Archives for the Date May 3rd, 2019

A detailed analysis of American ER bills reveals rampant, impossible-to-avoid price-gouging




For more than a year, Vox’s Sarah Kliff has been investigating hospital price-gouging in America, collecting hospital bills from her readers and comparing them, chasing up anomalies and pulling on threads, producing a stream of outstanding reports on her findings.

In her latest installment, Kliff digs deep into the famously bizarre
world of ER bills and points out some of the most egregious ways in
which these are rigged.

For example, if you are injured and also financially precarious, you
might travel to a more distant ER just to be sure that the hospital
you’re visiting is in-network for your insurer, but that means nothing.
“In-network” ERs often staff “out-of-network” doctors, and there is no
way to find out whether the doctor treating you is covered by your
insurer until you get the bill: one of Kliff’s readers got bills for
$8,000 from an out-of-network surgeon who treated his broken jaw at an
in-network hospital.

And much of the care you receive at an ER is subject to bizarre price
gouging: one of Kliff’s readers was charged $238 for two drops of the
generic eyedrop ofloxacin which retails for $15/vial; the routine
pregnancy test that ERs administer to women of childbearing years can
cost up to $465, enough to buy 84 pregnancy kits at the pharmacy; and
one Seattle hospital charged $76 for a squirt of generic neosporin. Not
all hospitals gouge on all drugs, and many of these drugs are not being
administered for urgent health problems – a halfway honest hospital
could advise a patient, “We charge $238 for this eyedrop, why don’t you
pick up a bottle for $15 next door and administer it yourself?”

Finally, Kliff uncovers wild variability in the “ER facility fee,” which
is a cover-charge you’re assessed just for walking in the door at an
ER. One of Kliff’s readers paid $5,751 for sitting in a hospital waiting
room with an ice-pack and a bandage while waiting to see a doctor, but
who left because she was feeling better and didn’t need care after all.
Kliff’s work reveals that these “facility fees” are rising at twice the
rate of other health charges, with no rhyme or reason.

All of this refers to people who come into the ER under their own power,
out of an abundance of caution – for example, my daughter recently
broke her collarbone, but we didn’t know that until we went to the ER
for an X-ray, and if we’d less prudent, we could have iced it and made a
regular doctor’s appointment for the next day, leaving her untreated
and undiagnosed. But of course, ERs treat large numbers of people who
are unconscious or in agony when they arrive, either on their own or on
an ambulance gurney. These patients can’t possibly be expected to shop
around, to demand to know whether their medicines are medically
necessary (I once had a small eye injury that I went to get checked out
on a Sunday just in case and had to stop the nurses from pumping me full
of IV dramamine just in case it turned out I would need neurosurgery!),
to evaluate whether the doctors are in- or out-of-network, and so on.

(We ended up paying $2,400 out of pocket for our daughter’s ER visit,
including $2.50 for a generic tylenol, despite having gold-plated
insurance from Cigna)

Kliff’s work reveals the whole story of “market based medicine” to be a
fiction. Markets are regulated zones where consumers compare the
offerings of producers and make purchase choices based on their
information. To call being wheeled unconscious into an ER and raced into
an operating theater and then presented with a bill months later a
“market transaction” is to make a terribly, grisly joke.

It’s as good an argument for Medicare for All and single-payer health care as you could ask for.

Article is from March 2019

Remember that hospitals around the world exist without this price gouging. This goes entirely to line the pockets of healthcare executives.

prussianmemes who is your avatar


It’s a Soviet Cosmonaut, Vladimir Komarov (1927- 1967) – who was the first human to die during a spaceflight – but is also more notable for his sacrifice

He was chosen as the pilot for the Soyuz-1′s first manned test flight. Initial evaluation of the craft by Yuri Gagarin and Komarov was done and they found around ~204 anomalies within the module.

Komarov tried to warn other engineers and his seniors about how the module won’t function properly, and that there would be a failure during testing – but nobody listened to him.

He was going to get out of the mission – but then he found out that his seniors would have sent Yuri Gagarin – who was an extremely close friend of Komarov.

Vladimir Komarov couldn’t do that to his friend. “That’s Yura,” his biography
quotes him saying, “and he’ll die instead of me. We’ve got to take care
of him.”
Komarov then burst into tears.

Komarov decided that he would go instead – knowing that he would most likely die.

At the same time, Yuri Gagarin tried to force his superiors to let him
replace Komarov on the mission for the same reason; he didn’t want to
see his buddy die. The whole thing is incredibly sad.

During the flight, the solar arrays didn’t deploy – EXACTLY as Komarov suspected, and at the same time the launch of the other module was cancelled – meaning he needed to re-enter.

The parachute failed to orient properly when entering the atmosphere, and the parachute failed to deploy.

During the re-entry he contacted the land base and cursed an yelled at his seniors for sending him to this mission – cried – and demanded that he had an open-casket funeral so Soviet officers had to see what they’d done.

He literally melted in that module – and crashed a couple of minutes later


He’s my personal hero for that sacrifice – and how he tried time and time again to prevent this from happening.

It’s a real shame that he’s almost unknown today – his entire tale was incredibly sad, but it’s also one of great heroism and selflessness.

assyrianjalebi:Gentleman’s Agreement (1947)


Gentleman’s Agreement (1947)

Deep as the Road is Long (Part II, Chapter 14)


Rating: MA for Major Angst

Also Read on: AO3

Previous Chapter


Time to put the pieces back together after this, slowly but surely. I promise ❤️

May 2016

It’s been two weeks since Faith’s funeral. Claire isn’t sure why she’s still in Scotland; whether it’s guilt or love or a combination of both. Jamie’s certainly done nothing to help clear it up for her and she doesn’t expect him to. Maybe she hasn’t left because she knows once she does, she’ll likely never see him again. Something in her wants to keep him close, while at the same time she knows she should go. Her life can’t stay on hold forever and she isn’t helping anymore. Everything that she can do has been done and it will never be close to enough. More than never having Jamie again though, now she’ll never see the people in his family she’s gotten to know and enjoy. Jenny, of course, though it had taken days to get the woman to speak directly to her. Ian has been most of Claire’s source of comfort. He seems to know when she needs a dram and pulls her aside. They don’t often speak during those moments, but Christ does she appreciate him for keeping her sane.

She hasn’t asked Jamie if he wants her to go anywhere; if he wants her to stay in the same bed as him, even. He’s never said anything, and as she tries to recall what they’ve spoken of lately nothing comes to mind. They hardly speak two words all day to one another. Or, more accurately, she tries to talk to him and he says nothing. She tries not to take it personally, seeing as how he doesn’t speak much at all in general to anyone but young Jamie and little Maggie and Katherine. He spends long hours holding either baby Michael or Janet, sitting along the couch with his knees raised so that the baby can rest against them. He speaks to them softly, mostly in Gaelic, when Claire catches sight of him. She stands upstairs in the shadows listening, able to make it out each time he smiles in his speech or when something makes his breath hitch. Never once has she interrupted, and always she’s in bed before he decides to let the babies sleep in their bassinet.

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