[OC] My daughter's medical bill after staying in the NICU for 12 days Queens County, NY

  1. I had twins in the NICU 10 years ago for 4 months each and the bill was over $2 million. The only upside to them being born small was they auto qualified for Medicaid who paid what my insurance didn’t. We ended up with a similar bill which was for the delivery.

  2. My son was in the nicu for about 3 months when he was born. Total bill just north of $1million. Our total out of pocket was $10k (5k per year but since he was there Dec-Feb it was 2 years worth). And this is with “good” insurance.

  3. It's still too much money even if you were lucky to have alot covered. It's ridiculous. When I had my son with my ex I think it cost around 50 euro for the whole visit and that was including staying three nights.

  4. I find it mind-bottling that anyone has to pay anything for having a kid in the USA. It just sounds so messed-up and backwards.

  5. No doubt your telling the truth. But $2 million sounds like a completely bullshit amount of money for the described medical services. I feel like American hospitals completely fabricate the costs based on absolutely nothing. Then apply discounts.

  6. I had twins by c-section. One of them spent 24 hours in the NICU. I spent 5 days in hospital before the birth with pre-eclampsia, and 5 days after the section recovering from blood loss, etc.

  7. Accountant here. That discount that their showing isn’t called a discount. It’s called a price concession. Price concessions could be explicit (negotiated) or implicit (not negotiated but essentially the insurance company is only going to pay a certain amount and it’s understood and accepted). I once asked a surgeon why he billed $10k for a surgery where he knew Medicare would only reimburse $800, and his response was, because not everyone has Medicare, and if he bills $10k, he will likely get more than $800 from another insurance company. Some may even pay him the full $10k. If he didn’t bill that amount, he’s potentially leaving money on the table. There really is no basis for the starting point, other than whatever the doctor wants to say it is, and then they just “discount” down to whatever it should cost (what insurance will pay for it). Sort of like shopping at Kohl’s. The income they ultimately report would be that gross billing amount of $257k, less the price concession discount of $156k, ultimately reporting net revenue of $101.5k.

  8. Basically, for decades hospitals have been steadily pushing the envelope for how much they can squeeze insurance for, and insurance has been responding by steadily increasing how much they'll cover, which leads to hospitals charging even more, to insurance covering even more, to...you get the idea. It's a cyclic system that's been building for a long time but nobody wants it to end because it means insane profit for the hospitals AND insurance companies though rising premiums.

  9. If you take a very simplistic view of the types of patient a hospital has you can define two groups: those that can pay (insurance, hefty bank account, etc), and those who cannot (or just don't) pay. You can't deny care to people who cannot pay you for it, and any other sane society would at the very least have some mechanism for hospitals to receive government reimbursement for care provided to patients who don't pay. But we're not a sane society. So they have to make the cost up somewhere else. They do that in part by passing it along to the people who can pay. But insurance only ever pays a fraction of what is billed (they have long, complicated contracts explaining the exact rate they'll cover for each procedure). So you end up with these insane numbers. Then they get further inflated by the fact hospitals have to pay entire departments of people whose specific job is to argue with insurance companies. Then add in the lost productivity from doctors and nurses having to argue with insurance over the phone that yes their patiently absolutely does need the lifesaving standard of care treatment and you can't ethically say no because it's bad for your insurance company bottom line. It's fucked.

  10. They do! 2/3 of bankruptcy in the US cite medical bills as as the main reason. This of course then causes other problems where they can no longer afford rent/mortgage, car payments, etc. It's a huge problem here that the government refuses to solve, because capitalism is sooooo great.

  11. Not sure but they all do it. Lots of people don't realize that the price they lay out is very negotiable. Insurance companies are usually the ones doing the negotiations usually but if you go to the hospital without insurance you can still haggle the price way down.

  12. My dad had a ruptured abdominal aorta. Very low survival rate but he was lucky it happened across the street from a hospital. Got him in quick for life saving surgery. He spent 6 weeks in ICU. His bill was more than $1 million.

  13. My nephew recently had complications from a malfunctioning shunt in his head and had a double ambulance ride, then was emergency airlifted to a hospital 400km away, followed by surgery to replace the shunt, a myriad of scans and testing and a 10 day stay in hospital.

  14. At that point it’s probably cheaper to buy all the medical equipment, build a clinic and hire doctors yourself..

  15. Oh damn. My father in law had a adnominal aneurysm that luckily didn't rupture but still required a 90k medflight to a hospital 30 miles away for emergency surgery. Then a second one found 3 days later and a second emergency surgery, all at 79 years old. Almost not making it through the second one with the doc say "You were the furthest gone I have ever had a patient that we didn't lose". We call him the Unicorn because he seems to have some kind of magically powers. Glad your dad is doing well.

  16. 92% of all patients with a ruptured abdominal aorta never make it to the hospital. Of those that do make it to the hospital, more than half never go home. He was lucky he was close to a hospital that had surgeons capable of repairing it, and he was fortunate he could afford health insurance or was old enough for medicare.

  17. Same as my old man. He was in the hospital at the time for another illness. All the surgery, rehab, medication, home care etc etc etc. total bill was AUD $ 0.00

  18. at what point do we sit back and rethink the medical system. because which individual from the working class is ever going to have enough the pay for that.

  19. I've taken care of people in the hospital that have died mid sentence, right in front of me from a bursting AAA. You're dad is lucky

  20. They are all made up. Insurance and hospitals run a scam and charge ridiculous numbers. Probably use them as tax write offs.....

  21. Probably to add some personal responsibility to pay it back. Like you've got to read it as "I owe the hospital 1100" rather than "I'm being charged 1100"? Idk I'm not American

  22. They paid less than a hotel stay for presumably life saving work from extremely high paid staff. I'd gladly pay the $93/day fee for that.

  23. Maybe I’m misinformed but I thought bankruptcy doesn’t actually cover student loans?

  24. Bingo. Government backed? Let's loan this 18-year-old half a million dollars to study the history of dance.

  25. Yeah. I suspect medical costs are based on nothing in the US. Except what is felt could be “gotten away with”. Even in Australia without government cover it wouldn’t be even in the same galaxy

  26. The last time I had to stay at a hospital in Germany, for nine days, I payed 90 Euros, ten for each day. Mostly for the food, I guess.

  27. This is nowhere near OPs situation but feel I should give a shout out to Valencia, Spain.

  28. 10€ a day is a co-pay. There are certain situations where you don't have to pay that. I had an emergency c-section in Germany and baby was on NICU for a week.

  29. When my son was born we spent a week in the hospital. There was no bill. I live in Spain. The food was really good! Public hospital. They had iPads to chose the next days food. Came home with lots of diapers and samples. The nurses were great. The doctors were awesome. Zero euros.

  30. That's disgusting. And they give you hyper inflated cost to stare at so your all happy you dodged a quarter million dollar bill

  31. Physicians/hospitals actually make a loss on many patients because of exactly this. They charge some sum, and the insurance company says, "No, we're not going to pay that much." Physicians/hospitals swallow that cost and then try to make it up elsewhere, or they insist and risk the insurance company's saying "None of our insured will ever be able to seek reimbursed care at your institution again."

  32. New Zealand citizen checking in. My kid was 8 weeks prem and spent 8 weeks getting to her original birth day in NICU. Total bill $0. No insurance either.

  33. My son was born 8 weeks early and is currently on day 16 in the NICU. Very thankful to be in Canada right now. I’m hoping we don’t have to be there all the way until the due date, but at least the staff are incredible.

  34. It screams of scam this shit the americans get. It’s like it’s supposed to make ya feel good it’s only 1200 usd. Like buying a damn car for 10k but HEY MAN IT’S ON 99% DISCOUNT USUALLY WE SELL THIS FOR 10 MILLION EASY. Like dude wtf?

  35. Can anyone explain to me how this isn’t some sort of scam? How do they expect anyone to pay over a quarter of a million dollars for life saving services? How do they justify “discounting” their services by fucking $100,000….

  36. They don’t expect anyone to pay it. I wrote this a couple weeks ago in an ELI5 question that was about a similar topic:

  37. They justify it by employing lobbyists to channel enormous sums of money to congress people who vote to make damn sure that the system doesn’t get fixed.

  38. Thank you all for asking how she's doing, I'm touched by your concern. She's 2 months old now, and doing extremely well.

  39. My little one was in the NICU (in a Manhattan hospital) for a couple weeks as well. Pretty similar situation. Born at 34 weeks with a scheduled c-section due to preeclampsia. CPAP for a day, uv light for a day, feeding tube until she could eat on her own.

  40. OMG. "Congrats on saving 99% on life-saving care for your premie. Next time be sure to download coupons from our app to save more!"

  41. This is a required disclosure as in the insurance co is required by law to mail these numbers to the beneficiary

  42. That's more than I pay for a whole month of health insurance no matter what, I a pay the highest amount for the legal insurance possible. But yes, how gorgeous of them.

  43. It's revolting and disgusting that they put the percentage that you "saved". Like anything else here, it's about the grift, not actual service.

  44. Just enough to still squeeze that last drop off the end user and make it still a heavy thing. Americans you being fucked with sand and still not enough to change things...

  45. it's because the predatory health industry in a certain FUCKED UP country lies about how much they charge for stuff to scam people into being grateful they have to pay for insurance.

  46. In Australia it would be free. I just had day surgery at the hospital under general anaesthetic, met with a physio, had some food, and got prescriptions from the doctor. All it cost was $5 for the painkillers I got from the pharmacy.

  47. Another another Aussie here. 6 months ago I had a major operation and was in hospital for 2 months with 2 surgeries. Paid nothing.

  48. Another Aussie here, my wife had her first ultrasound for her pregnancy today. The only thing we spent was $20 for some lunch on the way home. It's great living in a first-world country.

  49. Another Aussie here. Got taken in by the cops for drunk and disorderly, only to collapse from an overdose. Sent to the hospital, had an overnight trip in intensive care with a hundred needles sticking out of me and nurses coming in every 5 seconds to check on me. Walked out in the morning with a brochure for free drug addiction help services, and no bill. I did take those services and turned my life around, bless the Aussie spirit

  50. Dual American/Aussie here. Had an emergency C-section with my second child. It cost me about $5 for coffee. My friend paid US$10k for a normal delivery. I’m staying in Oz, thank you.

  51. There should be a national Apply for Australian or Canadian citizenship day for Americans and they could all move there and have free healthcare.

  52. English person here. Last summer-autumn I had an ultrasound, MRI with contrast, various other appointments, surgery under general anaesthetic, overnight hospital stay and other follow-ups. The only things I had to pay for was hospital parking (twice) and a few prescriptions. I'd have had change out of £100 if I hadn't decided to treat myself to a few things (another £100-ish) for being a big, brave girl.

  53. And another aussie. Emergency micro-surgery on my hand after, believe it or not, an icehockey accident. Scans, team of surgeons, general anesthetic. Total bill: $0.00. Paid sick leave. I think only the painkillers cost me like $20.

  54. My partner and I had a baby boy a month ago. He was an emergency c-section. We spent 5 nights in the hospital. Walked out on the 6th day. No bill. No discount. Free as in free beer.

  55. There is a time and place to point out when your customer saved money, this is not one of those moments. Although knowing insurers they will find a way to money out of this at your expense anyway.

  56. I have absolutely no doubt it’s pointed out to paint the people providing healthcare in a bad light rather than the insurance companies. If insurance companies paid exactly what was asked, these ridiculously inflated costs wouldn’t exist.

  57. Fr. Our taxes may be bad in comparison but at least compared to the US it feels like we actually get something out of it.

  58. Wow, you saved $250k, that is NICE. Well yes, but actually no, they scammed you into paying insurance and STILL charging you over $1k. My vitamin pills from the supermarket are way more expensive then my medical bills.

  59. It's all the money hungry insurances. It's so dumb. Imagine a world where corporations weren't so greedy. Yes, they should be allowed to make SOME profit. However, the amount of profit they actually make, is ridiculous.

  60. Also Canadian. Our first kid had a heart issue, so we had to spend a few days in the NICU to monitor and whatnot. Then ultrasounds, specialists, appointments. All turned out okay so that's cool.

  61. Damn, 99% savings and it's STILL about 100x more expensive than what you'd pay in any other first world country ($10‐15 for parking). Messed up system there! Can't imagine money being a factor in whether my kid dies.

  62. Well it truly is a tucked up system but hey >50% of voters think improving the system would be bad for corporate profits so they vote for people who promise to keep the fucked up system in place.

  63. America needs to rein in the costs. Have Congress pass bills to set price caps on every procedure and factor in inflation. Total costs and quoted cost to end patient must be the legal maximum the patient has to pay. Have a government funded hospital to create competition and break up monopolies. Undo the employer covering healthcare for it's workers and federally fund universal healthcare.

  64. My ex wife doesn't show an income just so that she can keep her two kids and our son on medicaid. I have not had to pay for anything medical for them, ever.

  65. Yep. I have insurance and still paid almost as much to have a 20 minute procedure at the friggin dermatologist. Would have been 8 grand without insurance.

  66. Meanwhile Archie's parents in the UK fought for most of the year to continue his totally-free healthcare while he was medically braindead and basically kept alive by machines. No bill.

  67. youve got amazing insurance. but in a real country you wouldnt even have gotten a bill. but we gotta spend that tanks planes and aircraft carrier money.

  68. Yep. Came here to point this out. The insurance companies need to be burned to the ground. Every last one of them. make the government negotiate en mass. See how the pig pharma squawked over this new law? You know why? Because it works.

  69. Just curious...What happens to your plan premiums now? Have you protection against increases now you’ve made a claim/used the plan?

  70. They really have the nerve to put a savings % like you just went shopping at Kohl’s.. hell they circled it too, should have highlighted it.

  71. When picking up some pills for my wife once, I forgot my medical card. They only occasionally ask for it as proof, but I didn't have it the day they asked. They said instead of paying the 25.00 copay, I could purchase the generic version outright. I thought it would be laughably expensive.

  72. Medical care in the US is just another business. Capitalism at its finest. They care more about making a $ than saving a human life. This country is fucked

  73. Was gonna comment something witty like "Well in the UK I'd pay nothing for that. Haw haw haw heff heff heff"

  74. Australian here. My husband had a heart attack. Ambulance ride, emergency surgery, then complications that made it a 4 month stay in hospital. Less then 2 years later he had to get a pacemaker put in.

  75. I feel like it’s paying $1 for a pack of gum when it’s listed $1000 and then they’re like oh 99% off so it’s a good deal.

  76. Non-american here; $1,120 seems atrociously high. This would be free in any other first world country. You're being stomped by your own companies and I feel awful for you - and would also never live there for healthcare reasons alone.

  77. Despite all of the negative comments, all of the "But where I live's", you are not there. So, those comments are mostly irrelevant.

  78. Just under $94 per day in NICU for the “what I owe part” isn’t bad compared to the way overinflated $21,447.24 per day without insurance. Always scary to think about.

  79. I find it amazing how they always seem to find a decent amount of money to charge you. Like you’ve got to hurt a little, can’t just cover everything.

  80. My daughter is in the nicu right now. Yesterday was 9 weeks… I’m almost scared to open it up when it comes on the mail.

  81. How is this legal? If I walked into a supermarket, and saw a sign that claimed an apple cost $1000 but they'll sell it to me for $1, it would breach advertising standards.

  82. This is just ridiculous. This would've cost you 120€ where I'm from (10€ per day), regardless of what was done.

  83. 1000 usd?? Damn, in europe for that money I could get 50 surgeries, 800 stitches, heart transplant, cybernetic leg, 6 years in hospital bed, 6 nurses doing striptease daily, and I would still have 1000 usd in a pocket

  84. The problem is essential what’s called a charge book. This allowed the hospitals to charge whatever they feel for service and items provided. Then ur insurance company will negotiate with the hospital based on the charge book and pay for services rendered.

  85. My daughter was in NICU for 7 weeks and we weren't billed a penny. I truly believe the NHS is the best thing the UK has ever done.

  86. Yeah but you’re only paying $1100, that’s not bad at all! My hernia surgery was more than that and I was only in the hospital for half a day

  87. On the one hand, it’s a welcome change to see a reasonable out-of-pocket bill from an American healthcare provider. On the other hand, the fact they even put the “discount” on the bill shows you just how broken the system is. It’s an admission that the initial bill is completely made up.

  88. Crazy, my hospital stay, as an adult, was 120k but that was 21 days, 6 in the ICU. ICU was 50% of the bill, with every day costing 12k. The cheapest thing in my bill was the gallons of Antibiotics shoved in me at the cost of around 200$...

  89. What I owe after having a stem cell transplant and multiple hospital stays over 5 years for Systemic Sclerosis. On top of that my son of 5 already getting over a dozen surgeries for his infintile scoliosis.

  90. My adult daughter got frostbite from losing a glove snowboarding. In ICU for one week. Medication to revasculate her hands flown in from a northern location. Social worker visited to get her wage loss insurance coverage in place and they sent us home with pain meds. Zero balance.

  91. I have three thoughts: 1. I am glad your child is getting better, 2, congratulations on being wise and having insurance, and 3, the health care system in the USA is a hot mess.

  92. Imagine profiting off the medically vulnerable… It takes a different species to wake up each morning and be ok with extracting money from the sick and injured…

  93. Keeping the jaws of bankruptcy, homelessness and health insecurity biting at out heels is key to keeping the US machine running the way it does.

  94. Americans know: you have astonishingly good insurance Folks from outside US: Wait, what? You guys have varying levels of health insurance?

  95. I love how they put "You saved 99%" in a big circle to make you believe it was a good thing lol. I'm not informed but American healthcare looks hiper inflated, right? At least it looks that way.

  96. Seriously, the medical and insurance systems in US are beyond the level of fucked up. Those money whore milliornares should be burn in hell.

  97. I feel like the hospitals, insurance companies, and prescription drug manufacturers all just point fingers at each other saying the other is responsible for exorbitant prices, and I honestly don't know who to believe.

  98. My daughter was born 6 weeks early and spent 2 weeks in the NICU, thankfully the insurance (which we paid $700/month for) covered most of it and we just had to pay the $10,000 out of pocket deductible. I probably could have paid it but had to quit my job because after my 12 weeks of unpaid leave was up she was still only 6lbs and no daycare would take her. Thanks US healthcare system! On the bright side, I got to stay home with my kid and channel my rage into dismantling the system.

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