Wednesday, November 4, 2009

Unreal Health Care Costs


I took my son to the ER for a broken thumb. It was a minor injury but the thumb is the most important digit on the hand. The ER care was just fine...a quick look, an Xray and a small splint. We didn't have to wait long and everyone was courteous.

Imagine my surprise to receive the bill from the hospital. Yes, I have insurance. My out of pocket expense was minimal but here is what the insurance company was charged:
  • Hospital Misc.- $56.00 (could this be the splint?)
  • Diagnostic Xray - $342.00
  • Emergency Care- $952.00
  • Surgery - $570.00
    Total $1920.00
Take a look...surgery? There was so surgery, no procedure. There was no break in the skin. The doctor component of the visit was about 7 minutes (mainly because I knew the doc and we chatted about politics)

This bill is unreal and is comprised of unreal health care costs. The insurance paid a component of the bill. They have a cap on what they will pay for each element.

I am an informed consumer so I will be calling the hospital billing office to discuss the unreal charges. I doubt that most patients would do that if they had insurance. It would be "somebody else's problem". We need to bring the patient back into the loop to control costs. We all pay in the end anyway.

The Doctor and Radiologist bill will be separate.

9 comments:

Linda Leighton said...

WOW!! That is a real eye opener. Thanks for sharing your experience, Toni.

KM said...

There is also usually a separate bill and charge for the doctor portion of it.

Raymond Bouchayer said...

I was told once by a very wealthy Lady that she had cheaper better care staying in a 5 star hotel suite with maids , in house Doctor , excellent food etc rather then staying in a room in some hospital.

Cary said...

Yep, absolutely ridiculous, always. I spent one night in the hospital after an auto accident years ago. No surgery, just observation, there less than 24 hours. $7,000. Luckily, insurance paid almost all of it. Still -- outrageous. As I recall they charged me $250 for something like Advil.

Knitted in the Womb said...

I absolutely agree that the consumer needs to get brought back into the loop on pricing! I really think that is the only way to get costs back under control. Insurance, as we expect it in America, is SO not the answer.

Actually, I was told that if I paid for some routine pregnancy bloodwork directly, I would pay $60 for it, but she said that often the insurance "allowable" fee was higher. Since I hadn't even touched my deductible on my insurance, and wouldn't, I knew that I would pay 100% of whatever the insurance considered to be a "reasonable" fee. So I asked my care provider to submit the labwork without my insurance.

For some reason she still included my insurance info, so I was billed $70--what the insurance company considered "allowable."

What we have in America is not "insurance"--it is "insulation." We are "insulated" from all of the costs, and thus often don't care what they are.

"Insurance" in its truest form is something that protects you from unexpected high bills. So, for example, with home owners insurance you still buy new mulch for your flower beds every year, and occassionally need to fix a plumbling problem for a few hundred dollars...but if a tree crashes through your roof, insurance pays for it.

ERP said...

Simple (and upsetting). We have just shifted all the costs of treating the uninsured, unable to pay, and medicaid patients onto you (and those of us with insurance). If your hospital does not contract with your insurer for a flat rate, the company will pay a large portion of that outrageous bill. Basically, throw it at the wall and see what sticks.....

Sunnydalai said...

While I'm certainly not on the side of the insurance companies, this does illustrate that cost containment has to be part of any healthcare overhaul. The insurance companies just pass the cost along in the form of higher premiums. A key element should be negotiated fees, as in Medicare I believe, as in negotiated with the power of a large group behind it.

Craig said...

What you forgot to tell us dr. brayer, is that the hospital will most likely not get their full invoice amount paid. So it is the health care billing system that is crazy. It seems that insurance companies deny coverage and or pay only a small percentage of the amount billed by providers. So doctors and hospitals have reacted by billing hugely inflated amounts for their services and on occasion charge for services they didn't perform just so they can get paid their cost and modest deserved profit by the insurance company. I think it would be best to take the insurance companies out of the equation. Private insurance companies are not in the business to provide health care. They are in business to maximize profits. If their profits were shrinking they would be leaving the industry but they are not. They are no different then a casino that will ask me to leave when I start winning to much. I don't fault the insurance companies they just don't belong in health care when there are better solutions for all of here in America the beautiful

chrissoup said...

I wonder if the charge for "surgery" was an error.