Need some level headed advice on healthcare dilemma...

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but decided to post to HF instead. This is an ethics question. Wife develops a backache, we don't know of any reason for it, hasn't been physically exerting herself. I suspect the problems is something like a pinched nerve or sciata, but I'm no doctor. Pain escalates and she feels she needs to go to the Dr. We call our Dr. and cannot get an appt at all, even on an urgent care basis. Wife is pissed. Pain gets worse, even on OTC pain relief, wife is unnerved and wants to go to the local hospital's emergency room.

We go. Wife lays down on the couches, we fill out the paperwork and see a Dr. after about an hour or so. I'm in there with them. Dr. comes in, asks my wife about 3 questions, has her make a couple of movements to check the pain she's feeling. Dr. make diagnosis, says basically she has a pinched nerve or sciata. He writes a presciption for Super Tylenol, and we're out of there. The Dr. was not with my wife longer than 10 minutes.

I get the bill, about $800. ********, I'm simply not paying that for 10 minutes of Dr. time and a generic pain killer prescription. Now I've got the collectors on my ***, of course. They don't care too much about the details or my rationale, as a matter of fact they won't even talk to me since my wife was the patient. I pay the bills however.

Am I wrong?
 
Wrong in what sense?

Wrong that you don't/shouldn't have the pay the bill? Yes, you're wrong.

Wrong that we've got a stupid system? No, you're not wrong.
 
Wrong that I'm not paying the bill. I did pay $50, that's what I considered "fair" and about all I could stomache.

Now I know that we can't have medical patients deciding what price they are going to pay. But at some point it just gets absurd. I wasn't given any idea that the minimum charge for service was $800 when I went in. If I was told that, I would have had a good laugh and the wife and I would have taken our chances with whatever the local drugstore could provide. But what if the bill had been $8,000 or $80,000? I mean why not, it makes about as much sense to me as $800 for 10 minutes of service. Should I just go home and take out a mortgage on my home to pay the bill? At some point it's just absurd, though I guess everyone would have their own breaking point.

I'm not a typical scofflaw - my daughter had an accident and we took her to the same emergency room about a year earlier. She had about cut off one of her big toes, and the Dr. numbed the wound, stitched it, etc. I paid every penny, no problem. Oddly enough it was a little less than what they are trying to charge me for my wife. The bottom line here is that their business model is totally ****** up. I refuse to make that my problem.
 
I understand where you're coming from. My recent experience: I had some bad chest pains one Sunday night about a year ago, so I called 911. Ambulance picked me up and took me to hospital ER.

The hospital was full, so they put me in a supply room, where I stayed from about 10 pm until 3 am the next morning. All the while, nurses were coming in to get sheets, pillow cases, etc., janitors coming in, etc. I got a regular room at 3 am and stayed there about 3 hours. In the meantime the pain had subsided (it turned out to be a mild heart attack) and I went home none the worse for wear. During my stay in the supply room, the Dr. on call came in and checked on me once and another Dr. checked on me the next morning. Bottom line: EKG, X-ray, blood tests, observation....no surgery or anything like that.

The bill for the hospital stay was $5,880, not counting the EKG or X-rays. The fire department (ambulance) bill was $640 for hauling my *** about 3 miles.

Fortunately, I had insurance, which took care of this, but is there any wonder about the causes of the "health-care crisis" when there are exorbitant, unjustifiable charges like this?
 
Several years ago my boy went to the pediatrician complaining of stomach pain. The new doc in the practice sent him to go get an MRI to the tune of $3k. The boy had no other signs of appendicitis.

How about the doctor says "x procedure is going to cost around $3k. Do you want to wait or do the test?"

He might have said he didn't want us to take a chance on an appendix rupturing, but he didn't. Their needs to be some disclosure up front.

About this time last year I went into the ER, spent 32 days in ICU and another 28 in a room. It's a special hospital and they only have private rooms. BCBS says they won't pay for the cost of a private room. The total bill was around $1,000,000 and I'm still battling to get things straightened out.

Another thing that the doctors do is schedule tests for January instead of December. That means it comes out of my deductible pocket. I just had an endoscopy to check for varisces when I hadn't had any symptons for almost 9 months. I have to go for an MRI every 6 months and they have already said that I'm on track for a January MRI and they're already balking at the idea of doing it in December to beat the deductible. It would be about a month earlier than 6 months.
 
I remember he asked if she felt pain down the back of her legs. It seems like he may have asked if she felt any pain in her jaw also, but I can't remember that well. Then it was lift your foot while I hold it, does that hurt, a couple of those.

Yeah, I kind of knew that back pain is a question mark even among physicians. But we were going for two reasons: prescription drugs and the psychological assurance to my wife that a Dr. had looked at it.

He gave her a script for the drugs and they worked like a charm for her, a few of those and a day on her back and the pain was just a memory. You're right, they were not Tylenol, it was generic Davocet.
 
NickDanger, I agree completely. You'd think that with the cost of healthcare rising so quickly the providers would by now be sensitized to the ways that their customers try to manage it. It's that whole heathcare culture of "money is no object" - for the provider. I can't think of anything else I spend money on where the producer is so willfully blind to their customers in that way.
 
The thing is, I hear about all of this stuff but I never see anyone actually do it. I really want to understand who the people are who pull this crap.

As for the charge, I would think that you should consider having a lawyer call them for you.
 
to the OP:

I believe that our system is *********, and I support ObamaCare.

Having said that, I question your judgement for going to the ER in the first place.

Here in CA, there are "urgent care" clinics all over the place. If you ain't bleeding too bad, or something serious (chest pains, etc) that's the place to go for something that "comes up".

The local place charges about $80 bucks for a consult with the Doc.

Which is about what you think the service was worth.

Take your car to the Porche dealer for an oil change, pay a few hundred. Go to the quick lube place, pay thirty or so.

You chose the porche dealer.
 
What no one has addressed is the justification for these outlandish and exorbitant charges. What value was derived from sitting in waiting room several hours, then seeing a doc for 5 minutes, that was worth $800?

And in my case, what was the value received during my stay in that supply room that was worth $5,880? Or the 3-mile ambulance trip that was worth $640?

Is it OK for hospitals, doctors, etc., to just arbitrarily charge whatever sum they want without regard to any true benefit received?

THIS is the "health care" crisis.
 
Nobody pays in the ED. They charge to make up their cost for the non-payers. They charge to keep a lot of equipment and meds that expire around in case they need them. They charge for lots of personnel it takes to keep an ED up and running and they charge because of tons of government hoops that make ED care more expensive.

That being said, you got the point about urgent care and you may want to look for a PCP that is tied in with other providers that can see you same day, even if it's a mid-level (PA).

Lastly, call the hospital, if it's not too late, and offer to settle the bill. If it's not a huge hospital, talk to the CFO directly and offer a compromise, payment plan, etc. They'll often bite.
 
Sept. 08, a spinal disk that I'd had two surgeries on slipped and left me essentially paralyzed with pain. Two hours in the emergency room for X-rays, 1 Valium tablet and two shot of Dilaudid and I was on my way. Insurance was charged $900+.for the ER visit.

In March of this year, my COBRA coverage had expired in Feb. and because of pre-existing back surgeries was without insurance for the first time in my life. Same thing happened. Slipped disk and a trip to same hospital ER. Exact same procedures as in Sept. Same two hour stay. This time because I didn't have insurance my bill was $3690 for just the hospital. Total charges are nearly $5000.

They referred me to a couple of programs for which I do not qualify and said, sorry but pay up. Which I am doing.

If I were to go to work for say, Dell tomorrow, I would not have coverage for my back for twelve months after I enrolled in Dell's plan. COBRA law says that if you are without coverage for more than 63 days, your new carrier can exclude pre-existing conditions for 12 months before they are covered.

Yeah, I want ObamaCare and as soon as possible.
 
What sort of cost did you expect at the emergency room? Individual payers are charged at a rate far higher than what they accept from insurance companies. You were aware that Emergency Rooms are some of the most expensive health care available?

You wife should ahve simply taken a bunch of ibruprophen or gone to a medical clinic where you wait. Not the Emergency room if you were concerned about cost.

I feel for you, and if you make a few calls you can probably settle, or I beleive you can pay a very small amout each month if you reach some agreement.
 
If i am unclear what exactly is wrong with me, why am i expected to diagnosis myself, choose the proper facility to go to and then get penalized if i choose erroneously.

If i feel like there is something really wrong with me and i have no idea if what i am feeling is potentially life threatening or not, i want to be in an hospital environment (ER) and not a clinic.
 
just because your insurance got "billed" $800 for an ER visit, doesn't mean that they paid it.
Check your EOB. I'll bet you a cold one that the insurance co. paid less than $250
 
well, if you are 1/3 as likely to pay as the insurance company, which the OP seems to be, then is seems 300% gets the hospital back to even.

my point was more to the clinic versus ER premium.
 
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