JordosIn the US, what happens if you sustain a life threatening injury and you don't have insurance?
Emergenty rooms in hospitals are legaly required to help all patieints, so you would recieve care. Usually until you are able to leave the hospital. You would not receive followup care without going to the emergecy room, or paying cash. You would be billed for all services, usually at a higher rate than insured patients
What kind of care is the question. Often times stabilize and terf em is the name of the game.
My wife worked in the ER room.
Understaffed, abused, and a huge chunk of people who are in the ER are desperate and came there as a last resort because of our fucked up healthcare system.
The Ramen DutchmanThat is awefulv I have no words
They’ll fix everyone at the ER.
But you get a ridiculous bill, then likely “settle” for a much lower amount of if you’re truly pennyless, you just never pay it and eventually the hospital gives up and uses it as a tax write off.
It’s a shit system
gabe [he/him]It’ll also wreck your credit, and if you’re unlucky they’ll sell your debt off to debt collectors to harass you. And then the truly desperate will sometimes commit heath insurance fraud making the system even more immensely fucked for everyone except for the hospitals and insurance companies
Not exactly. Medical debt is different compared to retail debt like credit cards. It still sucks but the rules are different to protect people at least a little bit.
Yep. Medical debt is often not calculated into your credit score by the credit agencies, either, though not in all cases. Or if it is calculated in, it is heavily weighted against so it doesn’t cause much damage.
And it makes sense. Credit score is supposed to be a judge of your credit worthniess based on your history seeking credit and repaying debts. While medical debt is legitimate debt, it isn’t credit seeking behavior in the way an auto loan is. You didn’t choose to take it on, it would be inaccurate to take a trip to the ER into account when determining your credit seeking habits.
nocturne213I sustained a workplace injury (working on a movie set) and the production company never filed the paperwork, so their insurance would not cover me. I refused to pay the bill and it showed up on my credit report and caused issues for three years. Eventually i found my wrap gift from movie and inside the set medic had put a copy of the paperwork. I scanned it and emailed it to the hospital and within 72 hours it was taken care of and like a month later it was off my credit report. (Time frames may be off as this transpired in 2015)
I can’t imagine the mixed emotions you felt when you found that lmao.
About five or six years ago, most creditors started using a different FICO model which doesn’t include medical debt. Basically, the idea is that being unable to pay medical debt says very little about how well you can handle debt.
There are also models that don’t consider student loans, but those aren’t used as often.
Mind you, that is a recent change and there are some places that still illegally do so and it is a pain in the ass to get it removed.
The big story in my city a while back was a shitty debt collector that stole money from a guy’s bank account.
‘It is like robbery’: A debt collector wrongly wiped out an Oregon man’s entire bank account
According to court records, the debt collector said Salazar owed money for treatment at Providence Portland Medical Center in late 2007 and 2008. Providence claimed it sent 26 billing statements and six financial assistance applications to the home address provided by the patient. The unpaid bills for six emergency room visits originally totaled $4,750 but have since ballooned to more than $14,000 after costs, fees and interests associated with the debt collection.
Salazar tried explaining to Professional Credit Service that he didn’t have the money to pay, but a customer service representative seemed unsympathetic.
“They did not care if my brother is sick and this is going to put us on the street,” explained Salazar. “They did not care.”
In April, Salazar filled out court papers challenging the garnishment. It temporarily froze his bank account, preventing the debt collector from taking any more money. At the same time, it kept Salazar from accessing much needed funds, including his paycheck, which is electronically deposited into the account.
it’s relatively common for some hospital systems to sue patients for non-payment if their bills are high enough.
I feel like a lot of people ignore collection agencies when they advise others to “just not pay.” Yeah you could probably get away without paying, but you and your entire family will be harassed nonstop. There’s been few things more chilling to me than a stranger calling me out of the blue with my sister’s name and info telling me to get her to settle up (thankfully just a small amount).
I’ve been telling people that the notion that the ER lets poor people die in the US is false; instead, they make you wish you did.
Part of the reason it’s like this is because insurance companies try their very hardest to avoid paying, but that means you have to do the same if paying yourself.
You go to the hospital and get a bill that puts you into debt for the rest of your life. Maybe you do a crowdfunding campaign to cover part of it
GoFundMe CEO: We Could Use A Few Fun Ones
If someone calls an ambulance and you’re unconscious they will take you the hospital for treatment. You will be responsible for the bill. Including the thousands of dollars for the ambulance ride.
And no, even though you were unconscious and not able to consent to treatment willingly you will still be responsible for the bill. There are ways of dealing with it, but one accident is all it takes for a ruined credit score for some people. It is as fucked up as it sounds.
There are ways of waiving bills, getting financial assistance etc but it’s a total nightmare dealing with hospital billing departments
§ɦṛɛɗɗịɛ ßịⱺ𝔩ⱺɠịᵴŧMedical bills should not impact credit score in the US until its been over a year. This being the case, if someone’s uninsured it can be best to wait for collectors to call and then haggle to pay it off at a fraction of the initial cost. Pretty demented this is basically a pro tip for approaching the repercussions of receiving life saving care…
Source: Autoimmune disorders run in my family
If I’m unconscious indoors in a safe place then leave me alone I’ll wake up eventually
You hope.
ChozoWith the looming medical debt, I'd actually hope not.
Unless you are out for a very brief period of time, being unconscious is a seriously bad sign. Like brain hemorrhaging which left untreated will kill you.
CrazyEddie041And if you don't, then the problem has still resolved itself!
bartolomeoInsurance companies hate this one simple trick!
Ah yes. Healthcare Rape. More terrors to my collection.
In short? Medical debt. Emergency rooms will treat you, and in some cases might offer discounted rates for patients without insurance, but at the end of the day you are still responsible for the bill, however large it may be.
Dharma CuriousWorth noting that those discounted rates are still significantly higher than what insured patients pay, and astronomically higher than what people in actually sane countries pay.
Emergency rooms are legally required to provide treatment, and will do so even for non-life-threatening conditions.
If you don’t have insurance coverage but can pay, you will get a bill. If you can’t pay, in most cases the hospital will write off the debt.
MxM111Also quite often charities step in to help with the bill.
52fightersMost hospitals are setup as non-profit entities and use medical debt write-offs to exhibit their charity. In all truth, they intentionally drive their own expenses sky high to increase revenue to astronomical levels so to give executives running these organizations excessively high compensation. These write-offs are just part of the gig.
Hospitals haven’t been non profit since they were delayed in the early 1980s, and are absolutely structured for profit, with shareholders and conglomerate ownership and everything.
The medical write offs are exactly that. Tax avoidance.
They absolutely will not write off the debt in most cases. They'll get you on a payment plan.
itsyourmomThe hospital will keep sending you bills. Every month, and if you don’t pay that or set up a payment plan with them… they absolutely send it to a collection agency. That law agency will hound you all day every day, phone calls… text messages… Mailing threats and lawyer fees on top of the OG bill.
Eventually, I know from personal experience… they will take you to debtor’s court. Where you sit in a room full of strangers till your name is called. Then you have to prove how poor you are and they can pause the collection efforts for a period of time… or if the judge believes you can afford something… then your court ordered to pay… or else.
NegativeLookBehindThe bells of freedom!
Eagle screech
AltoGo into enough debt that you wish you just died
What happens if I’m a foreigner? Let’s say I travel there as a tourist, break an arm hiking, they put me in plaster. Let’s assume I’m careless and made no travel insurance. Are they going to stop me on the border?
Someone else will need to answer on the border bit (though I doubt it), but I know from a friend who visited without travel insurance that he did have a bill for something like 30 thousand USD for a broken leg and rib. I think he just never paid it. He’s back in the UK now, and says he’ll never visit here again because of the experience with our hospitals
You get billed, but you can just go home and not pay it. That doesn’t necessarily mean that the issue won’t still be waiting for you if you come back, though.
Nah, you’ll have no problems going home. But if the collectors are smart, they’ll pursue you in your home country.
Something nobody else has mentioned her eis that even if a hostpital is required to provide care regardless of your insurance, in practice you’re not unlikely to get a lower standard of care if you have no insurance or even if you have insurance that’s seen as “inferior” like Medicaid.
Folks without insurance or with “lesser” insurance tende to be poorer. More likely to be seeking pain meds to use recreationally. More likely to be disabled, overweight, etc. More likely to be racially discriminated against or, if white, seen as “white trash”. So, having no insurance or inferior insurance itself may get you written off as somehow undeserving of the same level of care.
And if that’s an issue for life-threatening injuries, it’s… probably much more so an issue for more routine kinds of medical care. It’s literally not even an option to self pay in some cases. And I don’t just mean because it’s so expensive. Even if you did say “I don’t have insurance, but my bank account has $100 million in it and I can use my debit card,” you may be told you’re not allowed to self pay.
Poor people without insurance are often sent to alternative care facilities specifically for poor people without insurance. And as you might expect, those places are often very understaffed. So you can expect longer wait times and more rushed care.
Poor people without insurance also often don’t get treated early when a problem isn’t a huge deal for fear of accruing medical debt. So they’re also more likely to end up unexpectedly needing a trip to the ER because that minor infection that, had they gotten it treated a week ago, would have been taken care of with a round of antibiotics has now spread to some much more vital organ.
Adding to this, there is no requirement that hospitals ensure that you are safe when they release you from their care so sometimes people who can't pay for care and have dementia, uncontrolled or poorly controlled mental health issues, or are otherwise vulnerable get left at the nearest bus stop. It even makes the news sometimes because someone got dropped off only wearing a hospital gown at night in winter.
Edit to add link to an example: https://www.cnn.com/2018/01/11/health/baltimore-hospital-patient-video-bus-stop-trnd/index.html
CrackaAssCrackaI can’t speak for every hospital since I’ve only worked at a few but this is rare. Some places might still be doing it, dumping people who can’t be placed or don’t have insurance, but EMTLA was put in place to combat that stuff and the lawsuit and probably fines would make this a bad move. We’ve kept people where I work for months because we can’t place them or psych won’t take them. At minimum they’re going to a nursing home.
TwoGemsLove how the CEO pretends to care about what happens. The executives are the reason it does.
“Well, we never told them to make that the policy. We simply decreased wages and staffing enough that it was the natural conclusion to our decisions.”
The having money to pay for something and being turned down is such nonsense. I’ve run into something similar with some procedures I need done. Place would let people without insurance self pay, I have insurance but the wrong kind, they were apparently legally required to bill my insurance but they couldn’t. So I was denied service entirely even though I could have paid in full out of pocket. I spent two months getting my insurance to negotiate a contract with them but by then I was/am running into a time constraint and had to switch where I’m going. Things are so broken over here.
driving_croonerFolks without insurance or with “lesser” insurance tende to be poorer. More likely to be seeking pain meds to use recreationally.
Do you have a source for this? This sounds wrong, pain pills are rich/middle income people drug as I perceive it. You can’t really get hooked up on pills if you never got them by a doctor first.
You’re assuming doctors are the only source for these.
There are definitely pill mills in the poorer parts of town. And usually poor populations receive Medicaid, which will typically pay for the stuff. Just anecdotal evidence as a pharm tech in a rough part of town during college, but after a while we had to actually stop taking scripts for most pain meds (still got a ton of people using trazadone and stuff, though) because the pharmacist just didn’t think it was worth his license if the scripts were tied back to a pill mill.
The poor people often sell the pills as well.
Can’t afford a day off work lazing about on pain pills.
𞋴𝛂𝛋𝛆Even if you have good insurance, if you don’t recover quickly, and get back to work. The US is basically setup where suicide is your only option. I really wish I lived in an advanced ethical country in Europe. The USA is a shithole country to live in. I was disabled while riding a bicycle to work 2/26/14 by a driver with the cognitive capacity of an average 3rd grader and have spent ~80% of every day laying in a bed since.
My only hope is to one day get disability that doesn’t pay enough to live anywhere. It will pay for a pistol and a bullet and that is the entire design.
ER patches you up, you get a large bill, you declare bankruptcy, life goes on.
The question you should ask is, what happens if you have no insurance and you develop a series chronic illness.
How does “life go on” with a bankruptcy and health issues?
The point of a bankruptcy is to move on. You start off at zero again, but you can start building up assets again.
As far as the health issues go, because of the bankruptcy and the ACA you probably qualify for medical care under one of the programs.
Yeah, you get fucked over pretty good. Life goes on because you’re not dead. But everything you had, everything you worked for, is gone. You are left literally with life, not with your life.
For all its faults the ability for an individual to declare bankruptcy sounds like a rather good thing in the US and something we don’t have in Finland. Granted we don’t have that level of healthcare bills either but if you somehow get youself millions into debt here it sticks with you your whole life.
There has to be some form of bankruptcy, isn’t there?
When you declare bankruptcy, you’re basically going to the courts and saying, “Look. I don’t have the money or the income to cover all my debts. I need help.” If the court agrees, they’ll force all your creditors to come to the table to negotiate.
The court determines what assets you can keep and determines the best way to divvy up what’s left. Usually you keep your house, car, and basic necessities but that can vary. Some states don’t protect the house or car but even then the court will consider if it’s cheaper or better for you to keep either of those than to go rent a new house and take alternate transportation.
Then they look at your income and decide what you can afford to pay over time. If your income is too low, they may consider all your debts settled at that point. Otherwise, they may set up a payment plan for so many years and consider you even after that.
Medical debt is the number one reason for bankruptcy. To twist the knife a bit, people who have large medical bills are often in a physical condition that makes it hard to work. About 2/3 of all bankruptcies, or 530,000 families annually, cite their medical bills when filing. After that is mortgage debt (45%), living beyond their means (44.5%), providing help to friends and family (28.5%), student loans (25.5%), and divorce (24.5%).
“ student loans (25.5%)”
This seems odd to me because bankruptcy doesn’t currently get rid of student loans (which is completely wtf, but that’s another issue); maybe the student loan payments got so onerous that they got into other debt?
Federal student loans have exceptions to bankruptcy. Private student loans are subject to normal bankruptcy proceedings–much though they may imply they are not.