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I had to visit the emergency room earlier this year for a nose bleed. At the time I was discharged (October 2022) I paid a 200$ bill to the hospital, foolishly believing that this was the entire cost of the visit. I subsequently received a 357$ physicians statement. This little episode in medical billing really irritated me since I felt that the hospital had hidden the actual cost of their services and because the amount was absurd for the services rendered (10 minutes for a physicians assistant to apply some topical TCX). As a result I have been thinking of not paying it and am trying to understand if recent changes to that the credit reporting agencies have made may allow me to get away with this without damaging my >800 credit score.
In particular it sounds like medical debts < 500$ will no longer impact a credit score starting in 2023 https://www.equifax.com/personal/education/credit/score/can-medical-debt-impact-credit-scores/ and I am trying to determine if this determination is made based on the date of the service(s) (october 2022) or the date that a bill is sold to a collections entity, which could occur in late January. I also discovered that paid medical debt collections haven't impacted a consumers credit score since 2022 (https://investor.equifax.com/news-events/press-releases/detail/1222/equifax-experian-and-transunion-support-u-s-consumers), so its my understanding that even if they are able to sell this bill to a collections entity, the worst that could happen is that I would simply have to pay the amount at a later time.
Does anyone know if this analysis is basically correct? Its my understanding that their only other recourse would be to try and sue me which is unlikely to happen over a 357$ bill.
Is this for real? The person billing OP wasn't even a doctor, and no PA, NP, or doctor is getting paid that much for that type of work. Blame the admin and the billing people for the number, the PA has no control over it and is making 1/10 of that sticker price.
Again, as stated elsewhere doctors have been lobbying for their own competition for years, who proceed to do the same job for cheaper, with less training, and do a demonstrably worse job.
I'm always flabbergasted at how little people seem to know about this in relation to how enthusiastic their beliefs are.
Also the NHS is collapsing.
Ah you took this a different angle than everyone which is a better one.
-Restrictions on open immigration are not unique to medicine, no field wants to import competition and generally countries don't want to fuck over their knowledge workers. While the U.S. is notable for you needing to redo residency, that doesn't mean it's actually possible to move over (Canada and Australia will happily take U.S. docs but Germany is incredibly hard) for other reasons.
-Related to that, most countries aren't excited about this because in many countries a lot of people want to move to the U.S. because it's the U.S. or because salaries are higher. If you offered everyone in the NHS the chance to move to the U.S. healthcare in England would collapse instantly. So both the push and pull are blocked.
-Despite this if you wanted to import family medicine doctors (the only area that has true real need) from other countries I don't think anyone would complain, including the family care doctors.
-Training is strictly controlled in the U.S. and is better than elsewhere (mostly by being harder, potentially for no reason) but is also very much so less variable. You picked good countries but you couldn't do this with say India because of the training programs are absolutely U.S. grade and some are incredibly deficient.
-We don't have much of a shortage of doctors in most specialties, we have an allocation problem. Most doctors want to live in a relatively small number of urban areas so those places are flooded and everywhere else is lacking. The reasons for this are complex but increasing supply is unlikely to fix it, but doctors for clamoring for an increase in supply (in the form of residency spots) ANYWAY and have zero control it - blame the government.
-Physician political influence is abysmal right now, we've spent decades propping up our own competition, everyone hates us (because of envy of salaries, political involvement with covid, accusations of racism etc etc) and what lobbying we do do is just left wing politics.
-Physician pay is not unbelievably excessive. The average family care doctor makes 220k. That's a lot of money, but the ceiling is low and it comes with unbelievable sacrifices to that point. When people think of ridiculous pay they think of the orthopedic surgeon making 750k but those guys are less than 1% of doctors, over 90% of doctors are in primary care in some form and those people aren't making the "real" money.
-Medicine in general can be described as a skilled trade, that's what nurses are. Physician work cannot. In the U.S. doctors get training in (and are expected to use these skills) teaching, leadership/management, and research science. Depending on the field soft skills vary from mandatory to almost all of the job (as in Heme/Onc, Psych, and Palliative). On top of that some fields do have the manual skills. That is not an upscale plumber. In the U.S. we've made many attempts to drop in people with less training and skills and they do a demonstrably worse job and unlike in emergency plumbing people actually die.
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