I had to get a tetanus shot after my Labour Day Trip to L.A. (I stepped on a needle – sewing, not hypodermic). I found out when I called my doctor to make an appointment that there was a vaccine shortage and they told me I had to go the ER to get the shot.
I did that and it seemed that was that. Until today when I received the bill. How much do you think they charged me for a goddamned shot?
$100? Nope, higher
$200? Nope, higher still
$250? Uh-uh, guess again.
$298.50. That’s right, folks, almost $300 for one simple little shot (I didn’t even get a Band-Aid after!). It appears my insurance paid for $192.68, so my ‘share’ is $105.82. For a shot. Ri-fucking-diculous!
So I get charged $298.50 for something that would have cost me a measly $20 copay if it wasn’t for the shortage. I want to know where they get the fucking balls to charge that much money for a damned shot?!
The ironic part? The name of the hospital: Good Samaritan
Write a scathing letter to the president of the hospital and CC your doctor and the insurance company. You shouldn’t have to pay this.
Sending you to the ER was very bad advice on your doctor’s office’s part. They should have sent you to a walk-in clinic of some sort, even if it meant you calling around to see who had the vaccine. You are being charged not only for the vaccine, but just those high hospital charges that are intended to make up for money they lose on patients that don’t pay.
Word of advice to everyone: unless it is a real emergency involving heavy bleeding, broken bones, heart or breathing problems, serious seeming pregnancy problems or the possible need for immediate surgery (think accute appendicitis), stay clear of the ER. If you do go, you will wait forever and pay way too much for the visit. There are walk-in centers all over the place these days, often affiliated with a local hospital and they charge a fraction of what the ER charges, usually have on-site lab and X-ray facilities and you won’t be in the way of the real emergencies.
I know it’s kind of a wierd thing to feel strongly about, but I do.
Zette: Yes, they do. I was wondering why that was and I asked the nurse who gave me the shot. Her WAG was that the vaccine contained some tetanus virus (even if it’s dead – it is dead, isn’t it?) and that since tetanus causes your muscles to seize, it does that to a much smaller extent to the shot site.
Sounded good to me.
Caricci: In retrospect (damn that hindsight) I should have done a little more calling around, and in the future, you can be assured I will. I think I will call the hospital billing department and then my insurance company to start, see what they say. I’m not the best at writing scathing letters, but I think my Uncle is, I’ll have to ask his help depending on what they say. Thank you, I probably would have just paid it.
Gotta love that free-market medical system. When I got my tetanus shot in the People’s Republic of British Columbia last winter it cost me a big ole nothing. Socialized medicine rocks! Until you need chemo or something.
Tetanus is caused by a bacterium, genus Clostridium, not a virus. The shot is basically a suspension of immunoglobulins directed against the bacterium. These are honking big protein molecules to go around shooting into ones muscle tissue and that’s what makes it hurt so much.
Boy, that was an expensive shot all right.
The current state of the insurance industry in the United States ensures that medical care is anything but free-market. Whether or not you are receiving medical care by pilfering other people’s money has nothing to do with it.
I called the hospital’s billing department first to make sure they billed my correct insurance. They had.
Apparently the reason why the bill is so high is that there is a minimum ER charge of $200. Nice. However, the person I spoke with said that my account hasn’t been “reconciled yet” and that they show my portion to be only (ha!) $58.21, and not the $105.82 they billed me for. Still seems pretty steep for something that would have cost a measly $20 co-pay at the doctor’s office, but I won’t quibble. Sixty bucks isn’t as painful as a tetanus death would have been.
Why they send out a bill for the wrong amount is beyond me. I wonder how many people just pay their medical bills and don’t question them? I wonder how much money the hospital makes off this scam?
Not criticizing you Mauvaise, but your doctor’s advise to go to the ER sucked. To send someone there for a booster shot is an abuse of the system and makes all of our medical costs rise. Surely your doctor could have gotten ahold of it somehow. After all, you cut yourself and were therefore at risk, no?
(Hijacked topic)
And while I agree that socialized medicine is good for things like universal vaccinations, the BIG downside is that it’s non-profit. And almost all drug companies’ R&D budget comes from profit. What good is a system that will innoculate the population against known diseases but by doing so leaves them exposed to future disease? R&D is our most important resource for fighting the biggest threat to humans: bacteria and viruses. (/Hijacked topic)
In my area only the hospitals have tetanus vaccine. We’ve made some informal arrangements so we can send our patients to the outpatient department of the hospital to get it, but our organization seems to be the exception rather than the rule in making these arrangements. But our office stock of adult tetanus vaccine is gone, and we’re told not to expect any more soon. It’s even suggested that booster shots be restricted only to those with significant trauma.
Well, I did explain to my doctor why I needed one and that it wasn’t just a ‘regular’ booster. They said they did not have them and when they suggested the ER.
I am not one to go to the ER for any little thing and it seemed silly to go for this, but I wasn’t going to not get my booster and risk tetanus. In my defense, I did call the ER first and explained the situation and asked what they’d recommend. They told me that I should get the shot and to come down. So I didn’t feel like I was abusing the system in going to the ER for a non-emergency.
Believe me I would have rather stayed well away from the ER. Not just because of the expense.
I’ve been out of the clinics for a few months–what’s up with this?
A better solution would be to allocate some of the vaccine to the local health departments. Not too many private physicians do vaccinations in this state anyway (except for flu), since anyone can get them done at the HD for less than the doctor can pay for the shots themselves.
IIRC the tetanus toxoid vaccine is basically capsular proteins of the bacterium, made in hen’s eggs using recombinant DNA technology (woo!). It is not that antigenic, so they mix it with adjuvant. Adjuvant is basically chum for the immune system – it is like fish mixed with gasoline which sets the immune system off and sensitizes it to the tetanus antigen. This improves the antibody response, but it also causes lots of inflammation and swelling (kind of the point of the immune chum). They are not directly injecting immunoglobulin – that is done with post-exposure prophylaxis with some diseases (IVIg or gammaglobulin) like hepatitis. That injection is like honey and hurts like a mothafucka. It’s been a couple years so I may not know what I am talking about.
Well, when I was recently at my dictor’s for an episode involving my foot and a sharp piece of metal he seemed shocked to hear they had no Tetanus boosters. He didn’t have me go to the ER or anything, he didn’t seem to think it was critical. He is a very good doctor whom I trust so I wasn’t about to argue that I had to have one right then.
I heard the shortage was due to the war effort, the military had stocked up on it. No cite or anything, just something I heard/read.
edwino
You’re right about the toxoid shot. I guess what I was thinking about at the time was the tetanus immunoglobulin that was used to treat exposures at one time. Actually I don’t know if it’s still being used much.
That’s what I get for drive-by posting while at work.
