Kevin, M.D. - Medical Weblog

And if the doctors had missed anything, the guy would have sued.
Go ahead, move to France. But tell me, how you plan to afford it?
 

If you are going to ride a motorcycle and don't have a catastrophic policy, don't bitch if you get injured and have to pay a big bill.
 

Exactly how do you make a system that is "costly and time consuming" although that's debateable he's already got over a 40% discount and had immediate access to care with EMS and triage at a level 1 trauma center. Into a "cheap and quick" system and not take finite resources (physicians, Xray equipment, CT scanners) away from those that have the foresight and are paying the bills in case this kind of thing happens to them. He got his universal healthcare its called EMTALA.
 

"If you are going to ride a motorcycle and don't have a catastrophic policy"
Health insurance usually does not cover motor vehicle accidents
(at least the terrible policy offered by the state of Mississippi doesn't)
 

And if he is insured, he had to spend $3000 to $4000 a year to pay for health insurance. Then he has to be reponsible for the 20% of his $11,000 bill. This would still cost an insured person $5000 to $6000 for the year for that accident. No, I don't feel sorry for this guy.
 

Mock him if you want, but this is the guy who votes for universal healthcare in some form or another. And there are plenty more like him.

He may be a moron, but he's also a voting moron who will ultimately control you physicians' salaries.
 

A single-payer system like in Canada and the UK would be illegal in this country. In fact, the current Medicare opt-out rule is illegal and needs to be challenged in court for an easy victory. Unfortunately, the AMA is spineless, thus I am an ex-AMA member. Can someone please wake up the AMA on the opt-out issue??
 

What we don't know, but I think is relevant, is what charges would the hospital have made to it's most common private insurer? The government dictates rates, but if, lets say BCBS, is 60% of their private pay business, then it is reasonable to assume that they have not agreed to rates at which they do not make money. Yet I am willing to bet, that had he such coverage, the bill would have been much much less than 12,000. Probably less than half that.

We in the healthcare industry are screwing ourselves by unreasonable and frankly abusive charge practices. Sure, a contract with the insurance company guranteeing quick direct payment is worth something to the hospital, but not worth enough to charge the uninsured premiums of 100-300 % over what insured patients paid. A premium of 20% for the trouble of attempting to collect would be more reasonable. When they aren't going to collect, they aren't going to collect no matter what they charge--that is no reason why the few uninsured patients willing to try to pay should be screwed.

What the industry is achieving with abusive charging practices to the uninsured is pushing political support for more government intervention.

Regarding the holier than thou crap about him being on a motorcycle, in my city, liability for a young male to drive a care is 3000 a year, with no accidents. For a small motorcycle it is 80 a year. It is the only affordable transportation for some.

I charge all patients the same thing because I think it is the right thing to do. I would support state legislation restricting hospitals to charging the uninsured 120% of what rates they agree to with their largest private insurer. I think that would be fair given that, like this young man, the customer often does not have a choice.
 

Yeah, if you receive care you should have to pay for it. However, when someone has no insurance, hospitals should ok any costs with the patient beforehand if the patient is conscious. The patient should be allowed to refuse a test or procedure against medical advice. I am positive this man was not advised of the cost of his tests, and if he had been I am quite certain he would have denied many of them. If I take my car to the shop and they perform a bunch of repairs and inspections without telling me the cost and asking my permission, I WILL NOT be paying the bill even if it means taking them to court.
 

When I read the title it sounded like my wife's story. She suffered a broken hand and ribs during an auto accident where someone tried to make a quick left turn at an intersection. We don't have insurance either as I lost my job to a layoff. The bill was over $18,000 for one day in emergency.
Somebody is making some big bucks and it isn't me.
 

The reality is that hospital bills that are unaffordable are ultimately resolved by negotiation for pennies on the dollar or the government pays the hospital a fraction of uncollectable debt (the physicians are not paid, however). Only the very wealthy can forgo insurance and pay for hospitalization. The physician fees are infrequently the problem.
 

Yeah, if you receive care you should have to pay for it. However, when someone has no insurance, hospitals should ok any costs with the patient beforehand if the patient is conscious.

Ha. It's called "the first form you sign when you go into the ER". You sign the form agreeing to pay. It's assumed that if you arrive in an ER, you are trusting the staff to do what is necessary to diagnose/treat your problem. Obviously, one can refuse whatever it is they want as well.

This guy should have had a motorcycle policy which covered injuries and, at the very least, a high deductible health insurance plan which would have limited his out of pocket expenses to something like 2K per year. There's no reason to be completely uninsured. People don't realize that these "catastrophic" plans along with medical savings accounts are relatively reasonably priced. He was probably breaking the law by not having medical coverage on his motorcycle.
 

Ha. It's called "the first form you sign when you go into the ER". You sign the form agreeing to pay. It's assumed that if you arrive in an ER, you are trusting the staff to do what is necessary to diagnose/treat your problem. Obviously, one can refuse whatever it is they want as well.

That's why I specified my post with the way things should be rather than the way things are.

I would never trust the staff to make economically sound decisions on my behalf if I had no insurance. The staff focuses on providing complete care that will hold up to the scrutiny of a malpractice attorney.

A simple exchange could go like this:

Nurse:"The doctor has suggested you might take some more advil for your pain."
Patient:"How much?"
Nurse:"The hospital's unnegotiated rate is $5000/asprin"
Patient:"No thanks"
 

Nurse Kelly:

At this guy's income level he could not have afforded catastrophic insurance either. That is probably why he is riding a motorcycle. Hospital pricing is predatory for the uninsured, who, in any minimally free country, have a right to remain so even if they can afford insurance.

If hospitals charged fairly, the wealthy are not the only people who could afford to do without insurance. Lots of people have (or could soon have if they didn't spend 15,000 a year on health insurace) the hundred thousand or so that it takes to self insure--esp if the hospitals didn't so drastically overcharge them compared to what it charges everyone else.
 

I agree with the posters who understand that the hospital charge system is so completely whacked it bewilders everyone, even myself a physician who has tried to understand it and work out negotiations with payer groups.

In the ER where I work a "trauma alert" is made when a trauma patient meets certain criteria. They get a yellow clipboard versus the regular brown one to alert the ER doc who will try to see them within 5 minutes. For this yellow clipbard the hospital (not us, our fee won't be any different) can charge an extra $5K. And of course insurers aren't paying that charge. A "trauma code" summons the trauma surgeon, CT, blood bank, etc... For this the hospital will "charge" $20K. A lot of these patient will end up with head, abd, pelvis, c,t,and l ct scans at $2k a pop. It would not be out of the realm of possibility to have a $40K ER visit and at the end be told that you have some strain and bruises .... here, try some motrin.

The whole box that contains hospital pricing, charges, and cost shifting needs to be blown up. I very much sympathize with anger against the medical establishment when Mr. uninsured lays down his Harley.