Some well applied public shaming of the billing company may be in order.........

We really need to get Obamacare repealed so that we can have more of this private sector initiative.

Thanks Alan for your usual inaneness...

If every medical cost was posted and agreed upon BEFORE anyone actually had a medical service performed, healthcare costs would likely drop 30-40% overnight.

This is one of the few businesses where you have no idea what anything costs until you get the bill.

I believe that I read somewhere that you "old pal" (okay, maybe less than "pal"), Lars Larson, is raising funds to cover the expenses for this - which I agree was a travesty. Though lacking all of the details, it rather appears to me as though the ambulance boys charged the lifeguard for the full cost of the ride, when he was merely accompanying the young boy he'd rescued from the surf.

Is that legal? If so, it shouldn't be.

That said, the $485 or so charged by ER doesn't seem out of line - if the lifeguard had a headache and wanted to be checked out, those costs can add up in a hurry. It seems reasonable to suspect that they checked for minor concussion - had they suspected a major concussion, they'd have rolled him in for a really expensive MRI or CAT-scan. Been there, and that bill's a real eye-opener.

This doesn't happen in most other developed nations, where the government provides healthcare to everyone, and at a much lower cost per person than our system. (As Mitt Romney just pointed out in Israel.)

But those crazy communists in Canada and the UK must just be missing how wonderful our system is: Huge premiums. Healthcare disappears when you lose a job. Healthcare plan and doctors change every time you switch jobs, or just if your employer switches plans. 12% cost increases every year. Plus we still deal with faceless bureaucracies (insurance companies instead of the government, unless your one Medicare, then you deal with the government anyway.) But whatever we do we must preserve this wonderful "private market" system at all costs.

12% cost bumps every year is just the cost for all that sweet sweet Freedom(tm). Unless you lack insurance, then the cost is $2,600 per visit apparently.

I like to bookend my sentences with "thought" as well. Shameful, thought.

You call 9-1-1. They send a fire truck and an ambulance.

The ambulance is more likely than not privatized, so there is profit.

The ambulance sends a bill to insurance - profit.

The ambulance pulls up to a hospital E.R. The hospital is private - profit.

The E.R. doctor sees you - bill.

The E.R. doctor sends the bill to insurance - profit.

The E.R. doctor sends a test result, which goes to an outside lab. The outside lab is private - profit.

The lab sends a bill to insurance - profit.

You have a CT scan. the CT machine is leased to the hospital by its manufacturer, which is private. The hospital has to pay the manufacturer each time the machine is used. Profit.

The hospital sends the CT scan bill to the insurance. Profit.

The E.R. doctor admits you.

You get a hospital stay bill. Profit. It's sent to insurance. Profit.

You are assigned an attending physician.

The attending physician sends a bill to insurance. Profit.

And of course, all those medicines you're on during your hospital stay...all marked up heavily. Profit.

That is the problem with the U.S. healthcare system. There is an added mark-up to each step of the process, from the ambulance call, all the way to the very end. There are additional processing steps (the insurance billing, the approval/denial/appeals process) that sap money out of healthcare, that no other country has (or pays for).

Simply going to a single-payer system, and forcing costs to be held down would save Americans billions of dollars annually, while there would be no loss in care. Of course, a bunch of insurance paper-pushers would be out of a job...but they could always be retrained in patient care positions.

Single payer is one answer. Or we could take Tim's approach, above: when the patient comes to, he can be given a quote for the ambulance ride. When he comes to again, he can call a cab.

I don't know that single payer necessarily bring costs down. I mean, the federal gov't is the largest "payer" of health care in this country and costs keep going up and up anyway. I think it's gonna take more than that.

And good for Lars if he's helping the lifeguard out. And it'd be even better if he'd move back to 'mook and milk cows or something.

Another one sittin' ri'cheer on tha "Group W" bench....

I don't know that single payer necessarily bring costs down.

I don't know this, I don't know that. Do you know why the drug companies have insisted that Medicare be prohibited by law from negotiating the prices it pays for drugs under Part D? Do you kow that we Americans are prohibited by law from buying prescription drugs from Canada? Do you know that developed countries (like Israel, for example) with single payer systems have per-capita annual health care expenditures that are less than half of those in the US, with generally better health outcomes? Do you know that Medicare administrative costs (as a percentage of total costs) are about a tenth of those in the US private sector?

This is exactly why I've so long pressed for retiree-only lifeguards. Niave young do-gooders are nowhere near adequately educated or experienced enough to judge the complicated financial and legal liability eventualities of acting on behalf of drowning others, and are thus far more likely to create more problems than they resolve. Your average octogenarian is much better equipped to determine when life-saving measures ought to be deployed.

No good deed goes unpunished here in the land of the free and the brave.

Free Enterprise. It's for the Children.

Single payer is not going to bring the costs down if the providers can still charge whatever they want. That's the big problem with Medicare - most of the bills are simply paid and nobody questions them. That's a big reason why its administrative costs are so low. Nobody's checking. So single payer is not the cure-all. We have to address costs, too.

Putting the government in charge of *any* financial decision is a bad call, in my opinion. "They" spend thousands of dollars per item for things we can get down at Home Depot for a few bucks.

Anybody who has ever seen a medicare bill knows that there is a big difference between what medicare pays and what doctors, etc charge.

Also, a great deal of what is spent on health care today is for "for profit" insurance. Those guys are paying out a lot less that what they take in. The difference shows up in the hands of wall street fat cats.