I shared my toddler's hospital bill on Twitter

https://www.vox.com/first-person/2017/7/7/15934752/health-insurance-heterotaxy-twitter

by joshrotenberg • 9 years ago

60 46 9 years ago

mnm1• 9 years ago

It's depressing to me to think that people hate others so much that they would go to such great lengths to keep others from getting healthcare and ensure their demise. These same people would have no problem accepting healthcare from others if it was their lives that were in danger. I truly cannot fathom the hypocrisy, hate, and cruelty that must exist in these people's hearts towards their fellow citizens.

divbit• 9 years ago

It is really such a sad story - I'm glad that this mother seems to have been able to get her costs down at least (if I read the story correctly), sad that probably there are others that can't. We must all learn to love and forgive one another

wyager6• 9 years ago

In what way does wanting to keep what I earn mean I "hate others"? I feel sad when I walk by homeless people, but I don't stop and give them everything I can afford until I'm impoverished. Do you? If not, why do you hate others so much that you want to "keep them from getting housing"?

Hopefully you see why your argument is disingenuous. If you're really so hard on hypocrisy, you should go out right now and give every last penny to someone else's medical expenses. Or are you only generous enough to spend other people's money?

siidooloo• 9 years ago

Maybe you didn't read the story but people were sending her death threats.

nicky03• 9 years ago

No one is suggesting anyone should give every last cent to others.

The idea is that if everyone gives a small amount, then a large amount becomes available those unfortunate few that need it.

Aloha• 9 years ago

Part of why healthcare is so expensive today, is we're capable of saving so many more lives than before. As little as a generation ago, many more would have died, people who now go on to live fruitful productive lives.

toomuchtodo3• 9 years ago

America spends more per capita than any other first world country for worse outcomes [1]. Healthcare is expensive because of the profit motive. Single payer isn't implemented for (mostly) the same reason.

60% of Americans want single payer [2].

"A majority of Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage. And a growing share now supports a “single payer” approach to health insurance, according to a new national survey by Pew Research Center.

Currently, 60% say the federal government is responsible for ensuring health care coverage for all Americans, while 39% say this is not the government’s responsibility. These views are unchanged from January, but the share saying health coverage is a government responsibility remains at its highest level in nearly a decade.

Among those who see a government responsibility to provide health coverage for all, more now say it should be provided through a single health insurance system run by the government, rather than through a mix of private companies and government programs. Overall, 33% of the public now favors such a “single payer” approach to health insurance, up 5 percentage points since January and 12 points since 2014. Democrats – especially liberal Democrats – are much more supportive of this approach than they were even at the start of this year.

Even among those who say the federal government is not responsible for ensuring Americans have health care coverage, there is little public appetite for government withdrawing entirely from involvement in health care coverage. Among the public, 33% say that health care coverage is not the government’s responsibility, but that programs like Medicare and Medicaid should be continued; just 5% of Americans say the government should not be involved at all in providing health insurance."

Emphasis mine.

[1] http://www.npr.org/sections/goatsandsoda/2017/04/20/52477419...

[2] http://www.pewresearch.org/fact-tank/2017/06/23/public-suppo...

jquery• 9 years ago

Are "worse outcomes" controlled for lifestyle choices, demographics, and obesity? Or is it a stepping stone to a soapbox?

ajmurmann• 9 years ago

I used to be for single part until I listened to a recent episode of econtalk (http://www.econtalk.org/archives/2017/06/christy_ford_ch.htm...). Christy Ford described how the current medical system evolved and how the American Medical Association made the current, insurance based system happen. Before this we used to for example multi-disciplineray offices of doctors that you could directly buy health care coverage from. That was made illegal. What we currently have is the worst of any world. It's a artificially constrained market that's practically devoid of competition. On top of that we have insurance which is clearly the wrong model for something you know you are going to need. And it's employer provided on top of it. How could this market possibly be less functional? Let's try to fix the market before we pour out the baby with the bath water.

wyager6• 9 years ago

Having used healthcare in a wide variety of settings, super-deregulated private healthcare in countries like India, Mexico, etc. is vastly superior to government-run healthcare or the US's red-tape-choked "private" healthcare system.

I just pay for everything under the table with cash and it's much cheaper. If doctors can avoid American "insurance" providers (which are not allowed to function as actual insurers, and have to keep margins up by being as stingy as possible), they can save a lot of money and effort.

hkmurakami2• 9 years ago

It was eye-opening to see just how low our discourse has sunk, to be forced to acknowledge that what passes for debate in the age of the internet is often nothing more than spewing venom at the other side. How are we ever supposed to find a solution that’s better than either Trumpcare or Obamacare if we can’t even shut up long enough to recognize the humanity in the people on the other side of the debate?

So people on one side of the fence are not happy about the very high medical costs required to keep a child alive. They do not understand the humanity behind the numbers.

On the other side of the fence are parents who are not happy that some people think their child is an excessive burden on the system. They (understandably) do not understand (or at the least, are looking away from) the numbers behind making their child viable.

The author correctly identifies one side's shortcoming wrt balanced discourse, but does not see the blindness of her own implied position -- that no cost is too high to save a life. Nowhere in this piece does she broach the subject of numbers and real cost [1].

Finding balance is very difficult in any area, especially in areas where you only have _one shot_ (an example is your child's education, where many parents feel that no amount of investment is enough, and more is always better). But since the system does not have infinite resources, it's a necessary conversation to have (which the author could have brought up, but failed to do so -- understandably, since this article is a strategic opinion piece meant to further the author's self-interest, which I completely respect).

A billion dollars to save a child's life, we would likely agree, is too much. $1,000, we would likely agree, is entirely justified. Where we draw the line, why, and how we get there (of urgent need is our relationship with end of life care and treatments) is an important conversation that we are failing to have, and those of us on both sides of the fence are equally culpable for this shortcoming.

[1] The large 6 figure bill and post insurance $500 bill is only used qualitatively in the introduction.

lstamour2• 9 years ago

Who sets the numbers and why, though? How much is profit, how much should be profit, when it comes to human health and rehabilitation whether mental or physical assistance is required? Or, ignoring profit, why take away public funding to programs for poor people just to provide tax breaks to rich folks? How much is a dollar worth to each individual, relatively-speaking? There are few easy answers, except (almost) everybody wants to see costs lower to the levels they are in other countries. Setting price or profit caps and limits is one method, ensuring the system can’t ask for inflated amounts from insurers is another. This could affect quality of service, but then again, it might not. All stores might charge the same price for some brand name item but not all stores offer equal customer service or trained staff... The same is surely true of medical facilities.

RcouF1uZ4gsC2• 9 years ago

Just to provide tax breaks to rich folks

Your statement illustrates one of two competing views. The following statements are extremes of the two positions.

1) The government by default owns all your money, and any money you get to keep after taxes is just a tax break.

2) You own your money by default, and the government should not take your money except to provide things that the market is unable to (some examples of which are law enforcement, military).

Those who espouse one of these views, tend to see people who espouse the other as morally wrong and evil.

wyager6• 9 years ago

Profit doesn't need to have anything to do with it.

It doesn't make economic sense to spend, as an extreme example, $500M of public money to save one life. If we did whatever medical treatments we could, at whatever cost, we'd go broke as a society very quickly.

Utilitarian optimization places some upper bound on the amount of money we should be willing to spend to save a life. Making people pay for their own care approximates this bound but with more variance.

nicky03• 9 years ago

Where do you think the money goes? You write as if money is wasted or destroyed when it is spent on treatment.

RcouF1uZ4gsC2• 9 years ago

Based on the background of the mother, she would have been able to have had insurance even without Obamacare, and would have still been able to have insurance no matter what the Republican Congress passes. In this situation, no matter what the government did, her child would still have been able to get the necessary surgery.

In addition, Boston Children's Hospital is one of the premier hospitals in the world. Given the specialized nature of the problem and the fact that heterotaxy cases are pretty rare, even without insurance, the chances are high that the child would still have been treated and the hospital would have eaten the cost.

Thus, pre/post/no Obamacare, the child still would have had the treatment. Thus, you cannot derive a political position from this case.

hkmurakami2• 9 years ago

I am assuming that your statements are correct.

However, if we examine the author's motives, she seeks a society where any child who shares her son's ailment (or other life threatening but treatable -- albeit expensively -- diseases) can receive treatment, whether or not they share her fortunate circumstances or not.

In that light her rhetorical strategy remains reasonable.

secabeen• 9 years ago

I'm not so sure that's true. While it's likely that the mother would have had insurance pre-Obamacare, it could have very easily had a lifetime maximum. Given that this is his 4th surgery (at $200k each), plus NICU and other costs from his birth, and they are probably looking at at least $1mil in total expenses so far. In a pre-Obamacare world, they could be reaching the end of the funds available for his care.

quantummkv• 9 years ago

Am i missing something in here or are the costs in that bill really this high? $22,526 for room boarding for 2 weeks? Over here in India my grandma's bypass surgery costed somewhat about $10,000. That included everything including the stent, medicines and boarding, that too at a renowned, premiere private hospital.

Is this a special case or are healthcare costs generally this high in America?

justboxing• 9 years ago

are healthcare costs generally this high in America

Yes they are ridiculously high, even after factoring in cost of living / currency rates or as a %age of monthly salary, if you are comparing it to costs in a different country. 1 month after coming here (to America) from India (1999) I had to get wax from my left ear cleaned as it was blocking my hearing.

They squirted some liquid in my ear and got the wax out. 2 weeks later, I got the insurance Statement. It cost $ 800. I was astonished. In India a year before, I'd paid a Doc 100 Rupees (at that time, $2 equivalent in USD) for the same exact thing.

A month later, I had a chest x-ray taken, and some weird quirk in insurance it wasn't covered. So I had to boot the bill. $ 576 for 1 single chest x-ray. My take home at that time as a software engineer was about 2500 / month after tax and deductions, so this was 23% of my paycheck!

Health Insurance coverage is too closely tied to employment. In order to get continued coverage, you are more or less working "for the man" till you die.

tehlike• 9 years ago

If you or on high deductible plan, consider hsa :)

dogma1138• 9 years ago

That's what you get when most bills are either unpaid or paid at cents on the dollar by insurance companies.

pravda• 9 years ago

$ 576 for 1 single chest x-ray

Well, that's just a rip-off price.

Health Insurance coverage is too closely tied to employment. In order to get continued coverage, you are more or less working "for the man" till you die.

At age 65, you can enter the single-payer system!

anilgulecha• 9 years ago

Apropos the topic at hand, I want to post a picture I recently took at a hospital here in Bangalore, outlining patient rights.

http://imgur.com/a9axFK2

The first one is the right to an informed choice, including information upfront about the price of treatments.

everdayimhustln2• 9 years ago

In America, hospitals mostly charge whatever they want.

HillRat• 9 years ago

Specifically, the chargemaster rates for uncovered "off the street" procedures are essentially unmoored from the negotiated and mandated prices for the same procedures from payers. Quite a few "doc in the box" urgent care clinics will be happy to bill you $1,200 for your out-of-network hangnail procedure.

mettamage• 9 years ago

I once read a blog post of an American doing medical tourism to India. I can't find it now, but I think Americans agree with you.

koonsolo• 9 years ago

Because it's so easy to sue in US, doctors and hospitals need to pay a lot to insurances.

b3b0p• 9 years ago

I just had a stent. I stayed Friday night, Saturday Morning surgery, and left Sunday Morning. My bill was almost $100,000 USD (less than $2,000 short).

holydude• 9 years ago

In my country somewhere in europe you pay ridiculous taxes and you cannot opt out. The healthcare is shit, corrupt and if you want good care when they do not treat you like shit you need to go private and pay extra. Beware americans with your mentality you end up paying more ans getting less with programs like obamacare.

callalex• 9 years ago

[citation needed]

everdayimhustln2• 9 years ago

Bots and unthinking cyberdisinhibited people competively flame and troll whomever is the current punching-bag for brownie points, schadenfreude and negative attention seeking behavior.

BrandoElFollito• 9 years ago

This is one of the reasons I love my country (France) : because I do not even have a bill to tweet. Literally : there is no obvious financial trace of serious medical items.

Sure, when I go to the emergency with my child and his swollen ankle, I get charged 28€ (IIRC), which later get reinbursed. This is the highest medical bill I can think of (except dental and optical). A 100,000€ bill would not appear anywhere.

petraeus• 9 years ago

The are children, orphans, families, whole societies that live worse than even the poorest of americans. Sickening.

I shared my toddler's hospital bill on Twitter

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