Need some level headed advice on healthcare dilemma...

It's actually pretty ironic that most of the explanations for the high bills are from people who eschew socialized medicine, yet describe a socialistic model to explain why the bills are so high i.e., you are paying for the other people who don't pay
 
as with any purchase of services, there are three characteristics available of which you get to choose two.

1) Speed in which the services are rendered
2) the quality of the services rendered
3) the affordability of the services rendered

seems you chose 1) over 3). isn't it just that simple?

BTW, i dont fault you for choosing 1) above, being that you were in pain and all. its just that you have to be prepared to forgo 3).
 
Just count yourself lucky they didn't take out her tonsils.

. . .

ERs are for chest pain and bleeding, paralysis and unconsciousness, blue in the face inability to breathe and foreign objects where they don't belong . . ..

Back pain hurts, no question, but really isn't an ER issue unless your legs don't work or you are pissing and/or crapping all over yourself. Find an urgent care clinic if it is after hours. Find another family doc/internal medicine doc if your current one can't find the room to fit you into his/her schedule.

It wasn't worth the $800 - you are right. But, as said above, you unknowingly went to a 5 star restaurant when all you needed was a hot dog stand. Like everything else, it is part of the learning curve. You skipped ahead a few grades by recognizing you can negotiate the bill.

Hope your wife is doing better. Aside from the stay away from the ER advice - some more tips: Avoid surgery. Avoid ESI's. Avoid the chiropractor. If she isn't having radiculopathy (or incontinence), those things won't generally help her. She is better off learning ways to incorporate exercise as a treatment and a lifestyle. You can't do that on your own, usually, so asking for help on how to do that would be productive.

Back pain has a whole industry with a lot of people looking to take money for little in return. Most of the treatment is quackery and butchery. The nagging aspect of it and how to deal with it just isn't addressed well.

Best wishes.
 
I'd also recommend paying the bill. As soon as the lawyers get involved, the bill is going to go where you don't want it to go.

Just chalk it up as a lesson and move on.
 
If you have the means I would find someone who has insurance with a similar problem and find out what the insurance company paid and offer that.

I understand why insurance companies get to negotiate rates, but I don't like the way it's done.
 
I really do not understand why you did not take her to an urgent care office.

It would have been faster than waiting in an ER.

It would have cost closer to the $50.00 you were willing to spend.

They would have been able to give your wife a prescription for Darvocet.

I take it this is your first experience of going to an ER? If you would have asked anyone who has gone to an ER, they would have told you how expensive your bill was going to be. Why do you think urgent care facilities are doing so much business? They get you in and out in a reasonable amount of time and the cost is more in line with what you family physician charges.
 
All I want to say is these examples show small examples of how screwed up our health care system really is at this time. We don't always know which route to take when we have a problem, we don't know how much it will cost, we can't possibly understand the billing system. Too many people go to the emergency rooms, but a lot of them feel they have no other option.
The cost for billing an insurance company is what, 20% of what they bill an individual without insurance. Why is that? Do they expect the individual to negotiate the price down every time like a Mexican marketplace?
It's all crazy.
You get dozens of pieces of mail that look like bills, and half of them say "this is not a bill" at the top, but the others may or may not be bills, but they all have an amout to pay at the bottom. If you call the doctor's office, they usually say, after the obligatory 20 minute phone waiting period, that you don't have to pay that amount.
But if there is an amount to pay, you usually get a nasty letter asking why you haven't paid the amount, and this will be in less than 30 days after you received the statement.
Who needs this crap? It sucks. Get a stick and kill it.
 
Question: In what way is a hospital that charges a desperate person $6,000 for an overnight stay, or $800 for a 5-minute interview, different from someone who charges a desperate person $50 for a bag of ice after a hurricane?

Answer: The police don't come get them and put them in jail.
 
At some point, we have to enable to people to make their own decisions. I agree that better education as to the costs of emergency room treatment is warranted. We have long heard that it is highly wasteful for emergency departments to provide non-emergent care. It bears repeating.

We have also heard that there are people who over utilize health care resources.

We then also hear there are people who don't treat enough with primary care physicians (and then over utilize emergency departments for problems better addressed by primary care physicians).

Throw a political issue on top of it (providing coverage for the 40 million who don't have it) and you have the scope of the issue. Add the immigration issue, lobbyists for pharma and health insurers, those who actually think government can manage health care, health care providers who have little capacity, lawyers, marketers, billing specialists, . . .who make their living off this byzantine system and you understand the bizarreness of the radical change suggested. There aren't enough providers out there now. Add 40 million to the mix and the problems will be exacerbated - there is no other outcome that can be reasonably anticipated.

A guy who takes his wife to the emergency room because she is in pain and he wants the suffering to stop is logical. He probably won't next time, as he understands the costs and understands now there are alternative avenues that may be effective. A chronic pain patient going to the ER for a shot of Dilaudid is not uncommon in our system, but there are better avenues - including education and treatment of the patient using methods that lessen the suffering.

The raven screeching the alarm with both examples is what if there is something worse signaled by that pain. What if the wife has cauda equina syndrome and she is at risk for permanent paralysis? What if the chronic pain patient with thoracic pain has a syrinx in the cord? What if those patient doesn't go the ER because they fear the cost?

There are no easy answers to the questions. One can hope that the Urgent Care facility will ask the right questions. One can hope that the family doc is available enough that the questions can be asked. But the individual bears some of the responsibility. A medical system cannot work with anything other than self-responsibility.
 
There is an immediate financial reason many use the ER rather than going to an urgent care facility.

Most ER's do not require you to pay when you receive care even if you do not have health insurance. Urgent care facilities require payment at the time of service whether you have insurance or not. It is up to you to be reimbursed by your insurance company. Many people use the ER even when they know they just need an urgent care facility because they cannot pay at the time they receive care.

groverat, if you do not have enough common sense to know what constitutes the need of an ER rather than an urgent care facility, there is no need to waste time trying to explain it to you.
 
Washparkhorn, you hit the nail on the head when you said many are using ER's as their primary care giver. ER's are the only care givers for many people. They do not see a doctor unless they go to the ER. That is the primary reason your waiting time in an ER can be 7-12 hours. People that are actively having a heart attack, stroke, bleeding to death, or other emergency life and death problems are going to be taken straight back for immediate care while you sit an wait.

1234......., I call BS on your statement that you could not get an appointment at an urgent care facility. Most urgent care facilities work on a walk-in basis only. Even if they do schedule an :"appointment" to try and reduce your waiting time, you will be seen and cared for whether you had an appointment or walked-in.
 
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