been like.

Last edited Sat Mar 2, 2013, 02:51 PM - Edit history (1)

Unfortunately I can't talk about my last visit to the ER without my blood pressure reaching stroke levels. It may very well have been that experience that cause my hypertension to begin with, lol.

"And I can't help but wonder what they would have done (the hospital) if I didn't cough up the immediate $100?" The way corporations/for-profit industries are making the laws these days, I wouldn't be surprised if they'll be able to break your leg(s) soon if you don't have the money to pay right then and there. Or, let you die because you have no insurance or money.

from the 5 hours in the emergency room to the fact that they 'had' your driver's license and insurance card.

this is one fucked up country when it comes to our healthcare.

get well CW.

passports of their victims so they cannot leave the country where they are being abused.

Please take care...you are one of the coolest people on DU.

We really need to bring home how other countries handle their hospital ER's.



Tikki

You experience is frightening. I had a heart attack 2 years ago, had no insurance. Told them that from the moment I got to the hospital. Never had a problem, and that was without insurance. I am in Maryland, not sure if that makes a difference or not.

and my opinion is they (the health care system) will be bolder with someone with insurance than without it.

However, I do think your being in Maryland does make a difference.

BTW - It's snowing here

and I am not getting any snow.

Glad your BP is under control. I have high BP, but take medication daily to keep it down.

I had to wait for over 2 hours to get my cash back from an ER once......

Hope you are on your way to recovery!

the $325 is what the insurance company pays while the $601 is what they charge the uninsured. Insurance companies have leverage coming from serving many customers while the cash paying person doesn't.

emergency room for a tooth abscess late one Saturday night a couple years ago. Now I won't go to the ER unless it's severe and if you've ever had an abcess the pain is incredible. Nothing over the counter will touch it. I wasn't insured but I was desperate. It wasn't busy so I was only there about 45 minutes. I said I had an appointment with a dentist on the following Monday but I needed pain relief. First the Dr tried to fob me off with Motrin. Motrin?? For a tooth abscess? You could plainly see it sticking out of my gums so they could see I wasn't faking it. I told her if Motrin worked, I wouldn't be there. Told her I'd already taken a handful of ibuprofen that didn't work. After a short lecture on stomach ulcers caused by ibuprofen, she gave me the good stuff. It cost me $500. I wasn't even offered a discount for on the spot payment. All they did was check my blood pressure, temperature and saw the Dr for two minutes, gave me one Vicodin and a script for more. Just insane how much things cost now.

CW I hope you feel better! Take care of yourself!

hospitals recoup their losses from treating uninsured patients, which is a problem only because our country doesn't treat medical care as a right the way civilized countries do.

You're a better person than I am.

And I am speaking as someone who lost their life savings, retirement et al to the"Medical System" in this country.

But what happened here is extraordinary, that your family was pro-active about this pain. A lot of people wait out the dental pain. My husband was a social worker for a large County here in California. One of his friends at the agency's practice had a client who was in a lot of dental pain. Her insurance was to kick in in a week. The client wanted to wait it out, and although she was mildly admonished to get help sooner than that, she went home, took some Tylenol and went to sleep.

The infection that was causing her pain took over her body, and probably traveled to her brain. She never woke up. This woman left behind her husband, the love of her life, and two young kids.

The emotions ran pretty high at that agency over the next few weeks. What a loss of life! All because someone was doing what they thought was the right thing economically. And why should the greatest nation in the world force its citizens to even think this way!

infections in your mouth can be really dangerous. Sometimes the infection breaks out and goes to the heart (and probably the brain too) and can kill you in seconds. When I was at the hospital for an infected abscess the nurse who took care of me said he had one and it had to be surgically removed immediately. He said the Dr told him that had he waited any longer to get treatment, he would have died as the infection was beginning to spread.

Someone I used to work with had one but was waiting for her father's new insurance to kick in before going to have it looked at. The insurance we could have had from work sucked terribly, hence why she changed to her dad's. I begged her to go anyway, but she wouldn't. Lucky for her it wasn't that serious of an infection and she was ok.

Dental pain may not seem like a big deal, but remember folks, it can kill you if there is an infection.

so a simple call to him on a Sat night was enough for him to call in an antibiotic which helped within 12 hrs.

This is where we could definitely help to pattern after Europe. You can get an antibiotic in an pharmacy otc.

The doc in the box is also good on weekends. Might cost a hundred which is a lot, but better than ER

when this happened so I didn't have a dentist already. The one who could get me in the quickest would not do an emergency Saturday night visit. But yeah, if I had a dentist I probably wouldn't have needed to go to the ER.

My vet requires full payment at time service is rendered.

due to bad debt back in the day, so now none of us extend credit. CareCredit is a company that provides credit, but generally only when it's a huge multi-doctor or referral specialist practice - not when it's us little guys.

We aren't banks. And some of us barely eke out a living at times.

I really get tired of people expecting us to behave like we are all wealthy and have money to burn. We aren't. Veterinarians are the lowest paid of all the medical professions.

I fully understand and agree with all the points you make. As a landlord, I get it from the other side where tenants ask me to extend credit with deposits and rent. I'm not a bank either and have my own bills to pay. Somehow the mortgage company and utility company doesn't accept "I'm waiting on the tenants to pay me before I pay you" as an excuse not to make my payments.

The point that I in-artfully was trying to make is that some hospitals are running on thin margins too. I was talking with a hospital administrator recently at a party. He explained that due to the cost of uninsured that they are required to treat by law and unpaid bills/collections that they were going to have to make changes or close the doors in the next few years.

consider lowering the exorbitant pay of their executives, then. I don't buy most hospitals when they start their "we'll have to close because all of these greedy people who demand to be kept alive when they have a medical emergency can't pay us" bullshit. Because the vast majority pay their executives hugely exorbitant salaries and perks, and many invest in luxury suites and amenities to "attract customers" as their advertising so eloquently puts it. Not to mention their very well-paid PR and marketing departments.

I was just relating what this guy told me. He seemed sincere at the time.

I didn't know of their existence until I spent a month in the hospital with my very ill husband. I noticed that none of the elevators had a 7th floor button. But, heard some nurses talking about the 7th floor.

Actually they were saying that this man would be going "upstairs". I started listening. My husband was in Intensive Care for over two weeks as they fought daily for his life. I heard a lot, as the waiting room was filled with emergencies. One man was obviously getting a lot of attention. I didn't ask questions, just watched as he eventually got moved to a "special place". Talked to his wife briefly in waiting room, as people in emergency situations do, and heard her talking to a daughter about everything her husband would need for his room. His own TV, his own recliner and bed linens. I kept my mouth shut and heard a lot. There was not a special elevator that I could see. However, when they took him up I was in the room with my husband, and they used the IC elevator, and made sure it was empty except for this man and his family. Inside the huge elevator, there was part of his special furniture. I saw the huge recliner and his wife was assuring him that it was right there in the elevator with him.

I had no problems with the hospital. They were lovely. My husband was fully insured, so don't know if his treatment would have been any different. However, he certainly was not treated as this man was. He even had his own private nurses in ICU.

So, upstairs, downstairs is alive and well in this country at all levels. I wonder how much this man paid for his insurance? Zero I bet.

They pay out of pocket for everything including auto insurance. Its called self indemnification.

Edit most probably carry major medical though.

the fee is not exorbitant............

Which I recently read (here on DU?) dwarfs the MIC lobby!

I don't think that a hospital has to (or should) be advertising on TV and the radio.

problem with what you wrote: You (and our old vet that we don't see because we live in a different town now) consider themselves "part of the medical profession." I am sorry...I understand your training, and I certainly understand the role of vets re: food safety and zoonotic diseases (I realize I just spelled that incorrectly) but, you are not "part of the medical profession."

Veterinarians have caused their own problems: they push food through corporations that is basically super expensive corn based food--- with additives to correct problems (Our cat eats Royal Canine SO-- dry--- read the ingredients...it's cheap crap, that is expensive because it's "prescription only.&quot

The prices are ridiculous because the Vets are buying the latest and greatest equipment to keep up with changes....and charging clients a ton of money for vaccines, spays, etc. to make up for it.

Veterinarians are certainly not taking the lead in seeing that animals are treated humanely...for the MOST part (yes, I realize SOME Vets take part) activists in organizations such as PETA, Best Friends, etc have had to take that one up-

Please stop comparing your prices to those of human docs-- when we value-- monetarily or ethically as a whole-- lives of animals as much as we do people, OR become cannibals, and Soylent Green is a reality, maybe I'll be inclined to pay attention to that argument.

And one more thing--- basing pricing on a failed model (US medical care) was and IS pretty damned stupid. All your profession has done is make having a dog or cat from the pound (both our pets are abandoned "mutt" types...we love them dearly) "luxuries." And that....is bullshit.

I respect our Veterinarians....I have NO more respect for the profession itself. I find the AVMA silly....and the arguments about the cost to own an animal horrifying. There would be one less homeless old doggie put to sleep next week....but, we...(grad school educated, middle class) can't afford to have one.

And that's sad as hell.

Have you lost your mind? Do you have *any* idea what all a DVM has to go through to be licensed? Medical training, surgical training, radiology, dental training, etc, etc, etc... What "real medical professional" for humans has to go through all of that?

Are you of the mindset that Vet services should be given out for free - and that the Docs and their staff should work for free out of the goodness of their hearts? Maybe you need to lobby congress for a "free medical education and lifetime housing/needs" clause for animal practitioners so that these people can practice their skills.

Pray tell, what is it that you do for a living. Let us know so that we can all jump in and make recommendations as to why you shouldn't draw a paycheck for it.

Unbelievably rude rant, IMO.

Oh, and I see your Royal Canine and raise you Earthborn Holistics. Call me a better pet parent than you, but it is the best chow on the market - bar none. Hard to find, but most places ship for free.

Have a nice day.

food safety, and transmittable diseases.

Our cat eats Royal Canin because that is what her Dr. put her on...so, you want me to second guess the profession that you just gave me hell over, and go against that advice?

Our dog eats a Solid Gold product that she has been on for 8 years; we are familiar with holistic, organic diets.

As far as training goes....let's continue: 4 years of undergrad and 4 years of vet school to be a "general practioner." They can get a job after that--- care to name ONE human doc besides a dentist that can toss a shingle out immediately upon graduation?

Like I wrote; I love our vets-- and cannot stand what the profession has done to itself. If "they" as a whole, not the individuals.... are so fantastic....why are they comparing themselves to the most rapidly failing system in the US?

And WHERE in my "rude rant" did you discern that we want our animals to be treated "for free?" I wrote that because prices have gotten so out of hand that we can't afford to adopt any more, and won't be able to for years. We know many others like us....so, all those animals in the shelters that are going to die lonely, scary deaths....well...you figure it out. They are going to die...just like people are in ER waiting rooms with no money...because it's ALL about "profit" "overhead," etc right now. We are so far down the rabbit hole, that there's almost no possibility of digging out. And people like you are...concerned...but, almost cheering it on.

"Vets aren't part of the medical profession"...you have to be kidding me! Do you think they take a first aid course to take care of animals?? Considering all the species they deal with I would think their training would have to be very extensive. I know when our Rotweillor had cancer he recieved excellent care from our vet, through the diagnosis, biopsies, surgery and treatment. How do you think she learned all this, from instructions she looked up on the internet??

the fact that with everything they must learn and the years they spend doing it, vet schools are not cheap. They don't get their education for free lol

see my post above. I am sure your vet is great; do you think it's fabulous that the profession as a whole is comparing itself to one of the greatest failed medical systems in a developed country? Do you think it's wonderful that animals are tortured in food facilities, and are dying by the droves in shelters, and people are sitting in the ER wondering if they can pay, and praying "nothing expensive" is wrong with them?

Please. I understand the training very well--- maybe you should re-read what I wrote.

I'm curious as to why you think it's not part of the medical profession. I mean what the hell is it then?

So the vet buys the latest and greatest - I for one am glad they do. Good grief, I want my pets to get the best care possible. I was recommended a vet by a friend who was said to be considerably cheaper than all the others in my area when my cat suddenly became ill (turned out he had late stage stomach cancer and I had to put him to sleep 3 months ago). So I go to this vet and he says there is definitely something wrong with his gut area. My bill was $30, but can you guess why? It was because he didn't have an x-ray machine, he had no way of testing his blood - basically a very old vet who had nothing up to date in his office. You get what you pay for and I sure did there. So then I had to take him somewhere else. I never in a million years would have guessed this vet did not have any way at all to get to the bottom of the problem. The next vet charged me about $75 and they were able to give him an x-ray and diagnosis. Obviously there was nothing they could do for him as far as a cure. A couple weeks later he began suffering and I felt it was time. For the euthanasia and his single cremation so I could have his ashes cost $150. I didn't consider that to be particularly outrageous. Now obviously had his cancer been treatable it would have been a lot more, but a drop in the bucket compared to people being treated for cancer.

If the food you give your cat is so bad, why are you feeding your cat that? Is it because he/she won't eat anything else?

And PETA? Really? I'm not even going to go there except to say they don't even belong in the same sentence with Best Friends.

I wish more people could afford the vet bills so there would be less homeless but vets have to earn a living too. They have bills just like any other business. Vets need to pay off their student loans and earn a wage just like everyone else. And what model of pricing do you think they should follow? I lived in a country with universal care for humans. They didn't have that for pets. I had to pay out of pocket for that.

Vets have bills, lots of them. Maybe when it costs them little to nothing to become a vet, for med supplies, utilities, and not only paying themselves a wage, but all their employees too, then perhaps you'd see the prices come down hugely.

It's not veterinarian's fault that so many end up homeless. You need to take that up with the irresponsible jerks who don't spay/neuter and the ones who up and decide they don't want their pet any longer so they drop them off at shelters.

Edited to add: I wanted to become a vet, but I had one major problem. If someone needed expensive treatment for their pet but could not afford it, I would have to do it for free because it would kill me to watch an animal be euthanized just because of lack of funds. I would go out of business real quick if I kept doing that.

you just got emotional. The cat eats Royal Canin because it's a prescription diet. Do you think we just decided she needed that after reading something on DU? Maybe you should educate yourself about prescription diets.

As far as your "lol" comment re: cost of grad school. We know...we went through that in this family also. And those bills are probably another good rant.

Quit cheering on, and justifying what has gone so horribly wrong in this country. It's godawful...from the cost of education, to the reason our food animals are treated cruely, and people are sitting in the waiting room of the ER thinking about money, instead of health. Our entire system is broken-- to the point that animals and people are dying.

diet just fine, but you said it was nothing but crap. There are other brands of prescription diet food. Maybe your vet doesn't carry other brands, I don't know obviously. My comment about the food wasn't a smart ass one, I was simply asking why you used it out if curiosity.

Oh and I am not sticking up for our health care system, wtf? Are you kidding me? It's got to be the most immoral and corrupt system in the world in regard to health care. I lived with single payer, it was fricken awesome. My husband had Hodgkin's disease twice and all we paid was what we were charged through our taxes, which I can tell you was a small fraction of what most pay for in their insurance premiums here. We didn't have copays at the hospital or medical clinics. We didn't even pay for his take home prescription meds because he got them filled in the hospital, which had no way of charging for them because they don't charge for a thing. If he filled them in a pharmacy he still only would have to pay our equivalent of $7 per script no matter the drug or quantity. It was nice not to have to worry about the money and get harassed for payment that we could never have possibly afforded had we lived here. I've seen it in action and I used it myself in the 10 years I had it. What we have has got so out of control it's unreal. Prices keep skyrocketing and soon if this keeps up, only the rich will be able to afford healthcare.

The point I was making about veterinarians is that while they have gotten more expensive right along with our healthcare costs, they are still significantly cheaper, despite having tremendous costs. Would you rather nobody became a vet and we had none because that's exactly what would happen if they charged little to nothing because they couldn't support themselves or be able to pay back their loans. It's a fact of life that they have costs associated with their profession. Do I like that it's pricey? Of course I don't. What would be your solution? How can vets charge next to nothing but be able to stay afloat personally and professionally?

I hear you about education being too much. Hell that is one of the reasons I didn't go to vet school, or any school for that matter. It's awful how bad things have gotten, way too expensive for education, way too expensive for medical care, human and animal. I don't even have insurance right now because I cannot afford the premium, and even if I could just barely afford it, I wouldn't have anything left for copays so I couldn't even afford to use it.
Anyone who doesn't see the problem here evidently has more money than sense.

Now....since you hate the medical profession so badly...can you not see that the AVMA is leading the Veterinarians right down the exact SAME hellish highway?

As far as the prescription cat food....she has seen two different docs (again, we moved. We loved our old vet...we really like our "new" one.) BOTH of them have said she needs the Royal Canin SO. We are assuming they know what they are talking about, and she has had no more urinary problems since the round of antibiotics, and change of diet. Is it shitty food? I think so...the ingredients are crap: corn based, and I would put money on (and I don't know this...like I said....a bet only) Monsanto GMO crap.

I am not suggesting our Vets go broke....I am writing that the SYSTEM is broken, the frogs are being boiled in warm water....and when I read that Kestrel compared herself to the "medical profession," I am SAYING plainly, in writing...there is a problem right there.

I am NOT dumping on Kestrel....I am dumping on a system that is so cleverly screwed up...that people with YEARS of grad school...YEARS (note the lawyer/spouse of an ER doc on this thread)...don't even see the shit they are in.

broken, big time. Yes the vets are going the same way, I just don't know what the solution is for them specifically. I also would have more pets if I didn't have to worry about whether I could afford vet care. It sucks, it really does. As it is my cat will get better care than me for the foreseeable future. I care more about my cat than I do myself so that's my choice if it comes down to care for him, or for me.

I think there is plenty of blame to go around in this whole mess. How we fix it, for a start if we didn't send billions overseas we might have a fighting chance on providing care for everyone. I'm sure we could find other things that we could stop spending money on that we should only be spending if our economy was doing great. But of course, that would just be too easy I guess.

How to cap the costs of drugs, medical supplies, equipment, and what not, I don't know but I'm sure our government would have a problem with anything that was remotely practical.

I think also we are much on the same page about these issues really, as you said. I wouldn't mind paying for healthcare if it was reasonable but it's not even in the same ball park of reasonable now, not even on the same planet. My parents used to have excellent health insurance. My dad's company that he worked for (Lockheed Martin) changed to a cheaper policy. Well you know what that means. Their premiums went up, their copays went up and at the beginning of this year their premiums went up again, another 30%. My father is out on sick leave, probably going to retire because he's got more problems than anyone I know. He still has 3 years to wait for Medicare. He had a nasty infection on his leg (he's diabetic, along with arthritic and heart issues) and he went to a specialist. He saw the Dr. for 5 minutes - he dressed the wound and took a skin sample to test for cancer. The bill was $2,000 and his insurance won't pay for any of it. He's had to go back there several times and with him on the verge of retiring early, I don't know how he's going to pay for all this crap. It's truly a very scary time. And yes it appears to me lawyer and doctor wife may be a bit out of touch here. Not everyone has a money tree, you know?

With the cat food, I see your point. I guess as long as your cat has not had any issues so far and your vet thinks that's what you should use, what can you do? Stick with it for now really. I know you wouldn't want to rock the boat with her health. You can bet if Monsanto is involved in any if the ingredients, it's crap lol - that's my nervous lol, not that I think it's genuinely funny!

I guess we're all feeling the effects of such an uncertain future. You know, can't help wonder when it's all going to come to a head and how bad.

with equivalent education. Also with only 28 veterinary schools in the entire United States it is far more difficult to get into veterinary school then medical school or dental school or just about any other equivalent advanced medical program.

http://www.bls.gov/ooh/healthcare/veterinarians.htm

Even if you contrast their salary with say a pharmacist who have considerably less - albeit significant amounts of formal education and a considerably less albeit still a very significant amount of competition to get into a program - the median average income for a pharmacist is $112,160

http://www.bls.gov/ooh/healthcare/veterinarians.htm

a more realistic comparison would be with dentist -Although is still far more difficult to get into a one of the United States 28 veterinarian schools - the median average income for a dentist is $146,920 per year

http://www.bls.gov/ooh/healthcare/dentists.htm

but let's face it - they are still quite a bit cheaper than medical bills for people and vets have expensive medical supplies to buy, bills and staff to pay. I can easily believe that vets are the lowest paid in the profession, no doubt.

but does't extend credit to other clients normally. I've gone to that same clinic sice 1970, and the practice has gone through 4 different owners, plus one vet who didn' buy it but works part time there. The 3rd owner is now semiretired but still works part time there, too.

They know from my 43-year history with them that I will always pay in full--and in fact I did so even when I was surviving on $17,000 a year with 2 young kids. They know I always take care of my pets (which is why they live long lives) and that I would never stiff my pets' doctors.

But, as they also know, I often pay for necessary treatment for the pets of friends who absolutely cannot pay for it. Even when I was so poor, the fact that the vet would let me pay off a bill over time meant that I could manage it when my friends coukdn't. Often I just covered the cost, but if the friend COULD cover it, but just not all at once, I would arrange the treatment and promise to make sure it got paid for, no matter what. Then I would make the monthly payments, and the friend would pay me back.

A lot of dogs and cats were neutered or got needed treatments they would not otherwise have been able to get--including such things as surgery for bladder stones, which a little Bichon friend of mine needed a few years ago--because my vet trusts me to pay. That surgery for the Bichon cost nearly $1000, and I could not have paid it all at once at that time! But I made a $200 downpayment, and paid the rest off over 4 months.

Because I always have pets--3 cats at the moment-- and ALWAYS get them all appropriate vet care, as well as bringing the clinic other clients, and also bringing other people's pets that I then pay for, my vets often joke that I have bought their house or put their kid through college. For sure 43 years' worth of vet bills can add up!

My Rottweiler had cancer and I had to take her into the vet every week. Fortunately, I had pet insurance, which covered about 1/2 the cost.

I'm glad your pressure is now under control.

I hope you are feeling better. Please take care.

:O

the dizziness and headaches have gone away.

first thing I did when I got up today was take that medicine!!!

exercise and meds for very high blood pressure

Sure hope you feel better soon.

Seems to me that they cannot legally hold your license and ID and refuse to allow you to leave until you've made a payment. What, exactly, would they have done if you hadn't had it, kept you locked up in the hospital and then charged you the daily rate for it?

was they tried to return it to me earlier, but I was with a nurse.

total bs

There's a sickening story in last weeks time about the ills of our health care system. $100K+ bills for one day, 800K+ bills for a few days, etc.
The final bill is a "Starting point" they claim. It's your job to get them to discount it. SICK!

when I took husb ('stranged) to ER, where we 'resided' for more than 6 hours, much waiting, and most in a 'room,' having been triaged. He had fallen in shower.

When we arrived they took and photo'd his insurance ID (and maybe his photo driver's license,) returned them shortly thereafter. At NO TIME did they ask for ANY reimbursement.

While there they did blood tests and chest x-ray, and gave him i.v. pain meds.

I have no idea why the disparity in experiences. Different insurance???

and I too had to have blood tests, etc.

and very sorry, CatWoman.

In Oregon. The ambulance service was pretty agressive about payment, or at least getting the insurance information, ASAP and I've read that that company can be really, really difficult to deal with. Reminds me I should call them to make sure they got the goods from the insurance company.

Hm, I was at a "nonprofit" hospital. Wonder if that makes a difference.

Sorry that happened to the OP, though. Shouldn't happen anywhere, with any insurance.

under there that hasn't been diagnosed yet. I'm so sorry our system sucks. I had to go to the ER a month ago, but because I'm on Medicare, I didn't have to cough up any money up front. Wouldn't that public option to buy into Medicare have made a difference in the ACA?

Just a word of advice, since you can go to the VA, get a work up done and find out why your BP is so high while there is a good chance for a cure or management of what is behind it.

and far from the best. it's time to make the shysters/death panels in health care go out and earn their money. Perhaps they could work in sewage plants.

I was treated a lot better at the county hospital 3 years ago when I went in with septic shock. Once I got onto a gurney and got hooked up to the monitors and a nurse said "Oh shit! Get the doc in here!" things went as well as they could have. The financial person came in and listened to the fact that I wasn't made of money and had no insurance since the mid 80s and that's the last I heard of it. I was kept in ER holding because it was cheaper and given ICU level care. They apologized the last day because they needed the bed and had to send me to the expensive step down unit. They bent over backwards to keep the bill low as possible and didn't harass me on the way out.

I was actually shocked by how low that bill was when I got it, so I paid in full without a peep of protest. Yeah, it hurt to write a check that big but I was alive to write it.

Except for writing the big check once I'd gotten home, I'd say this is how it should be in any rational health care system. There should be no harassment at point of service, no demand of money from people who are sick and barely able to go home.

I hate the health care nonsystem in this country. It combines the most inefficiency with the maximum of cruelty. I worked in it off and on for most of my life and I've seen the changes as soon as MBAs got into management and those changes have all been bad ones.

It needs a complete overhaul, starting with getting docs who are too old to practice back into management, tossing the MBAs back to running supermarket chains, and instituting single payer insurance.

This ^^^^^^. They sure muck up everything, don't they, except their own bank accounts of course!

The lust for profits even in non profit hospitals combined with ruthlessness with employees and the constant need to speed up every single worker has been a failure. Nurses and other staff are burning out at record rates while management comes up with stupider and stupider hoops to jump through, none of which have done a thing to improve patient care or positive outcomes.

It's OK for these jackasses to degrade service in a big box store, that's merely annoying. When they do it in a hospital, it can be and is deadly.

High burnout here, and cutting salaries to where it's no longer worth it to go to school for it. Doesn't pay enough and there aren't enough jobs to pay off student loans or justify the investment. If it weren't for the President's income based student loan repayment program, I would have been forced to sell my home at bankruptcy price (half its market value) and I wouldn't have enough left to start over.

We recently got a replacement blood gas analyzer. The old analyzer had some timing involved, but it was enough time that we weren't stressing horribly.

The new one allows us exactly 12 seconds to complete a sequence of steps or it kicks us right back to square one. Then we get to start over with a rapidly degrading specimen. It is clearly designed to force us to sprint through the process, without consideration that we are already seriously stressed or consideration of the fact that it opens the door to mistakes. How easy to miss correcting the patient temp if we're clicking through steps as fast as possible. But if we take the time to ask the resp tech if the patient's temp was 37, we may miss the 12 second deadline. This just kicks the stress level up. Everybody hates this instrument.

It wasn't a working tech who chose this instrument. It was a lab manager who snottily makes it clear not to ask her any questions because she doesn't know anything about actually working on the bench.

That said, MBAs may not be directly killing patients and their caretakers, but it is not ok running workers and communities into the ground and generally destroying our overall economy. Which is what they have been part and parcel of.

Very glad toehar you were treated so well, Warpy.

When I lived in Marin County Calif., one of the most expensive and tony places in the world, there was always at least one instance every eighteen months or so of somebody being turned out of Marin General Hospital, regardless of their ability to cope, and dying soon afterwards.

In one event, the person had been in the mental crisis section of the hospital, and was turned out before they were truly stabilized. No one had bothered to see to it that this mentally ill person had a relative coming in to get them, or to even call them a cab. Their dead body was found on the premises within 24 hours of their release!

Imagine how the relatives felt - their loved one was finally "in hospital" and getting the needed help. Only to die because of the reprehensible system of caring for a patient only till the insurance was up, or that bed was needed by someone with a more "platinum" version of health insurance.

as soon as they located the diamond bracelet you had on when you came in. Put them on the defensive.

*ouch*

That is all.

and am confused about one thing. Did the treatment you receive relieve you of your symptoms? If so, are you upset that the hospital undertook steps to make sure it received payment? Or did you expect the service to be free?

It's hard to know how difficult is when you don't have money or have a very limited budget, ain't it. Hope you never get to walk in our shoes.

some people just don't have a fucking clue.

An ER is what it is. There is no prior patient-physician relationship at the time one walks in. Thus, no billing records/information, and no way to verify or ensure payment will be received.

I am NOT harping on a patient's (or the OP) questioning the propriety of a provider requesting financial information or even demanding payment while they are still at the hospital. I get that. But what are the alternatives? Free medical treatment? Bill the patient later and hope it gets paid?

Now, if the issue is that it costs too much, or there are two different sets of billing, then that is a great discussion to have. I have plenty of personal experience there because I work closely with folks and providers trying to have their medical bills reduced.

....then it's the JOB of the ER doc to form a relationship, don't you think? Those people aren't going to the ER because they want an aspirin...they need immediate help from someone who at least acts like they give a damn about them.

Just in case you didn't know, lots of people go to ERs as a last resort because they don't want to get even more ill or possibly die. Some of those people don't have health insurance or the money to pay for basic needs like food and utilities, much less for medical care.

Maybe you would prefer to see sick or injured people questioned first about their finances before they get treatment, and those that can't pay immediately are refused treatment. Is that what you would like to see?

I bet you're a real joy to deal with when you're working "closely with folks and providers trying to have their medical bills reduced".

Actually, no, it's not. Relationships form over time and that generally is something lacking in an ER environment. The relationship between doctor and patient in the ER is, by its nature, minimal. That doesn't mean the doctor doesn't do as much as possible to understand what is going on with the patient. That can include their poverty, as it relates to their illness. But they have no baseline history, which can make diagnosis and treatment very challenging.

The job of the ER doc is to figure out what is wrong with a patient about whom they frequently have zero medical history, and keep that person alive and get them as comfortable as possible.

That said, it is not the doctor's job to collect payment or know the patient's insurance situation. It is only to treat the patient.

The people doing the money thing are administration. And it seems like the hospital in question has shitty policies. I'll bet if the treating doctor knew how the high BP (or any other) patient was treated by administration, the doctor would not be happy.

(And I agree that the poster in question didn't phrase that post in a very acceptable way.)

That is really the issue here. We have THE MOST FUCKED UP health delivery system. I am speaking as someone who watched my sister with cancer die because she was poor and uninsured and am currently watching my best friend's insured family go broke because they she has brain cancer.

Until we have universal health care we are FUCKED. That is the only alternative.

One: are you OK? My wife couldn't find you on FB to find out... she goes by married last name now .... and her first comment was "omg, she's young to be having a BP that high" so... we are thinking of you! Keep everyone posted, please!

Two: This person's "spouse" might be....what's a good word? Imaginary? We have friends still in EMS, and they are WELL aware of how awful prices are for basic care. Constant conversation...prices, AND availability. (long wait times in the ER's) So, Dr. I.Spouse either graduated last week, or has some other bizarro excuse for not giving a damn about causing more stress to their patients economically.

We hope you are OK...thinking of you!

she was horrified by what was happening in the hospitals in the nineties...if your spouse hasn't noticed that things have gotten worse in terms of care or money, then you just told me that he or she graduated last week. On Friday.

sure trumps whatever experience my better half has--and you also presumed wrong. Besides, I didn't think this thread was about general health care. I thought it was about the hospital's efforts to be paid for its services.

This thread IS about the "efforts to be paid." If your spouse hasn't noticed that is stressing her patients, then maybe she should go into a different field. Like pathology. Medical examiners also get paid fairly well, and their patients generally are quiet and cooperative, and no longer worry about money.

...was that just a poor choice of wording on your part?

Are you upset by the legalized banditry performed by our ERs and hospitals these days, or do you think the Hippocratic Oath no longer has any meaning?

... far away...

You're confused alright. I guess everyone should be paid like lawyers, eh? Think again.

The health care delivery system does not produce widgets based on the emergent patient. Third party reimbursement defines the conditions of "coverage", so they do not have clerks collect the bill before ANYONE the course of care is finished during the episode of care. If the 3rd party reimbursement isn't fiscally "healthy" for the providers, they cost shift to private payers, who get boned up the ass pretty well by people like you.

Get unconfused wherever you trail off to, now... Buh-bye...

because I defend my wife's profession, and am generally appreciative of the hard work of 1) largely under appreciated people that live up to their elbows in stranger's blood, and 2) working in an environment where they do not get to pick and choose their customers--I'm a jerk. ER work is damned hard with notable burnout rates among all employees. And in this thread we have a patient that went to the ER for treatment, and was relieved of her terrible problem, and the focus is on the hospital trying to recover payment. If I blew up the point of this thread, I'll get out.

Now, is our healthcare system screwed up? Hell yes. I never said it wasn't. I'll be the first to say that the "haves" get better care than the "have nots". But that is an across the board sort of unfairness. I am hoping that the reforms which have pbeen implemented will balance out those inequities.

Ask that guy who's wife was a paramedic if she felt unappreciated. My guess is she was doing the best she could. And I suspect there were many times she left work having been punched, kicked, puked on, bled on, and whatever else may happen in a controlled chaotic environment.

until the billing situation was taken care of and you come in here and start attacking her and asking if doctor's deserve to get paid for what they do.

Yes, you acted like a jerk.

I think if you could separate the non-life threatening events and compare them to say, a doc in the box, would
the hospital match in cost? No. Obama always talked about the er being the most costly deliverer of medical
services.

My idea for fixing the system is to leave hospitals for surgery and high medical emergencies..and you could even leave it private - and limit coverage to "hospitalization" -- the way it used to be.

And let the government create clinics for non-life threatening events and subsidize those. Or, people could opt for private practice and pay oop - the way it used to be. And, do like Europe and expand the authority of pharmacies. It's a crime to have to pay a doctor $100 for an antibiotic when you know you have an abscessed tooth or a urinary infection. And, before someone says ...abuse of antibiotics....yada yada yada...cite the incidences of this in Europe

HMOs were the worst thing that was ever invented. I suspect the idea came from a bunch of medical fat cats in a hotel bar on a cocktail napkin. One person said "hey...how can we make more money?" "Let's get a piece of the pie every single time a person goes to the doctor."

Yep. She did. Everything you wrote is correct...EXCEPT one: the health profession, the ER should be focused upon wellness, NOT bills. Feeling "unappreciated" has exactly zero to do with the prohibitive cost of treatment. If your wife doesn't love her work...for the very real reasons you stated....then she should move on to a less stressful area. And perhaps work on changing the system. Many of the "punchers and pukers" are so beat down by the predatory capitalist system in the US that they are self-medicating with alcohol and illegal drugs. Ask your wife, I am pretty sure as an ER doc that she can tell you about this.

The complaint was about how administration goes about collecting $$. You're welcome to defend the practice of collecting payment up front, but would be well advised to do so in a more compassionate manner.

(I work in a hospital lab, so I get to go into the emergency room and draw people, never knowing what disease they're spewing all over me. As one of our phlebotomists put it, there's nothing like having someone cough all over you in the ED, and then a few hours later drawing them on precautions in a tb room. One of my co-lab techs recently had to undo prophylactic treatment for Hep C after an accidental needlestick thanks to the cheaper butterfly needles courtesy of administration saving a few cents.)

The 100 bucks was your co-pay right?

Given that you work for the gov, don't you have several ins options like a PPO/POS or HMO?

The only ins I'm aware of that costs a lot out of pocket are MSAs, that's why their cheap.

That's plenty out of pocket in my book and not cheap.

I don't know what ins CW has, but we have the plan offered by my husband's employer and just thinking about that 20% of a serious medical service bill we'd owe is a real stresser.

most of the big insurance companies have gone to "consumer driven' model. My wife works for one as a nurse case manager- and our deductible is 2500.00; copay at primary care is 15% of negotiated rate; copay for meds varies from 10 to 50 dollars an in some instances more; hospitalization requires a 20% copay until out of pocket max is met. (4500.00)

One of the things that I have learned from her is that primary care is an absolute must. Seeing your doctor BEFORE things get bad is much better for everyone involved- the patient; the ER (lessens their load); the insurance company. And you do have a relationship with your primary care doctor, so your care is likely to be much more personalized.

i realize there are times when one must utilize the ER, but there are many times when it wouldn't have been necessary if the patient was being followed by the primary care doctor and/or sought care when symptoms first appear.

All that being said, glad the OP is doing better!

Sorry about the high BP issue and the way you were treated post treatment. Hope you are better

Also sorry about you being attacked by that very sensitive attorney and his ER wife. My wife and I were in the health field for a combined 75 years. A goodly portion of it in the ER. Never was payment expected at discharge, especially when presented with a insurance card. But even without insurance, the priority was to improve the patient condition and get them either home or to the floor. Now I know that our 75 years of RN experience will be trumped by an ER "doctor", but this guy is out of touch. If he does not know how flawed our healthcare system is, maybe he is the presumptuous one. And if he does not understand that their are dual billing methods in health care, he probably is in the wrong business. His sensitivity is underwhelming, and he sounds like one of those "I got mine an to hell with you" guys that my wife put up with for so many years.

You hang in there. We are offering our best to you.

I gave them my insurance info when I checked in, and that was it.

They got my address and phone number too, verified by driver's license.

If it's a minimal mandatory fee of $100 due before you leave, they need to put up a significant sign stating that. Otherwise, it's not ok in my opinion. The vast majority of us pay our bills or at least try hard to.

Sorry to hear about your bad experience.

knowing that?



Sorry this happened to you Catwoman. I hope your insurance ends up picking up most of that $500

Nearly a year ago the Minnesota Attorney General went after Fairview Hospitals and Clinics and Accretive because they were using methods that sound similar to your story (see link).

http://m.startribune.com/news/?id=148697255&c=y

Accretive is a Chicago based outfit & Rahm Emmanuel tried to get AG to back off them (Rahm met his match in Lori Swanson):

http://www.democraticunderground.com/1059574

Several years ago, my mom wound up in Fairview's ER and they tried this shit on her which really upset her and made her ask if she should just leave because she couldn't afford any out of pocket. Fortunately, I was there and I knew she was not required to cough any cash at that time (because she had Medicare and a program called Minnesota Senior Health Options, not even a deductible) I chased the money changer out of the area and told her if mom couldn't pay her medical bill she'd just declare bankruptcy as that's the American Way.

Long story short, they are no longer doing business in Minnesota in fact I think they are banned from it for a number of years.

When Mom was in ER last spring they only checked her insurance cards. When I wound up in a Fairview ER a few weeks ago with a broken wrist because my doctor is at one of their clinics, they didn't even ask to see my insurance card or ask for the $100 deductible I owed them (and still haven't received a bill for).

Things can change when enough noise gets made. The reason this came to light is that people complained to the AG's office.

It may be worth your while to file a complaint with your state AG or whoever might have over site of matters like this. I know it can vary from state to state.

are IMO stupid. I just can not believe some Americans think healthcare is fine. There should be millions on the steps of congress telling those fuckers to get their act together and to get out of the $$$$$ pockets of the profiteers.

The healthcare system is pathetic. It's a cobbled together mess.

There's no excuse for how the financial department treated you. Can you file a complaint?

On the other hand, I hope your health is stable and you're doing well (aside from being super pissed off).

in my city's hospital. I registered the people who were there for things like blood tests and MRI's and x-rays and the like. We had -- the employees still have -- quotas of how much money they're expected to collect in co-pays, or as much up-front as possible from uninsured patients. If a patient was uninsured, we were authorized to offer a significant discount if they would pay the bill immediately.

Bet you didn't know that.

Insurance companies vary enormously on how much they pay for various procedures, or what they'll cover. Sometimes, but rarely, the person registering will know that your insurance isn't going to pay very much. Usually, it all waits until the insurance company denies coverage and then the real bull-shit begins. The problem isn't so much the hospitals as the insurance companies, who will do absolutely everything possible not to pay for the illness or accident or whatever. As I was told during my training, the insurance companies are in the business of denying payment.

Also, for those of you who feel you cannot afford insurance, try to find something with a truly enormous deductible, like $10,000. Because even though you'll be paying for everything out of pocket until you reach that amount, you'll be billed the far lower rate that insurance companies get charged, rather than the enormous amount an uninsured patient pays.

I still work at the hospital, only now I'm on the information desk. It's a great job. Nothing I do impacts how a patient is treated, nor what he's charged. I get to smile and be friendly and give out good information.

Sounds like extortion, as other folks said.

I can't believe they treated you that way.

I was in the ER last month. They asked for my insurance card at the registration desk but gave it back after reading stuff off of it. They didn't keep any ID or ask for money before I left. I just got the invoice for balance of the bill last week which was $50.00.

sorry our system sucks so much

when you were put under all that stress over the bill? Sheesh!!!

I really do believe some people are too stupid to live.

If you were told by the va that you needed to go to the ER you should call the va and get a caseworker on the phone. Very important that you get the information in your medical record. I dealt with a similar type situation a couple weeks back with a veteran who needed to go to ER and as long as the proper process was followed for non-VA care, the VA covered it. Again, call a VA caseworker or patient advocate.

I had a motorcycle wreck - nothing bad, I broke my jaw but was still mobile. BTW, I had no insurance. I went home and called a friend who was the ex of a doctor. She came and got me and ran interference for me at admitting, since I was starting to go into shock. Before she left my house with me, she grabbed some letter paper and a pen, and I took some cash I had. The crap started as soon as we walked in - basically they were trying to find a way to turn me away. I had enough cash for admitting, and they were very unhappy when I put $3K on the counter. Then they started to question me and come up with reasons to turn me away, and this is where my friend stepped in. She started talking to them, and they tried to not talk to her, and BS her about why, but she knew the rules. When they would throw out some BS reason, she would write it down, show it to them, and ask them, "is this what you just told me?". When they said yes, she said, great, now sign it to attest to your statement." Then the back pedaling began. "No, I'm not signing that." "But you just said this is hospital policy, so why won't you verify by your signature that this is the correct policy?". Then they came up with another reason, and she did the same thing, started writing it down. So I'm getting foggier, and the billing dept calls in the supervisor. Friend shows him the, by now, three papers with the reasons on them, and asks him to sign it, to, again, verify hospital policy. He gets belligerent, and refuses, so she tells him, that, if he won't sign it, and will not produce a printed copy of the policy, then somebody there is lying, and lining themselves up for a lawsuit, should they delay my admission anymore. Why won't he verify the policy by signing it? And if they expect me,the patient, to sign a contract that says I am responsible for payment, then why won't they sign one that explains the policies? All of a sudden, the guy realizes he is backed into a corner, so he grudgingly lets me in. She told me later, that admissions and billing will tell you anything, but as soon as you write it down and ask them to sign it, they will back away, because they do not want to be responsible should anything go wrong. And no one should go into a hospital without a patient advocate.