Better be an Emergency If You Go to the ER

[Pohemi]

Slightly different situation from an ER visit, but...reimbursement denials for emergency services are nothing new.

Fifteen years ago...I woke up at 4am one morning with my face and neck swollen and puffy (allergic reaction to shellfish...bit of prawn shell stuck in my teeth/gums).
I felt like my breathing was becoming harder (throat was tightening), so I called 9-1-1. EMTs arrived and shot me full of Benadryl, and stuck around long enough to ensure that I was okay.

Welp...my HMO (assigned through a state Medicaid program) decided that it hadn't been a legitimate emergency, and refused to pay the bill of $2600. For an ambulance to show up and allow me to breathe again. Great.

So yeah...United Health might be making this policy now, but this has been done for years (by far more than just United Health) when and where they are able to get away with it...it's nothing new.

Also: pretty sure it was United that my HMO was with at that time, coincidentally...

 

[ondma]

I 100% think our healthcare system needs major overhaul and we need universal healthcare like all other first world countries. We need single payer system and not let for profit insurance companies run the healthcare in our country.

I fall into not being rich enough to afford great health insurance and but not poor enough to receive Medicaid. So my family was in "you can all fuck right off and die" category. My family went many years without having health coverage. I weighed pros and cons of going without coverage and prayed we wouldn't have any major medical emergencies. Have you gone for years without medical coverage because it was too expensive? I bet you haven't. I have and it sucks major donkey dick. Do you know how I received checkups and medical care? I traveled outside the US and received checkups and healthcare during vacations because the cost in the US was too expensive without medical insurance. I know many people who do this. You can preach from your high horse but I'm betting you haven't experienced high cost premiums of our health care and never had to make life choices based on it.

Even today, I pay $1,050 a month for the shittiest bronze health plan for my family of 3. We're still relatively young so that's actually pretty low premium compared to other older families. I pretty much have this shitty health plan only as catastrophic insurance. So how much do you pay for your health insurance?

I pay almost 800 dollars a month for a family of 2. I could somewhat accept that if it provided full coverage. Problem is, there are co-payments and deductibles. Even in a year with no major healthcare issues, I can pay several hundred or even a couple of thousand more on top of the premium. Any kind of serious incident that requires surgery or in hospital care will easily push the co-pays to the catastrophic limit of 5000.00.

 

[darkswordsman17]

This thread is already all you need to know why America's health care system is so fucked up and nothing will change it.

 

[Muse]

Modern day US health care for you. Hospitals ripping off insurers, insurers ripping off customers, FDA approving snake oils, while the government is too captured or broken to fix anything.

We need universal health care in America. Any informed clear thinking person knows this.

 

[Muse]

everyone else just pays more. you usually get what you pay for in life right? go figure that your over priced insurance shouldn't pay for the hypochondriacs frequent visits to the ER thus raising the bill even more for insurance.

Hypochondria is itself a disease, very nasty and insidious.

 

[MtnMan]

Our health care system is damn good if you’re rich and can afford care, old and covered under Medicare, or poor and covered under Medicaid. We’re nothing like third world country. Travel to third world country and experience their health care. No amount of money will provide you with great health care in third world country.

The care that the rich can receive is probably some of the best in the world. That is "care", not the "system". The US is a third world country as the "system" is broken. There is a significant part of the population in your city, my city, and everywhere else that basic healthcare is out of their reach.

Lose your job, for whatever reason, and break your leg the next day, you will be filing for bankruptcy as soon as the "healthcare system bills" come in the mail. Sure you get your leg mended, but at what cost? Your home, your savings, retirement fund, your future, your kids' college fund? This is what happens in third world countries, including the US.

In third world countries, many people cannot afford the medication necessary to keep them alive. People in this country are dying because they can't afford life-saving drugs, like insulin. But that "system" allows big pharma to pour millions of dollars into support of politicians that further protect their golden egg laying goose.

 

[NTMBK]

How the hell have you lot not had a revolution. The corporations treat you like cattle.

 

[killster1]

The care that the rich can receive is probably some of the best in the world. That is "care", not the "system". The US is a third world country as the "system" is broken. There is a significant part of the population in your city, my city, and everywhere else that basic healthcare is out of their reach.

Lose your job, for whatever reason, and break your leg the next day, you will be filing for bankruptcy as soon as the "healthcare system bills" come in the mail. Sure you get your leg mended, but at what cost? Your home, your savings, retirement fund, your future, your kids' college fund? This is what happens in third world countries, including the US.

In third world countries, many people cannot afford the medication necessary to keep them alive. People in this country are dying because they can't afford life-saving drugs, like insulin. But that "system" allows big pharma to pour millions of dollars into support of politicians that further protect their golden egg laying goose.

in third world countries medications are dirt cheap, in third world countries you wont get your leg fixed with out paying ahead. You dont have to pay your bills or skip college if you get a medical bill dont be so silly.

 

[MtnMan]

in third world countries medications are dirt cheap, in third world countries you wont get your leg fixed with out paying ahead. You dont have to pay your bills or skip college if you get a medical bill dont be so silly.

Tell that to the 500,000 that file for bankruptcy every year due to medical bills.

Do Medical Bills Really Bankrupt America's Families?

Medical bills can cause bankruptcies. Medical costs impact both household finances and the economy as a whole.

www.thebalance.com

'I live on the street now': how Americans fall into medical bankruptcy

Having health insurance is often not enough to save Americans from massive debts when serious illness strikes

www.theguardian.com

Stop being so obtuse or naive.

 

[killster1]

Tell that to the 500,000 that file for bankruptcy every year due to medical bills.

Do Medical Bills Really Bankrupt America's Families?

Medical bills can cause bankruptcies. Medical costs impact both household finances and the economy as a whole.

www.thebalance.com

'I live on the street now': how Americans fall into medical bankruptcy

Having health insurance is often not enough to save Americans from massive debts when serious illness strikes

www.theguardian.com

Stop being so obtuse or naive.

people go to the ER for cancer!? if you throw insults at the end of your post it makes you sound right? or even on topic?

 

[MtnMan]

people go to the ER for cancer!? if you throw insults at the end of your post it makes you sound right? or even on topic?

I wasn't insulting you, I was merely describing your perception of health care in this country.

And yes, when they can't get (afford) timely treatment or management for cancer, they often end up in the ER at some point.

 

[Fenixgoon]

we are talking about the ER and you are talking about the price of epipens and insulin? imagine a emergency room people go for emergencies, yea yea I'm picturing it, you are worried they will overcharge you while saving your life? If its not a emergency then the price SHOULD be high at a emergency room. or have we switched to the topic of insurance and hospitals charging to much?

"you get what you pay for" doesn't apply strictly to ER visits, so i am talking about the broader aspects of price-inelasticity, healthcare economics, and how the cost of care can be reduced.

If you need life-saving care or life-saving medicine, you have no ability to choose or negotiate, because you need it. That means that hospitals, pharma companies, insurance, and whoever else CAN charge absurd amounts, because you need the care (or medicine) or you'll die.

if people get preventative care, that means fewer people go to the ER for non-emergency visits AND fewer things turn into emergencies because people get the care they need in the first place. This means fewer ER visits AND a more efficient ER for those that do need it. Win-win.

i'm not criticizing on any one thing, i'm criticizing the entire system.

 

[ponyo]

I pay almost 800 dollars a month for a family of 2. I could somewhat accept that if it provided full coverage. Problem is, there are co-payments and deductibles. Even in a year with no major healthcare issues, I can pay several hundred or even a couple of thousand more on top of the premium. Any kind of serious incident that requires surgery or in hospital care will easily push the co-pays to the catastrophic limit of 5000.00.

That's the part that really irritates me. It's not like the monthly premiums we pay are low. From worldwide perspective, we're paying crazy monthly premiums. Yet, we're getting major shaft in coverage. My deductible is like $12k a year and something like 35-40% co-pay. Something ridiculous like that. Like I said, I just keep it as catastrophic coverage. I don't really use it at all. I've been trained all my life to avoid the ER and avoid hospitals unless I'm dying because I always had the fear I couldn't afford it. That's no longer the case, but I still exercise the same fear. I've been programmed by the system to not seek medical care in this country.

 

[Fenixgoon]

That's the part that really irritates me. It's not like the monthly premiums we pay are low. From worldwide perspective, we're paying crazy monthly premiums. Yet, we're getting major shaft in coverage. My deductible is like $12k a year and something like 35-40% co-pay. Something ridiculous like that. Like I said, I just keep it as catastrophic coverage. I don't really use it at all. I've been trained all my life to avoid the ER and avoid hospitals unless I'm dying because I always had the fear I couldn't afford it. That's no longer the case, but I still exercise the same fear. I've been programmed by the system to not seek medical care in this country.

even the most conservative estimates indicate that for the amount we spend on healthcare each year, we could actually cover the entire population under UHC. that's how inefficient our system is.

and as for the bolded, you are far from alone. it's yet another thing that contributes to poor health outcomes in the US.

 

[Muse]

How the hell have you lot not had a revolution. The corporations treat you like cattle.

TBH, I thought that revolution was in the offing in 1970, that is to say within a few short years of then. But it didn't happen, and I was dismayed and disappointed to observe the cooptation that transpired.

It's like Iggy Pop said some years ago: You have it rough, really rough but they have you hypnotized into thinking you have it great. And it's all about the Almighty Dollar. They hang that out in front of you, a dangling carrot, the idea being that it can buy you anything, anything you want, anything you need, your heart's desire. "Introducing," "hurry on down," "whiles supplies last," "no money down," "see what you can get for your accident."

The corporations have twisted the public's perceptions. What is good is bad, what is bad is good. It's called cooptation.

In sociology, co-option refers to a trend or idea being incorporated into mainstream culture; see also Cultural appropriation. Cooptation may also refer to the tactic of neutralizing or winning over a minority by assimilating them into the established group or culture.

In co-opting a grievance it's watered down, neutralized, glossed over, made to seem quaint, peripheral, someone else's concern, doubted, insignificant in the grand scheme of things, even fodder for entertainment.

Any trend or proposal that doesn't honor the Almighty Dollar ethic is characterized by the Republican establishment (which has dominance in that party) as "socialist," even communist, extreme, and radical and not honoring the IGMFY ethos they so extoll and are committed to staunchly supporting in sheltering the exploitative rich, whose support they depend on to keep them in power. The super rich and the Republican Party are joined at the hip in America. There's a whole lot of obfuscation going on to obscure this.

 

[killster1]

I wasn't insulting you, I was merely describing your perception of health care in this country.

And yes, when they can't get (afford) timely treatment or management for cancer, they often end up in the ER at some point.

you def insulting, and how many people with cancer go to the ER? what exactly do you think they go to the ER for after a cancer diagnosis? this country is way to big for communist health care.

 

[MrSquished]

you def insulting, and how many people with cancer go to the ER? what exactly do you think they go to the ER for after a cancer diagnosis? this country is way to big for communist health care.

I guarantee you have zero idea what communist healthcare is, because it's nothing that anybody is seriously proposing for the US. You just fling that word about like an ignorant right wingger because that's what your puppet masters on TV and in office tell you to do.

 

[MtnMan]

you def insulting, and how many people with cancer go to the ER? what exactly do you think they go to the ER for after a cancer diagnosis? this country is way to big for communist health care.

They don't have the diagnosis, because they can't afford the doctor visits, tests, biopsies, etc., for a diagnosis. When the symptoms/pain become unbearable then they go to the ER.

Or if they do have a diagnosis and surgery/chemo/radiation are $200,000 to $1,000,000 they just go home. Then when symptoms/pain become unbearable they go to the ER.

This country is way too big to not have universal health care for everyone. But that would mean that health care executives and big pharma could not amass personal fortunes of personal wealth and be paid 10s of millions every year as a salary. Do you really want to deny these people their 100' yachts? How selfish of you.

 

[killster1]

They don't have the diagnosis, because they can't afford the doctor visits, tests, biopsies, etc., for a diagnosis. When the symptoms/pain become unbearable then they go to the ER.

Or if they do have a diagnosis and surgery/chemo/radiation are $200,000 to $1,000,000 they just go home. Then when symptoms/pain become unbearable they go to the ER.

This country is way too big to not have universal health care for everyone. But that would mean that health care executives and big pharma could not amass personal fortunes of personal wealth and be paid 10s of millions every year as a salary. Do you really want to deny these people their 100' yachts? How selfish of you.

you know this first hand about people going to the ER for pain caused by cancer, or perhaps you are just making it up?

 

[NWRMidnight]

you def insulting, and how many people with cancer go to the ER? what exactly do you think they go to the ER for after a cancer diagnosis? this country is way to big for communist health care.

I am going to insult you.. you are fucking heartless idiot. Dumb as a fucking rock! My dad died from cancer two years ago. He was in the emergency room multiple time AFTER his diagnosis with cancer because other systems in your body start to shut down as the cancer evades your body, causing a laundry list of problems from heart issues to breathing issues, which can lead to passing out in the middle of the parking lots etc. AS well as reasons directly due to the cancer itself. But yeah.. your so fucking brain dead you think people with Cancer should just give up... Go fuck yourself! (yes, you hit a nerve you piece of trash!)

So, STFU and pull your head out of your ass, There is NOTHING Communist about Universal Health Care, and no this country is not to big for it. (BTW, my dad had great health insurance... And my mom still had to deal with shit for over a year over his treatment.. But that is another argument you are to stupid to understand) Yet you can't even understand how people who don't have health insurance, or crappy insurance coverage would have the need to go to the ER. Talk about being brain dead and stupid as fuck!


Mods: Sorry if this post is over the line, but sometimes people need to hear the truth on how purely evil and stupid they are!

 

[killster1]

I guarantee you have zero idea what communist healthcare is, because it's nothing that anybody is seriously proposing for the US. You just fling that word about like an ignorant right wingger because that's what your puppet masters on TV and in office tell you to do.

i dont know what communist healthcare is because its nothing that anybody is proposing!? OH OK thats how it works? we just need more people to die, to many people bringing us down with cancer they cant afford~! this covid was suppose to help with that but it really hasnt helped enough. people should pay for what they get. If they cant afford to pay then everyone else should pay for them right? but then if no one is paying the quality of service goes down and people start to look where they can get quality service even if they have to pay extra.

 

[MrSquished]

i dont know what communist healthcare is because its nothing that anybody is proposing!? OH OK thats how it works? we just need more people to die, to many people bringing us down with cancer they cant afford~! this covid was suppose to help with that but it really hasnt helped enough. people should pay for what they get. If they cant afford to pay then everyone else should pay for them right? but then if no one is paying the quality of service goes down and people start to look where they can get quality service even if they have to pay extra.

My 9 year old niece could make a more cohesive argument than that. This is the problem with righties, their puppet masters give them keywords to use like communism and socialism bad, but they simply don't have the knowledge or critical thinking ability to understand what anything actually means or is.

Just call anything communism and the rubes will follow the pied Piper.

 

[killster1]

I am going to insult you.. you are fucking heartless idiot. Dumb as a fucking rock! My dad died from cancer two years ago. He was in the emergency room multiple time AFTER his diagnosis with cancer because other systems in your body start to shut down as the cancer evades your body, causing a laundry list of problems from heart issues to breathing issues, which can lead to passing out in the middle of the parking lots etc. AS well as reasons directly due to the cancer itself. But yeah.. your so fucking brain dead you think people with Cancer should just give up... Go fuck yourself! (yes, you hit a nerve you piece of trash!)

So, STFU and pull your head out of your ass, There is NOTHING Communist about Universal Health Care, and no this country is not to big for it. (BTW, my dad had great health insurance... And my mom still had to deal with shit for over a year over his treatment.. But that is another argument you are to stupid to understand) Yet you can't even understand how people who don't have health insurance, or crappy insurance coverage would have the need to go to the ER. Talk about being brain dead...


Mods: Sorry if this post is over the line, but sometimes people need to hear the truth on how stupid they are!

feel free to say anything you want the only thing off limits is to call someone a moderator! (last time it got me 4 weeks ban!)

So when you go to the ER with cancer because you have breathing issues what do they do for you? I have several people close to me die of cancer but none of them visited teh ER frequently.

Your failure to understand that, after numerous infractions for the offenses, mod baiting/callouts are not allowed is dismaying. Hopefully your time away will help with that.
admin allisolm

 

[MtnMan]

you know this first hand about people going to the ER for pain caused by cancer, or perhaps you are just making it up?

Yes... so fuck off

 

[killster1]

My 9 year old niece could make a more cohesive argument than that. This is the problem with righties, their puppet masters give them keywords to use like communism and socialism bad, but they simply don't have the knowledge or critical thinking ability to understand what anything actually means or is.

Just call anything communism and the rubes will follow the pied Piper.

im not the one arguing it was a quote from you. So funny that you call me political yet i have never voted before does that really make me a right winger?