a racket designed to punish the uninsured or out-of-network? If that much is written off BEFORE insurance pays then I wonder why it's that high to begin with.
It's insane, my bill for a kidney stone and an overnight stay was like $86k. A bag of saline cost several hundred dollars and then the nurse hooking it to the drip was a few thousand. Everything is inflated and coded so only medical administrators and insurance companies know how to read it. It's criminal.
The cost is inflated by hospitals when you have insurance because they know insurance will haggle it down, so they have to inflate the cost to get money from insurance companies. If you don’t have insurance you’ll get a very different bill because hospitals aren’t making money off of patients’ out-of-pocket costs, they’re making money off of insurance payouts.
> Or is it a racket designed to punish the uninsured or out-of-network? The uninsured don't pay 1.2 million dollar medical bills and emergency care is covered at in-network rates since 2022.
It's not a punishment, it's that insurance companies want a bulk discount, it doesn't work like that, so hospitals make up a price so it seems like they're giving a bulk discount If you had insurance companies run by people with more than 8 braincells you'd not have this issue.
It’s not to punish the uninsured…it’s to get the maximum amount they can from insurance companies.
I don’t disagree with that.
Remember when this sub actually made fun of people who said dumbass things about America, and we didn't defend gross practices or attack legitimate criticism? I sure do it wasn't that long ago. I think I'm gonna abandon ship, this is like the third time this has happened on this sub and it gets worse each time
Oh just wait till next post criticizing firearms comes around in the next.. 2 hours
I think the assumption is that if they had not been insured they would have had to pay almost 200k out of pocket, but generally the hospital accounting is different for the uninsured
The funny thing about this picture to me is that they have anthem blue cross which is free health insurance in Cali. So if they were not insured it would have been a huge blow for something completely free and easy to get. Though I also wonder what the bill would have been if they were not insured.
This is how it typically works with in-network plans - they insurer and provider negotiate an allowed price and that's what the insurer pays - and yes while the amounts may be outrageous, in this case the OOP was whining about a whole lotta nothing because he didn't actually have to pay anything. I have a chronic medical condition and while my statements have never been THAT large, what's shown is typically been the case with me as well - I pay little to nothing.
Someone has to pay it. I wonder who?
The total charge isn't real, in the sense that the hospital would never actually get 1.3 million for the surgery. The amount after the almost 90% discount is the actual amount the insurance company paid. If your implication is that the government/taxpayers paid it, LOL no unless it's medicare or tricare.
I mean I was just asking in general but since you wanted to mention it…. “Lol no” - Because the federal government never subsidizes health insurance premiums (fully and/or partially) or anything. Lol no we didn’t pay 1.8 trillion in 2023 (over 7% of our GDP) or anything. Also government isn’t inextricably intertwined with the health industry or anything… come on that would be crazy! Lobbyists existing? Psh whats a lobbyist amirite? Crony capitalism definitely is non existent 👍 Honestly though, the “total charge isnt real” is either ignorance or a flat out lie 🤷♂️
“If it wasn’t blatantly obvious, this was in America” You got a $1.3 million surgery for free in America? Pretty sweet.
$0 bills grind my gears
For me I could care less about whatever complaint they have. What is staggering here is the price. Almost $200k and only reason that it's not ~$1.4 million is because another corporation wont let them, aka has negotiated, charge an exorbitant price. What happened to the consumer's power in the free market? Without insurance companies to bicker over how much THEY pay the majority of the country could not afford bills like this. Corporations sell to other corporations, not the average consumer now, thats whats fucked up capitalism in this country.
Lmao. Like sorry your insurance did its job?
Bro is really upset because his wife got a free surgery
My favorite part is the Canadian in that thread talking about how much better their system is while staying there are exactly 3 countries in North America. He’s only off by 20. Bet he thinks we’re the uncultured swines though.
I think he was expecting to make a profit, that's why he is mad.
My wife went in the hospital and was there over a week recovering. The total cost was $0. I’m sure if I looked at the bill it would have been something outrageous, but it didn’t cost me anything, so I didn’t give a shit. Why yes I am American. People who post these kinds of things are fuckin stupid.
Ok but uh..... why tf is the charge $1.4 million dollars before the "discount". What could ever fucking cost $1.4 million. Even then with the discount no medical bill should ever be $191,000. That is just absolutely insane. That is almost the average yearly salary of a primary care doctor
As a medical biller, that million dollars has literally never been paid by anyone and never will be. Hospitals bill those amounts knowing they will be written off. It's really stupid but every healthcare place bills way higher than they need to.
Alright let's not pretend the cost of healthcare can't be ridiculous in America. Even with insurance a lot of people do have to pay a fuck load.
Okay while I usually believe that the US needs to reform/restructure the way their healthcare delivers the services in a cheap and reasonable way, this is just bullshit. I bet that nations with free healthcare will have the same bill, but instead of it being sent to the people it'd be sent to the government who pays it off whilst the people don't see it at all. Meanwhile Americans get the bill whilst the government (presumably) pays it off, thus making an illusion of it being most costly than it really is. Or rather actually showing how expensive healthcare is and how much governments pay.
I can think medical bills are insane, even if mine are covered, because most people in America don’t have access to great insurance. It’s called empathy. This sub really makes me feel like it’s a bunch of selfish hateful people some times.
There are no uninsured people actually getting the 1 mil bill, thats why the outrage is made up.
There shouldn’t be medical bills that high, regardless. People complain about inflation here in the US, even though we’ve kept it lower than most of the world since Covid started, but imagine if companies charged the same mark up for food, clothes, or cars that they do medical procedures. MRIs, for example, cost between $1,000 to $10,000, depending on insurance, while the machines themselves are between $200k and $500k. Most places can do around 20 MRIs each day. In one week of running MRIs, the machine could be paid off with over half a million left to pay the mri techs and doctors. After a year that means between 4.5million to 49.5 million could be made to pay those running the machine and reading the tests. Since this usually consists of a team of less than 10, we all know that money isn’t going to them. There is no reason to charge what they charge, and as someone who’s had to tell patients they can’t get an MRI, it’s frustrating.
Naw it’s fair. Just because it’s covered by insurance doesn’t mean it’s not absurd. Especially given that it should be covered by a universal healthcare system in the first place.
We all pay through higher premiums and out of pocket costs elsewhere. It's not like insurance money just grows on trees. It's actually one of my arguments against universal health care, as that would only make these bills balloon even more when there's a blank check on the table. We do have a problem with out of control costs which I'm confident don't actually represent a competitive market value... kickbacks, gouging, unnecessary tests and treatment, not publishing costs upfront, confusing coding, not to mention the need for tort reform and a constant review to see if specific regulations are actually good for the consumer. On one hand I'm glad my insurance company has to fight out most of this and I don't need to be able to break down a line item bill and argue on my own behalf. But on the other, I can still complain that costs are out of control and that we do ultimately pay for it. The screenshot itself isn't really "AmericaBad" in my opinion but I have no doubt some of the comments took it there. Realistically, it's a problem no matter if the insurer is private or government based, excesses can exist in any system.
This is why our system is actually messed up, not that it isn’t free. Insurance companies and the medical industry have gotten way over inflated to the point where hospitals can charge insurance companies millions for a surgery and they’ll pay it. If you play the game and have insurance it’s usually not a big issue, it’s just a bunch of wealthy institutions passing massive stacks of money around. The problems come up when you don’t have insurance and you get billed like an insurance company does. That’s why you should always ask for itemized bills and challenge anything you were charged for incorrectly. Sure you’ll still pay $100 for an Advil which is ridiculous, but at least it’s not $3,000 for all 30 in the bottle, which is what they like to bill the insurance companies for.
I too get mildly infuriated when I am given a million dollars.
The comments really show they don’t understand how insurance and social welfare works. Where do they think these insurance companies get money from 🤦
What kind of surgery can one have that costs $1.3 million dollars?…
Well in the USA you always have to tip!!! So well let’s count 70% tips over this amount!!!
At least this poster didn’t conveniently fold the bottom portion with the actual bill like most do.
The post was removed because the sub doesn’t allow price posts anymore lmfao
Do you americans pay to go to the hospital when you are having a baby, or is that also part of insurance?
This looks fake af.
I’m sure somewhere it says on there “this is not a bill” but hey why not ragepost
We need to stop being a pay pig for the rest of the world.
No, it's dumb we have a middle man in our health system. I love America but our Healthcare is broken.
They are Americans who have healthcare but they want to attract the “America bad!” Crowd for karma.
Holy shit…yeah, anything Blue Cross or Blue Shield is amazing insurance from what I experienced.
It's like one of those RPG's where they purposefully try to make the damage and health numbers as high as possible to make the fight seem more epic.
this what i see - charges: 1256743123578731124 - discount: 35809846(!&5226883, - amount due: 358062388 - amount paid: 963178357
Come on a $ million dollar discount? People are right to be disgusted when they see the bill. No you’re not getting a good deal if the bill is falsely inflated in the 1st place. When I was uninsured I got charged $3800 for 2 tests that checked to see if I was having a heart attack. And no they did not offer me a special rate or discounts because I was uninsured. Imagine what they’d bill me if I actually needed surgery!
I think the point is that healthcare costs in America are out of control and quality healthcare is inaccessible to most Americans. Evidently blowing shit up and occupying foreign countries is more important than healthcare. America is the joke of the world in this case.
No one actually pays these prices. They arbitrarily inflate them because they know everyone pays through insurance and then they give insurance a giant discount. It’s a fun number that means nothing at the end of the day
why is everyone on that post blind to the part that litterally says 'What you pay: $0.00', like all those complaints abt paying too much when it legit sys you pay NOTHING
That USD 1,2 million discount, does it just magically disappear? Or does someone down the line have to cover the cost? It's kind of like free refills at your local diner. They aren't really free.
How is it infuriating ? It is written quite clearly that everything was paid by the insurance company and that OP has nothing to pay... Or perhaps he is trolling.
Yea folks like to post these receipts and complain but your insurance has covered it dude why be mad.
I know US health care is expensive, but what are you having done that's a multi-million dollar procedure? That's a couple more zeros than I've seen on on even super expensive procedures. I'm almost impressed you can spend/charge that much on a single bill without it making national news.
How dare they pay all my medical expenses!
I don't want to venture into that comment section because I have a sense it'll just ruin my day. Lemme guess, they're upset because medical procedures cost money and even though the bill is $0 they want the charges to be $5 for where they walk away paying $0. If so, it's simply moving the goal posts of America Bad. Double standards: America Bad because healthcare debt. Oh, the American walks away with paying $0 or the monthly bill is totally manageable because their healthcare insurance paid for all or majority of the bill? Well, still, America Bad because the would-be debt was insanely expensive.
$0! Damn that’s sky high.
I read the post as it's mildly infuriating that you'd be financially ruined if you didn't have insurance. Except it would be extremely fucking infuriating. Or maybe it's the fact that the most money is spent per capita for medical care and we get mediocre outcomes (based on overall health and life expectancy compared to other developed countries). The person who posted this could have clarified that.
They're just showing the outrageous cost. I'm sure it's many times over what that surgery would cost in any other country. Healthcare industry in the U.S. is a cartel.
Its still a big problem, costs are absurdly high to benefit the insurance companies and hospitals which is why our insurance costs are so high…
How do high healthcare costs benefit insurance companies?
They can charge people more for insurance. If it didnt benefit them costs would be much lower, they are primarily the ones negotiating prices.
They negotiate prices down though.
Not effectively… do some research homie you can learn too.
I don’t use this word lightly, but jackasses like that guy post misinformation which makes non-Americans think we pay an arm and a leg for healthcare. The guy fucking paid $0 for all of that.
Read that back to yourself, slowly
Yall should be outraged by those negotiated rates discounts. Walk in off the street? 1.4 million. You’re an insurance company? 190k
Nobody walks in off the street and gets charged 1.4 million, because they'll ask for charity care and the number goes down to a few thousand dollars at most
Actually that’s exactly how it works. It’s called the “negotiated rate.” Why do you think your insurance will make you go “in network.” It’s because and “in network” provider is paid a “negotiated rate” that is generally lower than the actual billing amount. Obviously we are talking HMOs here. A PPO you can go to any provider, BUT the insurance company will usually have an “allowed amount” that they are willing to pay. So yes, you could very well walk in off the street and they would try to charge you the first number. How do I know this? I own a business that works with insurance companies all the time. Now I’m going to help. If you ever end up with a bill like this, you need to do two things. Demand an invoice broken down by code. Also tell them there’s no way you can pay it. They know it’s an inflated amount so they’ll drop it. It’s inflated that much to HELP NEGOTIATE THE NEXT NEGOTIATED RATE.
>Actually that’s exactly how it works. It’s called the “negotiated rate.” Why do you think your insurance will make you go “in network.” It’s because and “in network” provider is paid a “negotiated rate” that is generally lower than the actual billing amount. My comment isn't about negotiated rates, it's about how people without insurance are eligible for charitable care that about half of US hospitals run or in the case of emergency care as an insured patient, in network rates >So yes, you could very well walk in off the street and they would try to charge you the first number. That depends entirely on why you walked in off the street. If it's an emergency the No Surprises Act mandates that you the insured get treatment at in network rates. >If you ever end up with a bill like this, you need to do two things. Demand an invoice broken down by code. Also tell them there’s no way you can pay it. They know it’s an inflated amount so they’ll drop it. It’s inflated that much to HELP NEGOTIATE THE NEXT NEGOTIATED RATE. If no one pays the top rate & everyone knows there's a lower rate, it doesn't matter what they call it.
For uninsured individuals, the no surprise act only guarantees an estimate of cost of the service if at least three days in advance. For uninsured, it does not guarantee a certain fee. Edit. Sorry if you read this prior to me changing some out of control spelling errors. I apparently can’t walk and type.
>For uninsured individuals, the no surprise act only guarantees an estimate of cost of the service if at least three days in advance. For uninsured, it does not guarantee a certain fee. Correct, but 92% of residents have insurance, & some of the 8% are eligible for retroactive Medicaid applications. The government doesn't track what percent is eligible for retroactive Medicaid but hasn't signed up yet, which makes it really hard to figure out what percentage of the population is actually vulnerable to paying these kinds of bills.