Are you allowed to refuse medical treatment in a bike accident?

[d.vader123]

Of course, this applies to any accidents, but I started thinking about this after reading an article about a guy who was refusing medical treatment after an accident because he didn't have insurance.

The ambulance and hospital treated him anyway and then slapped him with a $40,000 bill.

As usual, there are different views on this, but I can't help but think that he shouldn't have to pay the bill. I motivated to say this even more because I have a friend who has fallen on hard times and does not have a steady job and medical insurance. If he ends up going to the hospital he'll have to pay for it even if he has no money.

That doesn't seem fair. Thus, I think it's reasonable (although it's unfortunate) for him to refuse treatment simple because of the fact that he can't pay it back!

Note: I know that the hospital can be held liable if they do not treat someone, but at the same time how can you charge a person who has no money and was adamantly refusing treatment?

[firerescuefin]

Yes, you can "expressly" deny medical treatment. Consent will be (most cases) considered "implied" if unconscious or demonstrating an altered mental status....the theory being that such a person is incapable of making a sound decision due to defect.

EMS providers carry refusal forms for the patient to fill out and sign to release the EMS provider from liability. Most agencies in these cases will have the Medics seek "on-line" medical direction from the Medical Director (Doctor) or his designate. The last thing providers want to do is not provide treatment to someone who needs it or whose condition may worsen (up to death). If your friend was deemed incompetent due to a altered LOC after an accident, one should be happy he was taken in. If you have link to the story, please post it.

That's the down and dirty. There may be differences from state to state/ jurisdiction to jurisdiction etc.....but the above will be apply to most instances.

[gasman]

Well covered fire.
It's sad to me that medical bills are responsible for about 70% of personal backruptcy filings in the US. At least that's my understanding.

[dekindy]

Well covered fire.
It's sad to me that medical bills are responsible for about 70% of personal backruptcy filings in the US. At least that's my understanding.

Significant percentage caused by an uncovered disability that leads to medical bills, loss of work, etc.

[d.vader123]

If you have link to the story, please post it.

That's the down and dirty. There may be differences from state to state/ jurisdiction to jurisdiction etc.....but the above will be apply to most instances.http://sacramento.cbslocal.com/2011/07/07/call-kurtis-i-dont-have-insurance-dont-take-me-to-the-hospital/

There's the story. The accident was on his motorcycle rather than a bicycle, not that it matters.

However, he was refusing treatment and the hospital billed him $40,000 anyway. I don't think he should have to pay.

[weiwentg]

Well covered fire.
It's sad to me that medical bills are responsible for about 70% of personal backruptcy filings in the US. At least that's my understanding.

I support universal coverage but the statistic was more like 50 percent of bankruptcies in 2001 involved medical bills. Not all of those would've been caused directly by medical issues, money being fungible and all. But still, a lot.

The person involved had a head injury, so they took him. They still had to charge him for the ride and the examination. So, yes, technically speaking he does have to pay. Now, hospitals tend to skimp on helping uninsured patients connect to community services that might help them pay their bills (like sorting through Medicaid eligibility), but he needs to try Medicaid. And hospitals usually 'charge' uninsured patients much more than they'd charge an insurance company, so he definitely should negotiate down.

Btw, this case is one illustration of why you need some sort of mandate to purchase insurance. There will always be some guy who'll think, I don't like going to the doctor, so I'm not buying insurance. And then he or she gets a head injury or cancer.

[Charles M]

The amount paid will be NO PLACE near 40,000...

And if it were the "retail rate", This guy was f'd up pretty bad and should be thankful for the treatment.


Medical bills are HUGELY negotiable, especially for uninsured and people who refused treatement.

[SamIAm]

Do people really file for bankruptcy due to medical bills? Or are medical bills just part of what gets settled in a high percentage of bankruptcies?

[xjahx]

...Medical bills are HUGELY negotiable, especially for uninsured and people who refused treatement.

That should read "Medical bills are HUGELY negotiable, especially for the insurance companies who have incredible leverage and market share." Typically, insurance companies have pre-existing contracts with hospitals or providers where they pay approximately 10-20% of the actual requested amount.

As for the uninsured, most hospitals do have programs and services designed to lower the actual dollar values owed. That being said, it is an endless amount of paperwork, time, and effort. That does not stop the collection notices from coming in the meantime.

FireRescueFin is exactly correct. We, med control MDs, receive many calls per day from the crews in the field with patients refusing care and/or transfer to a hospital; I typically ask for the history, the crew's evaluation of competency and/or concerns, and then speak directly to the patient to explain risks/benefits and to understand their desire for refusal. Provided that the pt is competent to make medical decisions, he/she may refuse care. Determination of competency is not always straight forward, and I imagine that in the referenced case there was concern for competency; this could include loss of consciousness, concern for closed head injury with resultant change in mental status, concern for intoxication (just a for instance).

[Dr. Sparrow]

Interesting the article is silent as to who called 911. Did he?

This idiot is out tooling around on what is most likely a 10-20K Harley without med insurance?

Darwin failed us on this one.

[goonster]

Do people really file for bankruptcy due to medical bills?
Heck, yes. Especially when a long-term medical condition leads to loss of job, and therefore loss of employer-provided health insurance.

Consumer Reports (http://news.consumerreports.org/health/2009/06/health-care-bankruptcy-on-rise-medical-debt-medical-bills-how-to-avoid-bankruptcy.html)

"Just over three-quarters of people who suffered a bankruptcy due to illness were insured at the onset of their health issue."

[benb]

I "refused treatment" in a bike/car accident in November.

I had gotten T-boned by a pickup truck that was exiting a driveway.. totally the drivers fault, but he was pretty cool. I had gotten beaned pretty hard and got launched 5-10 feet and was shook up but I didn't hit my head and I knew I was fine. I've taken harder crashes in races and gotten back up and finished.

I knew I needed/wanted to go to the doctor and file a police report but we didn't call 911.

When I got to the police station I said I was going to go get checked out, the police had forms for me to fill.. when they asked if I wanted an ice pack I said sure. Well "Sure" apparently meant "call 5 EMTs and get ready to roll the ambulance."

When the EMTs came into the station they said they were required to put me in a back brace. (This was after I had gotten to the police station on my own.) So I refused and went on my own. They did give me an ice pack even though I refused the ambulance ride.

I got X-rays and got my rash cleaned up, X-rays were negative.. bill was about $1000 and the guys insurance was very cooperative and paid.

If I'd been really hurt I would have called 911 but seeing as I wasn't the whole thing was super weird cause it seemed like they were dancing a line between covering their liabilities and racking up a massive unnecessary bill.

I did strain both my shoulders and my knee swelled up a little.. but they have gotten better. Been concentrating on my shoulder with weights to make sure everything is good when spring gets here. I was back on my bike after about a week so overall pretty minor.

If you're actually hurt so bad that they have to treat you (life threatening, etc..) I don't see how you can really say you "refused treatment".

[Charles M]

That should read "Medical bills are HUGELY negotiable, especially for the insurance companies who have incredible leverage and market share." Typically, insurance companies have pre-existing contracts with hospitals or providers where they pay approximately 10-20% of the actual requested amount.


I agree that insurance companies have agreements in place, but the general public can negotiate as well...

My wife handles the business for a large practice who's largest partner is also the chief of Staff for the Hospital they're joined to...

The public can count on paying less than half (usually MUCH less) of the top line suggested bill...

[EDS]

Of course, this applies to any accidents, but I started thinking about this after reading an article about a guy who was refusing medical treatment after an accident because he didn't have insurance.

The ambulance and hospital treated him anyway and then slapped him with a $40,000 bill.

As usual, there are different views on this, but I can't help but think that he shouldn't have to pay the bill. I motivated to say this even more because I have a friend who has fallen on hard times and does not have a steady job and medical insurance. If he ends up going to the hospital he'll have to pay for it even if he has no money.

That doesn't seem fair. Thus, I think it's reasonable (although it's unfortunate) for him to refuse treatment simple because of the fact that he can't pay it back!

Note: I know that the hospital can be held liable if they do not treat someone, but at the same time how can you charge a person who has no money and was adamantly refusing treatment?

At races you are allowed to say you don't want to go to the hospital even if the EMT's in the ambulance path you up.

[Fixed]

when we get ill
just shoot us
cheer

[fourflys]

Geoff (firerescuefin) pretty much summed it up and he might know a thing or two...

I've been an EMT since '97 and as Geoff said if I think you have an altered state of consciousness or are unconscious, you are getting in the rig and taking a ride...

in response to the article- the guy was on a motorcycle, went down and hit is head... not only are you worried about level of consciousness, but also a cervical spine (neck) injury... there have been stories about someone getting up after an accident, walking around for a but and then dropping dead because they turned their head when someone called their name and they pinched/cut a critical nerve in the spinal cord...

in response to the post that said anyone can refuse treatment at a bike race... I don't buy it if any of the above cases are present... the EMT/Paramedics could be sued for negligence...

the sad thing is if EMS didn't take that guy to the hospital (because he said no) and he did have a neck injury or something else that had a lasting effect, there's a good chance the ambulance and hospital (med director) would have been sued... even if the guy signed a refusal of care...

damned if you do, damned if you don't...

[Bob Ross]

EMS providers carry refusal forms for the patient to fill out and sign to release the EMS provider from liability.

^^^This. Happened just recently on a ride I was leading: A guy went down, the crash looked kinda gnarly so the cop who coincidentally showed up seconds later radio'd for EMS, crash-ee insisted he was fine & didn't want to go to the hospitol, so after a brief interview the EMS guys agreed

...and then made him sign a waiver stating that he had voluntarily refused medical treatment.

[fourflys]

^^^This. Happened just recently on a ride I was leading: A guy went down, the crash looked kinda gnarly so the cop who coincidentally showed up seconds later radio'd for EMS, crash-ee insisted he was fine & didn't want to go to the hospitol, so after a brief interview the EMS guys agreed

...and then made him sign a waiver stating that he had voluntarily refused medical treatment.

yep, CYA forms...

in that case, the officer called for EMS, I'm guessing, as standard operating procedure... some of those calls were the best after you've had a long night of being on call after call... ;)

[rain dogs]

I probably shouldn't get involved in this conversation, because last time we talked about insurance it turned into a real ****-show.

If that guy got treatment, someone needs to pay those workers, whether it's him or other. Americans signed up for that system, and if they don't like it... vote... or move.

If there is one thing in the world that should be at least non-profit, it's healthcare. Yet the only place in the world I know of, where it's a strict for-profit system is the US.

If something is bad enough to call an ambulance, you should be getting treatment, not having to worry about the financial implications.

That fact that they carry refusal waivers is good, but ultimately a frightening reality.

[fourflys]

If something is bad enough to call an ambulance, you should be getting treatment, not having to worry about the financial implications.

That fact that they carry refusal waivers is good, but ultimately a frightening reality.


as I alluded to above, sometimes a ambulance gets called as protocol and is not always needed... THAT's what the refusal forms are intended for NOT because someone doesn't have insurance...

[rain dogs]

as I alluded to above, sometimes a ambulance gets called as protocol and is not always needed... THAT's what the refusal forms are intended for NOT because someone doesn't have insurance...

I understand that. The OP was also describing a situation where someone believes they shouldn't have to pay because they tried to refuse service.

Ultimately you shouldn't have to be faced with that decision.

The "better to be safe than sorry" becomes a financial priority over a health priority

[fourflys]

I understand that. The OP was also describing a situation where someone believes they shouldn't have to pay because they tried to refuse service.

Ultimately you shouldn't have to be faced with that decision.

The "better to be safe than sorry" becomes a financial priority over a health priority

agree...