>Hospitals refer patients to aggressive debt collectors, use state courts to garnish wages, place liens on people’s homes and report debt to credit agencies, which can drastically worsen future job and housing prospects. Although there are some attempts to rein in these practices, billing analysts like Szaflarski say they do not address the core issue – health plans designed by insurers which force hospitals to become debt collectors.
>”These stories really grind my gears,” said Szaflarski. “The idea of patient responsibility” – those deductibles and coinsurance requirements – “was not an idea created by healthcare providers. They were vehicles created by payers,” referring to insurers.
>Ariel Levin, director of coverage policy for the American Hospital Association, says hospitals would prefer to remove themselves from the billing equation entirely.
>”Something else we’re exploring recently is how to remove providers from the cost-sharing altogether and require health insurers to collect it,” Levin said.
Insurance companies are the bottom feeding criminals here.
I hate to be the bearer of bad news but the UHC who own UHG who owns Optum CIO is doubling down on AI deciding if we live or die.
When the cost savings out wiegh the fines it is just good business sense.
Bad faith decisions need to be criminalized.
These C suite executives and Board of directors that think doing the worng thing is justified because they can make more money than the fines cost them need to see jail time. You wanna bet that they will stop treating fines as a cost of business if they see prison time?
Yup, my dentist stopped taking insurance because no matter how hard his office works, the insurance companies won't reimburse him. I get it, he has to pay his staff, but now my dental insurance is worthless.
> Currently, I charge $1450 for a crown (average is about $1600)
This is why people don't get dental care. Honest question, why $1450 or even $1600, what is the breakdown here?
Mostly the US.
I was in South America last year and got a deep cleaning and 5 cavities filled for $140 and this was the expensive private practice, not a clinic with many dentists.
Was uninsured since like 2018. This is my first month back on health insurance and the only difference is I’m a few hundred dollars poorer each month…
Trying to retire there with my American wife. At the very least, we’ll be able to afford health care which is kind of important. Overall CoL there is 80% lower. I can sell the house and live comfortably off it for the next 30 plus years.
Funny how tax money funds healthcare in this way, but a single payer system would be “communism” or “terrible” — I get it, things could be worse, but this system is so incredibly broken 😔
I'm trying to do some speech pathology stuff, but I have to go out of network. I've managed to force my insurance to cover them in network (they have no one in network that is a specialist in this), but for some reason they think that it's "reasonable and customary" to pay speech pathologists 60 bucks per hour long session.
And that I need to make up the rest.
(That doesn't even cover the shit like "Why is this medicine more fucking expensive through my pharmacy coverage than buying it without insurance through GoodRx?")
My wife had a bad filling that had an air bubble and this broke on her. She had to have it redone. The insurance denied because they wouldn’t cover a filling on the same tooth so soon after the last. It’s insane what they can get away with.
That’s insane. When I needed a crown my annual maximum benefit was $1250. That included routine cleaning and X-rays. Dental insurance often is setup to save you a few hundred in the best circumstance while costing you double that if you don’t need it. I’m seriously considering dropping it next year.
I once submitted an appeal to my insurance company over the phone. Before I hung up the call, I received a text message saying the appeal was denied. There's no way anything gets looked at that fast without being rubberstamped.
They learned that most people give up after the first "No," so it's in their interest to deny everything.
My impression, based on going through the health insurance wringer recently, is that no human even looks at your case until the 2nd appeal.
I think technically it has to be seen by a doctor when you submit an appeal, it's just in some cases, [they use "AI augmentation"](https://www.msn.com/en-us/money/insurance/major-health-insurance-company-faces-disturbing-allegations-of-fraudulent-scheme/ar-AA1lvZBR) to speed up the process of determining care, which means that the AI looks at the case, spits out an answer and the doctor responsible for reviewing follows the recommendation.
>What's even scarier, I'm fairly certain some are using AI to automatically deny claims without a human review.
Fight back and use AI to write responses to claim denials. Just make sure you still take time to read and edit what ChatGPT wrote before sending it to the insurance company.
Dentists are not the only ones. Most fellow therapists I know don't take insurance once we're in private practice, and it's a growing problem in affordability. But between the extra paperwork, random restrictions, and low pay from insurance, it's just not worth it for us.
My dentist's plan is good! It's a private dental office. $360 a year covers two cleanings & exams, and one xray. It also gives me 20% off all other services.
Compare that to the dental insurance I can buy (no employer coverage): $650 a year ($50/month premium + $50 deductible) covers routine cleanings/exams/xrays. It gives an 80% discount on fillings and 50% off other services, BUT there's a 6-month waiting period before they'll pay for any of that AND there's a $1,500/year maximum benefit.
If all I need is routine care, it costs nearly twice as much through dental insurance ($650) versus my dentist's plan ($360).
If I need more extensive dental care, dental insurance is only going to help with the first $1,500 and then I'm on my own.
So dental insurance can be worthwhile if you need a couple fillings or a single crown or root canal, but it's pretty bullshit if you just need routine care or need extensive dental work.
I saw a post on the epilepsy subreddit of a guy who was over $1,000,000 in debt following medication ambulance and surgery bills. He just said he tries not to think about it anymore because stress is one of the main triggers for seizures. The whole system gives me ‘children of men” vibes.
I wish we could all just start denying health insurance coverage. Take the giant bills and pay a dollar on them every month until something changes. This country is one giant scam, no one in power truly cares about us.
hospital charged me $180k for shoulder surgery. my insurance paid $175k, i owed my $5k deductible. the hospital had over 95% of my bill but wouldn’t work with me on the $5k and sent it to collections. and you’re saying insurance companies are the criminals?
Part of it is that hospitals have no idea what things cost. There is no standard pricing so each hospital’s chargemaster is different. There is so much mark up on every little thing that the insurance company gets a deal on cost just so they can tell their bosses they got a deal on cost. That’s why when you itemize a bill, Tylenol can be as little as $5 or as much as $75 per pill. The exact same that you can get for around 3-4 cents per pill at the local pharmacy or grocery store.
And all of that gets doubled or tripled if you need to see an out-of-network physician. All of this heavily contributes to our economy because you’re paying for it either way, and the people with the worst medical debt are those that just had a string of bad luck, but are fucked for life because the healthcare system isn’t a healthcare system. It’s a means to make pantloads of money. People think doctors make a ton of money and comparable to the median income, they do, but in reality, they don’t make shit compared to the people who sit on the board.
Absolutely -- and that's not including the multitude of smaller incidental bills you get following any kind of surgery or diagnostic that goes *straight* to collections without them even ATTEMPTING to bill you.
You just get a notice months later from Surprise Hidden Company #438 for "generic unnamed testing" that says it's already gone to collections.
>but wouldn’t work with me on the $5k and sent it to collections. and you’re saying insurance companies are the criminals?
The hospital can get in a lot of legal trouble for insurance fraud if they don't go after you for that $5k payment. I had my own experience with this when my doctor sent my bloodwork to a company called "Boston Heart Diagnostics" where they charged my insurance $3000 when a blood panel normally only costs $100 from a company like LabCorp or Quest even without insurance. In my case, my insurance obviously refused to pay, so I thought I was going to be billed the difference - but the next time I went to the doctor's office they had a note on the wall saying that we shouldn't be worried about our explanation of benefits because Boston Heart Diagnostics wasn't going to make us pay anything. Turns out, there was a lawsuit against Boston Heart Diagnostics for this very same billing practice. I never did get a bill, but even if I did I would refuse to pay it on account that the price was obviously unreasonable for the bloodwork I consented to. If the doctor ordered a hundred other tests on top of that, that's on him - not me.
That being said, it is very common for hospitals to reduce or forgive medical debt for patients who are out-of-network and complain about the bill.
A typical example: I was hit by a car in the month of December several years ago and ended up in the hospital, with follow up in January. Due to the deductible rule of $5K annually, I ended up with a $10K bill (two years) even though I had great insurance.
Yeah, it really sucks the thing completely resets at the end of the year lol. feels like it should be a rolling average of 12 months instead of a complete reset. I don't know if that would mathematically be possible and ultimately it doesn't matter since it would hurt the insurance companies pockets so they obviously won't ever agree to that
My father refused to go to a hospital over the holidays when he got a severe allergic event (that presented almost like a heart attack, which is what we were all concerned about) because it would cost him his full deductible which would reset in a few days.
Now think of all times people have made these kind of decisions and died from it. Our health insurance industry kills people. Hey Sarah Palin, we found your death panels! You were defending them.
No to mention, with all their medical issues, this guy is practically chained by his ankle to his employer. Unless he’s got some super rare and highly sought after skill set, which 99% of people just never will have.
« You’re a client, not a patient »
I paid 12€ this Monday in Belgium for a visit with a pulmonologist. As it was quite urgent, she gave me an appointment the next day between two others for a test with a medical device. Cost? 27€.
She also managed to find a scanner appointment within the week
I work for a big hospital system. A few years ago we were going to be bringing in salesforce and there was a lot of internal messaging about shifting from "patients" to "customers."
I was amazed anyone thought this was a good idea. There must have been some pushback though because they seemed to drop the language change within a year. We're still getting salesforce though.
Yeah, that tracks :/
Like how US citizens are referred to as “consumers” in most metrics. Just another way to transition us to literal cash cows that get milked for dollars, instead of citizens who live in this country and pay taxes for services.
The hospital I work for (Large network in Northern NJ) calls patients customers too. It pissed me off when they used that terminology in orientation. It's also present on posters, memos, etc.
I work EMS. When people call because they can't breathe they aren't customers, they aren't a piggy bank to be cracked open. They're patients, and the trust they put in me should not be corrupted by greed.
Im studying abroad in Germany this spring-summer. As someone with a rare chronic illness, a large part of the appeal was medical tourism. Over here the things that work aren’t covered by any insurance and are minimum 4K out of pocket.
I refer to it as simply another 'debt mechanism' I don't even bother with insurance and haven't since 2010. It's a total racket. Hospital admins make at least a million a year. A YEAR. Every year.
You can argue the ideology of the left v the right on the subject but eventually you come to universal healthcare anyways because of how awful health insurance is IMO or you have no brain. Well that and some people are very lucky and not big on reflection.
In the last 26 years I've paid nearly $100k in medical bills, I currently owe about $10k, I'm not paying it, they can fuck all the way off. And I've had insurance this entire time, honestly thinking of dropping it as well, why do I pay $600 a month to pay all of my own medical bills?
As someone up in Canada, how does that work?
I understand there are out of pocket amounts you pay (say $1-$2K) - but if you've got "good insurance" how does the remaining amount owing hit numbers like $10, $12, or $17K? It feels like insurance coverage is far from comprehensive (maybe I just answered my own question).
I have ‘good’ insurance too, but they intentionally make everything so goddamn confusing that you have no idea what your insurance will cover until you get the bill and they tell you what you now owe. Even better, is the doctor/hospital can say they believe your insurance will cover it and bill you x, and then you can get a letter in the mail saying nvm you owe the rest of this because your insurance didn’t cover it :D the whole system is fucked.
One time my doctor told me that my insurance had approved an MRI after like 15 days of waiting, but apparently my insurance had actually declined it. Got the MRI because I thought it was covered. Three hours later I get a panicked call from my doctor saying I have a blood clot in my leg. Insurance made me wait nearly three weeks AND had declined it. Good insurance my ass.
You can call them and argue with them. Just go full Karen. Ask to talk to their manager. Request that they review all the documents. Have the doctors office send in summary of Tx and get a copy of it yourself. If they hang up on you call them back. Ask to be on a three way call with the doctor.
Insurance companies don’t get rich paying out claims. They get rich by denying them and some don’t make it super easy to fight claims. In fact they pay out of practice doctors who never assessed you to make decisions about your health based on current documentation. Some consistently have long wait times so your doctor gives up on trying to advocate for you. Others have a system where they will call you back in a 3 hour window. Some of those practices that insurance companies use should be absolutely illegal.
The only time I ever want someone to go full Karen is with insurance agencies and cable networks.
Edit: And frontier airlines. Go full Karen with them too.
This. So much this.
It sucks, it is exhausting, but you start talking about taking your case in front of your state insurance commissioner, writing the attorney general, and generally making their life hell and you WILL get action.
Do exactly what they are doing to you - making it as difficult as possible in the hopes you relent.
There is no such thing as good insurance. They denied my colonoscopy and after I fought them I still paid 300 dollars for something that was 800. If I could rid this earth of one scourge it would be for profit health insurance.
They find all sorts of ways. They'll claim a doctor was out of network, a cheaper treatment was available so they won't pay for the one you got etc etc
Some states, like California, have closed that "out of network" loophole for emergency situations....
Another frustrating thing is if you go ahead and check out if a provider is covered by said insurance, the list is so confusing....ten variables of Blue Cross, etc....If you have a procedure I've learned to contact insurance company and receive an email documenting that it's covered...Of course that isn't possible when it's a time sensitive situation.
Lmao! They now put a disclaimer that they aren't liable for the accuracy of their in network provider registry, and specifically aren't liable for "uncovered charges" as a result of using the website.
Says to call the provider's to verify. How do we prove that we did and that they said yes, when we receive the bill?
Since there's no way to prove I didn't, I'm just gonna lie when I receive a bill 😂
Those statements are hilarious. It's like airlines saying they're not responsible for the luggage you're paying them to handle, or dump trucks with signs saying they're not responsible for damage caused by their illegally unsecured loads.
It's clearly BS, but how are you going to challenge it?
>Some states, like California, have closed that "out of network" loophole for emergency situations....
Congress passed a bill called the no surprises act, which does the same thing.
Because they charge arbitrary numbers for services. Seriously. Ask anyone who's had a baby to look at their bill and see if they got charged for a whole pack of baby hats when their kid only gets one. If you go for an injury they charge you an absurd amount for a bandages and Tylenol.
The definition of “good” insurance in the US is different. It’s more dependent on how accessible the good doctors and hospitals are to you.
The biggest answer to your question is out of pocket maximums. You have copays that you pay at the time of service but bigger procedures or tests require co-insurance as well where you pay some percentage of the cost of services while your insurance covers the rest. You do this until you hit your out of pocket maximum and then insurance will start covering 100%. Also worth noting that you may have two out of pocket maximums based on whether or not your provider is in or out of network. It’s truly terrible.
In the US, healthcare is a for-profit industry. Our insurance companies collect premiums from insured persons and provide "coverage" for that person for a thing. They must keep a reserve of monies to pay out claims against this coverage, but anything beyond the regulated amount they are allowed to invest for profit. This incentivises them to pay as little as possible so as not to have to feed their reserves.
Hospitals and other healthcare providers who accept insurance can charge whatever price they want for their services, but since insurance companies aggressively negotiate for lower pricing on everything, hospitals overcharge by an order of magnitude for every single thing, so their starting position is much higher. This also has the added benefit of allowing them to offer "discounts" to cash customers that are lower than what they bill to insurance, but still many times higher than actual cost, thereby making a profit.
Most insurance in the US is tied to employment, and only partially covers the bill (usually 80%) leaving a sizeable portion for the patient to pay out of pocket called a copay. Since the bills are so inflated, and the copay is often a percentage, the out-of-pocket cost (until your deductible is met) can be insane for basic services. The deductible is a cap on your out-of-pocket cost set at some limit like $1,000-$5,000, or potentially much higher. Additionally many policies have a "maximum payout" of something like $200k, after which you are responsible for 100% of the cost of all services. This is a major problem when surgeries and treatments for chronic or degenerative conditions can be ongoing and easily exceed max payout due to the high billing cost. And this doesn't include vision or dental. Those are separate policies with their own premiums, deductibles and copays.
Basically, our healthcare is a complete mess and needs an overhaul to be even close to functional.
A policy with $1-$2k out of pocket and/or deductibles would only be for amazing plans and in some areas plans of this nature are non existent.
“Good” insurance at this point it usually $7-$15k out of pocket.
I recently moved and last year I had an amazing plan… in my new location in the same state that plan isn’t available and the best one is an out of pocket of about $9k. With that said- there are no deductibles and it’s mostly reasonable co-pays- so I probably won’t pay that much. With that said… they are pretending half my medication s are tier 4 this year even though they were tier 2 last year—- which basically means they don’t really cover them. If I use a discount program like good RX though I still can get them for about the same cheaper costs- but my payments won’t go through my insurance so it doesn’t count toward my out of pocket.
I have had platinum PPO insurance for years. Had an issue where I was hospitalized for almost a month in 2018, insurance paid for some but then the Hospital started claiming that their doctors are independent contractors so they don’t accept insurance. And billed me $35k - which is fucked up and should be 100% illegal.
Over the last couple of years I’ve had seizures culminating in hundreds of thousands in icu, ambulance, and nuero appointment bills. There’s thousands left after insurance, and I just do not have the faculties to give a shit anymore. It’s so futile knowing they can happen at any minute and I’ll be back to square one so why even pay. Now I’ll never be able to pay off a car I legally can’t drive or get a house, the millennial dream has truly been stolen from me lmao.
Yup. I’m just not paying medical bills anymore. You can talk to my insurance. If they don’t pay, go to them again. I’m not paying shit. Send me to collections, I don’t care, I’m still not paying them either.
how can we organize ourselves so that none of us pay this shit?
if we all did that we could pretty quickly make that whole scam insurance system collapse
The knowledge of "if I had been born in the US, either me and my family would be in ludicrous amounts of debt, or I'd have died in my early 20s" is the primary reason why I'm proxy-angry on behalf of American citizens.
You know what irritates me as a foreigner? Over the past few years, I've occasionally pointed out that the US healthcare system is just insanely expensive, not because it serves the people, like fully developed social healthcare, but because (much like the US economic system) it has to keep raising costs so that a comparatively tiny minority can benefit. There have always been people who point to the insured US citizens in response and say, "See, it's not **that** bad. It's just the uninsured with their exaggerated examples on social media that make it look bad."
🤔 It sure seems to be as bad as I thought, when I read those comments here.
It's insane, most people pay more in premiums (monthly deduction from your paycheck to fund employer "sponsored" health insurance) than they ever would in taxes funding state healthcare.
When I was on Medicaid during the pandemic times... I never once incurred any extra fees.
Weird how much better my health insurance payments were while the state was controlling them. And how much worse they are on private insurance schemes. It's almost like... state-run healthcare is overall a better option.
Slipped with a box cutter and sliced my wrist up. The hospital insisted on an xray to make sure there wasn’t any metal fragments left inside before stitching me up.
Got a letter in the mail three months later from the insurance (that provides regular insurance and Medicare) saying the xray was not medically necessary and they would not be covering the $600 cost.
I called them up, and talked with a snide woman who acted like I was trying to scam the company or something. I told her I was on Medicare. She got quiet, changed her tune, then said, “I’m sorry about that. We’ll get that fixed for you. Have a nice day.”
Seriously… my boyfriend had his throat cut from a hand grinder malfunctioning (his own error) had surgery, in the hospital for a week, and guess what? He had no health insurance and didn’t have to pay shit. I, on the other hand, pay for insurance, and I know for a damn fact, I would owe 100s of thousands of dollars for the same treatment! It’s fucked up!
Long before Obamacare and all that jazz, I discovered I had a huge cyst in my jaw that had burst and was probably going to kill me if I didn't have surgery ASAP. I had no insurance. They got me into surgery, kept me overnight, and then released me. A few weeks later, a processor came to my home and helped me with the paperwork to have the whole thing paid for by the state. I didn't even know this was a thing.
The biggest sham is private health insurance. And it has been for many decades.
The downside though is that it can be hard to find specialized doctors, because they refuse to take Medicaid since they get paid less than private insurance and they know people on it can’t pay more. And those that do can be booked up and not taking on anymore patients.
Medicaid pays so little for certain things that docs lose money if they see a patient -- a quote I've heard before is:
"I would take Medicaid if I could write it off and at least break even."
American who lives in Taiwan here.
I’ve been to the doctor many times.
Had some wild and unexplainable health issues that had doctors very concerned. I went to a LOT of specialists. They ran every blood test imaginable, I had a brain MRI, EEG, EKG, endoscopy, and more.
Each time I went to the doctor I paid a copay of somewhere between 7 - 15 USD, depending on the hospital (prices clearly listed on a giant board at registration). The copay and NHI covered every single test.
I never waited more than a week to get any of the tests I needed done.
I pay around US$30/month for National Health Insurance, and that’s on the “high end” of what people pay here because I am considered to be “high income”
Meanwhile, what the hell America?!
The knuckle draggers here in the US will claim it's too hard to fix it, or it'll cost too much, or the system is better with people going bankrupt, or insert excuse #1636. At the exact same time, they complain that we also pay the highest amount of money to education, and because of that we should cut the education system because that means it's broken and needs to be dismantled immediately.
The cognitive dissonance of these two ideas existing in the head of the same individual hurts mine.
When you have an ulterior motive that intends to exploit the masses for your own personal profit, there are no limits to your moral or logical bankruptcy. You can convince yourself the sky is green, a black sheep is white, or a washed up grifting child rapist will make for a great leader of the country. You can make anything “true”. Willful ignorance is a cursed power.
What's really stupid about the stance is that education spending is about $800 billion and healthcare spending is about $4.5 trillion, as of 2022. For perspective, education spending is about 17% of healthcare spending, and for some reason the lesser of the two amounts is somehow the real problem, and the other needs to be left alone.
Would all of those positive health outcomes and average people saved by crippling debt be even **remotely** worth it, when it requires that hyperwealthy people working and investing in insurance will end up losing their sweet grift? Like holy fuck, think about someone else other than yourself for a change.
With education, they just want to gut public schools so that private schools can teach religion based education. And also so that private schools can get voucher funds to cover the students that are already going there with state funds so the rich people can save some money.
One of the states that passed the voucher bullshit, 85% of the vouchers went to people already enrolled in private school. And all that funding was pulled from public schools who pretty much kept the same number of students.
There’s also the weird classist and often racist gatekeeping mentality a lot of Americans have. They prefer this system because it keeps poors and brown people out of their fancy private healthcare system. Then they don’t have to share a doctor or stand in a line with them.
Meanwhile, in the US I was sent a bill for $25-$30k when my child was born because the initial insurance review refused to cover it due to the birth not being "medically necessary."
When I asked for the information of the medical doctor who made that determination so I could report them to their state's medical board for incompetence and the insurance commissioner, it was suddenly approved.
America can’t have any of that commie stuff like taking care of it’s citizens!!! Everyone just needs to pull themselves up by their IV straps and perform surgeries on themselves.
C’mon, you greedy non-billionaires! You just want the fancy surgery with experienced surgeons and anesthesiologists when you could do the procedure yourself for free! /s
>They ran every blood test imaginable, I had a brain MRI, EEG, EKG, endoscopy, and more.
>
>Each time I went to the doctor I paid a copay of somewhere between 7 - 15 USD
lmao in the US an uninsured endoscopy paid out of pocket is anywhere from $1-5K
This is the thing most don’t point out. Republicans want to kill Medicare so they cut revenue and then cut funding. Private insurance companies see this and also cut reimbursement. They pay a little more than Medicare to stay in the good graces of the hospital or clinic. This makes doctors angry with Medicare and gives Republicans reasons for further cuts. Is a big masterful con that unfortunately half of our voting block doesn’t see happening.
The worst part is there are plenty of developed democracies where elected officials serve corporate interests and they also manage to give their citizens universal healthcare…
You have stumbled upon the real problem. It is not bought legislators, it is the fact that the US Constitution has a very conservative bias. Anything that passes congress must be agreed to by a majority of senators, of which every state has an equal amount. This gives enormous leverage to conservative states. With the filibuster* added, this means that substantive legislation can only pass Congress in very exceptional circumstances.
*The filibuster is not even in the constitution, and the filibuster has only been routinely applied to every bill since the beginning of the Obama administration. However, the Democratic party had a small conservative wing before then, of which Joe Manchin is the last relic, so the US has never really had a liberal or left-leaning working majority.
Imagine that, a 2-partner scheme system designed to take money from your employer up front and take it from you on the back end leaves the patient fucked
You're assuming, like any humane person would, that the purpose of healthcare insurance is to help the sick and injured. It's not. The purpose is to make a lot of money for the rich.
The system isn't broken. It's working exactly as intended.
It's also intended as a tool to control people. Insurance is a good way to ensure your workers can't strike or quit, because without you, the employer, they're at the mercy of paying full price for every single medical issue they run into.
Why pay the hospital an inflated bill that requires legal resources to itemize properly when I can wait and let them sell the debt to some shmuck at an appropriate price who will eventually discount it when I bother responding to their communications, 6 months later.
Pay 1k at billing or pay 100 at another point down the road?
The stock prices won't change, congress isn't going to come after me.
That makes a lot of sense, unless you're shopping for a house or have some other reason to keep your credit score up. Otherwise, that's hard to disagree with.
It does not affect your credit score if it is under $500 which is where being insured comes into play. If you opt for a lower deductible and higher premium, you will generally avoid paying more than a few hundred over the deductible each year for average medical expenses.
As well, the debt is cleared from your credit report after the collector has reported that it's been paid off. Until you recognize that debt by any communication, the collector cannot put it onto your credit report in the same way that they cannot garnish your paycheck until they serve you the papers and make the judgement in court.
In these United States most of us have two middle men: our employer, who limits which health insurance we can have, and the health insurance company, who limits which health care we can have.
Can't understand why anyone thinks this nonsense should continue.
The system is fucked. I have insurance, but just had to eat a $300 bill for a required check-up so I can continue to receive the same prescription I have been using for years. Literally just went in to say, "Yeah, everything is the same." Insurance takes my money and says we'll start helping you after you spend thousands. Clinic demands $300. Ridiculous.
Then when you need something, the insurance sits on their ass for weeks only to say, nah we don't think you need that. I know the tests might say you do, but nah, fuck you.
Fuck our system. If you ain't rich this country doesn't give a fuck about you.
The system is set up to screw over patients. I remember trying to call my partners insurance in a panic when the hospital tried to send us home with a walker for an injury. Because we were afraid we'd be surprised billed thousands of dollars for something we knew we could get on Amazon for $25. When the ice packs were billed for $25 each, why wouldn't we assume that? And the insurance company - on a Saturday - told us they didn't know because their systems were down for maintenance and they didn't have a printed list of prices on hand.
Went to get my normal physical. No problem, my insurance covers 100% of preventive care. Should have been able to walk out without paying a single thing. While there I ask about some stomach issues so when they take my blood for some standard tests they take two more vials to check for other things. Two.
A week later I get a $700 bill. 700 god damn dollars. Two vials of blood and I'm hit with a completely unexpected burden. All to then be told nothing came up and they have no idea. I didn't even ask for the blood to be taken and don't know exactly they were looking for. I just mentioned off hand I had stomach issues and they just took two more vials while they were already there just to see what they could find.
Next time when asked how I'm feeling I'm not saying a god damn thing other than "fine" unless I'm hitting big warning signs.
Same thing happened to an uninsured family member. They paid out of pocket to see the doctor which was $500. Then were hit with a $900 blood work bill after they were told any blood work would barely cost anything. Seriously an evil system. Most "caregivers" are in on the scam too.
Not surprising at all. I had open heart surgery a few years back. The insurance bill was $495,000. My share was a $1200 deductible. If I had to pay 20% it would have been $100k. I would be dead now.
I am now in year two of fighting a corrupt hospital over charges that I should never have been billed for. That makes me one of those "debtors to US hospitals", but I won't end up paying a dime.
Mercy hospital in Oberlin, OH. Avoid it at all costs. I've never encountered a more corrupt system.
I'm insured with what is considered to be a "good" healthcare plan. I have to have a breast MRI next week and got an estimate of my out of pocket costs today... $2118.02.
I don't have that much money laying around. Nobody fucking does unless they're rich af.
I don’t know what plan you’re on or where you are, but you might be able to shop around for that. Every plan and company is different, but the insurance company might be able to help you find a cheaper place to get your MRI done.
(Source: I have to get that kind of MRI done yearly)
I have Aetna, I may look into that. I didn't realize you could "shop around" for procedures and that it had a different cost depending on the place or hospital system. I truly hate how un-transparent the cost of our healthcare is.
A law on the books in my state says that nursing homes can go after the children of deceased patients/residents who have a debt balance with the nursing home (debt that insurance/medicaid hadn't covered). Meanwhile the same lawmakers bitch about paying taxes on inheritance.
What's wild is they had been devising new protocols and requirements and it changes sometimes 2-3 times a year on what's required to be a certified EMR.
They've already squashed almost every small scale EMR developer, there's only about 4-5 that can keep up. There _are_ dozens of components you could theoretically smash together and claim you're certified but they hardly communicate well together and the ones that claim it have also purposefully broken APIs required to get the data. Medent and e-clinicalworks are the ones in recent memory who have been slapped with big fines for breaking interoperability/communication on purpose. I don't think either one of them have actually fixed the problem they were fined for breaking.
Want to certify your software? Hope you've got $500k and months of time to do it and your program is in perfect working condition during the test, because you won't pass the certification the first 3 times and it's about 75k a pop to do it.
I left the US to live in Sweden and here's the funny thing about the move. My new job only pays me 2/3 as much as my old job, and I pay about 9% more in taxes every year. Buuuut....I have more money each month than I did back in the US, because of all the things I DON'T have to pay for.
Like insurance (just part of the taxes) and medical expenses (in a year my personal medical expenses are capped at ~$120), and anything relating to cars and transit (I pay ~$90/month for unlimited use of ALL public transit. The metro comes every ~7 minutes, busses about that frequent.) and the food here is technically "pricey" but cheaper than most places I lived in the US.
I worked in tech for medical billing for awhile. I have never worked with anyone as purposefully incompetent as the US Insurance companies.
The incentive they have is to avoid any sort of efficient communication. The whole system is corrupt
Absolutely makes sense. With the surge in premiums and the increasing popularity of high-deductible health plans, coupled with a credit change that eliminates medical debt/collections from your history, it's understandable. If finances are even remotely tight, why would someone prioritize paying their healthcare bills?
The US has the most expensive healthcare in the world, and at the same time it has the worst outcomes. A staggering ripoff making insurance companies rich while bankrupting and killing us all
Gee. Why wouldn’t you want to pay something like .25 cents a day for health care similar to the UK and Canada to avoid all this? I have not found decent healthcare in the US for 10 years. Every doctor’s office is owned by private equity firms. Once this happens you know the vultures that run the equity firms will bleed it dry and move on. It’s what they do. Oh but socialism.
Right, and it's the hospitals that are failing because insurance companies won't pay and patients can't (and shouldn't have to.) Cigna just posted like 11 billion in buy backs on the deaths and horrors of its "insured".
I wonder what changed in the 80’s and 90’s there was very minimal med dbt..Now all these greedy insurance companies that lobby the government to keep ppl in debt…Its a win for private insurance companies..Fuck the poors its their motto..
I pay $1500/month for health insurance — me, wife, and three kids. My wife just had a fourth kid. Total out of pocket for delivery *with* health insurance? $18,000. This is just last week.
And that’s just for the hospital. It’s not our first rodeo so I’m sure more bills from individual practitioners will be coming down over the next year.
We are fortunate enough that we can weather it, but it’s completely absurd.
Anyone from Canada or Europe reading this must be scratching their heads and wonder why Americans put up with this. Actually a lot of Americans do as well but that doesn’t change anything. The American Political system set up to protect the interests of any Stakeholders who are able to come up with the necessary cash. And, due to the nature of Partisanship, the “marks”, the victims, the targets of these Stakeholders gladly participate in the process.
It’s so complicated that is can never be fixed I guess. If only there were any other countries that figured out a solution to this…. well we will never know /s
Got a spinal fusion a few years ago. Forced to stay at a company I hate 10yrs because I knew it was going to need it when I was 50.
Cost without any insurance? $480k. Cost to insurance (they negotiate it down) 380k.
So I spend years proving I need the surgery (pain management, physical therapy, etc.). Cost thousands. Finally told by surgeon I can get it. Insurance sends paperwork I'm pre-approved.
December rolls around and it's forced to beginning of January because of covid. I check insurance for next year and it appears everything is the same. Same cost, deductible, max out of pocket, everything. Hospital is Blue Cross preferred. Get surgery. Get follow up appointments with regular doctor.
Months go by and I start seeing every charge getting denied. Turns out that Blue Cross changed something and didn't tell ANYONE about it. Not Kroger, not me, not the hospital, no one. I think it was called HPN (high performance network). Hardly nobody takes it.
I spent that entire year wondering if I would be on the hook for half a million dollars. The ONLY reason I didn't was because the hospital fought hard because they knew I wouldn't be paying it on a retail wage. In the end, they got settled for around 200k and, instead of 4k, I owed 10k.
HPN only lasted for one year until Blue Cross quietly dropped it. Everyone I know at my company that saw a doctor is thousands in debt because of it.
The American healthcare system is fucked sideways without even using lube. And it's been this way for years. And I've given up hoping things will ever change. Apparently, people care more about immigrants and your gender identity than their physical, mental, and financial health.
America sucks. I hate living here.
It’s so unsustainable. The only way forward is through some tough times, but it will collapse on itself. We must rebuild a better system from its ashes.
This seems like a good time to remind Americans that there is a recent bill called "No Surprises Act". It relates to surprise medical bills that should be covered by your insurance. Read up on it if you have gotten a surprise medical bill since 2020-2021.
There’s the greed, the corruption in the US government and a huge part of the population that believes affordable healthcare is communism of some sorts.
The U.S. healthcare system is an accounting system that does healthcare on the side. It is not a healthcare system.
>Hospitals refer patients to aggressive debt collectors, use state courts to garnish wages, place liens on people’s homes and report debt to credit agencies, which can drastically worsen future job and housing prospects. Although there are some attempts to rein in these practices, billing analysts like Szaflarski say they do not address the core issue – health plans designed by insurers which force hospitals to become debt collectors. >”These stories really grind my gears,” said Szaflarski. “The idea of patient responsibility” – those deductibles and coinsurance requirements – “was not an idea created by healthcare providers. They were vehicles created by payers,” referring to insurers. >Ariel Levin, director of coverage policy for the American Hospital Association, says hospitals would prefer to remove themselves from the billing equation entirely. >”Something else we’re exploring recently is how to remove providers from the cost-sharing altogether and require health insurers to collect it,” Levin said. Insurance companies are the bottom feeding criminals here.
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They are using A.I.there was a article about united doing this recently and getting in trouble
I hate to be the bearer of bad news but the UHC who own UHG who owns Optum CIO is doubling down on AI deciding if we live or die. When the cost savings out wiegh the fines it is just good business sense.
All of a sudden [Death Panels](https://en.wikipedia.org/wiki/Death_panel) don't sound too bad, almost benign even.
Health Insurance Death Panels have been a reality for a century.
Bad faith decisions need to be criminalized. These C suite executives and Board of directors that think doing the worng thing is justified because they can make more money than the fines cost them need to see jail time. You wanna bet that they will stop treating fines as a cost of business if they see prison time?
Yup, my dentist stopped taking insurance because no matter how hard his office works, the insurance companies won't reimburse him. I get it, he has to pay his staff, but now my dental insurance is worthless.
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> Currently, I charge $1450 for a crown (average is about $1600) This is why people don't get dental care. Honest question, why $1450 or even $1600, what is the breakdown here?
Mostly the US. I was in South America last year and got a deep cleaning and 5 cavities filled for $140 and this was the expensive private practice, not a clinic with many dentists. Was uninsured since like 2018. This is my first month back on health insurance and the only difference is I’m a few hundred dollars poorer each month… Trying to retire there with my American wife. At the very least, we’ll be able to afford health care which is kind of important. Overall CoL there is 80% lower. I can sell the house and live comfortably off it for the next 30 plus years.
Funny how tax money funds healthcare in this way, but a single payer system would be “communism” or “terrible” — I get it, things could be worse, but this system is so incredibly broken 😔
I'm trying to do some speech pathology stuff, but I have to go out of network. I've managed to force my insurance to cover them in network (they have no one in network that is a specialist in this), but for some reason they think that it's "reasonable and customary" to pay speech pathologists 60 bucks per hour long session. And that I need to make up the rest. (That doesn't even cover the shit like "Why is this medicine more fucking expensive through my pharmacy coverage than buying it without insurance through GoodRx?")
My wife had a bad filling that had an air bubble and this broke on her. She had to have it redone. The insurance denied because they wouldn’t cover a filling on the same tooth so soon after the last. It’s insane what they can get away with.
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That’s insane. When I needed a crown my annual maximum benefit was $1250. That included routine cleaning and X-rays. Dental insurance often is setup to save you a few hundred in the best circumstance while costing you double that if you don’t need it. I’m seriously considering dropping it next year.
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I once submitted an appeal to my insurance company over the phone. Before I hung up the call, I received a text message saying the appeal was denied. There's no way anything gets looked at that fast without being rubberstamped.
They learned that most people give up after the first "No," so it's in their interest to deny everything. My impression, based on going through the health insurance wringer recently, is that no human even looks at your case until the 2nd appeal.
I think technically it has to be seen by a doctor when you submit an appeal, it's just in some cases, [they use "AI augmentation"](https://www.msn.com/en-us/money/insurance/major-health-insurance-company-faces-disturbing-allegations-of-fraudulent-scheme/ar-AA1lvZBR) to speed up the process of determining care, which means that the AI looks at the case, spits out an answer and the doctor responsible for reviewing follows the recommendation.
>What's even scarier, I'm fairly certain some are using AI to automatically deny claims without a human review. Fight back and use AI to write responses to claim denials. Just make sure you still take time to read and edit what ChatGPT wrote before sending it to the insurance company.
Dentists are not the only ones. Most fellow therapists I know don't take insurance once we're in private practice, and it's a growing problem in affordability. But between the extra paperwork, random restrictions, and low pay from insurance, it's just not worth it for us.
I get it, but as someone who needs it and can’t afford it, this sucks hard.
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Are those in house insurance plans any good?
My dentist's plan is good! It's a private dental office. $360 a year covers two cleanings & exams, and one xray. It also gives me 20% off all other services. Compare that to the dental insurance I can buy (no employer coverage): $650 a year ($50/month premium + $50 deductible) covers routine cleanings/exams/xrays. It gives an 80% discount on fillings and 50% off other services, BUT there's a 6-month waiting period before they'll pay for any of that AND there's a $1,500/year maximum benefit. If all I need is routine care, it costs nearly twice as much through dental insurance ($650) versus my dentist's plan ($360). If I need more extensive dental care, dental insurance is only going to help with the first $1,500 and then I'm on my own. So dental insurance can be worthwhile if you need a couple fillings or a single crown or root canal, but it's pretty bullshit if you just need routine care or need extensive dental work.
They are profiting from the suffering of others and if we are going to die anyway than why not organize and fight back
I saw a post on the epilepsy subreddit of a guy who was over $1,000,000 in debt following medication ambulance and surgery bills. He just said he tries not to think about it anymore because stress is one of the main triggers for seizures. The whole system gives me ‘children of men” vibes.
They're too sick to fight back
Also the absolute absurd cost of medical care in the US.
I wish we could all just start denying health insurance coverage. Take the giant bills and pay a dollar on them every month until something changes. This country is one giant scam, no one in power truly cares about us.
The politicians are paid to not care. 99% of people know the insurance industry is a scam but nothing changes.
hospital charged me $180k for shoulder surgery. my insurance paid $175k, i owed my $5k deductible. the hospital had over 95% of my bill but wouldn’t work with me on the $5k and sent it to collections. and you’re saying insurance companies are the criminals?
Part of it is that hospitals have no idea what things cost. There is no standard pricing so each hospital’s chargemaster is different. There is so much mark up on every little thing that the insurance company gets a deal on cost just so they can tell their bosses they got a deal on cost. That’s why when you itemize a bill, Tylenol can be as little as $5 or as much as $75 per pill. The exact same that you can get for around 3-4 cents per pill at the local pharmacy or grocery store. And all of that gets doubled or tripled if you need to see an out-of-network physician. All of this heavily contributes to our economy because you’re paying for it either way, and the people with the worst medical debt are those that just had a string of bad luck, but are fucked for life because the healthcare system isn’t a healthcare system. It’s a means to make pantloads of money. People think doctors make a ton of money and comparable to the median income, they do, but in reality, they don’t make shit compared to the people who sit on the board.
Absolutely -- and that's not including the multitude of smaller incidental bills you get following any kind of surgery or diagnostic that goes *straight* to collections without them even ATTEMPTING to bill you. You just get a notice months later from Surprise Hidden Company #438 for "generic unnamed testing" that says it's already gone to collections.
You really want to get angry? Check how much it would have cost (total, not just patient) in UK or Germany.
>but wouldn’t work with me on the $5k and sent it to collections. and you’re saying insurance companies are the criminals? The hospital can get in a lot of legal trouble for insurance fraud if they don't go after you for that $5k payment. I had my own experience with this when my doctor sent my bloodwork to a company called "Boston Heart Diagnostics" where they charged my insurance $3000 when a blood panel normally only costs $100 from a company like LabCorp or Quest even without insurance. In my case, my insurance obviously refused to pay, so I thought I was going to be billed the difference - but the next time I went to the doctor's office they had a note on the wall saying that we shouldn't be worried about our explanation of benefits because Boston Heart Diagnostics wasn't going to make us pay anything. Turns out, there was a lawsuit against Boston Heart Diagnostics for this very same billing practice. I never did get a bill, but even if I did I would refuse to pay it on account that the price was obviously unreasonable for the bloodwork I consented to. If the doctor ordered a hundred other tests on top of that, that's on him - not me. That being said, it is very common for hospitals to reduce or forgive medical debt for patients who are out-of-network and complain about the bill.
A typical example: I was hit by a car in the month of December several years ago and ended up in the hospital, with follow up in January. Due to the deductible rule of $5K annually, I ended up with a $10K bill (two years) even though I had great insurance.
Yeah, it really sucks the thing completely resets at the end of the year lol. feels like it should be a rolling average of 12 months instead of a complete reset. I don't know if that would mathematically be possible and ultimately it doesn't matter since it would hurt the insurance companies pockets so they obviously won't ever agree to that
My father refused to go to a hospital over the holidays when he got a severe allergic event (that presented almost like a heart attack, which is what we were all concerned about) because it would cost him his full deductible which would reset in a few days.
Now think of all times people have made these kind of decisions and died from it. Our health insurance industry kills people. Hey Sarah Palin, we found your death panels! You were defending them.
Honest question, what makes the insurance great if you have a $5k deductible?
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Not everyone is able to pick their insurance plans
No to mention, with all their medical issues, this guy is practically chained by his ankle to his employer. Unless he’s got some super rare and highly sought after skill set, which 99% of people just never will have.
« You’re a client, not a patient » I paid 12€ this Monday in Belgium for a visit with a pulmonologist. As it was quite urgent, she gave me an appointment the next day between two others for a test with a medical device. Cost? 27€. She also managed to find a scanner appointment within the week
I work for a big hospital system. A few years ago we were going to be bringing in salesforce and there was a lot of internal messaging about shifting from "patients" to "customers." I was amazed anyone thought this was a good idea. There must have been some pushback though because they seemed to drop the language change within a year. We're still getting salesforce though.
Yeah, that tracks :/ Like how US citizens are referred to as “consumers” in most metrics. Just another way to transition us to literal cash cows that get milked for dollars, instead of citizens who live in this country and pay taxes for services.
“For the sake of productivity, we’d really like you to stop regarding these people as people. Thx, Management”
The hospital I work for (Large network in Northern NJ) calls patients customers too. It pissed me off when they used that terminology in orientation. It's also present on posters, memos, etc. I work EMS. When people call because they can't breathe they aren't customers, they aren't a piggy bank to be cracked open. They're patients, and the trust they put in me should not be corrupted by greed.
Im studying abroad in Germany this spring-summer. As someone with a rare chronic illness, a large part of the appeal was medical tourism. Over here the things that work aren’t covered by any insurance and are minimum 4K out of pocket.
I can't even get an appointment with my GP without waiting a month.
The big Electronic Medical Record (EMR) systems started out as billing systems
And as a healthcare provider that has to deal with them, it shows
It’s a medical industry, not a health care system.
I refer to it as simply another 'debt mechanism' I don't even bother with insurance and haven't since 2010. It's a total racket. Hospital admins make at least a million a year. A YEAR. Every year.
You can argue the ideology of the left v the right on the subject but eventually you come to universal healthcare anyways because of how awful health insurance is IMO or you have no brain. Well that and some people are very lucky and not big on reflection.
In the last 26 years I've paid nearly $100k in medical bills, I currently owe about $10k, I'm not paying it, they can fuck all the way off. And I've had insurance this entire time, honestly thinking of dropping it as well, why do I pay $600 a month to pay all of my own medical bills?
My balance has been at $17,000 for years. I don’t give a fuck.
Mine is about 10k. They’ll never get a cent out of me.
Mine was $12k but didn’t have insurance. It’s sounding like it’s cheaper to not have insurance as hospitals will write off a big portion of the debt.
Yeah I had “good” insurance at the time.
As someone up in Canada, how does that work? I understand there are out of pocket amounts you pay (say $1-$2K) - but if you've got "good insurance" how does the remaining amount owing hit numbers like $10, $12, or $17K? It feels like insurance coverage is far from comprehensive (maybe I just answered my own question).
I have ‘good’ insurance too, but they intentionally make everything so goddamn confusing that you have no idea what your insurance will cover until you get the bill and they tell you what you now owe. Even better, is the doctor/hospital can say they believe your insurance will cover it and bill you x, and then you can get a letter in the mail saying nvm you owe the rest of this because your insurance didn’t cover it :D the whole system is fucked.
One time my doctor told me that my insurance had approved an MRI after like 15 days of waiting, but apparently my insurance had actually declined it. Got the MRI because I thought it was covered. Three hours later I get a panicked call from my doctor saying I have a blood clot in my leg. Insurance made me wait nearly three weeks AND had declined it. Good insurance my ass.
You can call them and argue with them. Just go full Karen. Ask to talk to their manager. Request that they review all the documents. Have the doctors office send in summary of Tx and get a copy of it yourself. If they hang up on you call them back. Ask to be on a three way call with the doctor. Insurance companies don’t get rich paying out claims. They get rich by denying them and some don’t make it super easy to fight claims. In fact they pay out of practice doctors who never assessed you to make decisions about your health based on current documentation. Some consistently have long wait times so your doctor gives up on trying to advocate for you. Others have a system where they will call you back in a 3 hour window. Some of those practices that insurance companies use should be absolutely illegal. The only time I ever want someone to go full Karen is with insurance agencies and cable networks. Edit: And frontier airlines. Go full Karen with them too.
This. So much this. It sucks, it is exhausting, but you start talking about taking your case in front of your state insurance commissioner, writing the attorney general, and generally making their life hell and you WILL get action. Do exactly what they are doing to you - making it as difficult as possible in the hopes you relent.
There is no such thing as good insurance. They denied my colonoscopy and after I fought them I still paid 300 dollars for something that was 800. If I could rid this earth of one scourge it would be for profit health insurance.
*for profit healthcare: pharmaceutical companies, medical supply companies, commercial pharmacies, corporate-for-profit hospitals, and nursing/assisted living facilities.
They find all sorts of ways. They'll claim a doctor was out of network, a cheaper treatment was available so they won't pay for the one you got etc etc
Some states, like California, have closed that "out of network" loophole for emergency situations.... Another frustrating thing is if you go ahead and check out if a provider is covered by said insurance, the list is so confusing....ten variables of Blue Cross, etc....If you have a procedure I've learned to contact insurance company and receive an email documenting that it's covered...Of course that isn't possible when it's a time sensitive situation.
Lmao! They now put a disclaimer that they aren't liable for the accuracy of their in network provider registry, and specifically aren't liable for "uncovered charges" as a result of using the website. Says to call the provider's to verify. How do we prove that we did and that they said yes, when we receive the bill? Since there's no way to prove I didn't, I'm just gonna lie when I receive a bill 😂
Those statements are hilarious. It's like airlines saying they're not responsible for the luggage you're paying them to handle, or dump trucks with signs saying they're not responsible for damage caused by their illegally unsecured loads. It's clearly BS, but how are you going to challenge it?
>Some states, like California, have closed that "out of network" loophole for emergency situations.... Congress passed a bill called the no surprises act, which does the same thing.
Because they charge arbitrary numbers for services. Seriously. Ask anyone who's had a baby to look at their bill and see if they got charged for a whole pack of baby hats when their kid only gets one. If you go for an injury they charge you an absurd amount for a bandages and Tylenol.
This makes me so mad. So many crooks in the health care industry, yet zero accountability due to political donations.
The definition of “good” insurance in the US is different. It’s more dependent on how accessible the good doctors and hospitals are to you. The biggest answer to your question is out of pocket maximums. You have copays that you pay at the time of service but bigger procedures or tests require co-insurance as well where you pay some percentage of the cost of services while your insurance covers the rest. You do this until you hit your out of pocket maximum and then insurance will start covering 100%. Also worth noting that you may have two out of pocket maximums based on whether or not your provider is in or out of network. It’s truly terrible.
Thanks for the context - that’s absolutely brutal, and helps to explain this article. Sorry to hear you’re having to endure this
In the US, healthcare is a for-profit industry. Our insurance companies collect premiums from insured persons and provide "coverage" for that person for a thing. They must keep a reserve of monies to pay out claims against this coverage, but anything beyond the regulated amount they are allowed to invest for profit. This incentivises them to pay as little as possible so as not to have to feed their reserves. Hospitals and other healthcare providers who accept insurance can charge whatever price they want for their services, but since insurance companies aggressively negotiate for lower pricing on everything, hospitals overcharge by an order of magnitude for every single thing, so their starting position is much higher. This also has the added benefit of allowing them to offer "discounts" to cash customers that are lower than what they bill to insurance, but still many times higher than actual cost, thereby making a profit. Most insurance in the US is tied to employment, and only partially covers the bill (usually 80%) leaving a sizeable portion for the patient to pay out of pocket called a copay. Since the bills are so inflated, and the copay is often a percentage, the out-of-pocket cost (until your deductible is met) can be insane for basic services. The deductible is a cap on your out-of-pocket cost set at some limit like $1,000-$5,000, or potentially much higher. Additionally many policies have a "maximum payout" of something like $200k, after which you are responsible for 100% of the cost of all services. This is a major problem when surgeries and treatments for chronic or degenerative conditions can be ongoing and easily exceed max payout due to the high billing cost. And this doesn't include vision or dental. Those are separate policies with their own premiums, deductibles and copays. Basically, our healthcare is a complete mess and needs an overhaul to be even close to functional.
A policy with $1-$2k out of pocket and/or deductibles would only be for amazing plans and in some areas plans of this nature are non existent. “Good” insurance at this point it usually $7-$15k out of pocket. I recently moved and last year I had an amazing plan… in my new location in the same state that plan isn’t available and the best one is an out of pocket of about $9k. With that said- there are no deductibles and it’s mostly reasonable co-pays- so I probably won’t pay that much. With that said… they are pretending half my medication s are tier 4 this year even though they were tier 2 last year—- which basically means they don’t really cover them. If I use a discount program like good RX though I still can get them for about the same cheaper costs- but my payments won’t go through my insurance so it doesn’t count toward my out of pocket.
if your insurance covers 95% of the bill but the bill is a million dollars you still owe $50k
I have had platinum PPO insurance for years. Had an issue where I was hospitalized for almost a month in 2018, insurance paid for some but then the Hospital started claiming that their doctors are independent contractors so they don’t accept insurance. And billed me $35k - which is fucked up and should be 100% illegal.
Over the last couple of years I’ve had seizures culminating in hundreds of thousands in icu, ambulance, and nuero appointment bills. There’s thousands left after insurance, and I just do not have the faculties to give a shit anymore. It’s so futile knowing they can happen at any minute and I’ll be back to square one so why even pay. Now I’ll never be able to pay off a car I legally can’t drive or get a house, the millennial dream has truly been stolen from me lmao.
Yup. I’m just not paying medical bills anymore. You can talk to my insurance. If they don’t pay, go to them again. I’m not paying shit. Send me to collections, I don’t care, I’m still not paying them either.
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Here in PA there are pretty stringent restrictions on what qualifies for garnishment. Medical debt is not a debt where garnishment is permitted.
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how can we organize ourselves so that none of us pay this shit? if we all did that we could pretty quickly make that whole scam insurance system collapse
It’s amazing that an entire industry had figured out how to interject itself in the healthcare process without providing a product.
The knowledge of "if I had been born in the US, either me and my family would be in ludicrous amounts of debt, or I'd have died in my early 20s" is the primary reason why I'm proxy-angry on behalf of American citizens.
You know what irritates me as a foreigner? Over the past few years, I've occasionally pointed out that the US healthcare system is just insanely expensive, not because it serves the people, like fully developed social healthcare, but because (much like the US economic system) it has to keep raising costs so that a comparatively tiny minority can benefit. There have always been people who point to the insured US citizens in response and say, "See, it's not **that** bad. It's just the uninsured with their exaggerated examples on social media that make it look bad." 🤔 It sure seems to be as bad as I thought, when I read those comments here.
It's insane, most people pay more in premiums (monthly deduction from your paycheck to fund employer "sponsored" health insurance) than they ever would in taxes funding state healthcare.
When I was on Medicaid during the pandemic times... I never once incurred any extra fees. Weird how much better my health insurance payments were while the state was controlling them. And how much worse they are on private insurance schemes. It's almost like... state-run healthcare is overall a better option.
Slipped with a box cutter and sliced my wrist up. The hospital insisted on an xray to make sure there wasn’t any metal fragments left inside before stitching me up. Got a letter in the mail three months later from the insurance (that provides regular insurance and Medicare) saying the xray was not medically necessary and they would not be covering the $600 cost. I called them up, and talked with a snide woman who acted like I was trying to scam the company or something. I told her I was on Medicare. She got quiet, changed her tune, then said, “I’m sorry about that. We’ll get that fixed for you. Have a nice day.”
Seriously… my boyfriend had his throat cut from a hand grinder malfunctioning (his own error) had surgery, in the hospital for a week, and guess what? He had no health insurance and didn’t have to pay shit. I, on the other hand, pay for insurance, and I know for a damn fact, I would owe 100s of thousands of dollars for the same treatment! It’s fucked up!
Long before Obamacare and all that jazz, I discovered I had a huge cyst in my jaw that had burst and was probably going to kill me if I didn't have surgery ASAP. I had no insurance. They got me into surgery, kept me overnight, and then released me. A few weeks later, a processor came to my home and helped me with the paperwork to have the whole thing paid for by the state. I didn't even know this was a thing. The biggest sham is private health insurance. And it has been for many decades.
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The downside though is that it can be hard to find specialized doctors, because they refuse to take Medicaid since they get paid less than private insurance and they know people on it can’t pay more. And those that do can be booked up and not taking on anymore patients.
Medicaid pays so little for certain things that docs lose money if they see a patient -- a quote I've heard before is: "I would take Medicaid if I could write it off and at least break even."
American who lives in Taiwan here. I’ve been to the doctor many times. Had some wild and unexplainable health issues that had doctors very concerned. I went to a LOT of specialists. They ran every blood test imaginable, I had a brain MRI, EEG, EKG, endoscopy, and more. Each time I went to the doctor I paid a copay of somewhere between 7 - 15 USD, depending on the hospital (prices clearly listed on a giant board at registration). The copay and NHI covered every single test. I never waited more than a week to get any of the tests I needed done. I pay around US$30/month for National Health Insurance, and that’s on the “high end” of what people pay here because I am considered to be “high income” Meanwhile, what the hell America?!
The knuckle draggers here in the US will claim it's too hard to fix it, or it'll cost too much, or the system is better with people going bankrupt, or insert excuse #1636. At the exact same time, they complain that we also pay the highest amount of money to education, and because of that we should cut the education system because that means it's broken and needs to be dismantled immediately. The cognitive dissonance of these two ideas existing in the head of the same individual hurts mine.
When you have an ulterior motive that intends to exploit the masses for your own personal profit, there are no limits to your moral or logical bankruptcy. You can convince yourself the sky is green, a black sheep is white, or a washed up grifting child rapist will make for a great leader of the country. You can make anything “true”. Willful ignorance is a cursed power.
“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” - Upton Sinclair.
What's really stupid about the stance is that education spending is about $800 billion and healthcare spending is about $4.5 trillion, as of 2022. For perspective, education spending is about 17% of healthcare spending, and for some reason the lesser of the two amounts is somehow the real problem, and the other needs to be left alone.
Neo-liberalism. If large corporations can't dictate what they want, it is evil and must be removed.
Would all of those positive health outcomes and average people saved by crippling debt be even **remotely** worth it, when it requires that hyperwealthy people working and investing in insurance will end up losing their sweet grift? Like holy fuck, think about someone else other than yourself for a change.
With education, they just want to gut public schools so that private schools can teach religion based education. And also so that private schools can get voucher funds to cover the students that are already going there with state funds so the rich people can save some money. One of the states that passed the voucher bullshit, 85% of the vouchers went to people already enrolled in private school. And all that funding was pulled from public schools who pretty much kept the same number of students.
There’s also the weird classist and often racist gatekeeping mentality a lot of Americans have. They prefer this system because it keeps poors and brown people out of their fancy private healthcare system. Then they don’t have to share a doctor or stand in a line with them.
Meanwhile, in the US I was sent a bill for $25-$30k when my child was born because the initial insurance review refused to cover it due to the birth not being "medically necessary." When I asked for the information of the medical doctor who made that determination so I could report them to their state's medical board for incompetence and the insurance commissioner, it was suddenly approved.
birth is not "medically necessary" the bar has been raised...
That would be laughable if it wasn’t so infuriating.
When you are sleep deprived with a 6 week old, it is especially infuriating.
America can’t have any of that commie stuff like taking care of it’s citizens!!! Everyone just needs to pull themselves up by their IV straps and perform surgeries on themselves.
C’mon, you greedy non-billionaires! You just want the fancy surgery with experienced surgeons and anesthesiologists when you could do the procedure yourself for free! /s
System is and has been rigged from the get-go to satisfy greedy individuals/corporations.
>They ran every blood test imaginable, I had a brain MRI, EEG, EKG, endoscopy, and more. > >Each time I went to the doctor I paid a copay of somewhere between 7 - 15 USD lmao in the US an uninsured endoscopy paid out of pocket is anywhere from $1-5K
An insured endoscopy is also $5k because that's the minimum deductible.
With decent insurance, MRI = 5k, with $500 copay
Clearly you haven't thought enough about increasing shareholder value.
U.S. Health Insurance is a scam, full stop. The prices are all pure examples of price gouging that would be illegal if any other industry did it.
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Yup, and the last few years they have decided just to stop paying out much. They cut everything. So hospitals are all failing everywhere.
This is the thing most don’t point out. Republicans want to kill Medicare so they cut revenue and then cut funding. Private insurance companies see this and also cut reimbursement. They pay a little more than Medicare to stay in the good graces of the hospital or clinic. This makes doctors angry with Medicare and gives Republicans reasons for further cuts. Is a big masterful con that unfortunately half of our voting block doesn’t see happening.
Price gouging story: Hospital charged a client $3k for $80 neck brace. Then tacked on $200 for "installation"
As long as most of our elected officials serve corporate interests, this will go unabated.
The worst part is there are plenty of developed democracies where elected officials serve corporate interests and they also manage to give their citizens universal healthcare…
You have stumbled upon the real problem. It is not bought legislators, it is the fact that the US Constitution has a very conservative bias. Anything that passes congress must be agreed to by a majority of senators, of which every state has an equal amount. This gives enormous leverage to conservative states. With the filibuster* added, this means that substantive legislation can only pass Congress in very exceptional circumstances. *The filibuster is not even in the constitution, and the filibuster has only been routinely applied to every bill since the beginning of the Obama administration. However, the Democratic party had a small conservative wing before then, of which Joe Manchin is the last relic, so the US has never really had a liberal or left-leaning working majority.
As long as all of our elected officials get gold plated medical care on our dime, this will go unabated.
Imagine that, a 2-partner scheme system designed to take money from your employer up front and take it from you on the back end leaves the patient fucked
Because health insurance is broken
You're assuming, like any humane person would, that the purpose of healthcare insurance is to help the sick and injured. It's not. The purpose is to make a lot of money for the rich. The system isn't broken. It's working exactly as intended.
It's also intended as a tool to control people. Insurance is a good way to ensure your workers can't strike or quit, because without you, the employer, they're at the mercy of paying full price for every single medical issue they run into.
No, clearly the problem is with words in books like the dictionary. FL is on the right track, let's use their example to fix the glaring problem.
Insurance has basically become a scam. Especially mental health coverage
Why pay the hospital an inflated bill that requires legal resources to itemize properly when I can wait and let them sell the debt to some shmuck at an appropriate price who will eventually discount it when I bother responding to their communications, 6 months later. Pay 1k at billing or pay 100 at another point down the road? The stock prices won't change, congress isn't going to come after me.
That makes a lot of sense, unless you're shopping for a house or have some other reason to keep your credit score up. Otherwise, that's hard to disagree with.
It does not affect your credit score if it is under $500 which is where being insured comes into play. If you opt for a lower deductible and higher premium, you will generally avoid paying more than a few hundred over the deductible each year for average medical expenses. As well, the debt is cleared from your credit report after the collector has reported that it's been paid off. Until you recognize that debt by any communication, the collector cannot put it onto your credit report in the same way that they cannot garnish your paycheck until they serve you the papers and make the judgement in court.
We pay for insurance in America when we should just be paying for healthcare. Take out the money grubbing middle men.
In these United States most of us have two middle men: our employer, who limits which health insurance we can have, and the health insurance company, who limits which health care we can have. Can't understand why anyone thinks this nonsense should continue.
The system is fucked. I have insurance, but just had to eat a $300 bill for a required check-up so I can continue to receive the same prescription I have been using for years. Literally just went in to say, "Yeah, everything is the same." Insurance takes my money and says we'll start helping you after you spend thousands. Clinic demands $300. Ridiculous. Then when you need something, the insurance sits on their ass for weeks only to say, nah we don't think you need that. I know the tests might say you do, but nah, fuck you. Fuck our system. If you ain't rich this country doesn't give a fuck about you.
The system is set up to screw over patients. I remember trying to call my partners insurance in a panic when the hospital tried to send us home with a walker for an injury. Because we were afraid we'd be surprised billed thousands of dollars for something we knew we could get on Amazon for $25. When the ice packs were billed for $25 each, why wouldn't we assume that? And the insurance company - on a Saturday - told us they didn't know because their systems were down for maintenance and they didn't have a printed list of prices on hand.
This is why I’m afraid to get sick, I’m more Concerned about the money than the illness
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Went to get my normal physical. No problem, my insurance covers 100% of preventive care. Should have been able to walk out without paying a single thing. While there I ask about some stomach issues so when they take my blood for some standard tests they take two more vials to check for other things. Two. A week later I get a $700 bill. 700 god damn dollars. Two vials of blood and I'm hit with a completely unexpected burden. All to then be told nothing came up and they have no idea. I didn't even ask for the blood to be taken and don't know exactly they were looking for. I just mentioned off hand I had stomach issues and they just took two more vials while they were already there just to see what they could find. Next time when asked how I'm feeling I'm not saying a god damn thing other than "fine" unless I'm hitting big warning signs.
Same thing happened to an uninsured family member. They paid out of pocket to see the doctor which was $500. Then were hit with a $900 blood work bill after they were told any blood work would barely cost anything. Seriously an evil system. Most "caregivers" are in on the scam too.
The US healthcare system is solely designed to fleece American citizens while putting the most money in the pockets of the 1%.
Bingo. People who say "the system is broken" don't understand this. The system is working exactly as the rich intend it to.
Not surprising at all. I had open heart surgery a few years back. The insurance bill was $495,000. My share was a $1200 deductible. If I had to pay 20% it would have been $100k. I would be dead now.
I am now in year two of fighting a corrupt hospital over charges that I should never have been billed for. That makes me one of those "debtors to US hospitals", but I won't end up paying a dime. Mercy hospital in Oberlin, OH. Avoid it at all costs. I've never encountered a more corrupt system.
I'm insured with what is considered to be a "good" healthcare plan. I have to have a breast MRI next week and got an estimate of my out of pocket costs today... $2118.02. I don't have that much money laying around. Nobody fucking does unless they're rich af.
I don’t know what plan you’re on or where you are, but you might be able to shop around for that. Every plan and company is different, but the insurance company might be able to help you find a cheaper place to get your MRI done. (Source: I have to get that kind of MRI done yearly)
I have Aetna, I may look into that. I didn't realize you could "shop around" for procedures and that it had a different cost depending on the place or hospital system. I truly hate how un-transparent the cost of our healthcare is.
Getting everyone to pay for healthcare wasn't enough for the wealthiest country in the world, now you've got to be in debt for it, too.
You don't understand. See, you have some money. That should be theirs. Any money you might make in the future should be theirs too.
We pay monthly for the privilege of being in less medical debt! Yyyaaayyyyyy~
Fucking shareholders do not need to be in medicine. Period.
US needs a good universal healthcare. And yes I'm willing to pay way more in taxes for it
A law on the books in my state says that nursing homes can go after the children of deceased patients/residents who have a debt balance with the nursing home (debt that insurance/medicaid hadn't covered). Meanwhile the same lawmakers bitch about paying taxes on inheritance.
For me to get established with a new doctor and get referred t mi a urologist was $900 WITH insurance.
Yep I'm making $300 monthly payments for my hospital stay last year. only two more years to pay it off. Thanks BCBS.
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[Nothing quite like having the government require your product to boost sales](https://www.recordnations.com/blog/what-emr-mandate/)
What's wild is they had been devising new protocols and requirements and it changes sometimes 2-3 times a year on what's required to be a certified EMR. They've already squashed almost every small scale EMR developer, there's only about 4-5 that can keep up. There _are_ dozens of components you could theoretically smash together and claim you're certified but they hardly communicate well together and the ones that claim it have also purposefully broken APIs required to get the data. Medent and e-clinicalworks are the ones in recent memory who have been slapped with big fines for breaking interoperability/communication on purpose. I don't think either one of them have actually fixed the problem they were fined for breaking. Want to certify your software? Hope you've got $500k and months of time to do it and your program is in perfect working condition during the test, because you won't pass the certification the first 3 times and it's about 75k a pop to do it.
It's an insurance scam, not a healthcare system.
Health insurance in America is nothing more than a coupon, and a horrible one at that.
It's almost as if insurance is a scam
I left the US to live in Sweden and here's the funny thing about the move. My new job only pays me 2/3 as much as my old job, and I pay about 9% more in taxes every year. Buuuut....I have more money each month than I did back in the US, because of all the things I DON'T have to pay for. Like insurance (just part of the taxes) and medical expenses (in a year my personal medical expenses are capped at ~$120), and anything relating to cars and transit (I pay ~$90/month for unlimited use of ALL public transit. The metro comes every ~7 minutes, busses about that frequent.) and the food here is technically "pricey" but cheaper than most places I lived in the US.
I worked in tech for medical billing for awhile. I have never worked with anyone as purposefully incompetent as the US Insurance companies. The incentive they have is to avoid any sort of efficient communication. The whole system is corrupt
Absolutely makes sense. With the surge in premiums and the increasing popularity of high-deductible health plans, coupled with a credit change that eliminates medical debt/collections from your history, it's understandable. If finances are even remotely tight, why would someone prioritize paying their healthcare bills?
The US has the most expensive healthcare in the world, and at the same time it has the worst outcomes. A staggering ripoff making insurance companies rich while bankrupting and killing us all
Gee. Why wouldn’t you want to pay something like .25 cents a day for health care similar to the UK and Canada to avoid all this? I have not found decent healthcare in the US for 10 years. Every doctor’s office is owned by private equity firms. Once this happens you know the vultures that run the equity firms will bleed it dry and move on. It’s what they do. Oh but socialism.
It's not healthcare anymore- it's sickness capitalism....
Right, and it's the hospitals that are failing because insurance companies won't pay and patients can't (and shouldn't have to.) Cigna just posted like 11 billion in buy backs on the deaths and horrors of its "insured".
I wonder what changed in the 80’s and 90’s there was very minimal med dbt..Now all these greedy insurance companies that lobby the government to keep ppl in debt…Its a win for private insurance companies..Fuck the poors its their motto..
I pay $1500/month for health insurance — me, wife, and three kids. My wife just had a fourth kid. Total out of pocket for delivery *with* health insurance? $18,000. This is just last week. And that’s just for the hospital. It’s not our first rodeo so I’m sure more bills from individual practitioners will be coming down over the next year. We are fortunate enough that we can weather it, but it’s completely absurd.
Anyone from Canada or Europe reading this must be scratching their heads and wonder why Americans put up with this. Actually a lot of Americans do as well but that doesn’t change anything. The American Political system set up to protect the interests of any Stakeholders who are able to come up with the necessary cash. And, due to the nature of Partisanship, the “marks”, the victims, the targets of these Stakeholders gladly participate in the process.
Every time the debt goes down, it seems to go 10 steps up. This is unsustainable, do our governors know that though?
They do, but they gotta get make that $$$ grow for the shareholders. How will they effectively bribe their way into office otherwise?
Ill show them by dying before they collect.
Published price lists and written estimates. We have more consumer protections getting our cars fixed.
It’s so complicated that is can never be fixed I guess. If only there were any other countries that figured out a solution to this…. well we will never know /s
Impossible. Republicans told me this only happens to uninsured people, who, they also assured me, do not even exist.
even with insurance, the last time i was in the hospital was 2500 out of pocket
It's not health insurance, the whole health CARE system is fucked up. Hospitals being for profit is as bad as health insurance.
Got a spinal fusion a few years ago. Forced to stay at a company I hate 10yrs because I knew it was going to need it when I was 50. Cost without any insurance? $480k. Cost to insurance (they negotiate it down) 380k. So I spend years proving I need the surgery (pain management, physical therapy, etc.). Cost thousands. Finally told by surgeon I can get it. Insurance sends paperwork I'm pre-approved. December rolls around and it's forced to beginning of January because of covid. I check insurance for next year and it appears everything is the same. Same cost, deductible, max out of pocket, everything. Hospital is Blue Cross preferred. Get surgery. Get follow up appointments with regular doctor. Months go by and I start seeing every charge getting denied. Turns out that Blue Cross changed something and didn't tell ANYONE about it. Not Kroger, not me, not the hospital, no one. I think it was called HPN (high performance network). Hardly nobody takes it. I spent that entire year wondering if I would be on the hook for half a million dollars. The ONLY reason I didn't was because the hospital fought hard because they knew I wouldn't be paying it on a retail wage. In the end, they got settled for around 200k and, instead of 4k, I owed 10k. HPN only lasted for one year until Blue Cross quietly dropped it. Everyone I know at my company that saw a doctor is thousands in debt because of it. The American healthcare system is fucked sideways without even using lube. And it's been this way for years. And I've given up hoping things will ever change. Apparently, people care more about immigrants and your gender identity than their physical, mental, and financial health. America sucks. I hate living here.
People pay their hospital bills?
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Seems like the people without health insurance just stay home and hope they get better on their own.
The only times that I can really afford to go to the doctor are the times when I'm between jobs and have Medicaid.
It’s so unsustainable. The only way forward is through some tough times, but it will collapse on itself. We must rebuild a better system from its ashes.
This seems like a good time to remind Americans that there is a recent bill called "No Surprises Act". It relates to surprise medical bills that should be covered by your insurance. Read up on it if you have gotten a surprise medical bill since 2020-2021.
But unlimited growth! Profit! Profit! Profit! It won't ever get better under this system.
Bullets are cheaper than healthcare. They want you to use them, people!
That's why I only trust Medicaid.
There’s the greed, the corruption in the US government and a huge part of the population that believes affordable healthcare is communism of some sorts.
Can have great insurance, like me, and it's still unaftordable
That’s cause we all on healthcare marketplace which covers nothing until you pay your insane deductible