I think I’ve told this story before, but sometime in the year 2000, I was working as an IT consultant in rural West Virginia. At the time (and they still do as far as I know) the state had a system where they provided for health clinics out in the sticks because nobody would ever do so for a profit motive.
Anyways, one day I’m working on the computer and an old man walks in as mad as can be. SLAMS his bill down on the counter and proceeds to chew the doctor out about HOW DARE HE charge such a price for his service. The doctor explained that he made a trip to the man’s home to give his wife an injection at 2am, and that fee was standard for this type of service.
The man argued some more, but finally pulled out his checkbook. He was so mad it took 3 checks before he got one written. On his way out the door, he yelled that the doctor was a “goddamn thief” and that all doctors are “goddamn thieves, and that is what is wrong with this country!” SLAM! goes the door as he leaves.
I couldn’t help myself. I walked over to the doctor and joked with him that his day could only get better from here. He slid the bill over to me. Thirty-five dollars. $35!!! for a house call at 2am. I couldn’t believe it.
*back to your regularly scheduled health care rant
I agree wholeheartedly. There was such a place in a little town of 8,000 near here that via time and geographic placement ended up having a helipad built to accommodate the 4-5 trips into fresno a week with critical patients that landed on their doorstep. This type of place is where I tend to go for the little stuff. Life threatening stuff should still go to the ER.
But the bill is much higher for the uninsured also – those who can pay full price while uninsured or who are not persistent and skilled enough to get their bills reduced to something reasonable pay completely outrageous amounts.
Last December my son went to the hospital with an asthma attack on Christmas morning. About two hours there, one X-ray, some inexpensive (relatively speaking) medications, and a few minutes of a doctor’s time: $4500. We saw the full-cost no-insurance bill due to being in limbo with some insurance paperwork and about had a heart attack apiece. Once the insurance paperwork was filled out, the bill was resubmitted; the insurance company was only billed about $1000. That’s not what they covered, but what they were actually billed.
Exactly. Just to echo what some others have said. If you want a reasonable idea of what many/most people would pay for the services she received, call the hospital to ask for a detailed bill with the billing codes. Then, you can call your insurance company and ask them what they would pay out for those specific services. That way, she will have an idea of what she can hope to negotiate them down to.
I won’t repeat what has already been said here, but when people say “10 minutes of the doctor’s time” they really mean that they saw the doctor in person for 10 minutes. That doesn’t count any charting the doctor has to do (which is often a ridiculous amount, to satisfy insurance companies, JCAHO, and ass-covering for when they get sued), time spent communicating with the nurses and other support staff about what you need done, and, for more complicated cases, thinking about the case and formulating the treatment plan, talking to consultants to get their opinions, and/or begging the surgeon/GI/etc. to admit the patient or get their butt down to the ER to look at the patient. These are all part of ED visits but are not directly apparent to the patient. I won’t deny, however, that the whole charging and reimbursement scheme in this country is screwed up, and I don’t know how to fix it.
To all those blabbing on about how the rates being charged incorporate massive amounts of overhead for whatever reasons, be it the cost of 24/7 availability, paying janitors to sanitize the room after you’re done, paying nurses, etc…
you do realize that in most publicly-run healthcare systems in the world, private enterprises are involved in delivery of the health care services, right? So those hospitals in Canada, France, Germany, Japan have to cover that overhead too - and they manage to cover that overhead with significantly lower reimbursement rates from the government run/price controlled insurers.
So… what gives?
(I’m sure i’ll be treated to some claptrap about how the gap in a 10k US hospital visit and a 1k Quebec hospital visit is all due to the tort system or some garbage :rolleyes:)
Read on; it says that if you want diagnostic scans, you can expect up to $1500 per body part. And it’s additive, so if you want four body parts scanned, that’s probably going to be about $6000, especially if you use contrast.
I’m Norwegian so this all seems a bit odd, to me. (Your country, your system and all that. It’s not the “she has to pay for qualified, highly specialized help” angle that I think is odd, but the twelve thousand dollars part. Seriously? Did she get warned before she went in?)
A huge hunk of our last ER bill was for scans. My Mig is paying 7k for a (mis)diagnosis and treatment for an ulcer (that he didn’t have). The original bill for the hospital was near 10k, but without insurance they brought the fee down. We still have various doctor bills to cover that came separately and won’t work with us other than turning us over to collections. We pay each of them around 20 bucks a month and will for a very, very long time.
(Within three days the entire family felt the same horrific pain. What Mig had was a very bad stomach virus.)
It’s not likely. Hospitals aren’t like retail clinics with a menu of prices posted in public view. IME the staff don’t have the slightest clue offhand what any given test or procedure costs and will look at you like you just sprouted an extra head if you ask or insist on knowing how much it’ll cost before consenting. They’ll just tell you not to worry about that right now and it can all be sorted out later.
Actually, all the ERs I’ve seen in the last 5 years do have exactly that. A “menu” that’s on the wall by the desk where you check in, with the uninsured out of pocket expense of the most common procedures performed there.
I like it.
They shouldn’t. It’s part of the Patient Bill of Rights that cost be considered and explained when choosing your course of treatment, if you ask. Refuse any treatment and they’ll find the numbers quickly enough.
Nurses are the one to ask about this, by the way. In my experience, hospital docs have no idea what the medications or tests cost. The nurse knows where to call to look it up.
At one recent hospital experience, I had to insist the doctor prescribe a different antibiotic, after the first one cost over $280. The perfectly effective second choice was $24. The nurse helped me call pharmacies to get their prices for both rounds of phone calls, but she had a general idea of “this one will be cheaper than that one” before we made any calls.
What people living outside the U.S don’t really understand is how screwed up and cruel our system is. One accident or one major medical procedure can bankrupt a family. Unpaid bills often for tens of thousand of dollars are placed to collection agencies, civil judgments are filed, your credit is ruined you could use your home.
It said diagnostic ct scans (when are they not diagnostic?) are $580 to $1,500.
I agree that $12,000 doesn’t make any sense.
Since there is no formal negotiation prior to the event I expect the hospital to charge the going rate plus the cost of waxing the floor plus the cost of the little rubber footies they give you for not slipping on the waxed floor.
Tell that to Princes Diana. She would have been airlifted to a hospital (as would the poorest person in the US) with all the necessary medical equipment. The US has a cost containment problem, not a medical treatment problem.
I had a double-barreled MRI in January (shoulder and knee problems) and the “rack rate” for the scan was about 3,800. The insurance negotiated rate was 2,200, and we paid about 440. The radiologist was also paid a few hundred dollars. Unless the CAT involves contrast and some really specialized procedures, it’s hard to imagine how it would cost more than two MRIs. Are you sure abut that figure?
Re the OP: definitely look into the negotiated rates, at the very least. I’ve got a spreadsheet tracking all of our expenses for this year and the “insurance discount” figure is roughly 50% off the rack rate for every single service (some less, some more obviously).
Um, you’re not going to get airlifted to a hospital if you’re in a car crash in Manhattan :dubious:
The standard fallback for excusing the costs that this system produces is always “well, you get far better care in the US” which is empirically unclear at the very best. Regardless, is always baldly asserted as some truism with absolutely no evidence, as we have in the post above.
Of course, if there was torn aorta and the imaging doctor didn’t catch it, a pregnant widow with a toddler gets a lot of sympathy with the malpractice jury…
Was that really necessary? You made your post almost a day after the thread started and nobody had made the comparison until you raised the topic first.