this post was submitted on 20 Jul 2026
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American here. Reluctantly went to the ER because I had been vomiting for a couple of days. Turned out that my gallbladder just stopped working. Was immediately placed into a room, given IV antibiotics, and had surgery the next morning.
Had to stay for 4 days to make sure I was in good shape. The surgery wasn’t super expensive, but the room itself cost me way too much.
Total cost was just over $24k. No insurance (contractor). Even on payments, it’s insane.
My plan is to just never get sick for the rest of my life so I don’t go into another debt hole.
That instant room you got is nothing special, but just how triage works. I came to the emergency room some years ago, shitting and vomiting my guts out, and they placed me in quarantine faster than I could hand over my insurance card. Come with a sore ankle and wait until the other patients are stabilized.
(Germany)
You can haggle with them. Save up a few k and then call them offering to pay a lump sum to settle the debt. A few years ago I broke my wrist and ended up with a 16k bill. I got 3k together, called them, told them I'm poor AF, that they could take the 3k or nothing. They took the 3k.
There's a horror in having to haggle for the price of your healthcare whilst in the hospital.
Similar story back when I didn't have insurance for a bit. In my case the hospital billing actively offered a settlement when I called and asked about options.
I ended up in the emergency room last year.
The ambulance ride was something like $1200, which I've come to learn was "cheap" comparatively speaking, as they're typically thousands of dollars each. My insurance didn't cover the cost of that ambulance because the particular service that picked me up was out-of-network. Insurance also didn't cover the ibuprofen I was given for pain citing the fact that they require prior authorization for it. Two ibuprofen alone cost me $40.
Medical debt aside, (not that it's not important) you are an example of something that's true about both systems: If you are at death's door you'll get treatment immediately, even if it's just to stop you actively dying and stabilize you enough to wait for admission to the ICU. If you are waiting 12 hours in the ER before being seen by anyone but Triage, you're probably the least sick/wounded person there.
Maybe instead of cursing the nurses and doctors, muster up the most powerful curse you can conjure, and send it to the germs and cancer cells in the Children's Ward. Can't hurt, might help. I like to start with "Fuck you, you filthy neuroblastomas! With your disgusting corrupted DNA and misshapen tumors oozing and squooging into places you don't belong! Just fucking shrivel up and die! Don't you know nobody wants you here? You're fucking waste, so waste yourself and go out the shithole!"
Then see if you can call some good vibes for a quick resolution to the people who look miserable enough to be ahead of you. You're on your own there, I'm not so good at prayers or that kind of thing.
Also a summertime reminder: a lot of people in the ER these months will be getting an IV because they're severely dehydrated. And others will be getting an IV because their ability to withstand whatever else they have will be improved by getting better hydrated. You can help keep yourself and your friends out of there by pre-emptively drinking more water and non-alcoholic no-caffeine drinks, and being a ...did "hydro homie" get ruined when I wasn't paying attention?
hydro homie is not ruined yet, as far as I'm aware.
I'm sure Canadian doctors do something similar
Yes I agree, both systems. That's what triage is for.
"Wasn't super expensive", " 24k", sorry what the actual fuck?
The worse part is that this is totally dependent on who your insurance is, and you don't know prices on anything until the bill shows up 3 months later. You or your doctor also might have to fight your insurance to prove a procedure is necessary, or that a medication needs to be covered. Most times you can expect your procedure to not be covered, so you have to tell the insurance company that yes, this is covered, here's why it was necessary (usually this first round of rejection is done via having an algorithm or ML setup "review" the case).
You seemed to miss the part where he said the surgery wasn't all that expensive, it was the stay in the hospital that was.
In some sense the US system is more reflective of the "true" cost of healthcare, just in the least humane way possible.
Take a country with "bad" socialized healthcare: Patient pays some percentage of visit cost, government pays the rest.
You break your leg: ambulance with two EMTs is $100/hr, 2 x-rays at $10/per, $30 in assorted bandages and plaster, and $150/hr for a doctor. Total patient cost: some percentage of $300.
The US system charges all those, but also reflects the cost of those things existing and being available as reflected in patient usage. The socialized system sees the ambulance ride as distinct from when the community needs a new ambulance, or the cost of having EMTs available 24/7/365.
Likewise, you get charged not just for the bandaging, but the cost of the person who brought the bandage to the nurse applying them, the cost of the person tracking the inventory, and the cost of the nurse isn't included in the medical care. Your room isn't charged as a room but as the room plus the services of everyone who keeps a hospital room ready to go.
A socialized system just happily says "of course a hospital needs skilled janitors and maintenance people, but only an idiot would call what they do patient care"
No one notices the cost of every hospital janitor and HVAC specialist in an entire country being divided amongst the entire tax base. You do when your share of the salary of all of them at your local hospital gets added to a bill addressed to you.
Our system is the way it is because otherwise no one pays for the pharmacist, and insurance caps things weirdly. Also, you have to multiply everything by 3 because the insurance company will refuse to pay anything above 1/3 of "list" price.
It may be outstandingly cruel, but it is ~~good~~ also terrible at providing cost transparency. Which is worthless to everyone except accountants at work paying for healthcare.
So yeah. That's cheap, and the WTF goes deeper than most people can imagine.
Don't all of those costs have a profit counted into them? I've always thought that a socialized system is incentivized to be as cheap as possible, to have as few "customers" as possible, which means that the whole system, from education to taxation, should make policies that improve people's health, to make sure they need to use the hospital as rarely as possible.
That depends a lot on the medical system. Some systems target profit, but some are non-profits, affiliated with universities or other arrangements that make sense for a medical system.
The city I live in has two main hospitals. One is run by a for profit corporation. The other was a non-profit that got government funding to cover the difference because they were the main "ER as only healthcare" hospital in the area, since the other was built on the rural side of the suburbs and this one was in the middle of the population center. Then they got bought by, of all things, another non-profit operated by a public university. The first non-profit also owned a for-profit insurance company and a fitness center. I think the disposition of those is an ongoing legal question, since the university also owns an insurance company and there's some weird conflict of interest interplay.
It's a clusterfuck but the redeeming side is that the hospitals are actually extremely good.
Having at some point or another used all three systems I can say that the prices were basically the same. The staff all like that they can transfer patients to the university easier, but dislike the new parking system.
Yeah it's actually a serious problem how many hospitals in the US are non profits run by religious organizations. Like, your local ER has a decent chance of being owned by the catholic church and you won't know until you need medical care they don't approve of.
Yup, it's preposterously cruddy. I like my random bits of research so I happen to know the ownership details of my local institutions, but that's far from common. And even if it was, it's not like you even get a choice if you're in need, if you even had options to choose from.
The previous non-profit, the one that got purchased by the university, started as a charitable outreach from a local women's group in the 1890s. Then a business man donated some land and money and they made a proper hospital.
The Catholic "hospital" was a ghoulish dive that was basically a small ER with a few other beds and offices. Eventually they got bought out by the womens group hospital and turned into a sleep medicine and medical imaging annex.
I'm just realizing we have three hospitals which feels like a lot for a city this size.
Yes, but that's socialism and therefore bad.
/S just in case
Edit: actually, it's lost potential revenue which is even worse.
Yes and, insurance companies spread out their costs among all their enrollees, whether or not they have to use those hospital services and equipment, in the form of premiums. (And of course they add on the cost of their CEO's yacht, etc. because evil.) So that's how they "save you" a portion of the billed amount.
But having so many uninsured people, whether healthy or sick, that aren't even part of the system hurts everyone.
Which is why we need to eliminate the insurance racket, make healthcare universal and pay for it through taxes, perhaps a sliding scale based on net worth as long as I'm fantasizing.
Remember, you can make payments, they just don't have to be the suggested amount. $10 a month for life.
I don't recall if medical debt impacts credit ratings like others. It shouldn't in a sane world, but here we are.
So far, that total hasn’t, but there was a $985 bill for something relating to the stay that did hit my credit as a “derogatory mark.”
I hate this system lol.
Based on the price and it affecting your credit, it must have been something that you asked for, rather than needed. Like a couple of Tylenol for pain.
I'm beginning to think if I need to call 911 for myself, I should grab a couple Tylenol to take with me, even if I'm not sure it's a good idea to actually take them. In my experience it's possible to get permission from a doctor to take one's usual home meds and the nurse will chart that you did so. In my husband's case it was Evrysdi, which they were very glad we could provide, and his insurance (Platinum Plan because he needs it) did cover Tylenol, but I bet mine doesn't.
I recently wound up with a ~$300 ER bill while unemployed for an extended period. I tried to negotiate a payment plan, and they insisted the minimum payment was $100/month. So, they got zero.
unfortunately we all become disabled. It's just a matter of time.
Not if you die violently on the assembly line
That's a great plan until it's not. If you're able to, I'd highly recommend looking into getting Obamacare if you can't get insurance through an employer due to being a contractor. I don't know your personal situation, but Obamacare plans are often more reasonable than people imagine.
Obamacare is getting gutted bit by bit. You might have noticed the enrollment has dropped. This is because the premiums are way up, it’s now harder to get a subsidy to offset this, there are less insurance companies available, and the plans that are there now cover less. If Dems don’t win in the midterms, it’s toast.
Romneycare*
Never let Republicans forget that the best socialized healthcare system in the country was copied from a Republican system created and approved by voters in one of the most leftist states in the nation. It makes them so mad that they can't blame a black guy for it when you do.
My gf had a mini stroke a few weeks ago. We were traveling so didn't go to the hospital right away, mostly because she hates them and is terrified of the bill. On the way home and got way worse. We went immediately. They tried to tell us it was nothing more then a headache, and charged us 18k. I'm also a contractor so even if I could get insurance, because I'm not married to her I would have to pay double. Fuck this system.