carcajou

Issues involving alcohol or drugs are almost never covered, and in fact a number of coverages can be voided if there is an incident where someone has been using either. I don't particularly think that's an American thing - I know it is true in Australia as well.

Rete

What was wrong with urgent care? Not available where you live?

petitefrancaise

About 10 years ago, the NHS in Newcastle showed that the cost of treating a drunk in the hospital ER was about 2k. Not much to do really except possibly a stomach pump and rehydration. I think if you thought about how much it costs to run a hospital you'd realise that $1800 for having all those facilities available should you need them is not too bad really.

I'd have taken the guest to an urgent care facility btw.

SanDiegogirl

Hope you pointed out that the military referred to was in a different country to the US - and that your guest paid the bill.

Bob

He didn't quality, as he was living alone and had insurance or some such.

morpeth

At that day and time no it wasn't.

In any case the type of charges hospitals and doctors get away with in America is quite unbelievable at times- and so many simply cannot afford to get medical care.

I know another instance where a heroin addict wished to get off the addiction. The medicine prescribed cost $15 a day, but (a) had to go to only one approved doctor 50 miles away ( person had no car and there was no pubic transport) (b) Medicaid didn't cover cost (c) and every other visit was supposed to pay $100 for examinations. In the end such people return to their habit, steal or other criminal activity to support it, end up dead or overdosed ( with obvious charges for emergency room treatment). While system almost seems designed to increase costs.

Same area- factory work IF wasn't temporary work, starting wage $2100- premium for worker with family $250 a month with a $6,000 deductible, company portion of premium about $1,050 per month : obvious for company whenever a temp worker could do same job ( though invariably lower quality) they would get temp worker at $1,300 per month, without incurring the company portion of medical premiums. But at $1,300 per month few temp workers through agency could afford $250 a month premium, and worker needs to pay the fixed percentage for social security + locally a school tax ( most schools in the are always have new buildings while test scores decline). A more idiotic system I can't imagine in a developed country.

morpeth

I speak 5 foreign languages, none of which along with English did the admittance clerk seem to understand too well. I did point out the address on the military ID card was in another country but was rudely brushed aside , they said they just needed a copy of the ID card. The amount of the charge we didn't know until months later as their bill never arrived in the foreign country, when a collection agent called me as I was the emergency contact threatening to sue me for the bill. The following year same guest visited and if I recall settled the bill at a discount with the collection agency. What a wonderful 'first world' country !

The point is the over-charging doctors and hospitals get away with, and then all the expense of the complicated, convoluted billing system and putting people on collection. If I recall correctly a significant percentage of bankruptcies in America are from medical bills.

morpeth

Sorry I do not accept that the costs in hospitals for medical care are reasonable, $1800 for 15 minutes no way does it cost that much no matter how they allocate the costs. I worked in cost engineering fro a while so I am familiar with cost allocation- considering the overhead that some hospitals believe is normal, and then try to allocate to operations, I just don't accept such charges are reasonable.

A few years ago I was at a dinner with a family who all worked for the same hospital, and one of youngest ones was assigned to the finance department. They wanted to offer to employees a free diagnostic test, so they asked the finance department to figure out the true cost. They charged patients and insurance companies for the test between $150 and $250, usually as standard procedure charging more than what they thought they would be reimbursed. Ends up in the end the true cost of the test was $12. And to add insult to injury, half of the diner conversation was complaining about poor patients who came to the hospital, or how Obamacare was affecting their personal finances - all of course had fancy cars and homes. While anecdotal I admit, I found the whole lot quite disgusting.

There wasn't an urgent care open or reasonably accessible (we were in rural area) at that particular moment.

Whatever the faults of NHS, I certainly prefer !

Bob

A few years back, we got a collections bill over a 32c underpaid bill, because we had moved and not gotten it. The stamp on the envelope cost more than that

Nutmegger

I don't see how any test could actually cost so little. There's the time for the receptionist who greets the patient and provides the records to the nurse or technician, the time that said nurse or technician spends administering the test, the time for the lab technician who processes the test (if relevant), the time for the doctor who reviews the results and communicates them to the patient. And then before the patient even arrived there was the person who cleaned the floors and made sure the facility was clean, the people who made sure it was warm, the cost of said heating, light, all the other overheads, etc. etc. The cost of a test is a lot more than the drawing of blood for a minor test, or the hour for an MRI.

MidAtlantic

Anian

Could you at least give a ballpark figure for how much you think it would cost? I don't see it taking much more than a dollar of anyone's time, which would seem to put it at around $10 of overhead. Even if that is woefully low, a 1000% markup on a simple test is excessive, but every one knows that medical charges bear little resemblance to how much the bill ends up as due to some magical formula and negotiation with a insurance company.

Nutmegger

That's like asking how long is a piece of string. What kind of test? A simple blood draw? Something that's going to sit in a petri dish and be observed for five days? A biopsy? An MRI? A CT scan? An ultrasound? To my mind, it's common sense that a nurse, technician, or doctor is going to expend far more than a dollar's worth of time on even the simplest of tests. I don't bill at a doctor's rate, but if I was in their shoes, I'd be charging about 50 times that for the time I've spent having a blood draw -- without taking into consideration the overheads of running a medical practice. Liability insurance, for instance . . . .

scrubbedexpat091

If your not covered by a provincial healthcare plan in British Columbia, its upwards of 600-800 for an ER visit before any doctor, nursing, lab, medications etc, that is just the fee to walk in the door.

Here are some examples from British Columbia for non-residents.

Vancouver General (main hospital for Vancouver) per day ward rate $3,530. ICU runs $13,665 per day, ER visit to walk in the door is $750.00

Children's Hospital runs a cool $7,133 per day for normal ward and $13,665 for ICU per day.

Doctor's fees, ambulance charges and out-patient prescription medication expenses are extra.


Healthcare isn't cheap no matter where one is. Now of course a resident of BC doesn't pay anything out of pocket for a hospital visit. I can spend a month in ICU and have $0 bill on discharge.

One thing to keep in mind if visiting Canada, hospitals don't always direct bill insurance, many times visitors will need to pay the bill and then seek reimbursement from their insurance.

morpeth

First of all the example was actual costs of providing the test, and any overhead to be allocated directly would be spread over all the different tests and procedures. I mean really not even lawyer can get away with the sort of charges doctors and hospitals get away with. Think about what the guy was saying- internally they figure actual cost of deliver was X- they billed over 10 times X to customers.

I had an operation a few years ago, simple operation- took 1 hour, 2 hours recuperation, so 3 hours. Total cost $25,000. Use of a room for three hours, one doctor, assistant, nurse . anaseologist all for 1 hour, nurse checked in afterwards once an hour. No one can tell me that $25,000 for a simple operation is reasonable.

In another instance had a simple procedure done at doctors office - in UK saw the GP, made appointment with specialist, went to specialist and everything over in 30 minutes. specialist had one assistant. Only information receptionist asked for was my name and address.. Same procedure in USA : visit to GP, filled out form, then specialist, more forms, deposit, then follow up meeting with specialist who had assistant and nurse. Total bill $4,000. Then I found out that the deposit wasn't necessary but they insisted on " to help our cash flow because sometimes insurance doesn't pay quickly, and we refund right after operation". Took two months to get deposit back.

Anyway, sorry just annoys me the American system that is so expensive yet so many can't get medical care- and so difficult to get system changed. Where I lived you could tell the fanciest and newest buildings were always the hospitals, they aren't hurting as far as I saw ( maybe different in other parts of the country).