Going under the Knife in the USA

I like to talk from experience and now that I have experienced Surgery I can tell you what I think are the plusses and minuses of getting Surgery done in the USA...

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under the knife

[NoCatsHere]

Always ask for an itemized list for every charge! You'd be surprised how much of your bill disappears.

[jcala]

You can tell Winston is feeling bad when his sunglasses don't whoosh when he takes them off.

But seriously, get well soon man!

[joest.pierre]

"Everyone is worried about being sued" Bingo! It's not just healthcare, but every facet of American life.

[cornheadahh]

As an American, our Healthcare is the worst thing about the country. The quality of care is good, but the cost and hurdles you need to jump through is ridiculous.

[JohnAdams-qcju]

Key advice: the hospital isn't what gets covered in the USA, a covered hospital has some items covered and you can NEVER find out ahead of time. Basically the bed/room may be covered but the blood test may be outsource (inside of the same building) to a different company that might not be covered. The doctors will each have their own agreements with insurance company (and it varies dr to dr inside the same building where you may or may not be covered) and they won't know off the top of their head if your covered and if you are if its 5%, 50%, 100%, etc. So in your case, there will be an ER room fee, nurses, meds, tests, ER dr - then your transferred to new surgical dr, his nurses, his sub drs and his tests/meds/etc - then transferred to the normal hositpal (non-ER room you spent recovery in) with their own staff, ests, meds. Then a week later the billing staff will gather those 20+ different insurance info from the tests, drs, meds, etc and will see what is charged to the insurance and wait for a response if they pay or negotiate it which could range from 0%-100% of the bill, then the drs/meds/etc that are not covered if charged to you directly which can vary widely in your case your looking at 10-40k personal bill insurance doesn't cover and they will charge you directly. You don't know until you get the bill a month later in the mail. Good news is you can call that hosiptal's billing dept and claim you can't pay and request an itemized list first. This always gets it reduce by 50%. If you still can't pay you can argue the items/services on the list you never had (they always add 20%+ padding of false charges). You can keep fighting it and get it reduced to like 1-2k and then pay it. I know this sounds wrong but trust me this is how it works and why no one can tell you ahead of time what is covered - the only thing you can do is check the hospital is covered by your insurance (which basically means they cover some stuff and make no promise what they will cover). If its a crazy high bill and the hositpal won't lower it to a reasonable level (few grand) you can then engage your insurance company and say you can't pay this and they often will pay more. In short you have to fight it (few month process with billing dept of the hospital and your insurance company). They view it this way: if you can afford it you will just pay the bill and if you can't you will engage them to lower it to a payable level (so set a hard limit you will fight for before giving up and paying it). If you don't engage and don't pay they will put it on your credit and sue you and/or kick you out of the US if your not a citizen (or not renew a visa due to debt). Good luck.

[betelgezaa]

Great that he has started to point out drawbacks of USA too.

[supremepartydude]

Dude - I got a 40, 000 dollar bill in 2019 for a hernia operation and found a lot of double billing and padded charges in my bill. I'm down in Florida using Florida Blue and its a bad experience for anybody with a lot of room for improvement. Your pain is not alone.

[stephanievaladez]

I am so sorry this happened to you. Unfortunately, as an American, when you have health insurance, this is the first thing you research 'What Hospital Takes Your Insurance'. The health care workers do not know about this information. Sorry to say this but American health care is about MONEY, MONEY, MONEY. So watch out for yourself or you WILL be taken advantage of. Sorry this happened to you.

[KellyStarks]

In Texas they passed a law limiting law suits for medical care … medical costs were halved. Yes, half of the costs of medicine is for defense against lawyers.

[yeet__]

Well.. Look on the bright-side, by driving yourself to the hospital while staving off your appendix from rupturing you saved at least 3500$ on ambulance costs!

[cptainsimian]

To help US citizens understand how this works in other developed countries:

My appendix burst one morning before work in Japan. I wasted a bit of time going to clinics thinking it was a stomach flu while walking like Quasimodo. Finally went to a hospital, got X-ray and CAT scanned. Emergency surgery immediately as I was losing the ability to stay conscious. 2 hour surgery vacuuming my guts out. Appendix had leaked through me so couldn’t do simple keyhole surgery. Progressed to peritonitis. 7 days in ICU followed by 8 days recovering from infection.

Final cost with nationalised health insurance was ¥5000 (about USD $50).

I assume it would be about the same cost and quality of care in my home country, Australia. US citizens deserve better.

[Ethos]

I work in medical insurance. I wish I could give you some advice, but the truth is I avoid using my own insurance because it's so convoluted.

[frannytm]

As an Aussie, I am absolutely shocked listening to this. I had an emergency situation where I needed surgery. I went to the closest public hospital, went to the ER, explained the type of pain I was having and where and pretty much got pushed in front of the line. I got a bed straight away with doctors and nurses looking after me and doing tests etc. When they found the root cause, they transferred me to another hospital via ambulance because the facilities at the other hospital had better specialist and equipment to deal with my issue. When I got there they doped me up with pain killers until the specialists and surgeons were ready to take me in. Long story short, I spent about 5 days in hospital. (well 2 hospitals really) I had a transfer via ambulance, and a surgery. How much did all that cost me at the end? $0. (well, my taxes pay for the service, but you get what I mean.) I don't even have private health insurance. I'm not saying our health system is perfect, but it's not going to put anyone in serious debt. When an emergency happens, the LAST thing you want to think about is "how am I going to pay for this!?"

[dirac]

American here, let me give you some advice... to find out where you are covered and for what, you need to ask your insurance provider, not the hospitals. Hospital workers will have no idea what your insurance covers. Your health insurance will provide you with a provider network directory which you use to pick

[mitchlew]

I'm from Australia and recently had a heart issue. I rang the ambulance, they took me to the ER. Gave me a bunch of treatments and I was on my way. Total cost $0.00. I will NEVER understand the American system. The crazy thing is many of them will defend their system to death. Seriously every other first world country has an answer for healthcare. Why can't America?

[delirium]

I got hernia surgery in California a few years ago. The negatives were like Winston said, it took forever to find out where I was eligible for treatment and then schedule the surgery. On the plus side my insurance actually covered 100% of it and the staff was great!

[laduzi]

I am so thankful for Australia Medicare and proud to be Australian. My sister had a similar situation. Drove 2 minutes to the hospital. She waited 30 minutes in the waiting room, 1hr for transfered to surgical then out the door next day with follow up in a community clinic. If I was to defend anything, I would defend Medicare with my life.

[manfredmuench]

First lesson from this is to check which hospitals are covered as soon as you get your insurance, and second is to locate them beforehand. Bit like checking out the emergency exits in an unfamiliar building, hoping you never need them but aware of where they are in case you do.
Speedy recovery.

[kats]

Also ask for a itemized bill and they’ll take out some of the random charges like bandages and stuff like that, they can’t add random stuff if you ask for it

[markw]

I am glad you feel better. Just FYI every hospital is legally required to provide emergency care to stabilize a patient regardless of insurance.