[HN Gopher] Bay Area couple shocked by $200K hospital bill for r...
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       Bay Area couple shocked by $200K hospital bill for rabies shots
        
       Author : kofejnik
       Score  : 46 points
       Date   : 2023-04-11 22:24 UTC (38 minutes ago)
        
 (HTM) web link (abc7news.com)
 (TXT) w3m dump (abc7news.com)
        
       | psychphysic wrote:
       | So healthcare costs like 500-1k per month for the good stuff. And
       | you still might have to pay through the nose for a PS75 vaccine?
       | 
       | Or is this a case of bad insurance?
       | 
       | That the US can spy on the entire world but can't get its own
       | people basic healthcare is shocking.
        
         | 1letterunixname wrote:
         | No, it depends on your age, health, and coverage. For limited
         | disastrous healthcare coverage, that might get you $1m in
         | lifetime coverage with a $8k deductible if you were 28 and in
         | perfect health.
        
       | lastofthemojito wrote:
       | Absolutely insane that they would have been better off heading to
       | SFO, walking up to the Air Canada or Aeromexico counters, and
       | leaving the country for care.
        
       | testemailfordg2 wrote:
       | Probably a DFT^P03 message caused an issue somewhere... Or this
       | was to be... "CDPH does not have a role in setting charge limits
       | or ranges for services."
        
       | ifdefdebug wrote:
       | I am so happy that I don't have to put up with crazy shit like
       | $200k for a few shots which is NOT just a billing failure, just
       | by not living on the other side of the Atlantic...
       | 
       | Because here where I live, if you walk into an emergency room and
       | walk out a few hours later with two shots and a $200k bill, ...
       | well it's unthinkable, but if it happened anyway and the hospital
       | tried to defend it, the judge would just laugh their lawyers out
       | of the door.
        
       | virgulino wrote:
       | Brazil here. A few years ago, my wife was bitten by a dog. We
       | simply went to the neighborhood free healthcare clinic, the
       | standard entry point to our free universal healthcare system.
       | After a very short wait they cleaned the wound and administered
       | the first rabies vaccine. We went back there for the next doses.
       | All free of charge, and the only "paperwork" she needed to do was
       | to present her national ID card.
       | 
       | https://en.wikipedia.org/wiki/Sistema_%C3%9Anico_de_Sa%C3%BA...
        
       | p1esk wrote:
       | What happens if you refuse to pay?
        
         | timy2shoes wrote:
         | They give your rabies back.
        
         | olliej wrote:
         | Debt collectors, A lien on their house, etc
        
           | AdamJacobMuller wrote:
           | Dispute the debt.
           | 
           | They can't put a lien on property without a court case and I
           | want to see someone stand in front of a judge and justify an
           | un-itemized 100k bill when their own public charge sheet
           | shows that the service should cost <1000.
        
         | arbuge wrote:
         | I'll just leave this here:
         | 
         | https://www.npr.org/sections/health-shots/2022/12/21/1144491...
        
         | toomuchtodo wrote:
         | https://news.gallup.com/poll/317948/fear-bankruptcy-due-majo...
         | 
         | https://www.texastribune.org/2022/06/16/americans-medical-de...
         | 
         | https://www.retireguide.com/retirement-planning/risks/medica...
        
           | mindslight wrote:
           | It really bothers me that none of these stories seem to
           | describe what legal theories are used to enforce these
           | fabricated "debts" against the victims. It would seem there
           | must be a whole collection of state laws that enable these
           | practices, and I would think they would be a prime area of
           | reform - if they were eliminated, providers would have to
           | publish prices and form an actual contract (including a lack
           | of duress and well-defined consideration), instead of being
           | able to play this game of "nobody can tell you how much
           | anything costs until the billing extorts you".
        
       | clueless wrote:
       | so a whole story about a billing mistake, which they could have
       | figured out without involving the news org?
        
         | ska wrote:
         | The insurance paid out 58,000, the couple paid out
         | 3000-something. So even if the initial 200k was a 'mistake',
         | the actual billed service is insane for a $600 shot (2x). The
         | entire bill should have been much less than their out of
         | pocket.
         | 
         | So there is more to the story.
        
         | darth_avocado wrote:
         | "Billing mistakes" happen way too often in this country and the
         | hospitals don't fix them that easily.
        
         | schemescape wrote:
         | Where does it say it's a billing mistake?
        
           | jlmorton wrote:
           | The article does not say it's a billing mistake, but it notes
           | that NorthBay Healthcare lists a price online of $547.65 for
           | a rabies vaccine. Surely human rabies immunoglobulin would be
           | another $1,000, maybe more, but there is no chance on Earth
           | that it is $100,000 each.
           | 
           | NorthBay Healthcare is a non-profit hospital.
           | 
           | This is a very, very obvious billing mistake. And while I
           | have zero evidence for what I am about to say, I would be
           | willing to bet that ABC7News did not even share the case they
           | were preparing to discuss with the hospital. They just wanted
           | to run the story, and so they asked the hospital for generic
           | comment about a patient's large bill.
           | 
           | I've looked for follow-up to this two-month old story, and I
           | can't find any. But I am sure it's a billing mistake.
        
       | dmarchuk wrote:
       | > Tens of thousands of people each year receive a series of shots
       | to prevent rabies after a possible exposure. It normally costs
       | between $1,200 and $6,800. Not in this case.
       | 
       | Even that "normal" cost is absolutely crazy.
        
         | 1letterunixname wrote:
         | Most Americans don't realize how bad they have it. They've
         | grown accustomed to being punched and slapped around and so
         | won't rebel. They'll keep giving all of what little and
         | shrinking of what they have to legitimized criminals.
        
       | darth_avocado wrote:
       | The insurance company paid $58000 for the treatment? How the hell
       | did they not get the hospital to get things fixed? My insurance
       | made me submit proof, rejected it, submit proof again, partially
       | approve, call them and then finally reimburse my $18 covid take
       | home tests. But somehow they don't do the same to hospitals?
        
         | AdamJacobMuller wrote:
         | What's their incentive to reduce the cost?
         | 
         | They make money as a % of care paid out (max profit is capped).
         | 
         | More costs == more profits and the costs are just passed onto
         | the people paying for insurance (both employees and employers)
        
           | 1letterunixname wrote:
           | There is no incentive except to commit highway robbery.
           | 
           | Pay, or pay and die.
           | 
           | It's the weakness and disorganization of the consumers who
           | emboldens them.
        
           | HPsquared wrote:
           | In a normal competitive market a series of new entrants would
           | come in and undercut the incumbents by charging 10% less than
           | the competition, one after the other until a sensible price
           | is reached. Why doesn't this happen? Also where does all that
           | money even go? It's so insane.
        
       | olliej wrote:
       | This is another of those cases which seem to be very clearly
       | price gouging, which is illegal, unless you're a hospital.
       | 
       | The hospital should be subpoena'd to get the actual cost of
       | treatment - both the vaccination, the amount paid to the ER staff
       | during the time the patients were there, etc.
       | 
       | Also this BS where they can just say "out of respect for patient
       | privacy we don't discuss billing matters", when the patient has
       | provide explicit documentation and consent saying the hospital
       | can discuss billing can also get shafted.
        
         | nradov wrote:
         | I won't attempt to defend the hospital but even outside of
         | healthcare, price gouging is almost always legal. There are
         | only a few limited circumstances where it is banned in a subset
         | of US states.
        
       | 1letterunixname wrote:
       | That's a shitty bill. It's also insane that US doctors and
       | hospitals aren't required to post prices, keep prices reasonably
       | within an allowed range, and are allowed to price gouge customers
       | for however much they want without limit.
       | 
       | In Redding CA, I ran across a woman with a nasal infusion pump
       | tube taped to her face in a coffee shop. She was hurriedly
       | collecting paperwork for a hearing across the street. It turns
       | out she was preparing to go through bankruptcy proceedings while
       | she was dying from incurable Stage IV cancer. That the doctors
       | and hospitals were vultures picking her life apart for money
       | while she was dying but still alive and making her end-of-life as
       | miserable as possible was adding insult to injury. Some
       | hippocratic oath. More like hypocritical chisels out to monetize
       | misery.
       | 
       | So when someone is out of money and dying in America, they are
       | treated like criminals with court proceedings. At their hearing,
       | they get a chance to justify their existence requires clothes,
       | transportation, and housing while everything else goes to
       | creditors.
        
         | akomtu wrote:
         | Somewhere in the hospital conference rooms, a model employee
         | was giving a presentation about "average customers lifetime
         | value (LTV) had increased by 25% YoY" thanks for his hard work.
         | His promotion was finally approved that year. An accountant in
         | an adjacent department was given a bonus for spotting a billing
         | mistake that significantly underbilled a customer with stage 4
         | cancer. He was made employee of the month.
        
         | JohnFen wrote:
         | My mother got cancer (she survived it, fortunately). She had a
         | fantastic insurance policy, made good money (well above the
         | average income), and had money in the bank.
         | 
         | Her medical costs ended up bankrupting her. That was where the
         | scales fell from my eyes and I learned that what we're taught
         | about the purpose of insurance (to protect us in the case of a
         | catastrophic expense) is just pure BS.
        
         | nitwit005 wrote:
         | > The hospital is required to make its charges public. NorthBay
         | Health's online listing shows $547.65 for a rabies vaccine.
        
         | bagels wrote:
         | Hospital administrators don't take a hippocratic oath, unless
         | they happened to also be doctors too.
        
           | 1letterunixname wrote:
           | Most were. Still, their staff do. But the point you're
           | appearing to make normalizes injustice if they didn't happen
           | to take an oath. What does this have to do with anything?
        
         | nradov wrote:
         | Hospitals have been required to post price lists for several
         | years.
         | 
         | https://www.cms.gov/hospital-price-transparency
        
           | m0llusk wrote:
           | From this recent HN thread it looks like we still have a ways
           | to go there: New health insurance "transparency data" looks
           | suspiciously wrong
           | 
           | https://news.ycombinator.com/item?id=35347647
        
           | dheera wrote:
           | It's meaningless unless you can get a price _before_ you get
           | services.
           | 
           | The trouble is even if the price list says $500 for
           | something, they'll charge you $8000 for "general
           | classification" and $2000 for a Tylenol.
           | 
           | I have a remote heart monitor at my bedside that wirelessly
           | retrieves data about arrythmia incidents from my implanted
           | defibrillator and sends any incidents to the hospital. Every
           | time I hit the button, even if there are ZERO incidents for
           | them to review, I get hit with a $300 bill for some "general
           | classification". So I hit the button less less often than I'm
           | supposed to.
        
           | 1letterunixname wrote:
           | Doesn't matter. Nothing has changed.
        
         | dheera wrote:
         | I got charged $5000 for a 30-minute preventative echocardiogram
         | (basically an ultrasound) that insurance was supposed to pay
         | 100%.
         | 
         | 20 emails later it's now at debt collectors, and I've contested
         | the debt twice.
         | 
         | I'm ready to appear in court if I have to. I'm ready to pay $8K
         | in lawyer fees to get rid of this $5K bill because it's wrong.
         | I just don't want this to impact my credit score because it's
         | not my debt.
         | 
         | I hate you, Stanford Healthcare.
        
       | paulpauper wrote:
       | These sort of stories like these go viral. The amount paid is
       | nowhere close to that, sometimes nothing is paid. The final price
       | is always negotiated vastly lower.
        
         | schemescape wrote:
         | Looks like there was already an outrageous payment:
         | 
         | > Even with plan discounts, United Healthcare still paid more
         | than $58,000 for the couple's rabies treatment.
        
         | pengaru wrote:
         | > The amount paid is nowhere close to that, sometimes nothing
         | is paid. The final price is always negotiated vastly lower.
         | 
         | Wow, look at the Stockholm Syndrome on this guy!
         | 
         | As if that's an acceptable normal process for anyone to be
         | subjected to...
        
       | s_m_t wrote:
       | How is that legal? What is stopping the hospital from charging
       | 200 million dollars for the rabies shots?
       | 
       | If I hired someone to fix my plumbing and they wouldn't give me
       | an estimate and then decided to charge me $20k/hr I don't think a
       | court would honor that contract.
        
       | rediguanayum wrote:
       | Agreed while this is excessive, many hospitals do this to cover
       | the uninsured who don't pay their bills. Hospitals have to care
       | for such patients due to EMTALA. Consequently many non-academic
       | hospitals are under huge financial stress
       | (https://www.kqed.org/science/1981588/half-of-california-hosp...)
       | and go after anyone that can pay to the point of bankrupting
       | them. The US medical system is simply dysfunctional.
        
         | JohnFen wrote:
         | > The US medical system is simply dysfunctional.
         | 
         | That's an epic understatement. I'm of the opinion that the root
         | cause is the insurance companies.
        
       | itake wrote:
       | Does anyone have advice on how to protect yourself from bills
       | like this?
       | 
       | My insurance is fighting me on a $450 test (that I could have
       | gotten done with an Amazon kit for $80).
        
       | pengaru wrote:
       | TIL Vacaville is considered Bay Area... that's a pretty far drive
       | from SF.
        
         | 1letterunixname wrote:
         | Cow city. It's a shithole halfway to Sacramento.
         | 
         | A woman crashed her car into my vehicle there. She didn't stop.
         | A cop was right there and did nothing. I called 911. The county
         | or city didn't have E911 properly configured with Verizon and
         | couldn't get my location. This is how America works. Broken,
         | lawless, and dysfunctional.
        
       | notch898b wrote:
       | I encountered a bat many years ago acting erratically inside the
       | house. It had evidently entered in my sleep.
       | 
       | I looked up the cost, and found out the household would be
       | bankrupted by the shots and we would end up homeless. I
       | calculated the danger from homelessness outweighed the risk of
       | rabies. I guess the bet paid off, as we're now well past the 99th
       | percentile of incubation period.
        
         | mongol wrote:
         | Can you get rabies still, theoretically, from this event?
        
           | AdamJacobMuller wrote:
           | Theoretically, yes. The infection can lie dormant for an
           | exceptionally long period of time in an exceptionally small
           | percent of cases and can be triggered by unrelated external
           | factors.
        
           | i386 wrote:
           | I believe it's only transmissible through saliva. Unless you
           | are bitten by the infected animal you will be fine.
           | 
           | https://www.cdc.gov/rabies/transmission/index.html
        
           | dr_dshiv wrote:
           | 25 years!
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424805/
        
         | klipklop wrote:
         | Seems pretty remote chance to get rabies without being bit, but
         | did you read the last paragraph?
         | 
         | "The Aguilars wound up paying $3,546.64 out of pocket. The
         | insurance company told us Wednesday that they "are reaching out
         | to NorthBay Healthcare... to address these excessive charges.""
         | 
         | The shot normally costs ~$600 USD. There is no way the
         | insurance in the end will pay the $54k the hospital tried to
         | get away with.
        
           | thaumaturgy wrote:
           | > _Seems pretty remote chance to get rabies without being
           | bit_
           | 
           | Just FYI, it's possible to get bit by a bat while sleeping
           | and not realize it. Most bats are small and a bite mark may
           | not be painful or immediately noticeable. There was a case in
           | 2021 in Illinois of a man being bitten by a bat in his sleep;
           | in his case, he realized he'd been bitten, but declined
           | treatment (cost, probably...) and died of rabies a month
           | later. Not a fun way to go.
           | 
           | I've heard the advice before to get a prophylactic rabies
           | shot if you find a bat trapped in your house while you were
           | sleeping. ...in civilized countries, anyway.
        
           | notch898b wrote:
           | If I recall correctly we had no insurance at the time. I was
           | able to afford to re-vaccinate my animal, as it's only $60 at
           | the vet, I figured at least my pet would survive.
        
             | AdamJacobMuller wrote:
             | It would almost definitely have been cheaper for you,
             | without insurance, than it was for this couple.
        
           | AdamJacobMuller wrote:
           | > United Healthcare still paid more than $58,000 for the
           | couple's rabies treatment
           | 
           | They did.
        
         | switchbak wrote:
         | Dang. I don't have a lot of financial reasons to prefer living
         | in Canada, but that's definitely one (for now at least).
         | 
         | That's rough though, lucky you didn't get sick. It's not a
         | choice I'd like to make.
        
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