patrick.net

zzyzzx says

Hanusz-Rajkowski got hit with an $8,200 bill for the emergency room visit. On top of that, Bayonne Medical Center charged $180 for a tetanus shot, $242 for sterile supplies, and $8 for some antibacterial ointment in addition to hundreds of dollars for the services of the nurse practitioner.

That $9,000 bill left Hanusz-Rajkowski speechless. From NBC:

The hospitals can do a great job keeping people alive. It's the bill that gives them a massive heart attack and kills them.

How this is legal under the sherman clayton acts you need to ask Obummer, or Boosh, or Eric Placeholder. Vote those bums out and imprison the hospital's CEO for violation of the aforementioned acts and usury.

Moron should have gone to an in-network urgent care center instead. I mean, I am guessing that this is a clueless old person who doesn't understand how ER's work these days. Expecting a hospital to be reasonable is just plain silly.

zzyzzx says

Moron should have gone to an in-network urgent care center instead. I mean, I am guessing that this is a clueless old person who doesn't understand how ER's work these days. Expecting a hospital to be reasonable is just plain silly.

Agreed, I am not even sure if this needed urgent care. But if it did and was after hours or on a weekend, you are pretty much stuck with the ER. At least here in the bay area.

This is like expecting to be charged a 1000% mark up, because you went to a Bistro instead of a Diner.
zzyzzx says

Moron should have gone to an in-network urgent care center instead. I mean, I am guessing that this is a clueless old person who doesn't understand how ER's work these days. Expecting a hospital to be reasonable is just plain silly.

mell says

you are pretty much stuck with the ER. At least here in the bay area.

Nope. There are centers opened on weekends for urgent care. But they will send you to ER for anything more than a flu or a bandage.

zzyzzx says

I got a Band-Aid and a tetanus shot. How could it be $9,000? This is crazy

You know how free market works: you shop around, ask for the price, pick the smallest price.

If you don't do that - or can't -, don't expect free market to work for you.

Think about it for a second: they are in a position to charge literally whatever they want. Why wouldn't they charge $9000? I mean, above $10,000 it would really start looking like extortion. But why not $9000?

Heraclitusstudent says

zzyzzx says

I got a Band-Aid and a tetanus shot. How could it be $9,000? This is crazy

You know how free market works: you shop around, ask for the price, pick the smallest price.

If you don't do that - or can't -, don't expect free market to work for you.

You can't shop around in an emergency.
Secondly, you have no idea what they are gonna do if you have chest pains or something. It is just not possible to shop.
Thirdly most people have insurance. Ours is $50.00 for an emergency room visit, and that is all I want to know.
Hospitals gouging patients like this should be a crime, and heavily fined.

Strategist says

Hospitals gouging patients like this should be a crime, and heavily fined.

Private entities decide on the pricing of their services.
Are you saying they shouldn't be able to make these decisions? Who will decide, if not them?

You would think insurances would shop around and restrict you to some hospital they have agreements with. But it's probably just as difficult for insurances to know whether each act was in fact necessary. Insurances don't really fight that battle, they just turn around and pass you their costs, after taking a cut from the extra charge.

So are you saying "free market" can't work with healthcare?

APOCALYPSEFUCKisShostikovitch says

Strategist says

Hospitals gouging patients like this should be a crime, and heavily fined.

Why do you hate Innovation and Success?

Heavy fines only justify further gouging.

Strategist says

You can't shop around in an emergency.

He did have 3 days to shop around.

APOCALYPSEFUCKisShostikovitch says

If Obama had his way, this guy would have been standing in front of a death panel.

It's all Obama's fault!!!

Heraclitusstudent says

Strategist says

Hospitals gouging patients like this should be a crime, and heavily fined.

Private entities decide on the pricing of their services.

Are you saying they shouldn't be able to make these decisions? Who will decide, if not them?

You would think insurances would shop around and restrict you to some hospital they have agreements with. But it's probably just as difficult for insurances to know whether each act was in fact necessary. Insurances don't really fight that battle, they just turn around and pass you their costs, after taking a cut from the extra charge.

So are you saying "free market" can't work with healthcare?

I am a supporter of free markets, but there are instances when it fails. This hospital charged $9,000 for a bandaid, maybe they will charge $99,000 next time for the same bandaid. Is that fair? Hospitals have a good faith duty to their patients, and taking advantage of someone in an emergency situation like this is not acceptable.
A $100,000 fine for every patient gouged ought to straighten them out.

Clearly should not have gone to an emergency room. That said, the cost is insane even for an ER. When I was a business owner (construction) any minor injury of that nature the guys were told to go to urgent care facility. This was to keep our workmans comp costs down. The cost difference was huge and we would often just pay the urgent care bill rather than put in a WC claim. It was a struggle to get them to do this as they were conditioned to go to the ER. Among the lower socioeconomic groups the ER is the only thing they know. BTW they all had good health insurance but on job injuries are covered through workman’s comp.

Strategist says

Is that fair? Hospitals have a good faith duty to their patients, and taking advantage of someone in an emergency situation like this is not acceptable.

Since when is free market "fair"?

Do you understand that the only duty a company has is to rake in as much money they possibly can? Public companies are legally bound to do so for their shareholders. That's their role - and only role.

Why are you trying to assign human emotions to something that is essentially mechanic?

Why would they be fined for playing their role within a free-market background?

I went to urgent care once for a stomach ailment. They made me wait for 3 hours, told me I had a stomach virus and kicked my ass out, charged me $150.

2 days later I crawled to the hospital. One blood test, some generic antibiotics, and two hours later, I'm released feeling almost totally cured. I was told if I had gone another day I probably would have gone into a coma. The cost: $4000, negotiated down to $2500.

Three weeks later the CDC called asking me if I had been to the Third World. I told the guy my girlfriend was a nurse at an ALF. He was like "ohhh, got it! Thank for your time."

American Health Care.

Urgent care sucks, the hospital gouges you for a routine test and some 50-year old drugs, then the CDC understands that diseases you get in sub-saharan Darkest Africa are the same you get in a suburban US Assisted Living Facility.

Heraclitusstudent says

Strategist says

Is that fair? Hospitals have a good faith duty to their patients, and taking advantage of someone in an emergency situation like this is not acceptable.

Since when is free market "fair"?

Do you understand that the only duty a company has is to rake in as much money they possibly can? Public companies are legally bound to do so for their shareholders. That's their role - and only role.

Why are you trying to assign human emotions to something that is essentially mechanic?

Why would they be fined for playing their role within a free-market background?

Making money is not by any means their only role. They are licensed, and are required to do business in good faith, and ethically. They do have a duty to their shareholders too. If they cannot comply, get out of the business. What's wrong with a win win situation?

thunderlips11 says

I went to urgent care once for a stomach ailment. They made me wait for 3 hours, told me I had a virus and sent me home, charged me $150.

2 days later I crawled to the hospital. One blood test, some generic antibiotics, and two hours later, I'm released feeling almost totally cured. The cost: $4000, negotiated down to $2500.

American Health Care.

That is probably more. Emergency rooms do have a tremendous amount of overheads, mostly due to gouging lawyers.

Strategist says

Making money is not by any means their only role. They are licensed, and are required to do business in good faith, and ethically. They do have a duty to their shareholders too. If they cannot comply, get out of the business. What's wrong with a win win situation?

Again. They *can* charge $9000. How many large businesses that can charge $9000 will charge $900?

Saying they have some kind of ethical duty to do so is incredibly naive.
No, they don't have such duty. Absolutely not.
Their only duties are to fix you up and charge you as much as they possibly can. That's it.

There is nothing wrong with "win-win", it's just better from their perspective to practice "win more - lose".

Do you understand that the ONLY force keeping prices in check in a free-market is something called "competition"? Remove "competition" and what you have is no different from "extortion".

Heraclitusstudent says

Do you understand that the ONLY force keeping prices in check in a free-market is something called "competition"? Remove "competition" and what you have is no different from "extortion".

That's the point. In an emergency situation there is no functioning competition. I am a capitalist, but I fully realize capitalism cannot function in certain situations, and you need government interference in those situations. This happens to be one of those situations.

Strategist says

That's the point. In an emergency situation there is no functioning competition. I am a capitalist, but I fully realize capitalism cannot function in certain situations, and you need government interference in those situations. This happens to be one of those situations.

This is the failing of our Democracy.

The definition of this clause is distorted by both parties as political fodder for a distorted reality. One party wants to paint them selves into a corner with a over zealous definition of "Free market" while the other wants paint the other into a corner with a socialist skew.

Of course there needs to be a free market with rules.
That is the whole point of Free Markets.

They are supposed to protect smaller players from the bigger players, while gains and profits are welcomed. There are supposed to be rules and laws that considers the impact of others when you made those profits.
We've gone off track of what was originally intended. Our free markets were supposed to protect Americans from the robber barons who once though "The game isn't over until someone has all of the Marbles" mentality.

CaptainShuddup says

Of course there needs to be a free market with rules.

That is the whole point of Free Markets.

Don't rules mean government cap? Aren't you totally against government? How does that work? I guess you don't have to worry about the foolish consistency problem.

Not that what this guy had was an emergency, but I believe in a true emergency, the EMTs have to take patients to the nearest ER. So, that would remove the element of choice,at least, in those situations.

Government involvement doesn't work without price controls. When no price controls are put into place, you have what we have now, which is people profiting off the government tit, while losses magically get subsidized. It happened with government subsidized student loans, housing, and healthcare. Though the government's involvement is well meaning, all it does is open up a much bigger pocket to gouge. The people who ultimately benefit are NEVER the ones the program was designed to help. So either the government needs to quit meddling altogether, or they need to man-up and set some price controls.

We need Affordable Legal Care!

The bill is so high because we don't put people in jail for fraud when they work for hospitals. We should. The first time that happens at a hospital is the last time the billing department at that hospital commits fraud.

Dan8267 says

The bill is so high because we don't put people in jail for fraud when they work for hospitals. We should. The first time that happens at a hospital is the last time the billing department at that hospital commits fraud.

Agreed.

bob2356 says

Don't rules mean government cap? Aren't you totally against government?

See what I mean, you can't believe that Family virtues in America is under attack from the rabbit left with out being "Totally Against the Government."

You can't clearly see that the Healthcare law that was being written was going to be total shame, and not "Socialist" enough(As I have said countless times) without being "Totally Against the Government".

Hey look Warren Buffet spotted a 1%'er run and see what all of the fuss is about!

CaptainShuddup says

This is the failing of our Democracy.

The definition of this clause is distorted by both parties as political fodder for a distorted reality. One party wants to paint them selves into a corner with a over zealous definition of "Free market" while the other wants paint the other into a corner with a socialist skew.

Of course there needs to be a free market with rules.

That is the whole point of Free Markets.

They are supposed to protect smaller players from the bigger players, while gains and profits are welcomed. There are supposed to be rules and laws that considers the impact of others when you made those profits.

We've gone off track of what was originally intended. Our free markets were supposed to protect Americans from the robber barons who once though "The game isn't over until someone has all of the Marbles" mentality.

The system we have in place is what allows them to make money. The system also demands they share some of the wealth in the form of taxes to keep the system going, and that they DO NOT screw anyone.
By and large democracy has worked, but does need some fine tuning here and there. I also want to see education as a right, not a privilege.

should they not have to tell you what the costs are up front, like any other capitalistic purchase?

Heraclitusstudent says

Again. They *can* charge $9000. How many large businesses that can charge $9000 will charge $900?

thunderlips11 says

I went to urgent care once for a stomach ailment. They made me wait for 3 hours, told me I had a stomach virus and kicked my ass out, charged me $150.

2 days later I crawled to the hospital. One blood test, some generic antibiotics, and two hours later, I'm released feeling almost totally cured. I was told if I had gone another day I probably would have gone into a coma. The cost: $4000, negotiated down to $2500.

I was in a similar situation once. The Urgent car Dr gave me the wrong (too weak) antibiotics. When they didn't work I went back and got a different doctor that prescribed the correct ones. I still had to pay twice. when I complained, they basically said FU.

SoftShell says

should they not have to tell you what the costs are up front, like any other capitalistic purchase?

Heraclitusstudent says

Again. They *can* charge $9000. How many large businesses that can charge $9000 will charge $900?

Not practical. When you are in pain you don't give a damn.
I had kidney stones. The pain was absolutely OMG.
They spent 45 minutes doing paperwork, and asking me questions. Hello I am dying? Finally they gave me something and the pain was gone in 30 seconds.

At the time that the guy was injured, it was an emergency (or not). An example of an emergency is when the finger is hanging by a thread, or there's a loss of feeling (which sometimes can't be fixed anyway - once those teeny nerves are severed there usually isn't anything that can be done). It might have been an emergency if the finger wouldn't stop bleeding - or was squirting blood - and it would have been an emergency if it appears to be infected immediately, it was red or had streaks up the arm... there are many reasons that it could be considered "emergent."

ER's are for conditions that just happened and are acute (life or death, or danger of loss of limb). Stitches can be done at a doc-in-the-box (instacares) unless there's a complication or the possibility of a complication. If you go to the instacare and they believe it's emergent, they will send you to the ER.

But according to the guy, it didn't look like it was healing. There is nothing emergent about that. It sounds like a Band-Aid & some Neosporin would have worked just fine. In fact, it did work just fine.

The guy deserves to be charged for stupidity. There's an ER nurse saying (and I'm paraphrasing), "What is it about your injury that makes it an emergency now (usually at 2:00am) when it wasn't an emergency during the hours instacare is open?"

The guy had the ability to be seen at any point between the time of injury and "a few days" later when he didn't think it was healing very well. He had many other options available, but chose not to do so.

His comment was that he won't go back there for treatment - but any ER would have billed him a huge fucking amount for the trip. What this teacher learnt himself was that he won't go back to that ER - when he should have learnt himself that he shouldn't have gone to any ER for an owie on his finger.

turtledove says

I believe in a true emergency, the EMTs have to take patients to the nearest ER. So, that would remove the element of choice,at least, in those situations.

Every hospital is "in network" during an emergency. What isn't "in network" are the extra charges of labs, xrays, doctors, etc. That shit needs to change. Private contractors at hospitals should charge in-network in those cases.

I still think we need a single-payer system.

Peter P says

I still think we need a single-payer system.

Absolutely. I agree 100%. I am not a fan of insurers. I am not a fan of our current system. My point was (and continues to be) that this dude was stupid, wasted resources and is now playing the victim.

Sure, the charges are high. Too high. It doesn't change the fact that he's an idiot. They will negotiate the charges down and they will look like the bad guy in this situation to those people who either don't understand or lack the ability to comprehend it.

Strategist says

The system also demands they share some of the wealth in the form of taxes to keep the system going, and that they DO NOT screw anyone.

The hospital corporations have reorganized as "charities," which means for example an SF "charity" hospital chain devotes literally 1% of revenue to "charity care," by which they mean bills they were unable to collect. A 99% collection rate would be the envy of most businesses, but in hospitalspeak it's "charity" (and "freeloading" that must be outlawed by requiring everyone to prepay via insurance that might not even cover you).

@elliemae, you go to incredible lengths to blame the victim in this report. If the guy had gone to an airport, they could have flown him to Mexico and back and his total cost including airfare and treatment would have been less. (Probably safer too: Mexican hospitals don't infect nearly as many patients with MRSA as American hospitals do.) Even if you say at 2am a hospital might reasonably charge 2x or 3x the ordinary local daytime price, something like the markup an all night convenience store might charge compared to the nearest supermarket, that is no excuse to rob someone. The medical sector has become accustomed to demanding ridiculous markups, because the programs that you extol have enabled them to do so. You don't even acknowledge why there are no cheaper competitors in many areas; for example, in SF you can find all night plumbers who make housecalls for less than this guy paid, but good luck finding the same for an infected finger. Your comments read like a hostage with Stockholm Syndrome, always defending your captors and blaming their enemies. Nothing justifies the markups we see in this sector in this country compared to all other sectors and countries, but credulous voters insist on even more and the lobbyists are happy to exploit your insistence.

elliemae says

My point was (and continues to be) that this dude was stupid, wasted resources and is now playing the victim.

Nine thousand dollars.

JH says

Nine thousand dollars.

The costs are too high - absolutely. Should have been around $1,000 (enough to punish him for his stupidity and to reimburse for the nurse practitioner, the room he occupied, the staff to check him in, the bandage, etc).

But the real issue is this: there was no reason for him to go to the ER; none. He had other options available to him - after all, as a public employee he has the best of insurance and a salary that is able to cover the out of pocket costs. He should have utilized one of the other options available, such as instacare or an MD that's an in-network provider. He could have looked it up on Web MD...

What he shouldn't have done was to go to the ER. He had many methods available to him to have his owie fixed.

Unfortunately, they can't fix his real problem. They simply can't fix stupid.