Remember a month or so ago when I split my scalp open and got an ambulance ride to the ER and a CT scan and an EKG and some staples whacked into my head? The bill came.

It was $200.

Well, that was my out-of-pocket. The actual bill was $4,598.37.

Well, that’s what the insurance company paid by contract. The actual actual bill was $25,546.25.

It’s like I got a twenty-five grand bonus just because I have a job.

The American medical system is insane.

Still waiting on the ambulance invoice.

@gknauss It's pretty much hopeless without an intermediary like private insurance or medicare to negotiate--total market failure. And the reason we have this nutty system is a 1940s policy that made employer-paid health insurance premiums pre-tax, so it's a tax-advantaged form of compensation.