Two Friends in Texas Were Tested for Coronavirus. One Bill Was $199. The Other? $6,408. (NYT)

[dalton99a]

https://www.nytimes.com/2020/06/29/upshot/coronavirus-tests-unpredictable-prices.html

Two Friends in Texas Were Tested for Coronavirus. One Bill Was $199. The Other? $6,408.
It’s an example of the unpredictable way health prices can vary for patients who receive identical care.
By Sarah Kliff
June 29, 2020

Before a camping and kayaking trip along the Texas Coast, Pam LeBlanc and Jimmy Harvey decided to get coronavirus tests. They wanted a bit more peace of mind before spending 13 days in close quarters along with three friends.

The two got drive-through tests at Austin Emergency Center in Austin. The center advertises a “minimally invasive” testing experience in a state now battling one of the country’s worst coronavirus outbreaks. Texas recorded 5,799 new cases Sunday, and recently reversed some if its reopening policies.

Their tests came back with the same result — negative, allowing the trip to go ahead — but the accompanying bills were quite different.

The emergency room charged Mr. Harvey $199 in cash. Ms. LeBlanc, who paid with insurance, was charged $6,408.

“I assumed, like an idiot, it would be cheaper to use my insurance than pay cash right there,” Ms. LeBlanc said. “This is 32 times the cost of what my friend paid for the exact same thing.”

Ms. LeBlanc’s health insurer negotiated the total bill down to $1,128. The plan said she was responsible for $928 of that.

...

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Freestanding ERs are scams preying on an unsuspecting public

[vsrazdem]

1. I thought testing was supposed to be free of charge?

[SeattleVet]

2. Katie Porter ran into that herself.

The test for coronavirus is free, but she had to pay for the *other* tests that are necessary as a part of the package. There is at least one test for flu, and something else that have to be ruled out before the coronavirus test, partially since the cv tests are so unreliable.

[BigmanPigman]

3. So did I.

It looks like it is still a state by state thing and even that varies.

https://www.kff.org/coronavirus-covid-19/issue-brief/five-things-to-know-about-the-cost-of-covid-19-testing-and-treatment/

In CA the tests are free...
"Testing is free for all individuals, including those who are uninsured or undocumented. Individual testing results are confidential."
https://www.cdph.ca.gov/Programs/OPA/Pages/NR20-076.aspx

[DFW]

4. Here in Germany, as usual, it's complicated.

If a doctor says you need it, AND you have German insurance, you don't have to pay for it. If you want one and don't have symptoms, you have to pay for it yourself. We're doing that today. You STILL have to come with a referral from another doctor, and it costs €170 per person, so around $195, like in the States. This is an improvement over that last few months, where you could practically only get tested if you could prove your were already dead, and your symptoms hadn't improved over the last week.

[denem]

5. I thought Germany had a rational health system?

[DFW]

8. That depends on what you call rational

It's a very complicated patchwork system with multiple private and semi-private companies, and where you fit depends on several factors (public employee, employee of a private company, income, legal status, etc.). As an immigrant employed by a foreign (USA) company and paid in the USA, I fall through all cracks, and am only eligible for what is called "privat" health insurance, which means I have to go to a completely private company and ask for a quote. As previously existing conditions count for a lot here, my quote was €2500 a month, or about $34,000 a year at today's exchange rates.

My wife is a German citizen, so she was covered until she took early retirement for health reasons at age 60. She would not have been covered at all until age 65 unless I paid the $500 (about) per month premium for those years. She is now covered by the German version of medicare, though exceptional care, such as this voluntary Corona test, is not covered at all.

There is also a class system here in Germany. First class means you get an appointment right away, your own room at a hospital, etc etc. These are the people with "privat" insurance. For people with health insurance from the various network of other providers, they are what is called "Kassenpatienten," and they have to wait for appointments, get the assistant surgeons, are 4 to a room in hospitals, etc. etc. That fact that I am alive, for example, is owed that I am not one of them. 16 years ago, I felt what I was sure were symptoms of serious heart trouble. I called to a local cardiologist for an appointment. I was told they had one in two months. I said I was from the USA and passing through, and would pay immediately. They suddenly had an opening that afternoon, and I was having emergency stents put in--the surgeon said "just in time" in English to make sure I understood--within three days. He said another day might have been too late. There is maybe ten percent of the country on the first class system, and the rest of the country on the "Kassenpatient" system.

My wife was delayed by 6 months for a needed breast cancer operation in 2001, which resulted in its spreading and requiring a bigger operation that was originally planned. In 2016, she got preferential treatment because a specialist surgeon saw her diagnosis of a rare, always-fatal cancer ("The murderer," because it is never found until it is too late), and recognized it was the earliest diagnosis he had ever seen. He insisted on taking her right away, thinking he might be able to save her, and he turned out to be right. Out of 84 biopsies, ALL turned out negative for malignancy, and he said it was the first time is his whole career that he recommended no chemotherapy after such a grave diagnosis. I still have her because she was categorized as an experimental guinea pig, but we didn't complain. The wife of a friend of ours over in Holland was diagnosed with the same thing a couple of years later, but she was stage 3, and she didn't make it through the year.

If, by the way, what you typed was a mistake, and you meant "national," that is a fiction often spread around on DU and elsewhere. It apparently serves to support various political arguments, but it is as bogus as "covfefe." There is no national health system here in Germany. Nowhere near as many people fall through the crack as in the USA, but my wife was a social worker before she retired, and she said there were still several hundred thousand Germans without any health insurance at all. The paperwork is cumbersome no matter what system you are under, and if you don't or won't or can't do the paperwork, then you are not insured.

[elias7]

6. Indications for testing in New Hampshire where changing weekly for a while too

And there was a period, like you describe in Germany, where only those deathly ill with presumed Covid could get tested.

[SKKY]

7. Which is exactly why we need a single-payer healthcare system STAT...

...And no, I do not care one iota how this affects the insurance industry. I Couldn't care less about an industry that only makes money by denying access to the product they sell, and then criminally overcharges when they actually do have to provide the product the sell.