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  #51  
Old 10-14-2019, 10:49 AM
Dewey Finn is offline
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We may be talking about two different networks here; there's the hospitals that are in-network for insurance coverage purposes and there's the network of hospitals under one ownership or operational umbrella.
  #52  
Old 10-14-2019, 11:24 AM
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Originally Posted by DSeid View Post
My best guess is “because they can”.
This. Swedish, here in Denver, will charge you $5,000 for a CT of your neck, but only if you tell them you were hurt in a car wreck. Otherwise it's maybe $1,200 (because they are a Level 1 trauma center and they do have some overhead). Oh, what's a car wreck got to do with anything? Well a few years ago our state supreme court ruled the value of a medical bill, for injury claim litigation purposes, is the face value of the original bill. The other side of that argument, which has been adopted by other states, is the value of the bill is the amount the provider accepts in payment. So what this means is that Swedish noticed, "Hey, we can charge whatever we want for the service and we'll have a good chance of getting it if it's a car wreck, because the car insurance people can only look at the bills when they are calculating a settlement." Prior to that supreme court ruling the cost of that CT scan was generally the same sort of number regardless of why you were getting it. They puffed the number only because they could. And Swedish wasn't the only hospital in town to pull this, they all did. Swedish was just more adventurous in investigating how much they could charge for a CT while keeping a straight face.

And I don't buy for one second that they're trying to make up for deadbeats. I haven't seen too many metropolitan hospitals that looked like they were hurting for cash. They're just lying predators who gouge people who are in no position to shop around for the services they need.
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Last edited by Inigo Montoya; 10-14-2019 at 11:26 AM.
  #53  
Old 10-14-2019, 04:17 PM
Wesley Clark is offline
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Quote:
Originally Posted by Inigo Montoya View Post
This. Swedish, here in Denver, will charge you $5,000 for a CT of your neck, but only if you tell them you were hurt in a car wreck. Otherwise it's maybe $1,200 (because they are a Level 1 trauma center and they do have some overhead). Oh, what's a car wreck got to do with anything? Well a few years ago our state supreme court ruled the value of a medical bill, for injury claim litigation purposes, is the face value of the original bill. The other side of that argument, which has been adopted by other states, is the value of the bill is the amount the provider accepts in payment. So what this means is that Swedish noticed, "Hey, we can charge whatever we want for the service and we'll have a good chance of getting it if it's a car wreck, because the car insurance people can only look at the bills when they are calculating a settlement." Prior to that supreme court ruling the cost of that CT scan was generally the same sort of number regardless of why you were getting it. They puffed the number only because they could. And Swedish wasn't the only hospital in town to pull this, they all did. Swedish was just more adventurous in investigating how much they could charge for a CT while keeping a straight face.

And I don't buy for one second that they're trying to make up for deadbeats. I haven't seen too many metropolitan hospitals that looked like they were hurting for cash. They're just lying predators who gouge people who are in no position to shop around for the services they need.
According to this, the median operating margin for hospitals is 1.7%.

https://www.modernhealthcare.com/pro...ill-vulnerable

My impression is median operating margin is the same as net profits, so a 1-2% operating margin isn't that high. THat implies the expenses to keep a hospital running are eating up 98% of the revenue they gather each quarter.

Also people say things like 'hospitals are open 24/7'. Yes, but how much does that affect the prices? I've seen urgent care clinics open 12-16 hours a day. The 24 hr grocery and 24 hr pharmacy don't seem more expensive than the ones that close for the night. Granted, labor costs in a hospital are higher.
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  #54  
Old 10-14-2019, 07:06 PM
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Originally Posted by Wesley Clark View Post
Also people say things like 'hospitals are open 24/7'. Yes, but how much does that affect the prices? I've seen urgent care clinics open 12-16 hours a day. The 24 hr grocery and 24 hr pharmacy don't seem more expensive than the ones that close for the night. Granted, labor costs in a hospital are higher.
It's a matter of who has to be there. A lot of times in large stores, it costs almost nothing to be open overnight - they have an overnight crew stocking the shelves and cleaning etc, so they add a cashier to stay open and pick up sales. That single, slightly above minimum wage cashier isn't going to have a noticeable effect on prices. The 24 hour pharmacy is paying a pharmacist and a cashier or two overnight . I took my husband to an urgent care on a Sunday morning. They decided he needed an X-ray - except their X-ray dept was closed Sunday morning. Off to the hospital for an X-ray, because the hospital has an ER which means they have to be able to do X-rays, CT scans, MRIs, angiograms, laboratory tests, surgery, etc 24 hours a day. That's what costs money- keeping all of those departments staffed, just in case. And it's not much of an ER if you have to call in people to do these things- at that point, it's more an urgent care located on a hospital campus.

Last edited by doreen; 10-14-2019 at 07:08 PM.
  #55  
Old 10-14-2019, 08:03 PM
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Quote:
Originally Posted by Wesley Clark View Post
Also people say things like 'hospitals are open 24/7'. Yes, but how much does that affect the prices? I've seen urgent care clinics open 12-16 hours a day. The 24 hr grocery and 24 hr pharmacy don't seem more expensive than the ones that close for the night. Granted, labor costs in a hospital are higher.
When my son got home from a ski trip at 1:30 a.m. having fallen down a mountain, we took him to the E.R. where he had a preliminary exam, X-rays, a blood panel drawn (and analyzed), a consultation with an orthopedist, his wrist set and a cast fitted, and a prescription written and called into his pharmacy - all in about 3.5 hours.

And he wasn't even a high-priority case.

BTW, does the 24 hour grocery have someone behind the butcher counter? In the floral department? Serving up fresh sushi? Not around here they don't. You get limited service. That's better than no service at all, but it ain't fresh sushi at 3:00 a.m.
  #56  
Old 10-14-2019, 09:49 PM
txjim is offline
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The OP stated that stand-alone medical clinics are 5X-10X cheaper than hospitals. In my state (at least, may be true elsewhere) the stand-alone ER pretty much charge on par with hospitals. This is a different animal than stand-alone clinics and the consumer was not always aware of the difference. The only difference is that "ER" is stuck somewhere on the sign and, in theory, the patient has to be advised of the fact. They are popping up everywhere. (link pops up a video news report but has text description as well)
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