Similar thing happened me.
TLDR: Went to two ER’s. The first one said they couldn’t help us and charged us over $1000, the second went to bat for us with our insurance and got the cost knocked down.
Full story.
I had a daughter (~4-ish) who was experiencing unexplained symptoms that appeared almost overnight.
She had complained of pain when moving her arms and developed, what looked like a sunburn, on her back. I put calamine lotion on it and put her to bed. The next morning, as I was rinsing her off in the shower, her skin just started sloughing off where I had put the lotion. It looked like a chemical burn to me.
It was a Saturday morning. Immediately went to urgent care. The Dx said he had no idea and that it looked like a chemical burn to him too. Said I needed to go to an ER. I went to the closest ER (Houston Methodist Willowbrook Hospital). It was empty. They checked us in, put her in an examination room and took her vitals. After an hour, a doctor came in and said they don’t know what the issue is, they don’t have a pediatrician on duty, and they can’t really help us!? The Dx then suggested I take her to Children’s in downtown Houston, and they would arrange an ambulance. Fuck that, I told them no and I took her myself right away.
Got to Children’s ER, they put us in an examination room right away. Within 5 minutes, a nurse was in the room and immediately diagnosed her with a stage 4 staph infection (scalding skin syndrome). She gave her an I.V. and they started pushing antibiotics and morphine. (Later had to swap pain meds, because the morphine made her itch and every where she itched, her skin would come away.) I still have to fight back the tears when I think about it. They said if we had waited another 8 hours, she would have likely died. She spent five days in the hospital recovering. But she did recover and is doing very well now.
So, two different stories about hospital billing from this experience.
The first hospital charge us over $1000 for the visit. $1,000 to be told we can’t help you, but let us make you sit and wait while this infection progresses in your child.
Children’s was out of network for our United Healthcare plan and UH passed the full bill on to us. However, Children’s actually went to bat for us and negotiated with them and got them to give us the in-network rate and paid off 80% of the bill. Not before or since have I had a hospital help us like that.
We ignored the bill from the other hospital. Fast forward a few months and the hospital is calling us. I sat on the phone with the lady talking to me and I argued (nicely) that I felt it was unreasonable for them to even accept us, knowing they didn’t have a pediatrician on duty, and actually put us at risk by delaying treatment. I actually got her to admit that she agreed that it did not seem right.
Then the bill just went away and never heard from the hospital or anyone else again about it. So I am assuming they wrote it off. I know that medical debt is sold to debt collectors sometimes, but we have not seen or heard from anyone for over ten years.
I get that hospitals are stuck between a rock and a hard place sometimes, especially in the states, but my experience, the experience of the woman in the article, and the fact we spend more money on healthcare, per capita, than countries with a fully socialized system, just proves to me the lie that is sold to us on a fully private system.
Wait wait wait… I thought only socialised healthcare had wait times???
Last time I visited public ER in Spain the wait time was about 30 minutes. I’m sure it can be a lot worse in some placed but for me it was never more than 1 hours.
ER triage is driven by risk of death or serious harm, not by level of suffering
In a system of free healthcare services, I would expect patients with more severe outcomes to be treated first…
Hell if they were kind enough not to bill for the privilege of sitting in a waiting room for hours of suffering, then I might also accept that…
But in a system where I’m being billed hundreds of dollars just for the privilege of being triaged and sitting in your waiting room, you can kindly fuck off with that prioritisation bullshit and get to work on the people who came in first.
But in a system where I’m being billed hundreds of dollars just for the privilege of being triaged and sitting in your waiting room, you can kindly fuck off with that prioritisation bullshit and get to work on the people who came in first.
That’s just not how emergency medicine works. The goal is to save as many lives as possible. If your condition is not immediately life-threatening, you can wait longer than someone having a heart attack or who got shot or who has a shattered femur or something.
In principle I do agree with you - ER care should absolutely prioritise the sickest individuals first, to ensure the least loss of life.
But I can only reconcile that in the case where you are not actively being charged for the privilege of waiting in line.
When everybody in that room is being charged hundreds of dollars for the privilege of suffering in line, then that philosophy can kindly fuck off. See the people who started paying first.
I mean I also believe you shouldn’t be charged for access to emergency medical help at all (tax payer fund it) - but that’s a non-sequitur
The charge isn’t for waiting in line, and it doesn’t increase with time spent in the waiting room. The charge is for whatever they already did. Triaging and vitals are a thing someone is doing. And in emergency medicine, everything is expensive. This is why for those who are able, Urgent Care centers are much more useful than an emergency department. And why we should be prioritizing preventative measures rather than treating the ER like a primary care physician.
(Or, more accurately, why we should become like every other developed nation and have universal healthcare.)
Now she’s getting targeted ads for 3D printers.
What about her billing the ED for waiting time? At $125.00/hour.
They billed her for waiting or what? Using the chair?
They took her pulse, blood pressure and billed her 410 dollars. What a scam.
Murica!
Yeah, that is how the health care system works over there. What’s the news?
Honestly, it’s not the billing for me.
It’s the doctor the day before that suggested going to an ED the next day—literally not an emergency—and her actually doing it. They must’ve actually said something like, “If it starts getting unexpectedly worse, Id recommend going to an ED, otherwise just keep doing what you’re doing.” And she took that as “If it’s still sore on Day 7, it’s suddenly an emergency.”
Unless that migraine started in the last few hours and is escalating at an alarming rate, that initial exam room is sending her back to the waiting room and her priority of “emergency” is going to be so low compared to everyone else the staff in the ED will see that week.
The other hospital that saw her as quick as an hour and a half must’ve been having the cruisiest day of the year.
If I got that bill, but I wouldn’t where I live, I’d look at it as a fine for calling the fire department on a trick candle I couldn’t put out.
The first Doctor was an urgent care center. They are usually very limited on what they can provide. They are generally MUCH cheaper than an ER, but they can only do so much and do not provide any in patient care. He suggested an ER, because if her migraine had not gone away by then, then she was going to possibly need more advanced care than he was able to provide. ER’s can diagnose to a higher level and then provide that advanced care.
I think of urgent care as a midpoint between school nurse and an actual hospital.
Kind of frustrating that she ultimately only received the same level of care at the ER, that she got at the urgent care clinic. But to the original Doctor’s point, he was not going to be able to provide anything further than they already had, so if there was anything else that could be done, or another contributing condition that he could not diagnose, the ER is where she would need to be, to determine that.
I see my PCP for my migraines, but he has hours, so if I have an episode that does not respond to meds, and is not going away, they also tell me to go to an ER.
