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Thread: Uninsured patient billed more than $12,000 for broken rib

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    Elite Member celeb_2006's Avatar
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    Default Uninsured patient billed more than $12,000 for broken rib

    Uninsured patient billed more than $12,000 for broken rib


    There are 47 million people in this country without health insurance. Richmond resident Joey Palmer is one of them.
    He learned how costly this can be after fracturing a rib in a relatively minor motorcycle accident and subsequently being hit with a bill for more than $12,000 from San Francisco General Hospital.
    "There's no way I could pay something like that," Palmer, 32, told me. "I'm not a bum, but I'm not making a lot of money right now. How is anyone supposed to pay a bill like that?"
    Iman Nazeeri-Simmons, director of administrative operations at San Francisco General, said she sympathizes with Palmer's situation.
    "It's not us," she said. "It's the whole system, and the system is broken. We need to look closely at making changes and at how we can deliver care in a rational way."
    Palmer's story illustrates the broader problem of runaway health care costs in the United States and a system that leaves millions of Americans to fend for themselves.
    It also underlines the importance of universal coverage that guarantees affordable health care to anyone, anywhere -- a goal that's become a central issue in California and in the current presidential campaign.
    "We are the only developed country that doesn't cover all its people," said Stan Dorn, a senior research associate at the nonpartisan Urban Institute. "We also spend a lot more than the rest of the developed world."
    The United States spent an average of $6,102 per person on health care in 2004 (the latest year for which figures are available), according to the Organization for Economic Cooperation and Development.
    Canada spent $3,165 per person, France $3,159, Australia $3,120 and Britain a mere $2,508. At the same time, life expectancy in the United States was lower than in each of these other countries and infant mortality was higher.
    But those are just statistics. When you talk about America's health care crisis, you're really talking about people. And Palmer's experience speaks volumes.
    He was riding his motorcycle through San Francisco's Presidio on Sept. 19. It was late afternoon. Palmer was heading toward the Golden Gate Bridge and then home to Richmond.
    Suddenly his brakes locked, sending the motorcycle into a slide. Palmer slammed into a guardrail. He was pretty shaken up, but he could tell he wasn't badly hurt.
    A passer-by saw the accident and called for help. An ambulance arrived within minutes.
    Palmer said he told the paramedics that his ribs felt banged up, possibly broken, but that he was basically OK. He said he preferred to be treated in Contra Costa County, where he lives and would probably qualify for reduced hospital rates because of his income level.
    Palmer is a woodworker who specializes in the decorative touches on wealthy people's yachts. He said he made only about $7,500 last year, getting by primarily with the assistance of relatives.
    Palmer said the paramedics were concerned that he may have sustained internal injuries and insisted that he be treated immediately at a hospital. So he was driven by ambulance to San Francisco General, the only trauma center in the city.
    Palmer got lucky here. The ambulance was from the Presidio Fire Department, which is run by the federal government and doesn't charge for ambulance service. Had the trip been made by a private ambulance company, it likely would have cost Palmer between $700 and $1,000.
    On the other hand, what Palmer didn't know is that as soon as the paramedics radioed ahead to say they were bringing in an accident victim, San Francisco General, as per the hospital's procedures, issued a trauma alert to its staff.
    Basically, that means a page was sent to doctors and anesthesiologists on call at the time. That page alone cost Palmer $4,659, and he hadn't even set foot yet inside the hospital.
    The actual hospital experience was, to put it mildly, a nightmare. After blood was drawn for a variety of tests (the cheapest of which cost $44 and the priciest $107), some X-rays were taken ($423).
    Then, Palmer said, he was left in a room ($2,070) with a junkie "who was having a real bad trip." He asked to be moved elsewhere but was told no other rooms were available. So Palmer ended up on a gurney in the hallway.
    And he waited there for five hours.
    Palmer's bill indicates that he was twice given Vicodin ($22) to ease his pain during this interval, but he insists he took no medication.
    "I finally saw someone and asked if I could check myself out," he said. "The guy said they were still waiting for the results of my CT scans. I said that I hadn't had any CT scans. It turns out they forgot to put me on the list."
    So Palmer was put on the list for CT scans. And he waited another hour.
    At last the CT scans were taken ($3,334) and then another round of X-rays because, Palmer said, the first batch apparently hadn't been done correctly.
    "Finally a doctor came to me -- it's now almost 2 in the morning -- and said, yes, I had a fractured rib and some bruised muscles," Palmer recalled. "That was that. End of conversation."
    Shortly afterward, he said, a clerical staffer approached with discharge papers for Palmer to sign.
    "She asked how I intended to pay for everything," Palmer said. "I told her I didn't have any insurance. She looked at me and then asked if there was anyone I could sue."
    Several weeks later, he received a bill for $11,082 in hospital charges and a separate bill for $922 in doctors' fees.
    Palmer's hospital visit was expensive and time consuming, but it wasn't unique. Many people could cite similar (and similarly costly) experiences in receiving "emergency" medical care at U.S. facilities.
    "We view health care as a chance to make as much money as you can," said Dorn at the Urban Institute. "The goal of health care should be improving people's health."
    San Francisco General's Nazeeri-Simmons was unable to comment on Palmer's lengthy hospital stay because she didn't have access to his medical records. But with Palmer's permission, she was able to examine his billing file.
    "These charges are comparable to the entire health care market," Nazeeri-Simmons said. "They aren't out of line with what other hospitals are charging. They're actually lower."
    Not always. Trauma activation charges, for example, typically range from about $2,000 at some Bay Area hospitals to $7,000. At Marin General Hospital, the charge can run as high as $12,636.
    Nazeeri-Simmons said a sliding scale is offered for low-income San Francisco residents. But Palmer, as a resident of Contra Costa County, wasn't eligible for the program.
    "If you were uninsured and making less than $10,000, you would pay nothing," Nazeeri-Simmons said. "But that's only if you live in the City and County of San Francisco."
    After receiving his bill, Palmer complained to the hospital about how much he was being charged. Nazeeri-Simmons acknowledged that a second look was given to the bill at Palmer's request "and we decided to eliminate the trauma activation charge."
    That reduced the amount due by $4,659. But Palmer still owes more than $7,000 for an eight-hour hospital visit that involved, by his estimate, only about 15 minutes of actual care.
    "It's unfortunate that he's in the situation he's in," Nazeeri-Simmons said. "But what is an individual hospital to do? Are we supposed to eat the costs?"
    She said a government-run program similar to systems in place in all other developed democracies would almost certainly keep costs in check while ensuring that everyone has access to treatment (without being impoverished in the process).
    "Universal coverage would mean that a Joey Palmer doesn't get left out in the cold just because he was in the wrong county," Nazeeri-Simmons said.
    For his part, Palmer said he'll try to pay off his hospital bill as best he can. And then, if he can swing it, he'll leave the country. He's thinking seriously about moving to France.
    "If you get sick over there," Palmer mused, "you can go to any hospital and it won't cost a fortune." He said that with a tone of quiet disbelief.

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    Elite Member Sleuth's Avatar
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    thats just obscene. i'm speechless.
    Alicia Silverstone: "I think that the film Clueless was very deep. I think it was deep in the way that it was very light. I think lightness has to come from a very deep place if it's true lightness."

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    Hit By Ban Bus! pacific breeze's Avatar
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    But universal health care is next to communism, remember? I'm being sarcastic of course.

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    Hit By Ban Bus! ediebrooks's Avatar
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    We desperately need universal health care. But we'll never get it as long as we have a Republican president.

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    Elite Member Aella's Avatar
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    Holy fucking shit. I'm still trying to wrap my head around that system, it seems just so absurd to me.

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    Hit By Ban Bus! ediebrooks's Avatar
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    It is absurd. Our health care system sucks. But we can't have universal health care because it would smack of "socialism"(sarcasm).

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    Elite Member Grimmlok's Avatar
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    people dont like to be lumped into groups! thats communism! The founding fathers! Pinkos! BOOGA BOOGA!
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    Elite Member Mr. Authority's Avatar
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    Well if the man had'nt ridden a motorcycle and broke his rib, he would'nt have needed to go to the hospital. He needs to shut his pinko ass up and get a job blahblahblahblahblah-typical republican scum response.

    The US is def in need of a universal health care system. Though I worry about it if it's in the hands of the government...

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    Gold Member Corsair's Avatar
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    Would you want Bush to have any part of a universal health care system??

    I love the idea but don't see how the government we have now could possibly make it work. I've lost faith.
    Don't worry about what other people think. They don't do it very often.

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    Elite Member Charmed Hour's Avatar
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    I'm not sure why a man being billed for services rendered is so unjust. I have insurance, which I pay a hefty amount into each paycheck. I also have co-pays and many times not all services are paid for in full by insurance nor does every doctor take the insurance as full payment.

    I recently needed to go to the ER. I had to pay $150 co-pay just to sign my name on the sheet, and then had some bloods done that weren't covered by insurance. The bill totaled nearly $3,000. I called the hospital billing, and asked to be put on a payment schedule, which they did willingly. They want their money whether it's $5 a month or what have you.

    I'm sure he could dispute parts of his bill (like the Vicodins) and I would think the hospital would work out a payment plan with him.

    As for socialized healthcare, everyone in this country does have access to healthcare. It's called Medicare/Medicaid. It's not necessarily free, they do have income guidelines for whether or not you'll need to pay into it or not.

    Here in NYC, you walk in with no coverage for something like say a pregnancy or heart issues, and the hospital will get that coverage put into place on an emergency basis.

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    Gold Member greeneyedbeauty's Avatar
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    Here where I live a tylenol for someone that is not insured is $50.00 per tablet. Also, insurance is sky high and unreasonalbe. For me to have health insurance with a pregnancy clause I have to pay $630.00 per MONTH. That is uncalled for and insane. The medicaid/medicare is normally only for lazy people that set home all day and do nothing. I have seen single working mother's try to get these services for their children, and for themselves, and they get turned down a lot. Whereas, you have people that do nothing but set home and get to have free babies. It really is unfair.

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    Elite Member crumpet's Avatar
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    I really feel sorry for this man. It also seems odd to me that health services are the one are where people seem to think you shouldn't be billed. I can't blame the hospital for sending him a bill. But if he were, say, an illegal alien they'd likely never see a dime and probably couldn't even track him down to sic the collectors on him. What also infuriates me is the hijacked costs of everything from a Kleenex to an aspirin. How can anybody justify $50 for a tylenol?

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    Hit By Ban Bus! AliceInWonderland's Avatar
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    how could you not have insurance and ride a motocycle?! and ribs just heal in place w/o doing anything to them; idiot.

    For me to have health insurance with a pregnancy clause I have to pay $630.00 per MONTH. That is uncalled for and insane.
    yeah that is ridic!

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    Elite Member MsDark's Avatar
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    A broken rib could have punctured a vital organ. Scores of other internal injuries are not usually apparent. Even uninsured, I think I'd want an xray after a typical mishap with a motorcycle. Alive and in debt beats slow painful death.
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    Elite Member msdeb's Avatar
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    health insurance, big mess! i was just laid off my job, effective friday. my insurance ends fri. i'm lucky, i'll be able to sign on with hubs insurance, but thats not effective fri. so i had one week notice, so i'm attempting to get refills on my meds, diabetes meds, kidney, breast cancer, and meds for my neuropathy. i'll be needing stress meds after this is over. people should not have to live in fear of getting sick.
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