While the ACA helps individuals with insurance costs, service fees for routine doctor visits and prescription costs, it has done little to curb rising hospital costs. Our US legal system has made it so easy for doctors to be taken to court for the slightest issues, that doctors and hospitals support even the easiest diagnosis with expensive tests, scans and lab work. “Take two aspirin and call me in the morning” has been replaced with “We’ll check the results of the brain scan and lab work before we prescribe the aspirin”. Doctors and hospitals must make a reasonable profit to stay in business, and with so many people unwilling (or unable) to pay, the burden still falls on the insured.
I recently entered the ER for a fall from a ladder that resulted in two broken ribs. After a two-hour ER visit I received a hospital bill for $23,628.11. My ACA Silver (IHMO) policy paid $13,307.73 after the charges were discounted $4,020.38. This left me with a bill of $6,300.00. The high items on the bill were: ER room-$3,977, Rad Head Scan-$2,533, Ct Body Scan-$8,123, Ct Body Scan-$3,815, Ct Body Scan-$3,107.
I am not complaining (in the least) about the great thorough and professional care I received. The entire staff was great! I do, however, believe that the imaging costs were far too high. I hope my experience will help inform anyone who is curious about the subject.
Says R. Fallis
Friend of Wally’s perchance?
Hope you are recovering well from your fall. Broken ribs suck. Two broken ribs suck doubly. 
So, for any conversation about healthcare costs, I always point out that anecdotes are not data.
What did you have to pay after the policy cut down the services to a more reasonable amount?
None of these charges, by the way, are new or different based on the ACA. Hospital charges are always insane, even after adjusted for the insurance company’s negotiated allowed amounts.
You had 3 body scans plus a head scan??
14k for 3 CT scans?
Hospitals can just make up a number and charge it. Apparently, there would be nothing illegal about charging a million dollars for an aspirin, or even the price of the US National Debt for a kleenex.
Hospitals only collect about 10% of what they charge or less. So, 2300 bucks - if you were seen by a couple doctors (including a radiologist you may not have actually laid eyes on but someone looked at the images from x-raying you), 5+ nurses, 5-10 other employees behind the scenes might have been involved, the cost of the building…believe it or not, but hospitals frequently lose money from their ERs.
I don’t think that charging more than the highest insurance company rate should be legal (or more than triple the medicare rate or something). De facto, you do not have the power to get up and leave. It’s ok if restaurants can charge what they want - if you went to a restaurant that wanted a million dollars for a shrimp appetizer, nobody would order it, and people would stop going to a restaurant that tried to collect million dollar tabs for some shrimp in a sauce.
That hospital, not only was it effectively the only one around (even if there were others, they often are owned by the same company, and you wouldn’t want to drive an hour with broken ribs), but it would be like a restaurant where the waiter decides what your order is, and you don’t get to see the prices on the menu until weeks later. And yeah, the waiter might get sued for malpractice if they don’t order you the right wine every meal, even if it’s the $1000 a bottle stuff and the $30 a bottle stuff is almost as good. (a cheaper X-ray that just makes sure those broken ribs aren’t doing anything crazy, taken from a couple of fixed angles instead of the hundreds of images in a CT scan, would have probably worked just as well) For that matter, the waiter does not usually even know what the menu prices are him or herself…
You should ask about the three body scans. That seems… odd. Be aware though, that the radiologist’s fee is a separate fee, not included in your doctor visit ot imaging charges.
Those ‘discounts’ are actually a lot lower than I’d expect. Hospitals tend to bill some fairly amazing numbers with zero expectation of getting anywhere near that - in all seriousness, I’ve had numerous items billed at 10-20 times the in-network rate.
And leaving you with 6,300 to pay - are you on a high-deductible plan or something, and this was your first medical encounter this year? Otherwise that’s pretty shocking.
This was, indeed, my first medical event of the year. It cost me my policy’s maximum out-of-pocket expense of $6400.00. The EKG alerted the cardiologist to the possibility that I have an abnormally enlarged heart muscle, for which I am to be tested tomorrow.
The head CT revealed a mass under my chin that led to another CT last week. The ribs are recovering well. In another 3 weeks I might not be able to tell that they were ever broken. For a guy who has had very few medical events in his life (and very few CT scans) this event was an eye opener. I continue to believe that things don’t just happen randomly, but for a reason. It appears that the purpose of my fall was not only to teach me to be more careful on ladders, but to provide the opportunity to address one or two other issues that I may have never even known about otherwise. I should know the answers sometime this week. I hope my experience is helpful to someone.
Oh, who is “Waldo”?
Yeah. There are SO many problems the ACA did not solve.
For example, the drought in Texas and California; the fact that even when I use color-preserving shampoo, my hair color still fades after five weeks; my 11-year old dog can’t take long walks any more; my favorite TV shows keep getting cancelled… and the list goes on and on. Damn you, Obama. And I voted for you twice. Donald Trump will fix ALL of these problems.
:rolleyes:
Holy crap. We have a public and a private system here. I use private if I want to get something non-essential done fast or a better room etc.
My last public ER visit was after a bike accident where I smashed into a car door that opened in front of me.
I had 2 x-rays and a scan of my head, 13 stitches IIRC and some nice meds. Took 4 hours and ALL costs were covered by the €150 I paid when entering the ER (that is a blanket cost unless you’ve got a medical card which is for unemployed, old etc. ) if I didn’t have a way to pay the €150 they’d have just billed me and carried out all of the above anyway.
Now I know that all the above didn’t actually cost €150 but that’s why I pay tax 
Would rather that that have to sweat out if I can pay for an emergency.