# She Had a Routine Throat Swab. The Bill Was $28K



## Robert59 (Dec 23, 2019)

https://www.newser.com/story/284712/she-had-a-routine-throat-swab-the-bill-was-28k.html


----------



## GreenSky (Dec 24, 2019)

Just why the insurance company didn't question this is amazing.  We've all had blood tests where the lab bills $1,000 but insurance (or Medicare) will cut it down to $18.  How this happened is beyond belief.

Rick


----------



## oldman (Dec 24, 2019)

GreenSky said:


> Just why the insurance company didn't question this is amazing.  We've all had blood tests where the lab bills $1,000 but insurance (or Medicare) will cut it down to $18.  How this happened is beyond belief.
> 
> Rick


Better yet, why does the hospital charge a person that does not have insurance the full amount, instead of the discounted amount that they charge or accept from an insurance company.

Case in point: My neighbor lost his job a few years back, which meant no job, no insurance. His wife woke up one morning with a severe headache. He thought maybe she had an aneurysm, so he took her to the hospital ER. They were there for nine hours. When they received the bills for all the tests, the ER room, the ER room doctor, etc., the final total was $6100.00. 

They asked the hospital billing department how much would an insurance company normally pay for the same services. The lady on the phone told him that she couldn’t tell him exactly, but it would be about 30-40% of what the hospital billed. He then asked why he couldn’t be billed and pay the same amount as an insurance carrier. The lady told them that isn’t the way any hospital operates. 

To me, this isn’t fair and there should be a law to protect the private individuals from having to overpay.


----------



## gennie (Dec 24, 2019)

If this happened in one of those disgusting Socialist countries, there probably would have been no charge.


----------



## GreenSky (Dec 24, 2019)

gennie said:


> If this happened in one of those disgusting Socialist countries, there probably would have been no charge.


She probably would have died waiting for treatment.

Rick


----------



## win231 (Dec 24, 2019)

Waiting for a retired MD to justify it with something like:
"Well, you're not just paying for the swab; you're also paying for the years the doctor spent in school and his skill & dedication."
"Well, your doctor is checking for throat cancer....what's your life worth?"


----------



## treeguy64 (Dec 24, 2019)

Disgusting money grab by a disgusting money grabber, from a group of folks sometimes known as "doctors" and "healthcare field workers!" They are all in bed together, and their main goal is to squeeze as much money out of their captive audience, their "patients," as possible! Only the very naive view these folks as wanting to sincerely help the sick and infirm. Rare, very rare, indeed.


----------



## Camper6 (Dec 25, 2019)

oldman said:


> Better yet, why does the hospital charge a person that does not have insurance the full amount, instead of the discounted amount that they charge or accept from an insurance company.
> 
> Case in point: My neighbor lost his job a few years back, which meant no job, no insurance. His wife woke up one morning with a severe headache. He thought maybe she had an aneurysm, so he took her to the hospital ER. They were there for nine hours. When they received the bills for all the tests, the ER room, the ER room doctor, etc., the final total was $6100.00.
> 
> ...


Let me try to explain.
First of all I live in Canada but my family lives in the U.S.so I know a little bit of what is going on. I was an accountant.
If a hospital in the U.S. Is non private they receive funding.
So if they provide a service they bill whatever they can get away with. If they can't collect they write the account off which helps to remain eligible for funding.
Although a person doesn't have insurance he is still expected to pay and he keeps getting billed . It has all to do with accounting for expenses.


----------



## Camper6 (Dec 25, 2019)

GreenSky said:


> She probably would have died waiting for treatment.
> 
> Rick


Rick. I live in Canada. My friend had a heart attack and was rushed to hospital. Within one hour he had a stent put in. So the wait times are exaggerated by the media. It depends on urgency.
It's not free however. It's paid for by taxes . Not everything is covered. Dental work, Hearing aids, for example are not covered. Prescriptions are co pay and seniors get a break at age 65 depending on the province you live in. I doubt there is one Canadian that would trade health care plans.


----------



## oldman (Dec 25, 2019)

oldman said:


> Better yet, why does the hospital charge a person that does not have insurance the full amount, instead of the discounted amount that they charge or accept from an insurance company.
> 
> Case in point: My neighbor lost his job a few years back, which meant no job, no insurance. His wife woke up one morning with a severe headache. He thought maybe she had an aneurysm, so he took her to the hospital ER. They were there for nine hours. When they received the bills for all the tests, the ER room, the ER room doctor, etc., the final total was $6100.00.
> 
> ...


Like you wrote, "you know a little bit about what is going on."

If you are employed and lose your job, you will also probably lose your insurance, unless you pick a COBRA plan. However, when my neighbor lost his job, his insurance was terminated just 4 days after his termination. Not hardly enough time to pick up a COBRA plan. So, to get his medical bills paid for, he would have to qualify for a Medicaid plan, but he had too much in assets to qualify, so he was left out to dry (so to speak). 

He received the bills totaling $6100.00 from different doctor billing vendors. He called and asked if they could reduce the costs. The answer was "NO!" His only choice was to pay so much per month until the bills were taken care of. Had he been on medicaid, no problem, the bills are paid. In his case, he is a home owner with a 401(k) plan, along with other monies in the bank. He had to take $6100.00 out of his savings or 401(k) plan to pay the bills.

My question isn't about why he has to pay the money, but why wouldn't he be permitted to pay the same amounts as the average insurance company would pay? I already knew the answer, I was speaking about the unfairness to individuals who don't get treated the same as those with insurance. My neighbor is a bio-engineer for a pharmaceutical lab near here and made very good money. He has since moved away in order to take a new job in Arizona. He says now that it was a blessing in disguise as he is now much better off; making more money and better benefits.


----------



## GreenSky (Dec 25, 2019)

Camper6 said:


> Rick. I live in Canada. My friend had a heart attack and was rushed to hospital. Within one hour he had a stent put in. So the wait times are exaggerated by the media. It depends on urgency.
> It's not free however. It's paid for by taxes . Not everything is covered. Dental work, Hearing aids, for example are not covered. Prescriptions are co pay and seniors get a break at age 65 depending on the province you live in. I doubt there is one Canadian that would trade health care plans.


The thread was about a throat swab, not an emergency service.  Nobody waits while having a heart attack.

A hip replacement, maybe you can just take medicine.

Rick


----------



## oldman (Dec 25, 2019)

Obviously, there is some connection between the doctor and the labs, which in this case shouldn’t matter. The fact that unnecessary tests may have been performed and like Rick stated, why didn’t the insurance company check into the costs, leads me to believe that all is not right here.


----------



## Camper6 (Dec 25, 2019)

GreenSky said:


> The thread was about a throat swab, not an emergency service.  Nobody waits while having a heart attack.
> 
> A hip replacement, maybe you can just take medicine.
> 
> Rick


 
I'm was responding to your post in the thread.
This is what you stated.

She probably would have died waiting for treatment.

Rick


----------



## GreenSky (Dec 25, 2019)

Camper6 said:


> I'm was responding to your post in the thread.
> This is what you stated.
> 
> She probably would have died waiting for treatment.
> ...



I stand by my (sarcastic) quote.  It's a ROUTINE culture and not an emergency.  Waiting periods in Canada are much longer than in the US.

Rick


----------



## oldmontana (Dec 25, 2019)

Robert59 said:


> https://www.newser.com/story/284712/she-had-a-routine-throat-swab-the-bill-was-28k.html



I would question the bill and/or go on line and find a source to get help ... that is outrages.


----------



## Camper6 (Dec 25, 2019)

GreenSky said:


> I stand by my (sarcastic) quote.  It's a ROUTINE culture and not an emergency.  Waiting periods in Canada are much longer than in the US.
> 
> Rick


You are entitled to your opinion but let no misrepresentation go unchallenged. The ones dying are those without insurance. You challenged the routine culture with your sarcastic quote. Better late than never.


----------



## Butterfly (Jan 4, 2020)

GreenSky said:


> Just why the insurance company didn't question this is amazing.  We've all had blood tests where the lab bills $1,000 but insurance (or Medicare) will cut it down to $18.  How this happened is beyond belief.
> 
> Rick



Before I was on Medicare I got a couple crazy bills (nothing this extreme though) and they've come out to a screwup in coding or some other mistake.

The most frustrating one was a bill for prenatal stuff when I was 64.  I demanded the records for those tests and they talked about how because I was so young (14) they did some non-routine stuff.  SO, when I still couldn't get anywhere with them, I just showed up there with my identification and asked them if they thought I looked 14.  Problem resolved.

Then there was a problem I had way back when, when I was married to my first husband, a widower whose first wife had died very young with a rare cancer of the liver.  Because of the way that Army hospital filed everything, the whole family's records were filed under his social  The hospital insisted that since I was dead, I was not entitled to medical care.  At any reasonable medical care facility, this would have been easy enough to rectify.  BUT, since the Army NEVER makes mistakes, it took almost a year to clear up, despite the fact that they had her death certificate in the file (different first name than mine, different. DOB).  There were times that year I just wanted to scream.


----------



## oldman (Jan 5, 2020)

Butterfly said:


> Before I was on Medicare I got a couple crazy bills (nothing this extreme though) and they've come out to a screwup in coding or some other mistake.
> 
> The most frustrating one was a bill for prenatal stuff when I was 64.  I demanded the records for those tests and they talked about how because I was so young (14) they did some non-routine stuff.  SO, when I still couldn't get anywhere with them, I just showed up there with my identification and asked them if they thought I looked 14.  Problem resolved.
> 
> Then there was a problem I had way back when, when I was married to my first husband, a widower whose first wife had died very young with a rare cancer of the liver.  Because of the way that Army hospital filed everything, the whole family's records were filed under his social  The hospital insisted that since I was dead, I was not entitled to medical care.  At any reasonable medical care facility, this would have been easy enough to rectify.  BUT, since the Army NEVER makes mistakes, it took almost a year to clear up, despite the fact that they had her death certificate in the file (different first name than mine, different. DOB).  There were times that year I just wanted to scream.


I agree. I think probably many of us have received crazy bills, but probably not to the degree of this one. I have found that insurance companies must really negotiate some crazy contracts with their vendors. I just received a statement from Medicare for a blood test that I had done a few months back. Actually, it was for five different tests done at the same time. 

The difference between what the lab charge was and what Medicare allowed was a huge difference. (Sorry, I don’t have the exact numbers in front of me.) I have always thought that if the lab is acceptable to the lesser amount that Medicare pays them, why do people who have no insurance have to pay the full price? It just never seemed fair.


----------



## GreenSky (Jan 5, 2020)

oldman said:


> I agree. I think probably many of us have received crazy bills, but probably not to the degree of this one. I have found that insurance companies must really negotiate some crazy contracts with their vendors. I just received a statement from Medicare for a blood test that I had done a few months back. Actually, it was for five different tests done at the same time.
> 
> The difference between what the lab charge was and what Medicare allowed was a huge difference. (Sorry, I don’t have the exact numbers in front of me.) I have always thought that if the lab is acceptable to the lesser amount that Medicare pays them, why do people who have no insurance have to pay the full price? It just never seemed fair.


While I'm not trying to justify high prices for those with insurance, here's the reasoning behind this.  Providers become "part" of an insurance company and/or Medicare because they will get more patients.  Hence they are willing to accept a lower fee.  How many of us are willing to pay to see a provider that does not accept our insurance?

When I was selling insurance to those not on Medicare I always pointed out that by staying in network they receive a negotiated price.  Those without insurance do not have the numbers to negotiate lower pricing.  It's really not much different than a restaurant being able to buy produce at a lower price than we can at the local supermarket.  If you have the "numbers" you can negotiate.

BTW, negotiating does work with dentists.  I don't actually sell dental insurance since generally it's a horrible value.  Instead I suggest people go to their dentist and ask "Are you a provider for Delta Dental PPO?"  If the answer is yes, the next question is "I'll pay 100% of their negotiated price if you will charge me the same."  If they refuse, I recommend another dentist.  And for those who don't want to go through that they can do exactly what I have done.  I pay $120/yr for myself and my wife to get about a 1/3 discount at quality dentists.  Well worth it.


----------



## oldman (Jan 5, 2020)

GreenSky said:


> While I'm not trying to justify high prices for those with insurance, here's the reasoning behind this.  Providers become "part" of an insurance company and/or Medicare because they will get more patients.  Hence they are willing to accept a lower fee.  How many of us are willing to pay to see a provider that does not accept our insurance?
> 
> When I was selling insurance to those not on Medicare I always pointed out that by staying in network they receive a negotiated price.  Those without insurance do not have the numbers to negotiate lower pricing.  It's really not much different than a restaurant being able to buy produce at a lower price than we can at the local supermarket.  If you have the "numbers" you can negotiate.
> 
> BTW, negotiating does work with dentists.  I don't actually sell dental insurance since generally it's a horrible value.  Instead I suggest people go to their dentist and ask "Are you a provider for Delta Dental PPO?"  If the answer is yes, the next question is "I'll pay 100% of their negotiated price if you will charge me the same."  If they refuse, I recommend another dentist.  And for those who don't want to go through that they can do exactly what I have done.  I pay $120/yr for myself and my wife to get about a 1/3 discount at quality dentists.  Well worth it.


Who is your dental insurance provider?


----------



## GreenSky (Jan 5, 2020)

oldman said:


> Who is your dental insurance provider?



You can use this link:  www.californiadiscountdental.com.  It's really not state specific.  You can search providers and see benefits in most if not all states.

Because there are those who are disgusted that I actually get commission for helping people, let it be know I make about $30 if someone signs up so clearly I must be doing this just for the money.  (But YOU did ask).

Rick


----------



## oldman (Jan 5, 2020)

GreenSky said:


> You can use this link:  www.californiadiscountdental.com.  It's really not state specific.  You can search providers and see benefits in most if not all states.
> 
> Because there are those who are disgusted that I actually get commission for helping people, let it be know I make about $30 if someone signs up so clearly I must be doing this just for the money.  (But YOU did ask).
> 
> Rick



Thanks, Rick. I’ll check it out.


----------



## mrstime (Mar 2, 2021)

GreenSky said:


> I stand by my (sarcastic) quote.  It's a ROUTINE culture and not an emergency.  Waiting periods in Canada are much longer than in the US.
> 
> Rick


I'm sorry but I live in BC Canada and I have never waited more than a couple of weeks for anything medical. And if you present to an ER you might wait as long as an hour depending on your problem, and no waiting at all if they think it is life threatening. We used to pay $150.00 for insurance  to cover the 2 of us. Then a change of government reduced the insurance by half, and a few months after that we pay nothing. We re complaining now since the pandemic  that we do not feel like we have a doctor, because it is all done by phone, however our doctors office finds it permissible to let the nurse practitioner  risk her life by actually seeing patients on occasion. Now we find she is every bit as good as a Dr and in fact the prescriptions say Dr on them and we like her more than the new Dr we had seen only about twice before the pandemic hit!


----------



## Liberty (Mar 3, 2021)

mrstime said:


> I'm sorry but I live in BC Canada and I have never waited more than a couple of weeks for anything medical. And if you present to an ER you might wait as long as an hour depending on your problem, and no waiting at all if they think it is life threatening. We used to pay $150.00 for insurance  to cover the 2 of us. Then a change of government reduced the insurance by half, and a few months after that we pay nothing. We re complaining now since the pandemic  that we do not feel like we have a doctor, because it is all done by phone, however our doctors office finds it permissible to let the nurse practitioner  risk her life by actually seeing patients on occasion. Now we find she is every bit as good as a Dr and in fact the prescriptions say Dr on them and we like her more than the new Dr we had seen only about twice before the pandemic hit!


Must be very different depending on where you live in Canada.  Have a friend in Vancouver who was "ok'd" for an abdominal hernia and who had to wait a year!  In the meantime she developed other health complications, lost a lot of blood. Thank heavens she's ok now. Kept asking her why she was waiting so long for the operation.  She said it was because it was "non life threatening."  

Must not be "universal" healthcare.  I felt so bad for her as she was in a lot of pain.


----------



## Giantsfan1954 (Mar 3, 2021)

treeguy64 said:


> Disgusting money grab by a disgusting money grabber, from a group of folks sometimes known as "doctors" and "healthcare field workers!" They are all in bed together, and their main goal is to squeeze as much money out of their captive audience, their "patients," as possible! Only the very naive view these folks as wanting to sincerely help the sick and infirm. Rare, very rare, indeed.


AMEN!!!


----------



## aMused (Mar 3, 2021)

GreenSky said:


> She probably would have died waiting for treatment.
> 
> Rick


My brother and his wife lived in a number of countries that have social medicine over the years. His wife was diagnosed with breast cancer while living abroad and was treated in a timely manner that saved her life but she had to continue with cancer medication when they moved back to the US. But getting that same medication here was so prohibitively expensive that it was actually cheaper for them to travel abroad to purchase her medicines than it was to buy them here.
When my husband was diagnosed with cancer that had already metastasized we had to wait nearly 3 months for all the proper steps, tests & insurance approval for treatment. Three months while we were helpless and the cancer just went crazy doing it’s thing to him. Then when the drug was approved the cost of it was $52,000 a month. Our health insurance cost $1,600 a month and even so we had to meet ad $10,000 deductible before they would pay one cent. He tried to go on disability because he was dying but we had to wait a couple of months for that appointment and when he was approved he was told that he had to be off work for 6 months before it paid and he would have to be off work for 2 years before he would qualify for Medicare. So although we were able to buy my husband nearly 2 years of life he would have otherwise forfeited, he had to work until 6 weeks before his death in order to have medical care.
We also have one child who is severely disabled, so prior to this a good deal of our income was already being claimed for special needs items. She needs 24 hour care which is why my husband was the sole bread winner, I sacrificed my ability to have a career to care for her. So with the death of my husband I lost a co-parent, bread winner and health insurance.
I could fill several books with horror stories of being in medical need in America. The wait times for urgently needed treatment and then the hold up while we wait to see if the insurance company will approve what the doctor ordered. I’m exhausted from having to get on the phone and argue with insurance companies, of having to plead with hospitals to push forward with tests for loved ones who can’t wait several months to be seen. The insurance companies themselves admit that they place all these obstacles because many people give up rather than fight for what they are entitled to, thus creating more profit for them.
I’m continually baffled by people who seem to believe that the very things they erroneously claim will happen if we collectively decide to pay for medical costs instead of giving away many times over what other countries pay for health care without realizing that this is actually what is happening to us, right here and now.


----------



## Judycat (Mar 3, 2021)

Only pay $25 a month no matter what they threaten. I used to do that when I didn't have insurance. I really only could afford to pay $25 a month though. If you are just trying to hold onto assets and cheapskate the doc, then pay the full amount skinflint.


----------



## mrstime (Mar 3, 2021)

Well Vancouver is a big city, we live in a smallish town a good 8 hours away from Vancouver. I did wait once a very long time for a test needed to be done 4 hours from here. Finally my Dr suggested calling that hospital. The woman who answered was shocked said they weren't busy when would I like my appt, got it, and immediately called a friend whose husband was waiting for the same test. Both of us then had the back surgery we so needed.


----------



## mrstime (May 20, 2021)

GreenSky said:


> She probably would have died waiting for treatment.
> 
> Rick


No, you believe what the AMA tells you about countries with universal health care! They lie to you because they are terrified that Americans might rise up and demand better!


----------



## Lethe200 (May 21, 2021)

Camper6 said:


> Rick. I live in Canada. My friend had a heart attack and was rushed to hospital. Within one hour he had a stent put in. So the wait times are exaggerated by the media. It depends on urgency.
> It's not free however. It's paid for by taxes . Not everything is covered. Dental work, Hearing aids, for example are not covered. Prescriptions are co pay and seniors get a break at age 65 depending on the province you live in. I doubt there is one Canadian that would trade health care plans.


Camper6, you are absolutely right. This gets debated on Quora regularly, where there are a lot of international members. *Not a single one *of the Canadian, European, or British members - ESPECIALLY those who have experience with the U.S. system - has ever said they would trade. 

Unanimously they think our system is absolutely terrible. The idea that people must risk bankruptcy to pay even basic healthcare bills is mind-boggling to them.

We live in the San Francisco Bay Area and chose the next best thing - Kaiser Permanente HMO, which is non-profit. It's not John Hopkins-Stanford Univ level of care, but they have very good staff, and owning their own hospitals and pharmacies makes care/expense *much simpler* for members.

We've been members for almost 50 yrs, through minor and major medical incidents. Have there ever been issues with them? Yes, but relatively minor ones. Their emergency care (broken limbs, stroke) has been outstanding. 

About seven years ago they began converting to digital records. Not an easy process, apparently! But now that it's up and running, it's great and really facilitates general/basic healthcare. You can even download a complete copy of your own medical records to print out. Website allows easy appt making for most basic procedures, or if not there's an advice nurse 24/7 who can help you make one by phone.

Most Americans have no idea how much healthcare actually costs. They get the paperwork every year from their employer and never really read through it. Then they're surprised as heck when they leave and find out what COBRA will cost them.


----------



## Nathan (May 21, 2021)

Lethe200 said:


> Kaiser Permanente HMO, which is non-profit. It's not John Hopkins-Stanford Univ level of care, but they have very good staff


I get miffed at Kaiser sometimes but they do step up to the plate and insure thorough care.


----------



## mellowyellow (May 21, 2021)

I was curious to find out what happens to poor US citizens who need urgent medical care but have no insurance.  The answer is Medicaid. 

_Almost every state has multiple *Medicaid* programs. But, as a good rule of thumb, if you make less than 100% to 200% of the federal poverty level (FPL) and are pregnant, elderly, disabled, a parent/caretaker or a child, there's likely a program for you.

But every state is different._

It appears to be a safety net, similar to our Medicare in Australia.  I hope this info is correct.


----------



## mrstime (May 23, 2021)

A friend in the US who's husband had a heart attack, she did the sensible thing and called an ambulance that took him to the hospital. They had insurance but the insurance company refused to pay the bill because she didn't call the insurance company for permission to o get him to the hospital. Their money problems eventually caused them to separate.

I'm so glad I am Canadian!


----------

