The Dolphins Make Me Cry.com - Forums

Story time.

I have good insurance.

I went to the ER a month back in the middle of the night.  I had severe abdominal pain.

I checked in at about 2 AM.  I essentially suffered, by writing around in a chair for 7 hours.  They couldn't give me a bed or a room or any medicine on the premesis.  There was only one nurse available because of their understaffing.  The place was rife with COVID and Influenza-A to the point that multiple people apologized for the lack of ability to help me and said that in the past, it would have been different.

I had:
- A urine sample analized.
- Blood drawn and analyzed.
- A CT scan.

After suffering without guidance for 7 hours, a doctor spoke to me for about 90 seconds.  He gave me 3 prescriptions (advil, a pain killer, and an anti-nausea, which wasn't even a symptom), said I have a kidney stone, and told me to see a urologist. 

The bill was $4000.
Even after my insurance was applied, I still owe $1000.

Worst medical system in the industrialized world.

Highest incarceration rate in the world.

One of the worst public transportation system in the world.

Worst gun violence problem of all industrialized nations.

One of the worst income inequality rate.

One of only two countries without paid maternity leave.

One of very few countries not on the metric system.

Spend more on war/preparing for war than any other country.

What makes us unique makes us weak.

If you didn't have a job, your bill would have been ZERO.  Hence, it pays not to work in Biden's America.

Just curious, did you get a copy of each of the charges?

I've gone to Urgent Care with chest pain for EKGs, but I don't remember the pre-insurance bills being over $100.

Is the COVID Situation really that bad in Florida?

Not true.

In my state, (and yours) it is.

Not sure about Florida.

I have had several medical tests covered by my insurance this year, including my first colonoscopy and endoscopy.  I get my insurance through my healthcare job

Being unemployed doesn't get you health insurance.  You are required to pay for Cobra.

We have MassHealth

In our state, people who live off the taxpayers never have to pay for medical bills

I know.  And you have a false and overly simplistic view of it that doesn't match reality.

You're embarrassing.

Your bill is not "zero."  Your bill goes to collections and remains unpaid, where it sits on your credit report and ruins your credit.  This makes it more difficult for you to rent a residence, more difficult and expensive to get a car loan, more expensive to use credit cards, etc.

Now, will you still receive the potentially life-saving medical treatment that you could not afford?  Sure; you will not die untreated on the sidewalk in front of the hospital.  But if you were already struggling too much financially to be able to pay that medical bill, your financial struggles are only going to get worse after you get out of the hospital.

P.S. This system you decry worked exactly the same in Donald Trump's America and George W. Bush's America.

This is wrong.  

At least in my state, if you don’t work you get your entire insurance and medical bills covered by the state.  Your bill goes to the taxpayers.

Spider, what you are describing happens to hard working Americans  

Please google, a physician’s letter to Obama

https://www.texasgopvote.com/doctors-letter-president-obama-001816 (https://www.texasgopvote.com/doctors-letter-president-obama-001816)

If you're talking about Medicaid, that program has existed since 1965.  So I'm not sure why you would describe that program as "Biden's America" when it is also Nixon's America and Reagan's America.

I got several articles about doctors in Syria, so you'll have to provide a direct link to your right-wing chain e-mail letter about how Obama has ruined medicine in this country.

Sounds like you don't have very good insurance.

I had Covid and spent 4 days in the hospital including an ambulance ride from the local ER outpost. It cost me exactly $250. No wait to being seen. My wife aslo had Covid and spent 3 days inthe hospital and it cost us $250. No wait to be seen. This was at the height of Covid in December/January of 2020/2021.

I choose jobs based on benefits ... which insurance is a huge part of. Otherwise I could be making much more and paying like 20% copays. It isn't worth it to me especially as we get older.

BTW ... many hospitals around here in Orlando get you right in. There are some who do not and you play the waiting game but most locals know who they are.

I was wrong about the bill.  $4000 wasn't the cost of everything -- it was only the cost of the service.

The actual bill was $34,000.


To essentially get turned away.  I'm getting an itemized bill but I think the CT scan probably cost $20,000.

Dave doesn't have bad insurance by USA standards, you have outstanding insurance.  Not everyone has the flexibility to choose a job with great benefits.

I have good insurance by comparative standard, provided by the State.

My issue isn't that they only paid 3/4th of it up to the deductible.  It's the cost of the service being 34K is fucking crazy.  I didn't even get admitted.  I sat in a chair in the lobby.

You may have paid more than 1/4.  It is not unusual for the following arrangement....

Insured pays 20% of list. 
Insurance company has an arrangement that they get a discount of 78% off list.

List $1000
Insured pays $200
Insurance company pays $20.

Procedure would cost the government $50 with zero copay in most European countries.

So if the US had single-payer health care - like, say, Canada - and you didn't have to worry about co-pays, you could be making much more (and also: have increased practical freedom in choosing a job).

Interesting.

But I would be waiting a hell of a lot more and not seeing who I would like to see. Rich people in the countries you guys like to quote come to the US for treatment in many circumstances. It isn't because of our insurance programs.

Except that Dave lives in America and still had to wait, as per this thread!

So unless you're saying that flashing your platinum insurance card would have let you jump the line Dave had to wait in, we already live in the hellscape that our overpriced health insurance is supposed to prevent.

I waited 5 hours in intense pain for essentially no service, was told to see a specialist, and then he wasn't available for 3 weeks.  It wasn't ideal.

US does have an excellent heathcare system for the ultrawealthy.  I completely agree.  That is why we are the number one choice for billionaires living in third world countries.

However unless you are part of the 1% our system has longer waits, less services, and worse care than most other industrialized countries.  The wealthiest 1% of Americans can get better healthcare than all Canadian, but all Canadians get better healthcare than 99% of Americans.  Being I am not part of the 1% I would prefer the Canadian system.  

I wonder how similar Massachusetts' system is to the Canadian system.

I have never had to wait too long to see doctors.  My rates have been reasonable.

I believe Massachusetts was the first state to implement universal health care

I am legitimately worried now --

Like, not even joking, I don't think that I would ever go to the hospital ER again ever, for any reason.  If I felt the signs of heart attack and tingling, I'd probably just hope it was anxiety, because you can't risk a 34 thousand dollar bill.  And I can see it cutting my life way short, unintentionally.

There's pretty much nothing that would make me go back.

Dave, your insurance should have a yearly cap on your out-of-pocket expenditures; you may have reached it already.

I seriously doubt that you would ever be asked to pay $34k out-of-pocket for one visit, though FL is a non-ACA state so I can't say for sure.

It's not that I'm going to have to pay 34K.  I think my entire family caps at 8K out of pocket.   

But I wouldn't willingly pay 8K for what I went through.

I guess the only thing is that I didn't know what I had.  It turns out, they couldn't do anything for me.  They gave me a prescription for Advil and some printable papers on kidney stones.  No pain relief or coaching or advice on-site.

Also, it's not like they said "hey, we'd like to do this scan.  It costs 20K."  They just do shit to you and that's that.  Was it necessary to give me a 20K scan?  Kidney stones are pretty common.  We were diagnosing that long before a CT scan was invented.

It all feels like an insurance scam to me.

In general you should avoid the ER unless you have no other choice.  If your issue is an emergency you need to go to the ER.  If you can wait for primary care provider that is preferable. 

Not saying going to the ER was a mistake in this case, but if you can avoid the ER it is better.  Your wait was in large part because triage decided that someone else needed treatment now for something life or death and your condition was not life or death. 

I am not someone who goes to the ER.  I'm 44 and have never been in my life until now.

I was crawling around on the floor like a dog after many, many hours of excruciating suffering.  I didn't even go to stop the pain.  I went because I didn't know that the pain would eventually stop and feared that something was very wrong with that.

It sounds like you went to a shit hospital Dave. I've had kidney stones twice and generally they have a good idea that's what they are dealing with very quickly, they still doped me up very good. Provided they determine it's small enough to pass that's all the treatment there is to be had. I was at least put into rooms.

And that's another issue.   Why is a CT scan $20,000?

So do you have to pay $34k or is your insurance covering some of it and that's the total charge?  My wife and I had our first kid a few months back and we were in the hospital for 3 days, it didn't cost this much total before insurance kicked in.

Because there is no one in our for-profit healthcare system with a vested interest in containing healthcare costs, which is why healthcare costs far more in the US than in any other country.

In other countries where the government pays for healthcare, there are auditors who challenge medical providers when they claim crazy costs for services, because those services are paid for by taxes and voters are extremely aware of who to blame when taxes go up (politicians).  But here, insurance companies don't care; they simply pass the costs on to the insured, and when health insurance premiums go up, people still blame politicians instead of blaming the healthcare insurance companies or the medical industry.

There is, of course, one prominent counter-example to the idea of government keeping costs down that many people are familiar with: the military.  I'm sure plenty of ex-military on this forum can regale us with tales of $40 screws or $2000 shelves.  And the reason for that is simple: there is no constituency in this country for controlling the costs of our military, so the exact same dynamic applies for the military as it does for private healthcare insurance companies.

Health insurance is the single most worthless industry ever conceived.  There's a 100% usage rate, everyone at some point needs health care. It's not optional, and there's no competition. It's the worst industry ever conceived of, only surpassed historically by the tobacco industry.

I certainly don't have to pay $34K myself out of pocket.  But the fact that that's getting charged anywhere is a scam -- the rates are unsustainable and it's getting paid by everyone.  They're ripping it off of somewhere.

But I'll probably end up paying 8K or something nuts, unless I can dispute it.  I have to get an itemized list.

Just shaking my head at just how bad that is over there compared to this corner of the world, and in so many ways...

Around 25 years ago I also had a bad episode with a kidney stone at about 4am in the morning in the same sort of pain Dave is describing. My brother took me to the public hospital where I was quickly admitted to a cubicle in emergency, examined and shot up shot up with Pethidine, and diagnosed with the problem (I think a urine test which had blood in the sample confirmed it) and was released that same day with an appointment to see a urologist plus a follow up IVP test to determine the size and position of the stone. No charge, apart from the cost of the pain relief tablets I was supplied by the hospital chemist to get me through to the specialist appointment and test (which were a LOT stronger than Advil).

Just over 10 years ago I had a tumor, and as part of the follow up I had to have CT scans with contrast for five years to make sure it did not return (at first every month, then every six months, then every year). Full cost for each one up front was about AUD $900 per scan, after Medicare it ended up being about $140 out of pocket each time. Allowing for medical inflation (which is always a LOT more than regular inflation) I wouldn't expect the full cost to be more than AUD $2-3K now before any subsidy... which would be probably around USD $1400-1700 each.

It's shocking that Dave was stuck in the waiting room - yet charged like a wounded bull as an admitted patient (with a decided lack of patient care). There's no way that would happen here, no matter how overloaded the hospitals are (and they are also struggling here right now with both Covid and Flu admissions during our winter). Arranging a CT scan may be a thorough diagnostic tool, but seems overkill considering the situation - and then there's the cost: USD $20K!!! My jaw dropped at that!

We have a bit of a two tiered system here - yes there is a basic universal healthcare for emergency procedures at public hospitals, and most GP visits. But if you earn over a certain amount you are taxed higher to encourage you to take out private health insurance. If you wait until after you turn 30, the cost of doing it increases, which again encourages people to pay for it before then. Non essential elective surgery (like knee or hip surgery) either has a typical waiting time of years to be eligible for free treatment, or you pay top dollar to have it done immediately through the private system - unless you have private health insurance which covers most (if not all) the cost. It ain't perfect, but it's a hell of a lot fairer and a lot better than what it sounds like in the USA.

Dave, depending on the size and position of the kidney stone, you will likely be given a couple of choices. If it's small enough you will be given a couple of weeks to drink a lot of water and piss it out (like I did) or the urologist will stick a probe up... you know where, to retrieve it (thankfully I pissed it out before then). If it's a large stone like my father once had, they can bombard it with ultrasound to break it up, and then it will come out in your urine like fine gravel. From what you described about your medical system over there, that could cost you $$$

Once you go through an experience like this you will never forget it, and you will pick the causes and warning signs - and then start upping your water intake. Usually it's do to lots of calcium and acid in the diet - and sometimes things you don't think of, like regular taking of Vitamin C tablets for years. The first signs are blood in the urine which you can pick by the darker color and really funky, pungent smell (to me it smells like an orange and passionfruit juice mix). Once you smell that and/or getting a few pains in the back, it's time to hit the water...

All I can say is welcome to the club Dave - and rest easy, it hurts like a bitch but it's not fatal and can be manageable. Good luck!

OK, I've held off from publicly talking about my health, but this thread (and the experience that Dave has detailed here) is sort of bringing it out...

I am a military veteran. I did 6-1/2 years in the Army during the cold war, breaking code from Soviet spetsnaz units in Eastern Europe. I have been out a very, very long time...1987 was my ETS (end tour of service). I am now 58 years old.

I was diagnosed about 4 years ago with extremely high blood pressure during an exam for an injured knee... 215/125. The FL hospital even made me sign an AMA (against medical advice) waiver before they let me leave, because as the doctor said "You could have a stroke walking out the door."  My general medical philosophy at the time was the same as it had always been..."rub some dirt on it, walk it off."

Well, that shit didn't really work.

Fast-forward 3-1/2 years to January of this year, and my problems turned serious. I started experiencing symptoms of vertigo, loss of muscle strength and swelling of my extremities. I was also having this little problem of "help I've fallen, and I can't get up!" After a couple of months of this (Did I mention I was an idiot?), I finally checked myself into a hospital. The diagnosis...severe kidney failure, and after tests, several aneurysms on my aortas. I spent 9 days in the hospital, the first two days, mostly unconscious and (according to the doctors) very near to death. I was put on all sort of medicine and had around the clock testing and monitoring. I literally woke up two days later to find my mother (my "emergency medical contact) sitting in tears at the foot of my hospital bed, praying for my survival. She had driven down from South arolins "just in case."

I was released by the hospital once they got my BP down to a semi-reasonable level (which for me was 180ish over 90-something). They prescribed a period of "home care nursing," and I came to an agreement with my family that I would move from Florida to my original home of Northern Arizona (Prescott)and stay with my sister (who had a background of healthcare and nutrition) who also had an easily schedulable job (world class photographer), so she could make sure I got to all my med appointments. She also lived very near a very large VA facility, which I qualified for, due to my former military status. At this point, I could barely walk with the use of crutches, and my medication intake was about 22 pills a day of various BP meds and other stuff.

Since I arrived in AZ in March, I have had 3 months of regular medical appointments with the VA, and many treatments/consultation appointments with non-VA specialists that were referred by the VA. I also have had 2-3 times a week physical therapy sessions and appointments, including MRI's and CT scans.

Getting to the point... The total cost of my 9 days in a FL hospital came to $8,713. I had Cigna insurance through the Obamacare care program. My cost since moving to AZ and having my treatment run through the VA...including the abnormal amount of prescriptions:  $254. Yes that is two hundred and fifty four dollars.

I recently had an ultrasound that revealed that I had a large cancerous mass on my right kidney, and that one of my aneurysms had expanded to the point where I will likely need to have both surgically removed. From what I have been told from my veteran's advisor, this will be done at virtually no cost.

Medically, I count myself blessed, as there would have been no way I could afford the mammoth amount of medical costs associated with my situation had I not been with the VA.

Sorry to about your medical issues, Sunstroke (and Dave, as well).
Hope you both have the best recovery you can.

I'm just floored that essentially 3 tests from a hospital waiting room costs anyone (whether I pay it or some insurance carrier does) $34K.

That's broken.

I fully support socialized medicine.  This system is so dumb.

I was floored when I read about your situation, and my sister (who really-really knows much more about medical insurance than I) was left shaking her head.

I definitely agree with the socialized medicine opinion. After nearly 60 years, experiencing the world in so many areas, the two words I keep coming to describe my beloved US of A are "corruption" and "greed."

Its broken because the hospital knows no one is paying that bill.  The insurance company "negotiated rate" is around 20% of the cost, so the actual bill that they pay on your behalf for that test is probably around $4k.  Your EOB should outline the actual money paid.  I believe the unregulated and innsane expenses of these are artificially inflated because of this "negotiated rate" - like when you sell list something for sale on Facebook Markeplace for double your real price, knowing you're going to get low-ball offers.

Can I get some clarification?

Was that Florida bill before or after insurance?

Why does the va not apply down in Florida?

If you didn’t get help through the va, what would the Cigna bill have been in Arizona?

Hope everything gets better

Stupid iPhone messes my words up

Had to edit this post twice

My apologies

I have asked Cigna and Boca West Hospital that same question multiple times. I haven't gotten any answer that is clear. They simply send me the same bill over and over.


I'm sure it would have, but I never went to the VA in Florida


No idea, but I did find out that the policy I purchased in FL was no longer valid once I moved to AZ. It was specifically for FL

I got an itemized bill.  Everything on it is crazy.

But one single CT scan cost $24,107.00

OK, so after talking to all the parties, here's what's going on:

The hospital is just charging crazy shit to write it off, essentially.
They just charge whatever crazy shit they want.  $5000 is the high end for the scan that I got.   This hospital billed over 24K.
My insurance company (and presumably all insurance companies) have a "contract" with the hospital, so my bill is discounted $30,000.  ...then, insurance pays their portion (in this case, $3000something.)  I pay the remainder, which is $925ish.

So, it's bullshit books-cooking, it sounds like.

To be perfectly honest: I have no idea what a "reasonable" price for a scan is in the first place.
So you tell me that $24K is unreasonable, $5K is the high end, and $3K is what they actually charged.  How long did the scan take?  What does $3K convert to in an hourly wage?

The prices are all just made up, man.

You can check the "self pay" prices at any clinic that offers CT scans. In the Miami area, prices seem to start around $300 for a simple non-contrast CT scan. Or you can use a price comparison site like:

https://www.newchoicehealth.com/places/florida/miami/ct-scan/

Yeah, I'm aware that cash prices for medical services are much less (having spent most of the '00s without health insurance).  But the prices are still completely arbitrary across the board.

On what basis can we, as laymen, say whether a CT scan should be $300, $3000, or $30K?  What's the difference between a CT scan that is price gouging, and a CT scan that is too cheap to be sustainable without being subsidized by overpayments from insurance companies?

I'm not arguing with you, but the fact there is a "cash price" and an "insurance price" is fucked up.  A few years ago I read an article about a guy that if he needed medical services he would tell the provider he didn't have insurance to get the cash price, which ended up being cheaper than the co-pay or deductible he would owe.  Then he would turn the payment into his insurance company to be applied against his annual deductible.  It's messed up that people have to go to these lengths.  I'm against universal medical care, but the healthcare industry is in need of regulation.

That's a dangerous game.  If the insurance company denies your claim, you have effectively uncapped your maximum expenses (beyond your annual deductible).