My wife was in the hospital for observation overnight because of pain on the left side .The bill was 28653.49 dollars
Why are you repeating to me your previous post.
My sister in law was for 2 months in hospital in Canada ( Toronto ) the bill was not even on half.
What do you―or the next person, as such―know of the
business model at any given hospital? Here's a detail that might be uniquely American:
Before the ACA, if you were uninsured, then the first thing you did when you got your bill was call the hospital and demand the insurance rate.
That is to say, the bills they sent uninsured individuals charged grotesquely higher prices, and every once in a while an insurance executive would commit a Kinsley gaffe and, in discussing other issues of the industry, let slip that these inflated prices were an offset for the cuts they were giving the insurance companies. Before it was all over, I'm pretty sure I heard a couple talking heads in the cable television discourse actually pushing the point as if it was some answer of merit. The bottom line is that some portion of the crippling debt wrecking the uninsured was intended to fund insurance outcomes.
And that's the thing. If you or I work in a certain part of the industry we can sit around all day talking up the details of how everything gets so expensive, but it's a bit obscure to everyday consumers; the important question for our purposes is how much of that money is profit in whose pocket?
And in the long run, the problem with simply providing care and figuring the rest out, later, is that providing care is rarely the first priority of the business model.
By making care provision the end product instead of the first priority, everybody else's slice of the financial pie becomes more important for being somehow "necessary" to the end product. And that financial priority applies at every functional layer of the industry, even seeping into doctor-patient relations.
And that will continue to affect circumstances and outcomes as long as the point of societal health policy is a business proposition first, and a health consideration whenever we can afford to get around to it.
• Related example from another industry ― There remains in the world today an apparel company that I generally think of as a shoe company; they make athletic gear. My father and I used to argue this bit a lot because he was known to preach the merits of "capitalism" in that context that has become some manner of political framework―i.e., American assertions of capitalism are not capitalism proper, and in some cases even dispute with Adam Smith―and for much of this period he really did seem to entertain a petit bourgeois attitude that sided with the bourgeoisie over the proletariat on the grounds that management had merit because without management there would be no labor. But it's true, the hippie selling necklaces in the concert parking lot is both labor and management in many cases; management is unavoidable as such. But it is also true that without labor, management has nothing to sell, and labor does not necessarily need such management as the American model supplies, sucking up money while pinching labor compensation. In the end, this shoe company I'm thinking of laid off three thousand workers for financial necessity, a notorious maneuver since the next thing the board did―very nearly literally, though I wasn't in the boardroom so I can't promise it was actually literally the immediately next thing―was award themselves bonuses. And the argument for the merit in this maneuver was that in saving the company a bunch of money, the executives had earned that money. Apparently, the company "needed" the money, as such, in order to give it to the executives.
With health insurance and medical costs, perhaps it is instructive to consider
recission. It is one thing to control for fraud, but another to invoke, say, a badly-dotted
i to cancel an insurance policy precisely at a time the company needs to pay out on it. This loss of health insurance severely damages, and even destroys, lives. Then again, if you manage to eliminate three hundred million dollars in payouts, yeah, the company is going to give you a bonus and throw you a party. And when the CEOs went before Congress, they were asked, one after the other, about recission, and not a one of them intended to end the practice.
Which in turn reminds: When and if medical liability becomes an issue, is the problem that people have rights and exercise them, or does anyone stop to talk about liability insurance rates, terms, and processes?