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(Time)   Snake bite causes $89,000 hospital bill. It would have been less but the snake demanded a private room   (healthland.time.com) divider line 157
    More: Asinine, North Carolina, hospitals, uncompensated care, medical bills, Mooresville, emergency rooms  
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6314 clicks; posted to Main » on 31 Jan 2014 at 8:26 AM (38 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



157 Comments   (+0 »)
   
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2014-01-31 08:31:31 AM  
Universal single-payer.

NOW!
 
2014-01-31 08:31:33 AM  
following the introduction of the American Care Act

Really, Time?
 
2014-01-31 08:32:26 AM  
It's their own fault for not utilizing the free market and shopping around for hospitals to get the best price. Hard to feel sorry for dumbasses that probably just went to the first hospital they found.
 
2014-01-31 08:32:44 AM  
Boo, hisssssss
 
2014-01-31 08:34:11 AM  
If I got that bill, they would have to tack on another $89,000 for the ensuing cardiac arrest and the intensive care that would be needed.
 
2014-01-31 08:36:40 AM  
"You can keep your snake insurance"!!
 
2014-01-31 08:38:35 AM  
I got a medical bill that seemed too high, so I asked for an itemized bill to be sent. It's been three goddamn months and they can't send me a bill for services *they already performed* and *have already billed me for*.

Now I'm trying to figure out the estimated cost of a future procedure, and it's a total clusterf**k. Three separate providers need to be contacted as well as the hospital, and while the doctors can give a fairly straight answer, the hospital is a nightmare. Everything they say is entirely contingent and full of weasel words, I still do not have a good idea about what services they might actually end up billing me for.

The general attitude among doctors is that health and care should always be the first priority. What happens when that care costs my family $2000 out of pocket? What about $5000? What about $80,000? Healthcare is expensive enough that lots of people seriously have to consider the trade off between quality of life and the cost of treatment. Meanwhile, some people do everything in their power to make sure that medical billing is an impenetrable secret.

I am not above saying that the medical industry as a whole is a bunch of crooks. I understand that stuff costs money, and medical grade stuff is inordinately expensive, but when you can't even give me a ballpark figure on how much a procedure costs, or justify your bill for three months after the fact, you have lost all my trust and respect. The single greatest thing we could do for healthcare in this country is to legally require that patients be given a price quote prior to an operation with a +10% upper bound on what they'll eventually be charged.
 
2014-01-31 08:40:43 AM  
$89,000 for one bottle of malt liquor???3.bp.blogspot.com
 
2014-01-31 08:45:14 AM  
Headline:   Snake Bite Costs North Carolina Couple $89,000 Hospital Bill

FTFA:  Though their Blue Cross Blue Shield Insurance reduced the bill to a little over $20,000, according to the Charlotte Observer, and they only ended up paying about $5,400 to cover their deductible and co-pay, the couple said they were shocked by the price of treatment.

Then it didn't cost them $89,000, did it?  That's how insurance works.
 
2014-01-31 08:46:43 AM  

Fubini: I am not above saying that the medical industry as a whole is a bunch of crooks


I am.
 
2014-01-31 08:47:43 AM  

MayoSlather: It's their own fault for not utilizing the free market and shopping around for hospitals to get the best price. Hard to feel sorry for dumbasses that probably just went to the first hospital they found.

 
2014-01-31 08:47:55 AM  
So..  No political slant to this article at all..


The couple visited the emergency room in August to receive treatment. The sticker shock comes as Americans continue to battle high health care costs following the introduction of the American Care Act

What does Obamacare have to do with this?

The article mentions this happened in the August.  So that's either some serious back billing by the hospital, or this issue all took place before ACA.

 
2014-01-31 08:48:18 AM  

MayoSlather: It's their own fault for not utilizing the free market and shopping around for hospitals to get the best price. Hard to feel sorry for dumbasses that probably just went to the first hospital they found.


I pray to God this is sarcasm.
 
2014-01-31 08:49:50 AM  

Fubini: I got a medical bill that seemed too high, so I asked for an itemized bill to be sent. It's been three goddamn months and they can't send me a bill for services *they already performed* and *have already billed me for*.

Now I'm trying to figure out the estimated cost of a future procedure, and it's a total clusterf**k. Three separate providers need to be contacted as well as the hospital, and while the doctors can give a fairly straight answer, the hospital is a nightmare. Everything they say is entirely contingent and full of weasel words, I still do not have a good idea about what services they might actually end up billing me for.

The general attitude among doctors is that health and care should always be the first priority. What happens when that care costs my family $2000 out of pocket? What about $5000? What about $80,000? Healthcare is expensive enough that lots of people seriously have to consider the trade off between quality of life and the cost of treatment. Meanwhile, some people do everything in their power to make sure that medical billing is an impenetrable secret.

I am not above saying that the medical industry as a whole is a bunch of crooks. I understand that stuff costs money, and medical grade stuff is inordinately expensive, but when you can't even give me a ballpark figure on how much a procedure costs, or justify your bill for three months after the fact, you have lost all my trust and respect. The single greatest thing we could do for healthcare in this country is to legally require that patients be given a price quote prior to an operation with a +10% upper bound on what they'll eventually be charged.


amen to all this
 
2014-01-31 08:49:59 AM  

RedPhoenix122: Headline:   Snake Bite Costs North Carolina Couple $89,000 Hospital Bill

FTFA:  Though their Blue Cross Blue Shield Insurance reduced the bill to a little over $20,000, according to the Charlotte Observer, and they only ended up paying about $5,400 to cover their deductible and co-pay, the couple said they were shocked by the price of treatment.

Then it didn't cost them $89,000, did it?  That's how insurance works.


Right, but that's still an example of the stupidity involved in health care pricing. That magical $89,000 number that no one pays? It's to prevent the insurance companies from trying to fark them. It's also the reason that even CASH patients can't get any clue what it's actually going to cost them.
 
2014-01-31 08:50:08 AM  

RedPhoenix122: Headline:   Snake Bite Costs North Carolina Couple $89,000 Hospital Bill

FTFA:  Though their Blue Cross Blue Shield Insurance reduced the bill to a little over $20,000, according to the Charlotte Observer, and they only ended up paying about $5,400 to cover their deductible and co-pay, the couple said they were shocked by the price of treatment.

Then it didn't cost them $89,000, did it?  That's how insurance works.


I would pay 5400 to not have to die an agonizing death and kiss everyone in the ICU on the lips when I walked out of there.
 
2014-01-31 08:50:54 AM  
...they only ended up paying about $5,400 to cover their deductible and co-pay...


Yeah but let's claim it was more than 25times that to make headlines.
 
2014-01-31 08:51:15 AM  
Translation: We knew they had insurance, so we charged as much as possible, knowing that the patient wouldn't really care.
 
2014-01-31 08:53:17 AM  

RedPhoenix122: Headline:   Snake Bite Costs North Carolina Couple $89,000 Hospital Bill

FTFA:  Though their Blue Cross Blue Shield Insurance reduced the bill to a little over $20,000, according to the Charlotte Observer, and they only ended up paying about $5,400 to cover their deductible and co-pay, the couple said they were shocked by the price of treatment.

Then it didn't cost them $89,000, did it?  That's how insurance works.


Hospitals bill insurance companies way too much for procedures because customers won't care.

Insurance companies will charge too much to cover their costs.

Customers will complain to insurance companies because that is the cost that they see, not the overcharged hospital bill.

So while customers (and more recently the Government on behalf of the people) complain to insurance companies, the hospitals are free to over charge without being criticised.

Of course there could be more to it than that. Maybe hospitals aren't overcharging, or they have to charge more since the medicines that they use are protected by patents.

The patents allow drug companies to charge a premium for their medicines, and they use the profits to pay off elected officials in the form of campaign contributions and lobbyists to ensure the law favors them.

There is more to it than, "That is what insurance is for."
 
2014-01-31 08:53:50 AM  
[Tonto] "Kemosabe, doctor say, you going to die."
 
2014-01-31 08:54:18 AM  
At some point everyone decided that what they do merits them becoming millionaires. We need doctors. I respect doctors. But let's be real. I grew up in the 1970s. My dad worked in a factory. We had a decent house in a decent neighborhood of a small town and in the same neighborhood lived several of the town's doctors. Their houses maybe were just a little nicer, but more or less the same. Maybe they had a more expensive car or they had a small boat or they took fancier vacations, but they weren't millionaires and they still lived pretty well.

Now, the same town, more or less the same population, more or less the same number of doctors, and the younger doctors all live in mcMansions in new, never-before-done-in-our-town gated communities.

It's kind of absurd. And I know it's not all them. It's also hospitals that have to pay dividends to shareholders and that's a big part of the problem, too. But we do have a problem with outlandish expectations of how we should live nowadays.
 
2014-01-31 08:55:02 AM  
Land of the free to STFU because Capitalism. Welcome to the nightmare of your own, superawesome, creation.

Thanks Osama!
 
2014-01-31 08:55:23 AM  

Fubini: got a medical bill that seemed too high, so I asked for an itemized bill to be sent. It's been three goddamn months and they can't send me a bill for services *they already performed* and *have already billed me for*.


Why would any hospital would want to send an itemized bill? So, you can learn that they ridiculously overcharged five hundred dollars for giving you two ibuprofen pills and then you can argue down the cost? That's how they make their money. By overcharging beyond scary amounts of money for things that should cost a few dollars. How this is legal, I don't know. The medical lobby?
 
2014-01-31 08:56:55 AM  
Our costs for providing uncompensated care are partially covered by higher bills for other patients.


In other words the middle class pretty much carry the burden of the uninsured and under-insured.
 
2014-01-31 08:59:09 AM  

Fubini: I got a medical bill that seemed too high, so I asked for an itemized bill to be sent. It's been three goddamn months and they can't send me a bill for services *they already performed* and *have already billed me for*.

Now I'm trying to figure out the estimated cost of a future procedure, and it's a total clusterf**k. Three separate providers need to be contacted as well as the hospital, and while the doctors can give a fairly straight answer, the hospital is a nightmare. Everything they say is entirely contingent and full of weasel words, I still do not have a good idea about what services they might actually end up billing me for.

The general attitude among doctors is that health and care should always be the first priority. What happens when that care costs my family $2000 out of pocket? What about $5000? What about $80,000? Healthcare is expensive enough that lots of people seriously have to consider the trade off between quality of life and the cost of treatment. Meanwhile, some people do everything in their power to make sure that medical billing is an impenetrable secret.

I am not above saying that the medical industry as a whole is a bunch of crooks. I understand that stuff costs money, and medical grade stuff is inordinately expensive, but when you can't even give me a ballpark figure on how much a procedure costs, or justify your bill for three months after the fact, you have lost all my trust and respect. The single greatest thing we could do for healthcare in this country is to legally require that patients be given a price quote prior to an operation with a +10% upper bound on what they'll eventually be charged.


I like your style. Do you have a newsletter?
 
2014-01-31 08:59:11 AM  

Headso: Our costs for providing uncompensated care are partially covered by higher bills for other patients.


In other words the middle class pretty much carry the burden of the uninsured and under-insured.


As it has been for the last 30 years or so. I'm pretty fed up, myself.
 
2014-01-31 09:00:13 AM  
 
2014-01-31 09:01:20 AM  

Headso: Our costs for providing uncompensated care are partially covered by higher bills for other patients.


In other words the middle class pretty much carry the burden of the uninsured and under-insured.


I know, right? It's like some kind of dystopian communistist nightmare y'all are living in.
 
2014-01-31 09:01:44 AM  
Typically, when I'm bitten by a venomous snake of going into cardiac arrest, I shop around for the best prices. Living in Virginia, I try to visit hospitals in North Carolina, West Virginia and Maryland and negotiate fees. Once I negotiate the best price, I collapse in front of the triage nurse and allow treatment. It's a little time consuming, but I feel I'm getting the best deal in the end.
 
2014-01-31 09:02:25 AM  
This is why, if I am ever diagnosed with cancer, I'm going to go find a quiet body of water that is 60F or less and soak in it for a few hours with a bottle of whiskey, even though (thanks Obamacaare), I have insurance. The CO-PAY for 12 hours was over $5,000! I have no idea about what to do if I am in a car wreck (or get bitten by a snake). I just hope I drop dead of a massive heart attack on my lunch hour like my grandfather.
 
2014-01-31 09:02:55 AM  

uttertosh: Headso: Our costs for providing uncompensated care are partially covered by higher bills for other patients.


In other words the middle class pretty much carry the burden of the uninsured and under-insured.

I know, right? It's like some kind of dystopian communistist nightmare y'all are living in.



Well you don't even live in the United States, so when you start paying for it then feel free to mouth off.
 
2014-01-31 09:04:10 AM  

Sybarite: following the introduction of the American Care Act

Really, Time?


The best part is that the bite/visit took place last summer, before marketplaces and all the other parts of the AFFORDABLE care act actually took effect.
 
2014-01-31 09:05:02 AM  

DubtodaIll: $89,000 for one bottle of malt liquor???


HAIL COBRA!
 
2014-01-31 09:05:31 AM  

Cold_Sassy: MayoSlather: It's their own fault for not utilizing the free market and shopping around for hospitals to get the best price. Hard to feel sorry for dumbasses that probably just went to the first hospital they found.

I pray to God this is sarcasm.


God is in your favor today my child.
 
2014-01-31 09:05:37 AM  

vonmatrices: There is more to it than, "That is what insurance is for."


Greek: Right, but that's still an example of the stupidity involved in health care pricing. That magical $89,000 number that no one pays? It's to prevent the insurance companies from trying to fark them. It's also the reason that even CASH patients can't get any clue what it's actually going to cost them.


I completely agree, and that's a very reasonable argument to have.  That's what the article should be about.  Not a deliberate attempt to get page views with a misleading headline.
 
2014-01-31 09:07:14 AM  
If we did not start with the list prices we have, we would not end up with enough revenue to remain in operation.

I don't see this changing anytime soon since the same insurance companies and government agencies are still running things.
 
2014-01-31 09:08:50 AM  

uttertosh: Headso: Our costs for providing uncompensated care are partially covered by higher bills for other patients.


In other words the middle class pretty much carry the burden of the uninsured and under-insured.

I know, right? It's like some kind of dystopian communistist nightmare y'all are living in.


it's more a combo oligarchy/cleptocracy...
 
2014-01-31 09:09:26 AM  

Fubini: The general attitude among doctors is that health and care should always be the first priority. What happens when that care costs my family $2000 out of pocket? What about $5000? What about $80,000? Healthcare is expensive enough that lots of people seriously have to consider the trade off between quality of life and the cost of treatment. Meanwhile, some people do everything in their power to make sure that medical billing is an impenetrable secret.


I'm not an expert, but I don't think it's your doctor's fault that he or she doesn't have the slightest idea what anything costs.

For the most part, i'ts not because the doctors don't care. If doctors spent the time to figure out how billing worked, they'd never have time to actually see patients. To find out costs, doctors would have to deal with exactly the same people you're dealing with -- the people who can't give you the straight cost of anything, and who give answers that are wrong far more than they're right. Billing rates are negotiated between insurance companies and the billing departments, and every single person who touches them from beginning to end participates in a giant clusterfarks of greed, bureaucracy, greed, incompetence, and more greed.  It's just a god damned mess.
 
2014-01-31 09:10:36 AM  

mekki: Fubini: got a medical bill that seemed too high, so I asked for an itemized bill to be sent. It's been three goddamn months and they can't send me a bill for services *they already performed* and *have already billed me for*.

Why would any hospital would want to send an itemized bill? So, you can learn that they ridiculously overcharged five hundred dollars for giving you two ibuprofen pills and then you can argue down the cost? That's how they make their money. By overcharging beyond scary amounts of money for things that should cost a few dollars. How this is legal, I don't know. The medical lobby?


Inelastic demand without regulation.
 
2014-01-31 09:11:38 AM  
The billed cost for my daughter's delivery and (mostly) her subsequent week-long stay in the ICU out of an abundance of caution was $85,000.

The final cost was $800. I have no idea how that happened.

minoridiot: If we did not start with the list prices we have, we would not end up with enough revenue to remain in operation.

I don't see this changing anytime soon since the same insurance companies and government agencies are still running things.


Exactly, the ACA is a huge boon to the insurance companies and government agencies that have set up this ridiculous system in the first place.
 
2014-01-31 09:17:15 AM  

uttertosh: Headso: Our costs for providing uncompensated care are partially covered by higher bills for other patients.


In other words the middle class pretty much carry the burden of the uninsured and under-insured.

I know, right? It's like some kind of dystopian communistist nightmare y'all are living in.


Insert John Boehner proclaiming the US has the best health care system in the world
 
2014-01-31 09:18:58 AM  

The Larch: Fubini: The general attitude among doctors is that health and care should always be the first priority. What happens when that care costs my family $2000 out of pocket? What about $5000? What about $80,000? Healthcare is expensive enough that lots of people seriously have to consider the trade off between quality of life and the cost of treatment. Meanwhile, some people do everything in their power to make sure that medical billing is an impenetrable secret.

I'm not an expert, but I don't think it's your doctor's fault that he or she doesn't have the slightest idea what anything costs.

For the most part, i'ts not because the doctors don't care. If doctors spent the time to figure out how billing worked, they'd never have time to actually see patients. To find out costs, doctors would have to deal with exactly the same people you're dealing with -- the people who can't give you the straight cost of anything, and who give answers that are wrong far more than they're right. Billing rates are negotiated between insurance companies and the billing departments, and every single person who touches them from beginning to end participates in a giant clusterfarks of greed, bureaucracy, greed, incompetence, and more greed.  It's just a god damned mess.


Giving their marketing divisions the force of law was a great idea though. If you don't think so you must a crypto-monarchist with half built serf pens waiting in your back yard.
 
2014-01-31 09:20:30 AM  

vudukungfu: Fubini: I am not above saying that the medical industry as a whole is a bunch of crooks

I am.


I've worked in the industry for 34 years.  I tend to agree with you.
 
2014-01-31 09:21:14 AM  

vudukungfu: Fubini: I am not above saying that the medical industry as a whole is a bunch of crooks

I am.


Me too.

Had a few mrsa infections last year. $1500 for a 15 minute lancing and 2 prescriptions. First day I waited about 8 hours and 6 the second before I was finally seen. 2nd infection was the same, only 1 day and 6 hours. 5th infection was surgery, 3 days in isolation, iv antibiotics, and $15000.

Nothing the doctors did I couldn't do. Before you surgery guys chime in, I wouldn't have needed the surgery if it wouldn't cost $500 to see a doc to get antibiotics.

Infections 3, 4, & 6-9 I lanced myself and used antibiotics from friends/family (luckily I found the same kind I was being prescribed).

When I was 21 my dumbass punched a wall and got a cracked bone in my hand. Didn't initially go to the hospital cause I thought I could manage. 1am I went cause my left hand was swollen all to hell. 3am I finally see a doc who eventually misread the xray and accused me of trying to get pain pills. I went off on the guy...I don't even like pain pill BTW...and an older doc walked by, glanced at the xray, and said you don't see those two cracks right there, turned to me and said you must be in pain. Yep, but I'm just here for some kind of brace or wrapping, I don't want any pills if necessary. About 10 minutes later the old doc returned with a brace and a vicodin prescription. $3500.
 
2014-01-31 09:24:10 AM  

skeevy420: vudukungfu: Fubini: I am not above saying that the medical industry as a whole is a bunch of crooks

I am.

Me too.

Had a few mrsa infections last year. $1500 for a 15 minute lancing and 2 prescriptions. First day I waited about 8 hours and 6 the second before I was finally seen. 2nd infection was the same, only 1 day and 6 hours. 5th infection was surgery, 3 days in isolation, iv antibiotics, and $15000.

Nothing the doctors did I couldn't do. Before you surgery guys chime in, I wouldn't have needed the surgery if it wouldn't cost $500 to see a doc to get antibiotics.

Infections 3, 4, & 6-9 I lanced myself and used antibiotics from friends/family (luckily I found the same kind I was being prescribed).

When I was 21 my dumbass punched a wall and got a cracked bone in my hand. Didn't initially go to the hospital cause I thought I could manage. 1am I went cause my left hand was swollen all to hell. 3am I finally see a doc who eventually misread the xray and accused me of trying to get pain pills. I went off on the guy...I don't even like pain pill BTW...and an older doc walked by, glanced at the xray, and said you don't see those two cracks right there, turned to me and said you must be in pain. Yep, but I'm just here for some kind of brace or wrapping, I don't want any pills if necessary. About 10 minutes later the old doc returned with a brace and a vicodin prescription. $3500.


You're going to the wrong doc-in-a-box. Got the telltale Lyme disease rash last summer and I think the visit will cost me $100. The pills were maybe $80.
 
2014-01-31 09:25:59 AM  
Fubini:
I am not above saying that the medical industry as a whole is a bunch of crooks. I understand that stuff costs money, and medical grade stuff is inordinately expensive, but when you can't even give me a ballpark figure on how much a procedure costs, or justify your bill for three months after the fact, you have lost all my trust and respect. The single greatest thing we could do for healthcare in this country is to legally require that patients be given a price quote prior to an operation with a +10% upper bound on what they'll eventually be charged.

I would agree with one small caveat: I really don't think it is the doctors.   It is mostly the insurance providers, with hospitals on board to so they can get paid.  Insurance providers are incentivized to make the process as byzantine as possible to protect their profits ; the more difficult it is to actually find out where the money is going, the better for them.  The problem is healthcare is a product that everyone needs at some point in their lives, so they also have no incentive to really compete, and it is very a regional business.  You generally end up at hospital 20 miles within your home if you live in a metro area, 100 miles or so in a rural area.  This means hospitals aren't competing with each other very much, and the barriers for entry are very high.  There is no "Costco" of healthcare to come in and undercut the local stores.  The effect is what you experienced,
 
2014-01-31 09:28:10 AM  
My question when I read TFA was - what kind of snake?  For the price tag on those anti-venom vials, I wondered if they were keeping a farkin' cobra as a pet.  But the linked report said the dude was bitten outside, where he felt a "bee sting," then saw fang marks.  My guesses would be a small rattler, moccasin or copperhead, based on that location.

/when something bites me outside, I don't leave whatever it was to guesswork
 
2014-01-31 09:32:58 AM  

Fubini: Healthcare is expensive enough that lots of people seriously have to consider the trade off between quality of life and the cost of treatment.


Um, good? It's unfortunate that this extends down to (for some people) whether or not to get a broken leg fixed, but this, to a degree, is how it needs to be. Frankly, I don't want to be paying for someone's brain-dead grandma to stay on $50,000/day life support, but this happens EVERY DAY, since the family knows that Medicare is picking up the tab. You can be damn sure that if the family had to pay for it, it would be time for Grandma to go, and they'd be right, since her quality of life is basically zero. We, has humans, need to get over this whole "every second of everyone's life is valuable" nonsense.

Fun fact: Regardless of other health issues, dialysis treatment for ESRD/585.6 patients costs $150,000/person/year. NIH estimates that there are 20 MILLION people receiving these treatments, the MAJORITY of which are on some form of Medicare/Medicaid. How many of these people would still be receiving treatments if they had to pay for it themselves, I wonder? Again, I'm not talking about 54-year-old Joe, with a job and health insurance and a family and two kids, I'm talking about  97-year-old Great Uncle James, the majority of whose weekly activity comes in the form of being wheeled into a clinic and hooked up to a machine.

I'm not saying healthcare in this country isn't completely farked- it is. I'm not saying Insurance companies aren't greedy, obfuscating organizations- they are. What I'm saying is, with costs what they are, we really need to reevaluate when it's no longer worth keeping someone alive relative to their quality of life.

/I get what you're saying, and I'm not talking about trauma care, obviously
 
2014-01-31 09:34:41 AM  

vonmatrices: Hospitals bill insurance companies way too much for procedures because customers won't care.


While that is partly true and a holdback from the olden days where employer-based health insurance actually covered just about everything, insurance companies are now dealing not with individually owned hospitals, but large corporations made up of a "network" of different hospitals.

This actually gives them more leverage to say "we will pay X amount, or X percent of the list price for these procedures."  Just as they already do with Medicare and Medicaid reimbursements.

The hospital simply jacks up the "list" price so that the pre-negotiated percentage the insurance company pays covers the actual costs.  Unfortunately the patient does not get this discount for their co-pay.  Unless you negotiate it somehow and if you really push the issue, you CAN bring your end of the cost down.
 
2014-01-31 09:36:29 AM  

Cold_Sassy: uttertosh: Headso: Our costs for providing uncompensated care are partially covered by higher bills for other patients.


In other words the middle class pretty much carry the burden of the uninsured and under-insured.

I know, right? It's like some kind of dystopian communistist nightmare y'all are living in.


Well you don't even live in the United States, so when you start paying for it then feel free to mouth off.


I do pay for it, you muppet. With taxes, and getting billed.

Even although I'm taxed 32% as a single man, I also get bills for hospital visits, doctor appointments, medications - it's just that the yearly total amount is capped over here (Doctor appointment is ~$30, but my monthly meds are ~ $450 - each Payment makes the next payment get a reduction, till It's no charge - But it's NEVAR FREE!!)
 
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