14 Comments

Medical insurance is “prepayment”, it is not free medicine. The $12,000 would be a lot of money to me, but insurance would not help in this case in that $12,000 buys only two years of coverage. Insurance shifts costs somewhat and imposes transaction costs. It is truely helpful for casastophic costs.

The non-trivial mystery is how to reduce the costs of hospitals.

I think he misunderstands the French system. First page I found states this:

“The French healthcare system is funded by the working population. French employees pay about 20 per cent of their gross salary – the self-employed pay even more – deducted at source, to fund the social security system, known as Sécurité sociale.. A significant proportion of this money goes towards public healthcare, to which every legal resident of France has access under the law of universal coverage called la Couverture maladie universelle. ”

I think that means his $7000 in salary last year would have automatically been lopped by more than $1400 (since he’s self-employed, it’s more than 20%). That also means his relatives would have 20% less money to lend to their bike-riding, slacker relative.

It would be interesting to know how much of that was defensive medicine. Perhaps none, but it seems unlikely that Canada would have given him a CT scan.

That $12,000 bill is subsidizing the uninsured people who use the hospital and don’t pay, and, to a lesser extent, the Medicare use where reimbursement ranges from low to inadequate.

How to reduce the high cost of healthcare – remove the “tort tax”. Rather than socialized medicine, why not have a socialized legal system? Then we’d all know what it is costing us. AND I doubt taxpayers would allow their tax dollars to pay millions to a lawyer for a few days weasel work.

So this fellow chooses a profession which provides a decidely limited income. He chooses to sponge off of his relatives. He chooses to engage in a decidely dangerous activity. And, not surprisingly, ends up injuring himself. One must wonder if he does his own motorcycle maintanence. Then he is surprised when he is expected to pay for his medical care ? One might also wonder if the motorcycle was insured, it would be very unfortunate for the victim should he have injured someone else. And to solve this dilema some want to create yet another beaureaucratic monstrosity ,run by individuals with no personal responsibilty for their actions, funded by ever increasing piles of tax dollars. Perhaps those low health care costs in other countries are less due to the economies of universal health care than the rationing of the care actually given.

That $12,000 bill is subsidizing the uninsured people who use the hospital and don’t pay, and, to a lesser extent, the Medicare use where reimbursement ranges from low to inadequate.

Just so. Medicare pays a fixed amount under its “prospective payment system” for groupings of care related to certain diagnoses. These amounts are not negotiated, and are often below the hospital’s cost of treatment. Hospitals write off millions of dollars of unreimbursed care rendered to uninsured patients. This underpayment and nonpayment has to be made up somewhere. That “somewhere” ends up being private third-party health insurance payors and, indirectly, the businesses and individual that pay the ever-increasing premiums for health insurance. Since many health care insurers pay hospitals based on a percentage of charges, hospital charges stay high so they can cover the Medicare and uninsured losses, and maintain a positive margin.

People, people! Of course he has someone to sue. As the article states:

Palmer was heading toward the Golden Gate Bridge and then home to Richmond. Suddenly his brakes locked, sending the motorcycle into a slide.

Nobody doing anything wrong and out of the blue, the brakes just suddenly lock up? Sounds like a defective product suit to me. Now, what deep pocket made this motorcycle?

It is actually worse than that. Medicare requires a hospital/docter to list rates at the beginning of the year. Medicare then uses those rates to decide reimbursement, which is usually at 50% of the quoted rates or less – obviously this quoted rate is artifically high to take this 50% cut into account. Additionally, hospitals and doctors have to increase these qouted rates every year or face a medicare reimbursement cut. When an uninsured patient walks in needing care, the hospital must charge him the inflated rate that it provided to medicare or it is committing fraud against medicare (the hospital can negotiate rates seperately with private insurers). Basically, it is medicare’s fault that unisured sick people face such high rates.

Couldn’t you also argue that the $12k bill is subsidizing doctors, who manage to inflate their earnings by controlling the medical licensure process?

The funny thing to me is that you would think malpracice suits would be the way of combating malpractice in a system free of licensure, where doctors could specialize or offer various levels of expertise at various prices. Instead, we have a system where it’s difficult and expensive to become a doctor, and you must generalize, and we have out-of-control litigation against doctors.

Add to that the fact that (1) virtually everyone uses third-party providers and (2) that third-party provider is often the government, and you have…

The worst possible world in terms of the price of medical care?

The most immediate question: he’s already sponging off his relatives; presumably he has at least 6 relatives; that’s only $2k each (less after the bill reduction). Why can’t he just have them pay the bill?

Of course, if they won’t, maybe he could sue because they left the impression that they would bail him out of any situation…

Ted,

Unwarrented defensive medicine is part of the “high-cost” problem.

The part of the $12,000 for those who do not pay or underpay would not be avoided by insurance, as the premium also would incorporate those costs.

The bank can REPO my car if I fail to pay, but one can not REPO medical treatment. That is why we have prepayment medical insurance.

These are difficult problems.

It is my understanding that the coffee case was triggered by a sky high hospital bill. The lady sued after she was denied help my the McDonalds.

Then he is surprised when he is expected to pay for his medical care ?

That’s a little harsh, I think. He knew he’d have to pay. The story seems to be more about the very high cost for care he didn’t ask for in the first place. He wanted to go to a different hospital, where he’d qualify for reduced rates. He didn’t ask for a CT scan. He was charged $2000 for a room he spent very little time in.

The majority of the cost was the $5000 activation fee (since waived) and the CT scan. The first was over his objections (recall he didn’t ask for an ER, and specifically not that one), the second he didn’t request. That’s $8000 that somebody else decided he should pay ($10K including the room; I’ll bet he’d have been willing to wait in the hall for two grand). It’s not him trying to skip out on $12K in medical charges. It’s him getting charged $12K without asking for the care in the first place.

Certainly, the high cost and the CT scan are partly the result of the malpractice bar. And the ambulance crew can be forgiven for wanting him to be seen asap; had there been something wrong that was made worse by the long ride his chosen hospital, they could well have been sued for that.

So this guy is paying not for his own actions, but for somebody else’s tort-enforced idea of what he should get. He probably would have accepted (and paid for) an x-ray, a tape job, and instructions to come back if he got headaches or blood in his urine. Instead, he got a lot of unecessary tests and a twelve-grand tab.

“Suddenly his brakes locked, sending the motorcycle into a slide”

Sounds like a defective product to you?

Sounds like a load of horse maure to me.

As does his claim of earning only $7,500 last year.

Here is a guy who does custom woodworking on yachts, not for the manufacturer, but for the wealthy owners. $7,500? I guess if he works 10 days a year. That’s the income he reports, in order to be able to collect food stamps and other government benefits.

Another way you can tell the guy is a BS artist? When you have no money and are faced with the high cost of living in the US, the solution of choice is never ‘I think I’ll move to France’.

I broke my leg in a motorcycle accident 30 years ago when I had no insurance. Didn’t find out it was broken for a week, because I had no insurance and didn’t go to the hospital until I still couldn’t walk after that week.

You never go to the hospital for injured ribs unless you are in tremendous pain. The treatment for broken ribs in a hospital or out is the same – nothing at all. You just wait for them to get better.

I agree with Frank. The brakes just “suddenly” locked up.

Reminds me of the age-old excuse, “it broke.”

I love how the story focuses on big government programs elsewhere and how we should follow suit. Having worked overseas in hospitals far and wide I’ll take our system warts and all. At least we have some choices about coverage, costs, and treatment.