Ah, good, it’s not just me out here.
Are those a recent thing?
Not tremendously new. Sometimes called “doc-in-a-box” or sometimes a clinic. It’s for “sick-but-not-likely-immediately-fatal” levels of care. Sort of like how a GP used to be, back in the day. Get stitches, x-rays, maybe set a closed fracture and put a cast on it, flu shots, antibiotics/steroids for lung issues, etc.
Anything really serious/life threatening they’ll put your ass in an ambulance straight to the nearest ER. If you have a problem in your PCP’s office they’ll often refer you there before the ER.
When I shattered my nose a couple years ago, I went to the ER but got sent to the ENT in my PCP’s urgent care center.
There’s one in the offices of my PCP that is open before-after normal office hrs.
Well, non-Americans are saying that.
My mom is always asking me when I plan to move back to the US. It’s these kind of threads, among other things, that keep me saying, ‘Not any time soon, thanks.’
Although I had a full course load, my uni in the States kept me at adjunct level (juuuust a smidge under where they’d have to make me full time). I tore a tendon in my shoulder a couple days before a trip over to the UK, and despite being in so much pain I had to be carried off the plane when I finally made the trip, it was worth it financially – emergency examination, x-rays, treatment, and meds came to £15 (for the meds). Even factoring in the plane ticket, which ran around $1500 (I was in so much pain that I upgraded to business at the airport), it was still massively cheaper to get treatment and physical therapy for the three weeks I was in Britain.
When I got back to the States, things still weren’t right, but rather than bankrupting myself trying to get to a doctor and a physical therapist, I ended up toughening it out.
The costs are so horrible out there that over the years I did a heck of a lot of (minor) self-surgery (I sew well, to put it mildly, and flesh isn’t all that difficult to stitch) and other primitive types of doctoring.
Even paying $500 for a tetanus jab, a swipe of iodine, and a bandage (as someone mentioned above) is absolutely mad, not to mention that bonkers paradigm psychobunny listed.
The calculations for those co-pays looks as if someone took Numberwang as their paradigm
I toughed out chest pain episodes for a month before going to my PCP who referred me for a stress test (a scary 72 hour wait for that). The pain was unstable angina, I’d had a mild heart-attack and needed a stent placed.
I can’t fathom going to the ER for a boo-boo finger.
I had to go to the ER in February of this year. I woke up on Sunday morning like normal, but then began to have severe stomach pains. Nausea soon followed. The pain would not let up. I tried antacid, a glass of milk, pep to bismol, everything I could think of. I was in so much pain and it had gone on for almost two hours with no let up. Then I started to cry when I thought about how much it was going to cost, which just added to my misery.
Just as they took me to the back room for treatment, the pain started to ease and I asked if I could leave, but they said my pain mimicked a heart attack so they needed to do some testing. The bill was over $10,000.00 and my share was $1800.00. That’s on top of the $640.00 a month premiums I pay. I fucking hate our system.
What is charged and what actually gets paid are often totally unrelated to each other.
I recently had a minor surgery on my hand (not an ER thing - the releasing of a trapped tendon and 4 stitches).
The surgeon billed my insurance $20,8000.
Insurance 'allowed $8,000.
Often, ER costs are very high because the insured indirectly pay for the uninsured.
A while back, Time Magazine ran an article entitled “Bitter Pill” by Brill. That article explained a lot about hospital charges and bills. Often, there is little or no rhyme or reason for particular charges, and it often doesn’t even mater what the charge is if one’s insurance has contracted rates various medical procedures.
It also explained a lot about how hospitals bill ‘charity’ care (and if you think there might be some serious scamming going on here, you would be correct).
That article really explained a lot about our messed up our health care billing.
Last year, researchers at the University of Iowa called hospitals around the country, asking the cost of a total hip replacement for a patient withough health insurance but able to pay out of pocket. The cost estimates ranged from about $11,000 to about $125,000.
Another story. A guy who lived in an Indiana town that is the headquarters for some of the big joint manufacturers needed a hip replacement. Through a friend of a friend, he was able to get access to a replacement hip at the “list price” (i.e., no hospital markup) of $13,000 (against a manufacturing cost of $350). But the hospital costs would have been an additional $65,000. That was unaffordable. So instead, he flew to Belgium, where he had his hip replaced at a private hospital near Brussels for $13,660, including travel and a week in rehab.
Just want to point out that in my experience (not always personally, but people I know) wait times in the US can be stupid long too. Definitely at the ER, and quite often when seeing a specialist.
Any time I hear people say that universal health care will make us suddenly have to wait a long time to see a doctor, I wonder where they live in America that ERs have no lines and specialists are sitting around twiddling their thumbs.
(This post isn’t pointed at MrSquishy, just using his post as a comparison)
I’m glad I’m not the only one thinking that.
We had to call an ambulance for our son when he was four, because he had croup, and suddenly started to have trouble breathing. He was in the ER for about four hours, and then they decided to admit him. He was there a night and a day. Our total personal bill after insurance for the ambulance, ER, and in-patient was $1200, and the way our insurance is, that was applied to our out-of-pocket, which we ended up hitting much earlier in the year than we usually would, because of this, so by August or so, we had no more co-pays on anything except medication.
If we had itemized, it would have been deductible as well, but it ended up working out better for us to take the standard deduction.
FWIW, when you arrive at the ER in an ambulance, there is no waiting. At least not for a child with difficulty breathing-- although, the EMTs treated him with inhaled steroids and oxygen, and he was actually a lot better by the time we arrived.
I had to wait six weeks for a first appointment with a urologist. Not surgery - just an evaluation. :mad:
Just to be clear, nobody with trouble breathing waits in the ER.
Some ER’s seem to be making changes. Or maybe I just got really lucky, when I went in last December with abdominal pain, I was triaged with all vitals while getting checked in and then seen by a doctor within 15 minutes. Visiting the hospital’s website later, that appears to be their goal, to see people in 15 minutes or less. If they actually can do that on weekends, that’s really impressive.
When the pigment in the backs of my hands began disappearing I went to my PCP, who referred me to a dermatologist. The receptionist I spoke with offered me an appointment date which included the year (13 month wait). By the time I saw her I had read all that I could find about vitiligo, making her diagnosis rather anticlimactic.
This is easy peasy. I’m a veterinarian, and emergency or not, my clients are always given an idea of the cost of treatment on the front end. For a non-emergent visit, they know that an office visit costs $X, so before they come in with the pet, they expect to be paying $X, at minimum. This buys them a complete exam and history taking for the patient, from which I formulate my diagnostic and treatment plan.
I then go prepare a treatment plan, with exact cost for each thing I want to do, and I then go over every single item on the treatment plan with the pet owner. I tell them why I want to do each test or what each treatment is for. I show them the actual cost before proceeding.
In an emergency, as in their pet is in danger of dying if I don’t start doing something immediately, the pet is taken to the treatment area and life saving treatment is provided right away, such as oxygen or IV fluids or basic pain management. As the pet is being taken for this assessment and basic life supporting/stabilization measures are started, one of my technicians (analogous to a nurse), or the front desk staff, tells them that basic stabilization will cost $XX, do they want us to proceed? If they do, then we continue to stabilize only, with everyone understanding the client will be spending, at minimum, $XX. Once the patient is no longer is danger of immediate death or intractable pain, I put together (or my technician does, on my orders), a more comprehensive diagnostic and treatment plan, and we go over it, in detail, with the client, before other diagnostics or treatments are provided. There is none of this whisking the patient away, doing a bunch of non-lifesaving diagnostics and treatments, and then presenting a bill that seems to be the standard in human hospitals.
I guess I don’t really understand what is so difficult about this, and why human patients aren’t given the same option to consent to diagnostics and treatments they are expected to pay for, ahead of time.
I have gone to the ER in Iran and my wife went in Yemen. Both modern hospitals. The fee in Iran was about $30 (about 90 minutes with nurses/docs) and in Yemen it was about $40 (about 4 hours with nurses/docs).
Or that UHC means inferior care because it’s ‘free’. One of my colleagues brought students over from the US for a study-abroad semester in Great Britain a few winters back. It was a bit icy and slippy, and a student fell and broke her arm. They took her in to the shop, got her x-rays, cast put on, pain relief. £0/$0.
When the poor kid got home, her parents immediately hustled her off to their doctor to have the cast removed, and the arm reset and rebroken because no way could ‘free’ healthcare have been any good.
(I put ‘free’ in quotes because it’s not really; 30% of my wages go to NI, which covers NHS and pension).
My problem would be that all the time taken to make a calculation or gain consent is time wasted. You should use your judgement to do what is best for the patient and cost really shouldn’t come into it when we talk about humans.
Surely it is better to have the conversation on purely clinical grounds in terms of risk vs outcome. The moment you start throwing the cost in there then people are going to make bad choices. Not so much of an issue for a pooch but rather more important for Mr/Mrs Breadwinner.
Just to clarify, you don’t mean 30% in “national insurance” do you? Do you mean your total tax-take?
The NHS costs around £3,400 per head in the UK. But seeing as it is all funded through taxes the big tax payers fund those not working at all.
(still cheaper per head than the USA which is far less comprehensive)
The problem, of course, is that when treating humans under the current American system of care, the clinician has no idea what any given procedure will cost any given patient. There is, of course, the price listed on the chargemaster, but the actual price to be paid varies, depending on whether the patient has Medicare/Medicaid, traditional fee-for-service insurance, capitation, self-pay, etc.