Survivor Guilt?

[dales]

A 70-year-old man was hospitalized with COVID-19 for 62 days. Then he received a $1.1 million hospital bill, including over $80,000 for using a ventilator.

insider@insider.com (Connor Perrett)
INSIDERJune 13, 2020, 10:01 AM PDT

A man in Washington state who spent more than two months in the hospital and more than a month in the Intensive Care Unit with COVID-19 received a 181-page itemized bill that totals more than $1.1 million, The Seattle Times reported.

Michael Flor, 70, will likely foot little of the bill due to his being insured through Medicare, according to the report.

"I feel guilty about surviving," Flor told The Seattle Times. "There's a sense of 'why me?' Why did I deserve all this? Looking at the incredible cost of it all definitely adds to that survivor's guilt."

A 70-year-old man in Seattle, Washington, was hit with a $1.1 million 181-page long hospital bill following his more than two-month stay in a local hospital while he was treated for — and nearly died from — COVID-19.

"I opened it and said 'holy (expletive)!' " the patient, Michael Flor, who received the $1,122,501.04 bill told The Seattle Times.

He added: "I feel guilty about surviving. There's a sense of 'why me?' Why did I deserve all this? Looking at the incredible cost of it all definitely adds to that survivor's guilt.

According to the report, Flor will not have to pay for the majority of the charges because he has Medicare, which will foot the cost of most if not all of his COVID-19 treatment. The 70-year-old spent 62 days in the Swedish Medical Center in Issaquah, Washington, 42 days of which he spent isolated in the Intensive Care Unit (ICU).

Of the more than one month he spent in a sealed-off room in the ICU, Flor spent 29 days on a ventilator. According to the Seattle Times, a nurse on one occasion even helped him call his loved ones to say his final goodbyes, as he believed he was close to death from the virus.

While in the ICU, Flor was billed $9,736 each day; more than $80,000 of the bill is made up of charges incurred from his use of a ventilator, which cost $2,835 per day, according to the report. A two-day span of his stay in the hospital when his organs, including his kidneys, lungs, and heart began to fail, cost $100,000, according to the report.

In total, there are approximately 3,000 itemized charges on Flor's bill — about 50 charges for each day of his hospital stay, according to The Seattle Times. Flor will have to pay for little of the charges — including his Medicare Advantage policy's $6,000 out-of-pocket charges — due to $100 billion set aside by Congress to help hospitals and insurance companies offset the costs of COVID-19.

Flor is recovering in his home in West Seattle, according to the report.

[RayThom]

The medical bills are so high because he's on Medicare. Hospitals go for the extremes and then settle with the system for a much reduced rate.

My recent surgery and chemotherapy are close to the $1M mark. My copay to date is $3300.

Government bureaucracy is bloated. In the end it will all be sorted out.

If they reestablish "debtors prisons" I'll have more than my illness killing me. As far as I know Trump hasn't discussed this with his trusted advisors... yet.

[BoSoxGal]

The medical bills are so high because he's on Medicare. Hospitals go for the extremes and then settle with the system for a much reduced rate.

My recent surgery and chemotherapy are close to the $1M mark. My copay to date is $3300.

Government bureaucracy is bloated. In the end it will all be sorted out.

If they reestablish "debtors prisons" I'll have more than my illness killing me. As far as I know Trump hasn't discussed this with his trusted advisors... yet.

That’s actually inaccurate. Hospitals get paid less by Medicare and Medicaid because the negotiated rates of reimbursement are much less - that’s actually the whole reason that a national healthcare system would save money, especially if the laws preventing negotiated rates on pharmaceuticals were repealed. The charges are the same, but the actual payment is significantly reduced.

I’m on Medicaid and this disparity is detailed on my bill - and I’m always shocked by what the provider felt like it should have been paid for the service I received - like, $900 for a 20 minute followup visit with the PA at my ortho’s office and a couple of simple xrays. (Most of the 20 minutes was actually with the X-ray tech, only about 5 with the PA.) That was last year’s broken ankle/foot, I haven’t yet looked up to see what outrageous amount was charged for the surgery I just had.

Private insurers pay more than Medicare and Medicaid, but still negotiate reimbursement rates significantly lower than what is charged to the poor SOBs with no insurance at all who must pay full cost.

The ‘extremes’ are simply what hospitals and providers are able to charge in an unregulated Wild West of medical pricing with zero transparency and thus zero ability for the consumer to shop around by cost. Try calling a provider or hospital and getting an estimate ahead of time for a particular surgery - it’s insanely difficult, as researchers have found. The charges are often nonsensical, too. I believe I posted a long harangue back in the day at CSB about the almost $5000 ER visit I had that consisted of 10 hours of waiting around for one hour on a bag of Ringer’s with a single X-ray to rule out appendicitis and 5 minutes with a doctor who prescribed anti nausea meds for norovirus.

There is a ton of research on this issue, and on the insanity that is the hospital pricing system in the USA - so don’t take my word for it, but I would encourage you to educate yourself because you’ve got it a bit backward. Medicare/Medicaid is not the bad guy driving up costs.

[RayThom]

The ‘extremes’ are simply what hospitals are able to charge in an unregulated Wild West of medical pricing with zero transparency.

There is a ton of research on this issue, and on the insanity that is the hospital pricing system in the USA - so don’t take my word for it, but I would encourage you to educate yourself because you’ve got it a bit backward. Medicare/Medicaid is not the bad guy.

OK, I can accept that. Unfortunately, as a simple layman, it all seems to be so excessive and unreal. Big money charges like this quickly become an abstract, far removed from reality.

Other than my copay I won't have much of an issue either way. I'll do my best to take care of that but if I'm struggling with the payments I'll negotiate with the hospitals. In the past they have even gone so far as forgiving the debt.

The doctor gave me six months to live. I told him I couldn't pay my bill, so he gave me another six months. So then my doctor grabbed me by the wallet and said, "Cough!"

[BoSoxGal]

Most hospitals have what they call charity care which is a program that reduces the bill for folks of very modest means - many hospitals aren’t very forthcoming in telling folks about that though. Providers will often reduce bills for patients and they are limited by law on the interest rate they can charge for medical debt. They usually won’t report you to credit bureaus themselves, but more and more providers and hospitals are cheerfully willing to quickly send your outstanding bill to a cutthroat debt collector who will report you to credit bureaus and ruin your rating - I’ve seen it happen to far too many clients. The 3 credit bureaus now have a 180 day waiting period on medical debt to allow time for debtors to sort out a payment plan or work with insurance to get them to cover what they will - but it’s still a nightmare and one of the saddest things I’ve seen working with clients in legal aid and private practice is people struggling to battle cancer or other serious illness and using far too much of their limited energy trying to get their medical bills covered or payment plans in place.

We need single payer national healthcare. I hope I live to see it happen.

[RayThom]

... The 3 credit bureaus now have a 180 day waiting period on medical debt to allow time for debtors to sort out a payment plan or work with insurance to get them to cover what they will - but it’s still a nightmare and one of the saddest things I’ve seen working with clients in legal aid and private practice is people struggling to battle cancer or other serious illness and using far too much of their limited energy trying to get their medical bills covered or payment plans in place.

We need single payer national healthcare. I hope I live to see it happen.

I certainly agree with the 'single payer' aspect.

I've been dealing with personal hospital payments (copays) for more than two decades. My debts have yet to be turned over to a collection agency.

Your FICO® Score 8 based on TransUnion data, pulled on 05/24/20, is 807."

I'm into 72 years of living. I'm on median SS as my only source of income. If it comes down to my debt be handled by a collection agency I can't see where it could possible screw up my quality of life at this point.

As 'Dubya' Bush said, "Bring 'em on."

[dales]

If they reestablish "debtors prisons" I'll have more than my illness killing me. As far as I know Trump hasn't discussed this with his trusted advisors... yet.

Be patient, Ray.

Everything will fall into place.

I heard 2021, but I could be wrong.

[BoSoxGal]

RT they don’t turn them over until/unless they become delinquent - anywhere from 90-180 days, depending on the provider’s or hospital’s rules.

Folks in your financial situation - judgment proof due to having only protected income - are often counseled not to pay, unless there is really no harm to your ability to pay all your other essential costs of living. Most providers won’t refuse you future treatment over unpaid copays that are a fraction of your total medical bills. It’s great if you are able and want to pay.

[MGMcAnick]

I lost a friend of several years to prostate cancer last month. Larry was self employed and didn't have insurance of any kind. According to his daughter, whom I saw Saturday, he put off going to the doctor because he knew he couldn't pay for it.

Another friend was in the hospital for 13 days in May, out for three, and back in for 14 more. It was two totally different issues. Also no insurance. I took him to the ER for his second visit. He waited for five hours before seeing anyone, and was admitted only minutes later. Serious stuff. He has not seen the second bill yet, but the first one was over $84,000. The hospital will probably have to write both bills off, and he may be going on SS disability, not that I think he deserves it.

Yes we need single payer health care, and everyone needs to sign up for it.

[Gob]

What a great country!!

[datsunaholic]

What a great country!!

We have the rights of Life, Liberty, and the Pursuit of Happiness... so long as you can afford them.

[Big RR]

Years ago (in the late 90s) my mother was hospitalized for 3 (or maybe 4) days when they thought she had cellulitis; at the time my dad was on medicare, but she had no insurance (private insurance cost too much and she was too young for medicare, too high an income (her and my father's socail security) for medicaid). For the 4 day stay in a regular semi private rooms where she received intravenous antibiotics for two days (until they realized she did not have cellulitis) she received an $84,000 bill. What I have found is most hospitals negotiate lower rates with the insurers, but bill privae patients for the "list price" (kind of like the sticker price for cars).

They eventually took her to court and she was lucky she had no real asses which could be seized, but many lose their houses and other assets for such a bill (I handled many bankruptcies for just this reason); I told her to just tell the judge that she was willing to pay but had few assets and no income but social security and he ordered her to pay the bill at $1.00 a month (presumable for 84,000 months or 7000 years)--she sent in that $1.00 a month for the rest of her life, But how many people would lost their entire life savings to pay a similar 4 day bill?

[dales]

They eventually took her to court and she was lucky she had no real asses which could be seized

Grab ass?

[Big RR]

Damn spell check doesn't pick that up; it didn't pick up "privae" either, not sure why.