An ER visit is not the same as a simple doctor's visit. If ER visits are necessary (questionable in this case), they are covered by insurance - by law. Your deductible still applies.

Who cares about the deductible? It’s still a ripoff. My girlfriend had an eye infection while we were in Germany. We went to an eye doctor and paid 25 Euro cash including an ointment. The US is just horribly expensive and very unpredictable.

"You should care about the deductible, cause you entered the contract, silly."

This is stupid. There is no real way to shop and bring down health insurance costs in the US. It's tied to your job, meaning you would need to get many job offers, and turn them down when you find out the actual insurance costs until you find one that's better, and ignoring other employment factors.

And then everything can change the next time open enrollment comes around. Don't like the deductible, time to start the job search again! Oh, and the deductibles are probably about the same at all the other companies, anyway.

It's just a stupid system from top to bottom, locked into place because our political representatives are completely uninterested in governing.

When I worked at HP/HPE, we had decent insurance. My family rate was average, not too expensiv. After they spun us off to DXC they claimed to be contributing the same amount, but our rates went up to about double or triple per pay period (varied some with the different plans).

Insurance isn't tied to your job. You can (and often should) forego the employer's plan and purchase insurance on the open market. Most insurances have some form of deductible, it's what keeps them affordable. Insurance should be protecting you against a huge financial fallout, not against petty expenses.

I agree it is a stupid system though and I'll tell you why: People want something for nothing. They want coverage for everyone, they don't want a tax, but they don't want compulsion to purchase and they also want to force insurers to take people with pre-existing conditions. Insurance can't work that way, the money has to come from somewhere.

If there was a compulsion to purchase, the system could work, as it does in many other countries. That's probably unconstitutional though, so it probably wouldn't stand.

Lastly you have "Medicare for all" which would basically bankrupt hospitals if you extrapolate from what current Medicare does to them financially.

You honestly can't blame representatives for dealing with voters that understand nothing and want everything. They voted for Obamacare, then they voted for Trump to make Obamacare even worse. I don't even want to know what's next...

Thanks for engaging, your comments are interesting and thought provoking.

"If there was a compulsion to purchase, the system could work, as it does in many other countries."

Wasn't that one of the major points of Obamacare, to make strides in that direction? And it did pass Supreme Court scrutiny, who decided yes it is a tax, and yes the government is allowed to tax us.

"Lastly you have "Medicare for all" which would basically bankrupt hospitals if you extrapolate from what current Medicare does to them financially."

Across our economy, competition and technology drive higher quality at lower cost. Doctors and hospitals need to have an incentive structure that rewards keeping the most people healthy at the lowest cost. "Capitation" models are meant to provide these incentives, where you don't get paid for "doing things" to patients, like ordering tests or performing surgeries. You get paid a fixed sum per patient to keep them healthy, adjusted for the "risk" associated with the patient (for example, if they have a chronic condition that needs ongoing treatment).

So an intelligent "Medicare for All" system could be designed to incentivize innovation and cost cutting and overall patient health, if implemented intelligently.

It’s tied to your job because health ins through your employer gets an effective tax discount compared to that bought through the ACA market. There is no way for latter to be as economical.

I've priced insurance outside my job. It's never even close and your employer isn't going to hand you the money they were spending on your policy. You basically pay at least 150% and give you employer money if you want to self-insure. You still won't be able to pay your policy if you get critically injured, so what's the difference.

In what way is your comment about price fixing relevant? I don't care if the lower price is because of price fixing or not.

"you're completely ignorant"

Thanks. Very stylish.

mate, the health situation in the US is a joke. the US is less healthy than Oman and Slovenia.

$359 is an order of magnitude less than four figures.

It's also about what we paid for my wife's shoulder. Which, like I said, is bad enough on its own.

What is included in that fee is malpractice insurance premiums (because it isn't that nothing can go wrong in that 10 min interaction which causes you to sue the doctor) paid by the doctor.

On the top of that, he didn't charge you for what it was, but for what it wasn't and confirming it.

Take for instance if that muscle spasm actually lead to something darn serious, the doctor ruled that out, that's why he sent you back after 10 mins. For some weird reason (or counter-intuitive economic reasoning which everyone has got), if you had a serious problem, and the doctor had identified it in that 10 mins, then you'd be ok with that billing.

See it this way, if you're tech security contractor and the CEO calls you urgently to come take a look at suspicious behavior on his computer which he thinks might be a hacker hacking his computer, but it turns out to be a quite known windows bug, that doesn't mean you shouldn't charge him your regular fee if it was an actual hacking attempt. You're getting paid for being on call.

That price has little to do with malpractice premiums. You're paying for the fact that the ER was there, fully staffed, ready to treat literally anything that you could have walked in with at a moment's notice. That and you're subsidizing people who don't pay.