'Helping me to not die is part of our social contract. Isn't it part of yours?'

A 20-year-old Californian got appendicitis in October 2013. A few months later the bill arrived for his surgery and one-day hospital stay. He posted a picture of his United Health bill and the following comment at the social media site Reddit.

I never truly understood how much healthcare in the US costs until I got Appendicitis in October. I'm a 20 year old guy. Thought other people should see this to get a real idea of how much an unpreventable illness costs in the US.

The rest is history.

Some Guy Posted His Hospital Bill Online. You’ll See Why Everyone’s Talking About It.

A 20 year-old man came down with appendicitis in October of [2013]. He posted the bill on Reddit and it has gone viral. The US Health Care system is a topic of much debate, not only in the US but around the world. A lot of countries get ‘free’ health care, so needless to say, this has stirred up a lot of conversation.

More than 10,000 comments have been generated since zcypher posted his $55,029.31 hospital bill, which seems to lend a lie to the claim that "young invincibles" do not care about, want or need health insurance coverage.

Here is what a few commenters around the world had to say about the $55,000 charges.

Aussie here. Had appendicitis a few years ago. Went into hospital, stayed 3-4 nights after the operation and until my fever went down.

Never saw a bill. Even had a follow up appointment a month later to make sure everything was going ok.

We pay a few hundred dollars a year extra on our taxes as a levy for our Medicare system. Less if we have some kind of private insurance.

I don't have private insurance, what you Americans would call health insurance. I am simply a citizen of the country I pay taxes to. Helping me to not die is part of our social contract. Isn't it part of yours?

Malaysian here... for my appendicitis a few years ago...my total bill was RM 87.50 (USD 25.24)

Two people, from different parts of the world. The patient in Malaysia is charged $25.00 and the other, living under 'the best healthcare system in the world,' gets a bill for $55,000 for the same emergency.

Here is what a fellow American, who also had an unforeseen medical emergency as a 20-year-old, had to say:

I had the unfortunate luck to have cancer when I was 20. I had no insurance due to taking a year off from college, so my parents didn't cover me any longer. By the end of 2009 I was looking at 150k of bills, praying Medicaid came through. They did and paid everything in full. Though cancer stuff doesn't stop when treatments are over. After 09 I still racked up 50k in bills from scans, visits, blood work etc. I was forced to declare bankruptcy at 24 due to it.

I'm now at a disadvantage for the main years to buy a home, get a career, marry, and make my life. All because some cells decided to mutate.

I'm looking at 5 years cancer free in June. So I've got that going me, which is nice.

It is odd, baffling and frustrating that these stories have been missing from the mainstream media coverage and the political conversation in D.C., since the passage of Obamacare.

Instead of getting stories about how a lack of affordable health insurance coverage has been devastating millions of long-suffering Americans for decades, we have been bombarded with stories of how an underperforming website and the outlawing of junk insurance has devastated long-suffering insurance companies.

The 10,000 comments generated by zcypher's Reddit post, highlight the gaping disconnect between media mouthpieces for the insurance industry and the actual lives of Americans at the mercy of a broken healthcare delivery system.

My cousin died because he couldn't afford his cancer treatment back in 2005. The bills over a 2-year period exceeded $500k, and the insurance company cut him off. I still remember my uncle pleading with the insurance company over the phone. They said he had reached his lifetime limit. He was 27. Not to get too political, but thank god this crap is illegal now thanks to the ACA.

The fact is, even though the Reddit user does not have to pay the full $55,000 because he is on his parent's health insurance, that is still an astronomical amount of money to charge for a procedure and one-day hospital stay.

Here's the cost break down from his stay, which included:

$16,000 for the actual surgery.
$7,501 for two hours in the recovery room.
$4,878 for one night's stay.
$4,562 for anesthesia.

His total charges came to $55,029.31, and even though insurance covered most of that, he was still sacked with $11,119.53 to come up with on his own.[...]

So what's going on?

1. Sutter Health, which owns the hospital where zcypher had his appendectomy, has been sued for overcharging."The chain, which runs 24 acute-care hospitals in California, agreed to pay $46 million in [an] out-of-court settlement, and also to give more pricing information to consumers, as the result of a whistleblower complaint charging that the chain's billing practices were false and misleading," Jeanne Pinder writes at Clear Health Costs.

2. Hospitals routinely charge vastly different amounts for the same procedure. A California study published last year in the Archives of Internal Medicine found that after an appendectomy, patients received bills varying from $1,500 to $180,000. The average was $33,000, and the researchers "included only uncomplicated cases with hospital stays of less than four days," the Associated Press notes. "There's no system at all to determine what is a rational price for this condition or this procedure," study author Renee Hsia of UC San Francisco told the AP.

Today is not just another New Year's Day.

January 1, 2014 means that for the first time, in a very long time, millions of Americans have affordable healthcare coverage, including thankfully and finally, yours truly.

But the viral story of a $55,000 hospital bill posted by a 20-year-old young invincible and a comment from a 27-year-old Medicaid recipient having to declare bankruptcy to cover health costs, reminds us that we still have much more work and organizing to do, in order to get insurance companies to focus on healing instead of gouging.

Below are a few more comments posted to the Reddit story, that are more insightful and useful than any of the junk journalism we have been getting for the past year.

They are some of the top Reddit comments among more than 10,000; comments that should put politicians, the media and insurance companies on notice that there are some Americans who are more outraged with insurers than they are with Obamacare and some of these Americans are young, healthy, voting invincibles and they are having the necessary conversation with each other that the media and politicians refuse to participate in.

13special

First, the hospital is obviously charging you too much. Healthcare Blue Book has an appendectomy at $10,092 (far short of the 55k that they are trying to charge you).

AETNA negotiated for the whole thing down to $17,581 but if you hassle the hospital you might be able to get closer to the $10,092 that it should cost (give or take for the exact surgery and location). You only save $.20 for each dollar you get the hospital down but thats certainly a place that you should attack.

Here is the big one. If your plan is an 80/20 co-insurance (as it appears but the math doesn't totally work), you need to fight the insurance company on the grounds that they are responsible for 80% of what the hospital actually charges, rather than what they pretend to charge. The total came to $17,581 (ie, thats the total that the hospital will get) and they should pay 80% of that and leave you with the other 20% (less your deductible). That means that you really should owe $3,516.20 best case (assuming you have met your deductible).

You need to fight this. Start by contacting Sutter Health. Consider this paperwork the first communication in a negotiation rather than just a bill. Be strong. I just spend a good chunk of time navigating the nuances of American health insurance. PM me if you have other questions and I'll do my best to help.

nugsu

Let's start a subreddit /r/medicalbills. You should be a mod. I just got a 3,000 dollar bill for blood work. it's outrageous and nobody knows the strategies to fight it.

hyperfl0w

Cbc and bmp (complete blood count and basic metabolic panel) should cost no more than 100$ tops. If it is either of those, fight the charges. Those are the two most common lab tests ordered in usa, with the result that they are very inexpensive to do on scale now.

Lifebox02

It blows my mind you have to even consider negotiating over your health. I am so thankful to be Canadian.