Snake Oil

Silicon Valley has not rebooted my doctor. Andy Kessler's vision is still yet to materialize. Judging by the millions that flowed into Threanos, Silicon Valley is still aware of the problem and would love to reboot the healthcare industry. But the industry is holding well. In the mean time Theranos was named the scam that rocked the Silicon Valley. But it seems a much bigger scam has been brewing absolutely legally.

While the recent story on  the $143,000 bill for snakebite treatment may be shocking to many, I can just confirm I experienced something very similar (although it was not - thankfully - a 6-figure experience).

I was bitten by a dog on a hiking trip to Caucasus mountains in Georgia. Guide books warn about Caucasus shepherd dogs who often would not let you pass on a trail. This exactly happened to me, perhaps I was jut too naive thinking why would the dog ever bite me if I was posing no harm to it nor to the herd of sheep. But these dogs have very strong instinct and it ended as it ended - I was bitten.

After returning home I showed up at a private vaccination clinic in Poland to get a rabies shot. They told me to go to an ER (Emergency Room) where I could get one for free or they would charge ~$65 for it. I was very short on time so decided not to go to the ER at the other of the city and have the paid shot. It took 10 minutes. A standard interview, a blood pressure check, the shot in the arm.

For the following two weeks I was in the USA, so had to continue the shots (it is a 5-shot series) there. It was nice but not easy. Upon showing up at an ER, they admitted me to a private room full of equipment and there were about 15 different people (nurses, doctors) doing different things (interviews, blood pressure checks etc). In the end I got the shot, but then they kept me for another hour ("to check for a potential reaction") until I was let go. It all smelled a bad bill  in the end. Which totaled $1300. The same medicine, 20x more expensive. And you could feel there were doing all sorts of things to bump the bill up.

Having the alternative perspective (which most Americans don't), I could clearly see I was manipulated, as in the end "don't worry, this would be your insurer to pay":

When KHN questioned St. Vincent Evansville hospital on its charges for Crofab, the hospital noted that the snake-bitten girl’s family wasn’t on the hook for the bill. Insurance covered the price of the antivenin. And, in the end, the family’s insurer negotiated the $67,957 antivenin bill to $44,092.87.

USA is really a scary jungle to go to. The healthcare bills are most dangerous, but price transparency generally is very low. Visitors learn that the hard way, probably the first moment after arrival is the rental car bill that typically is 2x-3x higher than the advertised price and includes self-explanatory items like "Facility charge". Earlier this year I visited Mexico City and we decided to rent a car and drive to Acapulco, to spend a few days at the Pacific Ocean. It was an incredibly pleasant experience and I paid for the car exactly what the rental company was advertising. This was contrary to the opinions posted on the Internet about renting a car in Mexico. It seems that Americans have no problem accepting the price scam on their home turf while they are the first to complain about how things are elsewhere.

Regarding the healthcare, I sincerely hope one day we will see what Andy Kessler has been predicting - technology that will ultimately reboot that system.