[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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(page generated 2023-04-11 23:02 UTC)