Anecdotal illustration time:

Both my kids were born early. The medical bills for both totaled (with hospital stays for babies and mom) north of 100k each, the second WAY north.

Both involved situations that were "emergency" type situations. We couldn't shop around, we couldn't even sign anything. We trusted the hospitals and doctors and went from there. Fortunately I had good insurance, if for some reason I had to pay it would have been a huge financal burden for years and years.

And let's say I did have time to think about it? What then? I'm not a doctor, this isn't shopping for a car... I don't feel like I could possibly know enough about emergency baby birthing, surgery, etc to know... "Gosh honey when the baby's heart rate starts to slow unexpectedly, I think we should save a few bucks".

I think pregnancy and labor is what's going to finally break the camel's back.

Having children is a pretty basic part of being human. And the costs are such that even millionaires are going to feel it. When basically nobody can afford to participate in reproduction, something is going to go sideways.

With my "good" insurance, I still ended up with a multi-thousand dollar deductible. Which I thought was problematic until I started hearing about people who have high deductible plans that only make you pay 20% after hitting your deductible.

For a 100K bill, 20% is still absurd and especially after you've already paid $2-10K out of pocket.

Usually coinsurance is limited by an 'out of pocket maximum'. So even if something happens where you end up with like 600k in medical bills the most you will pay will be like 8-20k (depending on in-network vs out of network). Which is still insane but not as scary as six-figure medical bills despite being insured.

One issue with describing figures like 600k is that I think the medical industry has a lot of funny money running around. The doctor somewhat arbitrarily charges 10k to the insurance company, insurance disputes, the doctor hires a lawyer who takes 30% of the negotiated outcome, and negotiation finally ends up at $2k.

The patient sees a $10k bill, pays a $300 deductible, and only $2k ever actually materializes in the exchange between doctor/insurance. And afaict, this is the expected operation.

Of course, when you're uninsured, the numbers stop making any sense, because they fail to go through the convoluted process that reduces it. You just get the $10k bill and thats the end of story. But for the insured, a $10k bill is not $10k exchanged.

Yeah, some of the explanation of benefits I've received are insane. Insurance is apparently able to negotiate ~50% bill reductions for multi 10K bills.

Dealing with Indians, the normal bargaining tactic is apparently start with like 300%/10% of the expected, and end up at 110%/90% as anywhere else would. From America, starting is 120%/80% or so. Totally confounding when you first start negotiations, because they're offering these absurd numbers as if its normal..

I think the same culture exists with doctors/insurance. It's not that they're skilled enough or have enough power to negotiate down 50%... doctors are putting numbers up expecting to be reduced to 50%.

And then us poor saps get slapped with these absurd numbers and thank the gods we had insurance... but no one involved ever really expected to pay that number. And ofc, without insurance, you're like an american trying to shop in india -- no idea how to play the game, trying to negotiate in the american fashion with 120%/80% when the other guy started with 300%, and don't have the information to realize that initial $20 offer negotiated down to $18 isn't even close to what an indian would have managed (probably $5).

And its not like he's going to correct you when you fail to negotiate properly.

> Which I thought was problematic until I started hearing about people who have high deductible plans that only make you pay 20% after hitting your deductible.

If I'm not mistaken, those plans also have an Out-of-Pocket Maximum. So you pay 100% up to your deductible, then some fraction of the cost above that until you hit the OOP max.

Well that’s how they get you. Well it’s your dear ones life. Surely money isn’t an issue right ?

Here take this bill that will bankrupt for the rest of your life.

The big problem is that every other modern country has this shit sorted out. They don’t bring crippling debt because you got a minor surgery.

In US, we are literally murdering people because they are too afraid of what it will cost.

>...literally murdering...

Literally one of those words is not being used correctly.

Considering she was unconscious she could not possibly have consented to those transactions. What laws exist that allow these companies to unilaterally create these transactions, and what limitations do they have?

They have literally no limitations. The reason that an advil at the hospital costs $200 is because they were afraid if they made it cost $20000 people would burn down the hospital.

This is the first comment on the page that has something other than "more government regulation" as a solution. Just sayin'.

Considering how many people have had their lives ruined by absurd hospital bills I'm honestly surprised nobody's shot one up yet.

Really, the only surprise is that you didn't Google "hospital shooting", the following hit from Google lists 15 hospital shootings in 2018 alone:

https://www.campussafetymagazine.com/tag/hospital_shootings/

I guess you can go look for the motivation, most shootings probably isn't financially motivated thought.

There is an out of pocket maximum of $7350 for 2018(going up to $7900 for 2019) for ACA compatible plans. Many plans have lower out of pocket maximums too. The health insurance company will negotiate and generally pay substantially less than $377k for a $377k bill.

On the flip side, what laws exists to say a hospital can't treat any unconscious person since they can't consent. Damned if you do, damned if you don't.

I would imagine regulation is a lot of what stops competing on price like everything else.

> I would imagine regulation is a lot of what stops competing on price like everything else.

Say again? Unconscious people don't have the agency to make price competition work, regulation or no.

You need to be conscious to comparison shop. You also need lots of time to do so, time you don't have when you're having a heart attack or bleeding out from a severe injury. Regulation isn't the problem here, it's the lack of the right kind of it.

Being conscious or not has little to do with inability to comparison shop for healthcare in general. I wouldn't disagree that what you're talking about should be illegal and I would expect it to already be illegal.