That’s post- secondary you’re referring to, right? “Secondary” is high-school which tends to be largely public-system in most provinces, with a smattering of private schools mixed in.
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wiping out a rural family with cholera is not uncommon even today. rural sanitation ain’t rainbows and unicorns either. with something highly infectious you’ll have problems in just about any low tech environment. Not to mention the diseases that are spread through livestock and poultry. Anthrax is a rural disease that rarely hits urban areas with the exception of those working in the wool industry.
Would there be any chance to challenge this in court? In German criminal law, the concept of ‘usury’ is rather broad and makes it punishable to “exploit a person’s predicament to charge them in a way that is noticeably disproportionate to the service provided” (my slapdash translation). What constitutes a disproportionate charge is evaluated on a case-by-case basis, but as a rule of thumb, it starts at around charging twice the market value. But, I know that US law is very different.
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My understanding from having just spent a week in hospital for major surgery (and still paying off what insurance didn’t cover - about 1/7th of the total) is that the hospital charges these outrageous totals on the bill so that when the insurance company rejects most of it, they can take the bill to the government who will reimburse them. It’s all very labyrinthine. And forget about getting a breakdown of those charges. For example, that’s why they won’t allow you to bring your own prescription drug supply with you, and can only take drugs supplied by them at many times the cost.
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I believe it’s a bit more complicated, and i’d argue more pernicious, than that. The insurance companies have deals with the hospitals that they get charged some percent, say 15%, of the cost of the bill* so the hospitals raise the prices so that that 15% covers costs+, but they have to raise it for everyone.
* I’ve a feeling that there’s actually a different negotiated rate for varied procedures and tests and this is complicated by the fact that different insurance companies negotiate different rates.
(Edited to add: “this is complicated by”)
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Sitting in rehab pondering similar things.
There’s great difficulty in telling what market value is. There’s no standard pricing at all in American medicine, they vary wildly, and getting a solid number for any given procedure or service from a hospital, ahead of time, is for all intents and purposes impossible.
It’s a “market”, but you’re not allowed to know what they’re charging and what the market generally looks like.
It’s a bit like agreeing to buy a car ubder duress and not seeing what your lease payment is until it’s in your driveway.
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The difference is that after that single family is wiped out the disease is pretty much done. When it wipes out a family in a city with poor sanitation there’s a chance that everybody who lives nearby is also wiped out.
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Thank you. That is corrected.
That assumption doesn’t hold true for pathogens that typically vector through another species. Or are endemic but mostly benign in livestock but have acute symptoms in humans or undergo an antigenic shift when hoping between host species.
Something like anthrax doesn’t transfer between humans very easily, but does spread between animals and from animal to human. Many parasites have life stages that must be in hosts other than humans. And you won’t catch malaria for not flushing the toilet, that nasty little parasite needs to be in a mosquito.
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There’s a shot for that
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Don’t hate on the trash pandas, friend.
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I dont get Americans why have you not voted democrat and got a NHS yet?
Even voting for brexit, no one here is stupid enough to give up the NHS
I was briefly talking to a manager in the NHS who criticised people in the UK who were worried about the creeping privatization of the NHS on the basis that GP’s surgeries and hospitals are run as enterprises and paid by the NHS.
I didn’t have a fully-formed answer at the time, but it’s become entirely clear since then that when people talk uneasily about “privatising the NHS”, they don’t mean “a GP’s surgery is a business”, they’re talking about the shit in the OP.
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What’s not clear is what the actual diagnosis was. If you are in intensive care for a month with an infected knee, you are probably being treated for sepsis. The fatality rate is around 40% if untreated. The average hospital stay is a week, but people are often re-admitted (another problem). This guy beat the average stay by a couple of standard deviations. The average cost is still an order of magnitude cheaper than $619k. Another factor is whether this was hospital incurred due to a previous procedure or bad wound care after an injury at home. At any rate, the guy is lucky to be alive. And the price doesn’t jive with NIH price ranges for even the most serious cases of septic shock.
“Elite attitudes” being “We don’t have our citizens dying due to lack of health care in our countries, because we’re civilized.” How “elitist” of them – giving healthcare to everybody, not just the elite!
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A year ago I spent 11 days in the ER and ICU. My bill was almost $56K.
Because I was poor and uninsured they wiped the whole thing away…to this day, I don’t know how I got that lucky.
“Inflation” isn’t the right comparison, because advances in testing and treatment mean that today’s care costs more for a reason. Not $600,000 more, but more than simple inflation would suggest.
Some local governments have laws against price gouging during an emergency, such as in the aftermath of a tornado or hurricane, and there are laws against excessive interest rates for loans, but other than that, I’m not aware of any laws in the US preventing excessive pricing. The general idea is that market forces should result in reasonable prices. And this works fine when you’re talking about the price of sneakers, Oreo cookies, or Bic pens, but health care is not a free market. I don’t have to buy Oreos when I’m hungry for something sweet, I can buy fancy name brand sneakers or cheap Walmart generic ones, and I can take free pens from my doctor’s office, but if I have cancer, my options are get treatment or die. That’s not really a choice. But we treat it in the US like it is.
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We had both the Congress and the White House controlled by democrats and barely got the most corporate friendly healthcare option through. Turns out that healthcare middlemen and profit seekers know how to butter their bread on both sides.
