Posted on 10/10/2025 10:51:51 AM PDT by SeekAndFind
Ten years ago, my daughter asked me “Why do we have health insurance if we aren’t allowed to see the doctor?” I had a three-day rule where my premise -- most non-serious conditions resolve in 72 hours -- so no need to waste my time or money going to urgent care. Besides, rising premiums pushed me into high-deductible health insurance.
More than a year ago I rushed my younger child to urgent care and the bill remains unresolved. After a heavy object was inadvertently dropped on his finger, causing it to swell 2X its original size, we headed to urgent care the next day when swelling, pain, and movement ballooned.
The visit was brief. Though the front desk clerks were inefficient, the nurse whisked him quickly to the exam room. The doctor’s exam was thorough -- he was judged unlikely to have broken bones or require surgery, yet a plain x-ray was ordered to confirm.
So I summarize: time spent included a 10-minute doctor visit, 10-minute x-ray, and 1 hour check-in. The bill arrived a few months later: doctor visit was $426.07 and plain x-ray was $501.38 for the facility and $78 for the radiologist. The $1000+ bill was crazy expensive. My outpatient kidney CT scan a few years ago was under $500, and despite my rule, my son saw the same urgent care doctor the month prior with a lower visit cost ($240.86) and a longer visit time (30 minutes). A friend seen at the same urgent care with a swollen ankle was also billed the lower cost visit.
I assumed they made a mistake. I called Stanford Healthcare to dispute my bill and was told only procedure codes can be disputed. So the rep gave me the procedure codes responsible for each item on my bill.
(Excerpt) Read more at americanthinker.com ...
Here’s how the author ends her piece:
The protections offered by the CFPB and estimate’s accuracy limitations illustrate how the regulations designed to prevent “surprise bills” or price transparency ultimately fail when divine moral law based on love, rather than fear, isn’t followed.
The laws protect those with financial self-interest to upcode (physician) or collect higher reimbursement (organization re: private insurance). The internal law subject to human conscience and moral intuition would create a more fair system that would enable patients to observe the hospital’s irrational pricing variation they’d prefer to keep hidden.
If I were told the correct cost of the visit upfront, what would I have done differently? Perhaps I should return to my first principle, that a swollen finger or twisted ankle isn’t sufficiently serious to warrant medical attention. But in the end, we don’t know the billed amount until the bill arrives since the visit’s complexity level remains a variable.
Personally, I’d rather take my car to the mechanic where I’m given a binding estimate prior to agreeing to service.
The whole system is built to enable cost shifting, courtesy of a third party payment system plus Obamacare, which established community rating and guaranteed issue.
If you have good insurance, you are a cash cow for the socialists in charge. Everyone with insurance will be billed to the max on every procedure, with the obvious overcharges offsetting the uninsured and gender affirmation surgeries for people with too many piercings and tattoos to hold a real job.
Then perhaps the solution is to abandon the system, patients and doctors, and return to cash only. No more insurance beyond catastrophic.
Why does elective surgery, say plastic surgery, not have this problem? They can quote and stick to the cost down to the dollar, consistently and the costs are actually far less bloated.
When government comes to help, even if it's a black guy that articulate and clean (Biden's words), things WILL get messed up, even if they sell it really hard and the MSM gets behind it because it's a liberal cause pushed by a Democrat.
That option should certainly be available to people. It would require repealing Obamacare.
I retired recently and ran in to former co-worker.
Since my departure the plant I worked at has been sold off.
The new owner company is outsourcing pretty much all workers.
His group was the first. They cut pay drastically and medical insurance has faced the cost cutters.
His deductible is now $9000. Doctor's visits have a $100 co-pay.
With that kind of insurance I think you may as well not have any or buy insurance on your own. Catastrophic insurance should be more affordable.
I was shocked.
The group I worked with has not yet been outsourced but he told me they were working on it.
I retired early because the company was working on eliminating my position.
I have yet to have any reason to suspect that I made the wrong choice.
Hospitals are so crooked. I had to have emergency surgery about 10 years ago. They presented a bill of close to $60,000. When I said I am paying cash they knocked off half the cost. After arguing over the bill further it was knocked down to $17,000. So much bogus non existent drugs, services, and equipment that was never used was getting billed and when they get called out they know it. They just expect some insurance company to write check.
If people had to pay up front and see what it really costs the system would radically change.
Do what I did once, pay them what you think it is worth and ignore the rest.
First I made them an offer in writing, It was for 75% of the billing. They refused.
I wrote them a check for the amount and stated invoice number and 75%, “Paid in Full”. They never cashed the check.
They turned it over to collections and I ignored them. Collections said it would put bad marks on my credit rating. I told them I didn’t care.
About 4 or 5 years later the letters and calls ended. My credit rating never changed. I never borrow money, haven’t in at least 35 years and I pay all my other bills in full each month.
When you go to urgent care you should expect to get raped. That is the business model for service you can’t get at an ER.
Prices are outrageous, but do not confuse price with the amount you pay. It is Medicare and insurance that determine approved amount and determine your contractual deductible or copay based of your coverage.
UK private sector: my optician has full eyeball scanning technology plus other diagnostic kit - the fee for an emergency appointment with full assessment is £80 with each scanning technology £25. Don’t bother with insurance as it’s never going to break the bank. My last trip, including the cost of the basic exam + new spectacles + three advanced scans was £400.
Also UK private sector: dental appointment with X-rays, a root canal and one filling: £600 all in. Insurance covered it fully.
Pet health is the closest we’ve got to your setup. Our puppy ate something he shouldn’t and the emergency vets did a general check and an X-ray, then prescribed him a 5 day course of meds just to be on the safe side. Nothing else. The bill for less than 45 minutes’ worth of work and the pills: £800. We had pet insurance that covered all but a £100 excess.
Difference between pet care and everything else (in the private sector, never mind the NHS) is that many vetinerary surgeries are effectively sponsored by one of a few nationwide insurance companies, who in turn are sponsored by the drug companies. Absolutely everything inside that system has layers of mark-up - to the point where even a drop of shampoo out of a £10 bottle (actual value £0.75 at the most), looks like £50 on the bill. But the system hasn’t been so poorly designed as to allow a quack to generate a £5000 bill out of a 2-hour appointment with off-the-shelf meds and no bespoke kit involved.
Obviously private systems are better than statist ones, which is why I’ve gone private - but the UK private healthcare insurance systems can’t make the cost of treatment utterly unmanageable; they’re not there to bankrupt us in the name of rampant overcharging.
Any system where the insurance company decides a treatment that actually costs $X to deliver should be insured for $10x AND it’s in cahoots with the hospital that sends them the $10x bill, is operating like a cartel.
If car repairs were subject to reimbursement by Medicare, the mechanic would be unable to provide an estimate of cost before the repair. After Medicare came along in 1965, the “invoice amount” has been disconnected from expected settlement and subject to contract pricing, regulations, write downs and “Medicare write-offs”. The whole system has become as complicated (or more) than trying to send a living mammal into outer space and bringing back alive.
If you are self pay it’s $150 at urgent care.
My PCP charges $100 for office visits.
I took my hubby to the dermatologist for a skin cancer check. Self pay was $150 and that included removal of two moles, multiple wens and a cyst on his eyelid.
This is a large part of it. I've lived in the South Bay 30+ years and learned years ago to run if the word "Stanford" shows up.
I've gone to urgent care twice in the past two years. Went to Action Urgent Care on Blossom Hill Road in South San Jose. It was clean. I was treated respectfully. I got in fairly quickly. They did a bang up job. The cost was far lower than I expected. I was quite satisfied and pleased. I chose it the first time by calling my insurance (Alignment) and asking the concierge where to go. He said there was a bunch. I asked him to recommended one and without hesitation he said Action Urgent Care. It was one of the furthest ones from my house and I would not have chosen it on my own but I have never regretted going there and would do so again.
I had an similar outcome when I asked another concierge to recommend a new Dentist after my Dentist of 20 years passed. She said they're all ok. I pressed her and she said "Well we do get a lot of complaints from [name redacted] Dental Services. I went elsewhere and from what I have heard since makes me grateful for the advice.
Don’t take your kid to urgent care for stupid stuff—unless you can pay for it.
All because of government and their control of insurance companies.
Pay cash and it’s cheaper.
Quick story. In 1997 I was in a car accident. I was literally 2 weeks away from being covered so I didn’t pay my Cobra.
Oh well. Cost was going to be $80K. Told them I’d be paying and it dropped to $15K.
Paid the hospital $200 a month. That’s all they asked for. Eventually I started sending $500 or more.
They do that because tgey only get about 40 to 50% from insurance. It’s all controlled by stupid government rules.
I recently had to have an emergency surgery for a perforated intestine, it was 2 months before medicare kicked in and my useless health insurance was cancelled already, so I had no insurance. Anyway, 911, ambulance, emergency room, surgery, drugs, various treatments the whole thing and the Hospital gave me a huge discount. They cut the bill down from $680,000 to $385,000 and then asked me how I would pay for it. I looked at her and said, “This is why people file Bankruptcy and you don’t get paid”. Now they did save my life and took care of my problems so I looked at her and said :
normally this would be a $35,000 surgery all in, it was an emergency so I think you deserve extra for that so I will write you a check right now for $50,000 and we call it even. She came back in the morning and said the hospital agrees to the settlement, I wrote her a check and was discharged.
You do realize the way cobra works you can pay the missed premiums and they will cover you?
I canceled it. So I couldn’t go back. 1997. Rules might be different now.
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