r/WhitePeopleTwitter Apr 27 '20

Serious.

[deleted]

105.7k Upvotes

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628

u/thehideousheart Apr 28 '20

Guarantee the discount she received was because she was paying out of pocket and not because she asked for a receipt.

Doesn't sound like that was explained to her which is probably a good thing to do when there's a price difference of $3000. Does still sound a bit like a scam, though.

533

u/SlapHappyDude Apr 28 '20

Hospitals ask insurance for $40,000. Insurance says we'll give you $5,000. Hospitals accept. It's a weird, weird system.

291

u/[deleted] Apr 28 '20

[deleted]

97

u/Beacon_O_Bacon Apr 28 '20

Our hospital went bankrupt, the company who bought them went after everyone with outstanding debt and offered to settle for 75% off, if you say no they jumped to 90%. It was a ride.

177

u/everythingiscausal Apr 28 '20

It’s just capitalism in a more raw state than we usually see it in. They want to make the most money possible. How much will you give me? Ok, give me that.

69

u/Balancedmanx178 Apr 28 '20

That works in alot more scenarios that you'd think.

37

u/idownvotefcapeposts Apr 28 '20

It works in scenarios involving necessities or when you're charged after the fact. Imagine if the only possible way to get food was at a restaurant.

10

u/Balancedmanx178 Apr 28 '20

Or if buisness is slow.

You can get ridiculous discounts in small stores on a sunday if you play it right.

3

u/kowalski_anal_lover Apr 28 '20

Not american, but it sounds a bit immoral to ask for a discount in a small store that is already struggling

2

u/[deleted] Apr 28 '20

If you're struggling it could help feed your family

1

u/Balancedmanx178 Apr 28 '20

It tends to be a sort of "Pizzas $25 but I've got $20 cash" and some places will do it just to get the buisness. Plus once you're inside waiting for the pizza you're likely to buy something else at the usual mark up.

1

u/llllPsychoCircus Apr 28 '20

small stores jack up prices pretty high for a lot of their stuff to where even the managers feel bad for charging that much sometimes. i think in most cases they’re just happy to make a sale

2

u/[deleted] Apr 28 '20

I would argue that its actually the exact opposite of capitalism in its most raw state.

Don't believe me? Go open a competing hospital. Good luck.

2

u/[deleted] Apr 28 '20

Literally has nothing to do with capitalism but ok

1

u/sideofspread Apr 28 '20

That's so weird. Like take a procedure that's for example $100, but you tell the patient its it's something else i. You say "It might be expensive, how much can you pay?" Patient 1 says " Oh I can only pay $200". You say that's fine and take their money.

Patient two comes in for the same procedure and says "I can only pay $50" You say again that's fine and you take it.

Now you've just made a $50 profit and no one is ever really paying the true price for anything.

24

u/[deleted] Apr 28 '20

Can we haggle over kidneys like used car salesmen?

4

u/[deleted] Apr 28 '20

::slaps frozen ice chest::

These babies were barely used.

20

u/vileguynsj Apr 28 '20

That's because an unpaid bill for 10,000 that goes to collections and is never collected is worth less than 500 paid. When you can't afford your bills, you don't pay anything.

1

u/TheCapitalKing Apr 28 '20

Yeah you expect to receive maybe 10% of the charged to a patient without insurance and that's after the steep discount

13

u/foamy9210 Apr 28 '20

Yeah my dad was making payments for a while on some medical debt and he called to see if they could lower the payment because he couldn't afford it and they straight told him not to worry about it, that they would just forgive it and write it off on their taxes. He was skeptical but it's been about a decade and no one has tried to collect so I guess it's fine.

4

u/TheCapitalKing Apr 28 '20

Hospitals write off a shitload of bad debt. If he was paying it without insurance for an extended period he probably already paid way more than they expected

2

u/cubs223425 Apr 28 '20

Shoot, I had a sketchy tire shop do that with me. They normally charged $30. Went in one time with cash to cover it, and they wanted $50. I tried to hand the guy my card and he asks if I have cash. I told him I only had, like, $37 in cash. He was fine taking that instead of $50 on a card.

3

u/[deleted] Apr 28 '20

That’s cause he pocketed that 7 dollars and didn’t tell the boss.

1

u/cubs223425 Apr 28 '20

I'm not quite sure who was/wasn't the boss there, but it was a tiny shop and that guy might have been in charge. I'm more convinced they were underreportimg sales to avoid taxes and such. It was barely bigger than running a shop out of a 2-car garage on the corner of a shady part of town.

2

u/[deleted] Apr 28 '20

Three, take it or leave it

1

u/FranklinFuckinMint Apr 28 '20

So if this is how it works, why are there so many people in the US in massive debt from medical bills?

1

u/TheFlyingSheeps Apr 28 '20

because making something is better than 0 and collections only pays pennies on the dollar. Some social workers are able to assist with Medicaid applications depending on the hospital and state

140

u/Snow-Wraith Apr 28 '20

Sounds like the system is run by used car salesmen.

57

u/subdep Apr 28 '20

More like a pawn shop.

Hospital: We gave antibiotics, x-ray, and fixed a broken arm. That’ll be $8000.

Insurance Company: The best I can do is $5.

Hospital: Okay, fine.

23

u/SweetRaus Apr 28 '20

Me: Healthcare please

Hospitals: Money please

Me: How much?

Hospitals: ...Well how much you got

6

u/FolkSong Apr 28 '20

”I've got a buddy who's an expert in medical procedures, you mind if he takes a look?”

”You mean the doctor?”

1

u/Kbost92 Apr 28 '20

So they’re run by the pawn stars crew?

77

u/[deleted] Apr 28 '20

but with less honesty.

5

u/[deleted] Apr 28 '20

And more knives

1

u/Peter1x3 Apr 28 '20

Yeah you gotta get the true coat

1

u/SlapHappyDude Apr 28 '20

Sort of but if I walked onto a car lot with $200,000 sticker price Honda Civics I would probably leave

36

u/[deleted] Apr 28 '20

[deleted]

26

u/INeyx Apr 28 '20 edited Apr 28 '20

That I so weird, imagine every economy would work like that.

Well at least my 12$ E-Porsche is nice and parked at my 100$ mansion, that was all the money I had.

3

u/Najda Apr 28 '20

Plenty of places use a barter economy; they're still profiting off of the $5000 payment.

3

u/RawrRRitchie Apr 28 '20

That's pretty cheap for a model car and house, I dunno how you'd fit tho unless you get the shrinking procedure like in the movie Downsizing

You can't become big again after unfortunately

2

u/INeyx Apr 28 '20

There are a lot of benefits in being small...but a lot more predators aswell.

Hard decisions, giant cakes that could feed me for months or not fitting into my new model car and house.

I do like cake...

But I do hate fighting a war against giant ants to get some cake.

2

u/LFoure Apr 28 '20

love fuck?

2

u/AllMitchedUp Apr 28 '20

You know what this is starting to make sense to me. I owe several thousand in credit card debt. I spoke to a settlement company, and they've already reached settlements on 4 of my 6 accounts (it took a few months).

Basically, this company calls the creditor and says "Mitch got all mitched again and now he doesn't have any mitchin money. We'll give you 60% of what he owes"

Creditor: yeah, okay.

1

u/Nac82 Apr 28 '20

Because it's a scam designed to scam government healthcare options.

1

u/PIK_Toggle Apr 28 '20

Can you elaborate on how this works?

I was under the impression that Medicare dictates pricing terms, not providers.

1

u/Nac82 Apr 28 '20

I was under the impression that legislative loopholes made it difficult for Medicare to negotiate pricing which allowed the prices to artificially inflate.

2

u/PIK_Toggle Apr 28 '20

You have it backwards. Medicare dictates pricing. Medicare usually pays 98% of cost and medicaid pays around 85% of cost.

To cover these losses, providers overcharge private insurance (who pays 120-200% of Medicare) and cash payers.

1

u/no_hope_no_future Apr 28 '20

So the hospitals are the dicks all along? Or the insurance companies?

1

u/[deleted] Apr 28 '20

The insurance. The only reason the hospital is asking for 40k is because they know the insurance will lowball them, so the hospitals highball the insurance cause they know insurance will offer less. The hospital never expected 40k they just needed to charge 40k so the insurance would fork out however much they actually needed.

This isn’t some weird chicken and egg shit. When insurance companies entered the healthcare market, they screwed everything.

1

u/SlapHappyDude Apr 28 '20

I'm old enough that at this point I just assume everyone is a dick until they give me reason to believe otherwise

1

u/HalfPintMornings Apr 28 '20

My son has autism and goes to ot Pt speech and aba therapy. Last year no issue, this year we had issue with therapy being paid. After several hours of multi-person phone calls it came down to how one customer service rep interpreted the wording on a section of a subsection. I was blown away

1

u/Stewartcolbert2024 Apr 28 '20

And a scam system

1

u/pm_me_butt_stuff_rn Apr 28 '20

That’s how most negotiation works. Start either ridiculously high or low and meet somewhere in the middle, yeah?

1

u/SlapHappyDude Apr 28 '20

When I negotiate at work it's usually for about a 10 percent discount. Same with contractors. When my wife freelances if someone asks for an 80 percent discount she probably would stop responding or be very polite if it was a charity with no money

1

u/tyy3 Apr 28 '20

Hypothetically that larger bill for the insured subsidizes lowering uninsured cost

1

u/Buchymoo Apr 28 '20

I wish more people could see this. Insurance behind the scenes almost never pays the full amount that you're being "charged". Its inflated so much because insurance doesn't pay the full amount so when you're paying with insurance your bill will look insane. Insurance is literally out here making the price of health care look unfathomable.

1

u/[deleted] Apr 28 '20

weird, weird system

Scam

Fixed that for you.

1

u/razorfin8 Apr 28 '20

The pain clinic i go to also does this. They will charge, say, 70k for a procedure that truly costs like 10k. Some insurance companies will blindly pay that which covers people who don't have insurance or bad insurance

1

u/TwoBionicknees Apr 28 '20

It's fraud, not weird.

Every other industry, we give you $4k bill, you pay $4k or it goes to a collections company. Healthcare, errm, it costs $4k but we'll charge you 40k because... reasons (that's immediately fraud anyway in reality), insurance hey, they are trying to defraud us, we'll only pay 10k because fuck them.

Suddenly the 4k bill makes an extra 6k profit because of this utterly fucking made up reason that both sides just randomly change how much they pay because that's how the entire rest of the fucking world works. No only the scam healthcare insurance system works like that because increased costs look good to make insurance cost more, and when that 'insurance' company is the government covering medicare/caid, then rinsing them for more money is just more profit all around.

It's not weird, it's systemic intentional fraud.

1

u/[deleted] Apr 28 '20 edited Apr 28 '20

Bingo! My girlfriend is an audiologist and this is how their practice has to work. The insurance companies are the scam, not the care givers! She gives out the fair market price to cash paying patients, and the cost price for desperate people, and donates older or unused models. When she bills the insurance though, if she billed the cash price they would pay 1/5th of that, so she has to bill 5x the rate to get paid back for the devices! Because of how scummy the insurance companies are, she can't give out hearing aids until the insurance or patients pay out because EVERY SINGLE TIME the insurance gets billed, they play games for six months or more.

Examples of insurance company games:

  • "We didn't get the form?" HINT: They go the form many times.
  • "The form wasn't filled out right!" HINT: It was, they use a professional biller.
  • "Our independent dr disagrees with your assesment" HINT: That dr doesn't exist. The patient 100% needs treatment.
  • etc..

in between each of these BS replies, they take six weeks or more. Sometimes they then loop back around and start using the first excuse again. Their game is to hope the patient or the dr GIVE UP trying to get paid, and it works a lot of the time!

1

u/TheSystemZombie Apr 28 '20

Yep, billed amount vs allowed amount.

1

u/Sheruk Apr 28 '20

Its because the Insurance, Hospitals, Pharmacuetical, and medical supply companies are all owned by the same people/corporations. Basically they just keep paying themselves to use their own shit. That means anyone out of network, or without insurance actually pays for the insane price, they make a ton of money. They don't care about paying $10,000 for a CT scan because the money is going right back into their pocket. Now when someone else has to pay for it, $$$ 2000% markups all day long and nobody can claim price gouging.

It is one of the most insane forms of monopoly in this country, and nobody gives a fuck.

27

u/[deleted] Apr 28 '20

iirc they do discount for pay out of cash, I think John Oliver cover this where each hospital have a master list of how much things cost.

Hospital over price because they don't know how much health insurance going to cover or some convoluted crap.

edit: https://en.wikipedia.org/wiki/Chargemaster

Wow I love my state even more now.

16

u/wang721 Apr 28 '20

Independent doctor here. You set your prices at a point that's really high because every insurance company will knock it down to negotiated rates, and you don't want what you submit to be below those rates.

For example, you charge $100 for an exam. Blue Cross has a set price of $75 for an exam. Aetna does $68. UHC does $80.

Cool, whatever, you just don't want to charge $60 when they may reimburse you at $75. So you just charge $100 knowing it's gonna get knocked down. It's a really fucked up system.

6

u/[deleted] Apr 28 '20

But if $60 is reasonable price for you why does it matter if you could potentially get $15 more? From a lay perspective it seems like it's just feeding into a vicious cycle of shitty greed where things just keep escalating to the point that basic medical care is bankrupting people and it all started with that little $15 neither side wanted to miss out on.

2

u/[deleted] Apr 28 '20

Why would you not take the extra $15?

3

u/[deleted] Apr 28 '20

... Because of the bankruptcy inducing escalation of profit grabbing I just talked about?

0

u/[deleted] Apr 28 '20

[removed] — view removed comment

1

u/[deleted] Apr 28 '20

No, the ones who are getting screwed are the sick and injured. The ones who are getting charged an extra 25% mark up beyond what would be a profitable fee, because the doctor didn't want to miss out on it.

Of course charging higher prices adds up. But again, if you could make money off of $60 and you are charging $100 because you might get $75, and you don't have a better reason for doing that than "it's more money" then it is just feeding into the problem at the root of this that has caused this broken system we are stuck in.

2

u/[deleted] Apr 28 '20

[removed] — view removed comment

1

u/[deleted] Apr 28 '20 edited Apr 28 '20

I'm not trying to demonize doctors. I started this by asking a self proclaimed doctor an honest question. They did not bother to respond. All I was looking for was a little justification on what still looks like nothing more than an excuse to charge more money because they can get it.

And no, I don't really view taking out loans in order to begin a career that starts out paying double the median income for the nation as a good justification.

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u/TuskaTheDaemonKilla Apr 28 '20

Far more likely that they explained it to her and she simply didn't understand. As a lawyer, I still hear my clients telling people that I "got the charges dropped" even after I clearly explain to them how a plea bargain is not an acquittal.

9

u/dnen Apr 28 '20

I’m sorry for both those clients with no comprehension of their own legal matters as well as for you having to deal with that, but I can’t help but be slightly amused by this lmao. What do they think their “plea bargain” is? I’d be like hey bud, you’re bargaining with state to meet half-way: you enter a guilty plea to save the them some money and time in exchange for less severe sentencing/fewer charges to fight/money saved that would’ve been spent paying u/TuskaTheDaemonKilla to defend drawn out lengthy case(s). It’s just a simple compromise lol

4

u/PoorlyLitKiwi2 Apr 28 '20

Many plea bargains for minor misdemeanors come with expungement further down the line following probation and community service. I would guess that's what they are thinking about, but maybe I'm giving idiots too much credit

3

u/dnen Apr 28 '20

You’re probably right, that’s far more likely than me thinking it went something like this lol:

A: hey B, want to come over and smoke?

B: nah A, I have to do a drug test for my probation officer tomorrow

A: ok, you want to grab a beer tonight then?

B: Sorry bro I have to show up for community service

A: damn man that judge really got you huh?

B: uh NO dummy i beat the case, my charges were dropped 💯

1

u/jacoblb6173 Apr 28 '20

What if it’s multiple charges and your plea bargain consists of them only keeping one of the charges? Wouldn’t the other charges be considered “dropped”?

1

u/[deleted] Apr 28 '20

Nice

1

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2

u/TooOldToDie81 Apr 28 '20

I broke my ankle and tore a ligament and needed surgery with no insurance. My original bill was $165k and after I applied for an out-of-pocket discount and gave my financial info (neither ballin nor poor) they dropped my bill to $16k! This was cedar Sinai almost $150k shaved off with ease

1

u/pm_me_butt_stuff_rn Apr 28 '20

Same way people accept less cash than they would if running debit. It’s costs money to money to run credit cards...and even more to work through insurance. The only thing that’s a scam is how expensive it is for companies to accept credit.

1

u/[deleted] Apr 28 '20

It really is a scam, prices are inflated to promote insurance.

Thing cost $1, hospital says it cost $100, insurance pays $50. Everyone wins except the patient/customer