I got 1 stitch at the ER (before I was aware that Urgent Care was a a thing). First hospital visit in my adult life. Some saline solution, an alcohol wipe, a shot of Novocaine, and 1 stitch. $3,200. I now avoid the hospital like the plague (ironically).

It's amazing what tiny tidbits of knowledge like the urgent care thing can save you.

Recently when picking up the tab for a relative who went to an out of network hospital I discovered another one. The first was an enormous discount for paying same day (so if you're well off but have bad insurance they just pretend you have mediocre insurance). Combined with the power of saying "Really??? Isn't there anything you can do?" to as many people as possible, $1,600 became $360.

So the lesson is on one of the worst days of your life focus on what really matters: haggling, being an informed consumer, and obscure policies.

I hit my head a while back and had to get about 10 staples. Total cost was only $150 without insurance. This was at Penn Urgent Care in Philadelphia. Our combined anecdotes reveal how useful it would be for customers to be able to shop around.

I got the same procedure at a cash-only walk-in clinic. (Eight stitches, actually -- a chunk of flesh was literally dangling from my finger.) $200.

We will never get control of the insane cost of health care until we force medical facilities to actually compete with each other.

Normal countries do this by imposing price controls, and it works remarkably well to contain costs. Why can't the US do the same?

Unfortunately, central planning stifles innovation. We have the best cutting-edge medical technology in the world for the few who would like it and can afford it. But by eliminating pricing transparency we've also eliminated the incentive to make those technologies cheaper and more accessible to the common man.

You don't need innovation for the usual complaints that you see a primary care physician for - broken arm, throat infection &c. That stuff lends itself to standardization and following of protocols.

Except when your broken arm needs to be reduced or you have an open fracture and you require moderate sedation to have a physician perform those procedures. Not so standardized and not to protocolized.

I don't know about suicide or ruining their lives per-se, but people often go bankrupt from medical bullshit. Also it is quite common for people suffering from all sorts of things to wait until their minor discomforts become intolerable suffering before seeing a doctor, which is how I operate. Too many physician visits where a doctor filled out some Epic form bullshit while ignoring me and then pushing me out of their office as quickly as possible because I wasn't currently dying.

>I don't know about suicide or ruining their lives per-se, but people often go bankrupt from medical bullshit.

One study found that only 4% of US bankruptcies are because of medical bills https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0... . A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause. The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.

As a comparison: For ultrasound, the price range in Germany is 100-200€ - but our hospitals don't have to inflate prices to account for non-paying patients and the salaries/other overhead costs are lower too...

If the US wants to get rid of horribly high sticker prices it needs a reform of how stuff is paid for, especially homeless/unemployed/undocumented patients. In Germany, the state covers insurance premiums for the first two categories and undocumented/asylum seeking patients only get life-saving treatments (truly inhumane if you ask me).

Non-paying patients are, while frequently trotted out, not the reason for why prices are 3-4x higher in the US.

Outside of the ER, if you don't have insurance, and can't pay, you'll get shown the door. The overwhelming majority of medical procedures that take place across the country are not done in the ER.

So many medical clinics and outpatient facilities don't have to deal with costs supporting those groups and they still have outrageous pricing. The homeless/unemployed/etc groups only really affect emergency care. If they aren't about to die from lack of care, the hospitals aren't required to treat them.

I saw a hand doctor and got hit with an $800 “facility fee”. Total BS.

My wife got one of those “fun scans” 3D color ultrasound when she was pregnant. $75 a full 45 minutes with technician on a brand new $$$ ultrasound machine.

A regular, 5 minute diagnostic scan on archaic machine is over $1k.