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0 pointsold-gregg15y ago0 comments

Doctors and nurses and supporting staff must exist

I got a $800 bill for 10 minutes doctor visit (swollen toe). Not exaggerating a tiny bit. No insurance company involved. "Must exist" is not an argument. Something is broken in the system where a doctor charges you $4,800 per hour. Insurance companies, obesity, poor lifestyle choices (all usual BS reasons I hear on TV) do not explain why this particular ####le charged me $4,800 per hour.

This saddens me hearing that most discussions about healthcare are circling around the question of "how?" instead of asking ourselves "why so much?".

0 comments

13 comments · 4 top-level

jrockway15y ago· 5 in thread

You went to the wrong doctor. When I get my bills for office visits, the rate is something like $300 on average (including lab tests). My insurance company then negotiates that down to something like $75, and then I pay the $10 co-pay. Now, all these numbers could be made up, but $300 seems about right for a doctor's visit when you consider how expensive it is to run a medical practice. It's not something I'd want to have to pay every week because I would die if I didn't, but it's not exactly financial ruination either.

If I had some rare disease but still wanted to do a startup, I think I would just work for Starbucks for 20 hours a week or something, simply for the health insurance.

_delirium15y ago

It's very difficult to price-shop, though, because unlike in most normal businesses, nobody seems to publish price lists, and they aren't very forthcoming giving quotes over the phone, either. So it's not too uncommon to end up with something absurd more or less by chance, especially if it's urgent to see a doctor.

Unless I've totally missed it, there's certainly no hipmunk for medicine, where I can put in that I want X service, and get a list of doctors and prices within a 50-mile radius.

tertius15y ago

Your health insurance should have this service.

I'm with Aetna and I can get lists of MDs within a 10 mile radius and I can get a price list of common procedures.

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mkramlich15y ago

> Unless I've totally missed it, there's certainly no hipmunk for medicine,

note to self: build a startup that's HipMunk for medicine

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anonymous24615y ago

Doctors and hospitals bill you more if you're uninsured. TFA mentions this as one of the reasons to get a high-deductible plan in which you will be paying most of the cost out of pocket.

Vivtek15y ago

Not in Indiana, they don't. Right now my wife is teaching, so we have insurance - but last year we normally got a 10% discount for being uninsured. Lots less hassle for the office, so they're willing to kick back a little for you.

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rdouble15y ago· 2 in thread

Something is broken in the system where a doctor charges you $4,800 per hour

That's about right. A few years ago, I thought I had food poisoning and 40 uninsured minutes in the ER set me back $3800. But I was "lucky." I've had friends who were in bicycle accidents and ended up with $13,000 and $37,000 hospital bills.

Groxx15y ago

ER bills are absolutely insane. It's not hard to break a few dozen thousand dollars in almost no time for almost no treatment. It strikes me as opportunistic preying.

gthank15y ago

The way it works is they bill outrageous amounts in the expectation that they will either be totally stiffed or have to negotiate a much lower settlement (which is essentially what insurance companies do, AFAIK). In the rare case where somebody actually pays the full bill, they're subsidizing care for those who walk out on the bill (or part of it). This strikes me as an extremely broken way of doing things, but it seems to be the norm, so maybe it's a really, really bad Nash equilibrium.

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dalke15y ago· 2 in thread

Last year visiting California I was sick for over a week. 30 minutes for a prescription (which I knew would be the result of that visit) cost me $600. $300 for the doctor and the same for the hospital. In New Mexico (one of the poorest states in the US), the equivalent a few years previous cost me about $100.

I stopped getting insurance because as a self-employed person it was expensive and rising. I played the odds and won. Sure doesn't make me feel happy.

WildUtah15y ago

In a civilized country, if you knew what the prescription would be, you could just walk into a pharmacy and buy it. The dotor charges $600 and provides no value. He exists to charge rent on his DEA license.

enjo15y ago

You do realize how terrible that idea is right? We'd see the rates of antibiotic resistant bacteria go through the roof in the first week.

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joelhaasnoot15y ago

I had a 1000 euro bill for getting 4 wisdom teeth removed by the oral surgeon, in a hospital, where I was out in 30 min (two 15 min procedures). The beauty? I pay 100 euros a month in coverage, with a 175 euro deductable, which I easily went over that year. Oh, and doctor's visits are free.

Welcome to the Netherlands... (and yes, we have waiting lists, and other issues with healthcare, but atleast it's affordable)

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0 comments

13 comments · 4 top-level

jrockway15y ago· 5 in thread

If I had some rare disease but still wanted to do a startup, I think I would just work for Starbucks for 20 hours a week or something, simply for the health insurance.

_delirium15y ago

Unless I've totally missed it, there's certainly no hipmunk for medicine, where I can put in that I want X service, and get a list of doctors and prices within a 50-mile radius.

tertius15y ago

Your health insurance should have this service.

I'm with Aetna and I can get lists of MDs within a 10 mile radius and I can get a price list of common procedures.

1 more reply

mkramlich15y ago

> Unless I've totally missed it, there's certainly no hipmunk for medicine,

note to self: build a startup that's HipMunk for medicine

1 more reply

anonymous24615y ago

Doctors and hospitals bill you more if you're uninsured. TFA mentions this as one of the reasons to get a high-deductible plan in which you will be paying most of the cost out of pocket.

Vivtek15y ago

1 more reply

rdouble15y ago· 2 in thread

Something is broken in the system where a doctor charges you $4,800 per hour

Groxx15y ago

ER bills are absolutely insane. It's not hard to break a few dozen thousand dollars in almost no time for almost no treatment. It strikes me as opportunistic preying.

gthank15y ago

1 more reply

dalke15y ago· 2 in thread

I stopped getting insurance because as a self-employed person it was expensive and rising. I played the odds and won. Sure doesn't make me feel happy.

WildUtah15y ago

enjo15y ago

You do realize how terrible that idea is right? We'd see the rates of antibiotic resistant bacteria go through the roof in the first week.

1 more reply

joelhaasnoot15y ago

Welcome to the Netherlands... (and yes, we have waiting lists, and other issues with healthcare, but atleast it's affordable)

2 more replies

j / k navigate · click thread line to collapse