Urgent! Heading to ER, surprise bills

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Libertarian666
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Re: Urgent! Heading to ER, surprise bills

Post by Libertarian666 » Thu Oct 26, 2017 3:26 pm

WiseOne wrote:
Libertarian666 wrote:Health care cost almost nothing until the mid 20th century. It now costs a fortune, largely due to State intrusion.

Why is it that everything provided by the free market, including cosmetic surgery, gets cheaper in real terms over time, whereas everything provided at taxpayer expense gets more expensive over time?

It is because the State is evil.
Partially true, yes. Meaning, overhead due to ever-increasing third-party control over the medical process, all nominally to curb excesses by doctors. Wonder if just letting doctors overbill would be cheaper :-). There is a medical safety argument too, but I doubt it would stand up to serious scrutiny.

However - you do have to remember that in the mid-20th century, medicine was very, very limited compared to what we can do today. There was no CT or MRI at that time, for example, and the only brain imaging techniques that didn't require opening up the skull for a direct look were skull X rays and pneumoencephalograms - a painful procedure involving injecting air into the CSF spaces and then doing an X ray. Very happy not to be going back to that!
Automobiles are much better than they were in 1950, yet they cost less in real terms than they did then, all costs taken into account.

Airplane travel is MUCH cheaper than it was in the 1950's.

In fact, EVERYTHING that the government hasn't ruined has gotten much cheaper and better since then.

Maybe that's a coincidence.

But that would be stretching credulity, especially because we know why this should be expected, even if all we consider is the incorrect incentives that State intervention causes.
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Re: Urgent! Heading to ER, surprise bills

Post by Xan » Thu Oct 26, 2017 3:58 pm

Libertarian666 wrote:
farjean2 wrote:Ironically, 3 days after starting this thread I found myself at an Urgent Care facility this morning. The reason was because I was having stabbing pains in my shoulder for several days and then bumps started breaking out in the same spot. Thought maybe a spider had bitten me in my sleep or something.

The diagnosis took all of 2 seconds. Shingles. Should have gotten that vaccination.
In my opinion, no, you should NOT have gotten that vaccination!

I got the vaccination... then I got shingles.

The same has happened to everyone that my wife and I know, who has gotten the vaccination.

In fact, there is a class action suit against the makers of that vaccine.
First I've heard of this. Scary, if true. I believe I read recently that a different shingles vaccine was just approved.

Actually it's shingles that's really scary. If you're really unlucky you can end up with it in an awful place (mouth/eyes?) and it might never go away.
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Re: Urgent! Heading to ER, surprise bills

Post by Libertarian666 » Thu Oct 26, 2017 4:06 pm

Xan wrote:
Libertarian666 wrote:
farjean2 wrote:Ironically, 3 days after starting this thread I found myself at an Urgent Care facility this morning. The reason was because I was having stabbing pains in my shoulder for several days and then bumps started breaking out in the same spot. Thought maybe a spider had bitten me in my sleep or something.

The diagnosis took all of 2 seconds. Shingles. Should have gotten that vaccination.
In my opinion, no, you should NOT have gotten that vaccination!

I got the vaccination... then I got shingles.

The same has happened to everyone that my wife and I know, who has gotten the vaccination.

In fact, there is a class action suit against the makers of that vaccine.
First I've heard of this. Scary, if true. I believe I read recently that a different shingles vaccine was just approved.

Actually it's shingles that's really scary. If you're really unlucky you can end up with it in an awful place (mouth/eyes?) and it might never go away.
You can go blind if you get it in your eyes.

Fortunately I have no permanent injury but it was extremely unpleasant, painful, and potentially expensive due to loss of work. In the event, I was able to use up all of my sick days and then work from home.
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Re: Urgent! Heading to ER, surprise bills

Post by Don » Thu Oct 26, 2017 4:52 pm

The old shingles vaccine produced by Merck used a "weakened" live virus. I'm sure that many contracted the disease because of this fact.
I'm not certain if the new vaccine is available yet.
Something tells me that MachineGhost would be adamantly against using this vaccine.
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Re: Urgent! Heading to ER, surprise bills

Post by Xan » Thu Oct 26, 2017 5:01 pm

Don wrote:The old shingles vaccine produced by Merck used a "weakened" live virus. I'm sure that many contracted the disease because of this fact.
I'm not certain if the new vaccine is available yet.
Something tells me that MachineGhost would be adamantly against using this vaccine.
Would it matter if you'd already had the chicken pox? Actually I guess there's no need for the shingles vaccine if you haven't had chicken pox... Right?
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Re: Urgent! Heading to ER, surprise bills

Post by Don » Thu Oct 26, 2017 5:28 pm

Xan wrote:
Don wrote:The old shingles vaccine produced by Merck used a "weakened" live virus. I'm sure that many contracted the disease because of this fact.
I'm not certain if the new vaccine is available yet.
Something tells me that MachineGhost would be adamantly against using this vaccine.
Would it matter if you'd already had the chicken pox? Actually I guess there's no need for the shingles vaccine if you haven't had chicken pox... Right?
I'm not a physician but I did stay at a Holiday Inn once. That caveat aside, I believe that it would be necessary to have had chicken pox to contract shingles at a later date.
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Re: Urgent! Heading to ER, surprise bills

Post by farjean2 » Thu Oct 26, 2017 5:35 pm

Libertarian666 wrote:
farjean2 wrote:Ironically, 3 days after starting this thread I found myself at an Urgent Care facility this morning. The reason was because I was having stabbing pains in my shoulder for several days and then bumps started breaking out in the same spot. Thought maybe a spider had bitten me in my sleep or something.

The diagnosis took all of 2 seconds. Shingles. Should have gotten that vaccination.
In my opinion, no, you should NOT have gotten that vaccination!

I got the vaccination... then I got shingles.

The same has happened to everyone that my wife and I know, who has gotten the vaccination.

In fact, there is a class action suit against the makers of that vaccine.
That's good to know because the doctor told me I should still get it after my current case clears up. I'll have to check into what you are saying.
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Re: Urgent! Heading to ER, surprise bills

Post by farjean2 » Thu Oct 26, 2017 5:42 pm

Don wrote:
Xan wrote:
Don wrote:The old shingles vaccine produced by Merck used a "weakened" live virus. I'm sure that many contracted the disease because of this fact.
I'm not certain if the new vaccine is available yet.
Something tells me that MachineGhost would be adamantly against using this vaccine.
Would it matter if you'd already had the chicken pox? Actually I guess there's no need for the shingles vaccine if you haven't had chicken pox... Right?
I'm not a physician but I did stay at a Holiday Inn once. That caveat aside, I believe that it would be necessary to have had chicken pox to contract shingles at a later date.
That's my understanding too based on the research I've been doing today. Also, at some point in the early stages of shingles you are contagious for spreading chicken pox. I think I'm past that now but I was at a Halloween party last weekend when I first started feeling bad. Hope I didn't give it to anyone. Fortunately, you can't get shingles from somebody else with it.
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Re: Urgent! Heading to ER, surprise bills

Post by dualstow » Fri Oct 27, 2017 9:01 am

Oh, bogleheads with their glut of stupid abbreviations conditioned me to read the title as “heading to early retirement.”
Xan wrote:Health insurance is pretty close to a complete racket.

If you have it, then you think you "save" a lot of money, but you don't. If you were self-pay you'd get services even more cheaply.

The only insurance that's worthwhile is the same as any other kind of insurance: catastrophic insurance that makes sure you don't lose your shirt if something really awful happens. Of course that's now illegal.

I probably don’t understand your post, Xan. I have something like catastrophic coverage which I have to buy out-of pocket. But without it, I’d have to pay the outrageous prices that no one is really expected to pay. Maybe you mean self pay in a world where prices are fair?
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Re: Urgent! Heading to ER, surprise bills

Post by Xan » Fri Oct 27, 2017 9:14 am

dualstow wrote:Oh, bogleheads with their glut of stupid abbreviations conditioned me to read the title as “heading to early retirement.”
Xan wrote:Health insurance is pretty close to a complete racket.

If you have it, then you think you "save" a lot of money, but you don't. If you were self-pay you'd get services even more cheaply.

The only insurance that's worthwhile is the same as any other kind of insurance: catastrophic insurance that makes sure you don't lose your shirt if something really awful happens. Of course that's now illegal.

I probably don’t understand your post, Xan. I have something like catastrophic coverage which I have to buy out-of pocket. But without it, I’d have to pay the outrageous prices that no one is really expected to pay. Maybe you mean self pay in a world where prices are fair?
I'm technically self-pay now, as a member of a health-cost-sharing ministry. My previous catastrophic coverage didn't cover maternity, which has been a big part of our health expenses the past few years, and so I've been effectively self-pay for a while.

I've found that most providers have a self-pay rate which perhaps doesn't get quite as low as the negotiated insurance rate, but is still a huge cut below the "sticker price" which, as far as I can tell, only exists to make people think they need the negotiated rates via insurance.

The hospital bill for maternity, for example. I called and asked what it would cost. $25,000. Yowza! Oh, but our self-pay rate is ~$8,000. And if you pay before your service, then there's an additional discount down to $5,000 and change. So in fact there's a 5x fake markup.

For lab work, if you self-pay at the time of service, the amount you pay is about 10% of what it would be if they sent you a bill. I'm not joking: they'd charge $100 for a test that's only $10.

The bill for things like routine well-visits are no longer picked up by insurance, but it's pretty easy to pay for the occasional $150 doc visit by not having a sky-high premium payment every month.

Oh, and things like vaccinations. At our pediatrician, because we're self-pay, our vaccinations automatically go through some state program that gives free vaccines to uninsured children. Yes, it's probably intended for the poor, but that's not the way it's set up, and anyway if the state wants us to have these vaccinations then it's perfectly free to pay for them. So those are cheaper than with insurance!
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Re: Urgent! Heading to ER, surprise bills

Post by dualstow » Fri Oct 27, 2017 9:20 am

Wow. I was never lucky enough to have a self pay rate when I was off insurance. Only free pills (samples).

I paid a small fortune for an ER visit once when I had no insurance. I will never go back.

I forgot to mention, two providers have neglected to bill me.I got the “not a bill” from the insurance company, but I’ve been waiting on bills for maybe 8 months now.
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Re: Urgent! Heading to ER, surprise bills

Post by Xan » Fri Oct 27, 2017 9:23 am

I wouldn't be surprised if that were negotiable. But really I have no idea.

I agree with you: I wouldn't go completely without coverage. I (and you) just can't afford the risk of being bankrupted by something big. Maybe with the latest Trump order, catastrophic-only coverage will come back. For me, the cost-sharing ministry is working out great. It's kind of a best-of-all-worlds scenario, being insurance without technically being insurance.
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