Michael

You file bankruptcy. If it is a county hospital, they'll take whatever they can get but usually not more than about 10% and write the rest off as paid in full.

100weight

Thanks, good to know.

CWT

Lion in Winter

And the bankruptcy will stay on your credit record for 10 years, making it virtually impossible for you to get any credit.

Michael

With a county hospital, you can sometimes ask in advance by telling them that you don't have insurance and ask what percentage they would charge if you became hospitalized to be considered paid in full.

Lion in Winter

And then you get to use all your disposable income to pay that bill.

Michael

Some self employed people with large salaries don't like to pay for health insurance and save a lot of money in premiums and take their chances by checking out policies at county hospitals. A $100,000 hospital bill reduced to $10,000 will pay a lot of premiums. Even young healthy people that can get insurance for about $100-$200 per month have an aversion to pay for health insurance but will purchase a muscle car with very expensive car insurance.

Lion in Winter

And some companies self insure.

However, the problem is for the ordinary working person, not the wealthy who could buy what they like.

Lion in Winter

And, to your subsequent edit, I find it unethical that a wealthy person would negotiate down a bill from a fund-strapped country hospital that needs those funds to support those who are uninsured but not by choice.

Michael

That is one reason why we need health care reform. The poor (family incomes below 125% of the poverty level) get free Medicaid, moderate income families get subsidies, and anyone that can afford it has to pay.

That system has worked well in Switzerland and Massachusetts but both are fairly costly.

Now if changes could be made to become a single payer system, negotiate the price of drugs, and eliminate reimbursements by the insurance companies and/or the government for treatment that is deemed ineffective during end of life, US health care costs should come into a similar cost structure as Europe. People can't still demand ineffective or unproven end of life treatment but they will have to pay for it themselves.

Bluegrass Lass

Also depends on how much you own. If you don't have a pot to piss in, then you really don't have too many worries. But if you're a homeowner, I do believe in some (most?) states the hospital can put a lien on your home or even force you to sell it. Not a good situation to be in..and not very fair.

RoadWarriorFromLP

Someone can correct me, but I believe that the difference is that doctors in the UK work for both the NHS and in private practice, simultaneously. You get the same doctors, it's just that the insurance just provides you with nicer wallpaper and perhaps somewhat faster access. The concept of the network doesn't really exist there, as it does here.

RoadWarriorFromLP

Yep. They'll do a credit check and try to figure out what you can pay. They'll try to work out a payment plan if necessary, probably with the goal of getting the bill paid over two years time.

A lower-income person will have their bill sold off to collections, and their credit (if they had any) will be ruined. A homeowner with equity is probably going to have less leverage, although someone with cash can probably still haggle.

Ash UK/US

When I had mine out 5 years ago (supposed to be a day surgery in & out but turn out to be more complicated) I was in for a week and had to have 4 different procedures, after the bills totaled around $90,000 my out of pocket was $1500.

Jerseygirl

I think that is correct unless the doctor has retired from the NHS. A consultant I knew said his NHS work was his bread and butter...the private work was the jam.

Lion in Winter

Correct. This was exactly my father's experience.