heh…if I am remembering correctly, my wifes C-section and ante natal care came to about $11k TOTAL
Last August I had a da Vinci hysterectomy and the entire kick - operation, anesthetist, path lab for the tumor, assorted meds and an overnight stay was $10k, and Yale-New Haven is not a cheap hospital. I had already hit my catastrophic cap for the year so it didn’t actually cost me anything.
I’ve always been told that they gouge the insurance companies because, in other places, the insurance company stiffs them. In fact, every place I’ve ever been, the non-insured rate has been higher, not lower, to the point where I’ve negotiated with some doctors to get the lower rates. And to the point where many doctors I know won’t accept stuff like medicaid.
When they do an X-ray for a sprained ankle, they’re not looking to assess the soft-tissue damage because they can’t see that on an x-ray. They’re looking for a fracture. If there is no fracture, they treat you for a sprain. If the pain doesn’t go away after about a week of rest and Advil, they go looking for more severe damage, which is best seen on an MRI. The right tools for the job, and all that.
Did the doctor have a financial interest in the MRI imaging place? It’s common enough.
A simple fix would be to make it illegal for a doctor to refer you to to a facility in which he has a financial interest. At the very least, he would have to reveal that to you.
Our medical system pays doctors for procedures ,not results. The more stuff they do, the more money they make. Lots of doctors own or invest in the imaging and testing companies they use. It is a terrible way to run a medical system.
MRIs are like candy where I work. If I see one more MRI referral/note for time missed from work… well… I will need an MRI for when my brain starts imploding.
Or perhaps a too large number of those instruments. At least, I’ve seen it mentioned as one of the many causes of the high level of medical expenses in the USA (hospitals recouping the costs of pricey medical apparatus by recommending their use when it isn’t necessary).
Frankly, I was surprised it took 6 posts to blame the lawyers here :rolleyes:
Funny, my doctor diagnosed tennis elbow via a 5-minute conversation and a physical exam of my arm; no tools or machinery involved at all. Eyes, ears, and anti-inflammatories - all very handy things.
It’s just as bad, if not more, for pets. We have a neighbor who owns one of the few Emergency Vet Clinics in the area. From my and my friend’s experiences, I really do believe that they take advantage of our emotional attachment in order to over-prescribe treatments.
A few weeks ago, Buddy the Beagle got into something. God knows what; he’s a beagle and will eat just about anything, including rotting animal corpses.
Anywho, this particular day, even his iron stomach couldn’t handle whatever he’d eaten and he started vomiting. Then he’d lay down and pant and salivate and moan. Then he’d get up and vomit/dry heave. After several hours of intense distress, I started getting worried. He’s not a young dog (nearly 10) and I knew that the constant heavy panting was exhausting him. I got his leash out and he didn’t even lift his little head. So I knew that he was really sick.
OF COURSE it was on a Saturday and the vet was closed. So off to the emergency vet we went. Yippee!
Let’s just say that they were all very professional but CLEARLY not on a mission to control costs. Upon the initial exam, the vet said that his heart rate and breathing were normal, which really surprised me because he was panting so hard. She said that excessive salivation was normal with vomiting, and that he probably was reacting to something he ingested (duh). Her initial impression was pancreatitis. And she prescribed IVs to rehydrate him, anti-nausea medicine, and the withdrawal of food for 12 hours (which is a lifetime for a beagle) to give his stomach a chance to rest. Sounded reasonable to me.
BUT.
(Cue in the sound of cash registers: “Cha-ching!”)
It was ALSO possible that he had a blockage. And that would be bad. Bad, bad, bad. Is it possible that he ingested something, a bone or a ball?, that might have gotten lodged in his intestines? Doc, he’s a BEAGLE. It’d be shorter to list the things he DOESN’T eat: fruit and iceburg lettuce (the latter of which can only be included if it’s sans ranch dressing).
Hmm, well the best way to rule out the Evil Blockage would be an x-ray (150). If it showed a blockage, then they'd be forced to operate to remove it ( infinity). :eek:
By this time, I was CONVINCED that the dog had a sharp bone lodged in his large intestine and that he currently and actively dying.
So we (in retrospect, stupidly) agreed to the x-ray and admitted him for the night for observation. Before we left, they had us sign an estimate which listed the LOW end as $1100. I’m pretty my husband muttered “Helluva lot cheaper to put the damn dog down,” but utterly denied it when I tearfully confronted him in the parking lot. Or perhaps he realized that I was still convinced that my dog was on death’s door and didn’t want to join him there.
Anywho, they called me 4 hours later to report that they’d given him an antibiotic and anti-nausea medicine and that he was finally resting without the extreme panting and salivating. The x-ray didn’t clearly show a blockage (oh blessed relief!), but because it was grainy, they were going to repeat the x-ray in the morning and do a comparison on one area that looked “suspicious.”
Okay, I was still worried, but less convinced he was going to die.
In the morning, I called and asked how he was doing. The tech said, “Oh, Buddy is doing great. He’s up and wagging his tail at me. (Joy!) We’re just about ready to take him for the second x-ray.”
But now that I was no longer convinced he was going to die, the rational part of my brain began working again.
I said, “Wait a minute. Why are you doing a second x-ray?”
“To do a comparison from the first x-ray to see if there is a blockage.”
“But you just said that he’s acting fine!”
“Yes.”
“So why are you doing another one?”
“To make sure that there’s no blockage.”
“I’m going to go out on a limb and say that there is no blockage.”
“But it’s possible that there’s still a blockage and when he’s reintroduced to food, he will begin vomiting again.”
“Well, wouldn’t it be a helluva lot cheaper to just introduce food and see if he starts vomiting again? I mean, an x-ray is $150!”
“I think you should speak to the vet.”
After speaking with the vet, “we” decided on a different course of action. They would give him small amounts of food to see if he could tolerate it. If he ate it without vomiting, they’d assume no blockage and send him home with the initial diagnosis of pancreatitis. 8 hours later, we picked him up. And he didn’t even have the grace to act even a tiny bit sick when he saw us. Nope, he was jubilant!
All in all, his little tummy ache cost us $1100. My only consolation is that it WOULD have cost us $150 more had I not intervened.
If a doctor has an interest in the MRI place he’s committing Medicare fraud (if he accepts Medicare/Medicaid patients, that is). This hospital does accept them. So no, he did not.
It’s funny how nobody has acknowledged the point of my post, which is, the services (x-ray, but no MRI) were rendered at the time I started the thread. And I just got the bill. Let me repeat that: I JUST got the bill.
My experience was similar – up to a point. Then the canned vegetables entered the treatment plan.
I had pain in my elbow and forearm – I thought it might be carpal tunnel. I went to my GP and he asked me questions, then poked the arm in a few very specific spots, asking me if it hurt or did not hurt.
“You’ve got tennis elbow,” he said, with certainty. Apparently the symptoms are pretty consistent, making it simple to diagnose. He explained to me that we would immobilize the arm and hand while the tendons healed. Then, to prevent recurrence, he suggested an exercise program.
“Toughen up the tendon by dangling your arm straight down and rotating it slowly while holding a small weight,” he began, as I took notes. “A can of vegetables would be ideal.”
I nodded, but apparently didn’t give him the impression I fully understood, so he continued. “Corn, for example.”
I stopped writing, trying to process this. Firstly, how could it matter what kind of vegetables were in the can? Secondly, why would THAT be the part that needs clarifying?
“Or green beans,”" he added gravely, looking at me to be sure I understood the importance of this cutting-edge treatment. God knows how many research animals died while slowly rotating cans of carrots or beets.
It was quite the weirdest medical advice session I’ve ever been party to.
No, there is logic to it. My doctor had an X-ray machine for years. The insurance company stopped paying him because they contracted stand-alone radiology services. The problem is how you look at the cost breakdowns. One doctor/one bill or multiple bills. There are costs associated with separate billing. He eventually went back to using his own equipment but it took awhile for common sense to prevail.
Anybody who grinds numbers knows that you have to look at the largest snapshot of costs to make a good decision. Stand-alone radiology companies provide a service for doctors and specialists who don’t want to front the money for the equipment. However, it is not a one-size fits-all arrangement.
So did my wife’s doctor, based apparently on the two known facts that a) her elbow hurt, and b) she plays tennis. However, he was wrong. My wife thought he was jumping to conclusions (she is a PT, so has some expertise) and went elsewhere for a second opinion. She was diagnosed with something different (I forget what) and got fixed without needing the surgery that the first guy wanted to do.