How to deal with hospital and clinics


American hospitals are usually very good and well-equipped. Many public hospitals, however, are overburdened with the treatment of uninsured patients, so most Americans prefer to be treated in a private hospital.

People are referred to hospitals in the U.S. more often than in other countries, even for tests and out-patient treatment. This is partially due to the extremely expensive lawsuits in America – many doctors will prefer to send you to a hospital if in any doubt about your condition than being sued by you or your family if something serious happens due to a wrong diagnosis.

If you’re admitted to a private hospital you will probably receive one of the best treatments in the world. However, private hospitals are extremely expensive. The cost of a hospital room alone can be up to $1000, and this does not include treatment, tests or medicines. You should therefore ensure that you have sufficient health insurance, or your hospital stay could turn into a financial disaster.

A general community hospital will normally be adequate for most treatments. For serious illnesses or major surgery, you might want to visit a university clinic or specialized clinic.

Note that there is no such thing as free hospital treatment in the U.S. All fees have to be paid for either by you or your insurance company, even in the case of an emergency.

If it is your decision whether or not to go into hospital, check your coverage with your insurance company. When going to a hospital or clinic, take proof of your health insurance coverage with you. If you are admitted to the hospital, your health insurance will cover the costs of that stay. The payment is made directly by the insurance company – you don’t have to pay it yourself first and then ask for reimbursements (you probably wouldn’t even be able to pay it anyway). If you get a bill from the hospital, send it directly to your insurance company – although in most hospitals your insurer will have to pay the bill before you leave the hospital.

What if you don’t have health insurance?

If you don’t have health insurance, you will probably have to pay a large deposit in order to be even admitted to the hospital (up to several thousand dollars). If you’re not able to pay this money, the hospital will simply not accept you.

In case of critical emergencies, you will usually be taken to the nearest hospital (private or public), even if you have no health insurance and are unable to pay. However, note that the world “critical” refers to life-threatening situations only. If you’ve broken your leg in a car accident, this might not be considered critical (you’ll probably survive but might never walk properly again).

If you’ve been taken to a private hospital, you may be transferred to a public hospital if your situation has stabilized. Public hospitals also offer out-patient treatment to uninsured patients without advance payment. However, this treatment is often of only a basic or even inadequate nature, and you should expect long waiting lists. Public hospitals are simply unable to cope with the millions of uninsured people, and the situation is getting worse due to increasing homelessness, AIDS, drug abuse and immigration.

Even if you receive treatment in a public hospital, you will get billed for it afterwards. If you can’t pay, the hospital is forced to sue you (even if you have nothing) to get reimbursement from the government. If you still can’t pay a court will judge against you, and this judgement will remain in effect for years.

We hope that after reading this section the message is clear - don’t try your luck by going to the U.S. without adequate hospital insurance. If you don’t have insurance and suddenly need treatment, be prepared for a very bad experience.

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Other comments

  • ER doctor, 12 April 2009 Reply

    a few errors in this article

    I'm a doctor in an emergency room.

    The main point of this article is correct: you have to pay for health care you receive. The government doesn't pay for you.

    However, there are a few errors in the article.

    First, hospitals must provide emergency care to all patients, even if it's not a *life-threatening* emergency. In the broken leg example, if you didn't have insurance, your emergency room visit would be the same as if you did. If you need a hospitalization for an emergency surgery or procedure, the hospital is required by law to admit you and stabilize you regardless of your ability to pay. The difference would be where you follow up as an outpatient--if you don't have insurance, you will have to see a bone doctor in a public clinic, since a private bone doctor won't schedule an appointment with someone who won't pay.

    Second, if you don't pay your bill, you won't get sued. The hospital might send a collections agency after you, but you won't get sued by the hospital.

    I've worked in private and public hospitals. The only consistent difference between the two types of hospitals is the decor and quality of the cafeteria. Some public hospitals have great doctors and provide excellent care, some private hospitals are nightmares. Private hospitals do not necessarily provide better care than public ones.

    • L HUnt 18 Jul 2012, 07:30

      sued for ER visit

      This may have true in your experience, however, the notice of a claim filed against me by my local emergency room hospitals debt collection agency proves you wrong today. I am being sued for an emergency room visit, charges totaling 1522.00. I am filing my answer today. I cant pay the bill, and was told there is no help they will offer to pay the bill, and that I must pay in full. LOL..,..I asked to make small payments, not enough, they demanded their standard monthly payment.
      For me it was not financially possible. Now they sue me, and will get nothing.......I have nothing.....unreal that they would not let me pay them in a way I could.

  • Donna Miller, 03 May 2009 Reply


    My husband and I are uninsured. Both in our 40's and self employed. My husband recently went to the emergency room with chest pains. Finding he had 3 blocked arteries he had 2 stints put in. Bottom line so far the bill is up to $4500. That is only the 2 main doctors who cared for him. NOT the room, hospital etc..more to come. The emergency room doctor saw him for a total of 20 mins gave him an asprin told him to get a stress test and and his bill alone was $900.
    My sister(also uninsured and self employed) who WAS 44 died last July from brain damage resulting from a Massive heart attack..all this happened AT the hospital! She stayed on life support for 3 weeks hoping for a miracle... that bill was over $100,000. In my opinion They killed her and it cost $100k to do so..
    I don't mind paying for CARE. What I do mind is paying thousands and the doctors treating us like WE did something to ourselves and it's all OUR fault. We provide the means for them to live a comfortable life and this is the treatment we get. You have to get irrate with them to even get them in the room. They get aggitated answering your valid questions. They are insensitive and ungrateful. You have to rely on the family cheering the ill ones up because no one in the hospital seems to value life. We live in a fast paced life trying to merely survive. They make ungodly money to treat us like crap. It's ridiculous.