Originally Posted by Toni Breyer in Everything Health blog
I took my son to the ER for a broken thumb. It was a minor injury but the thumb is the most important digit on the hand. The ER care was just fine...a quick look, an Xray and a small splint. We didn't have to wait long and everyone was courteous.
Imagine my surprise to receive the bill from the hospital. Yes, I have insurance. My out of pocket expense was minimal but here is what the insurance company was charged:
* Hospital Misc.- $56.00 (could this be the splint?)
* Diagnostic Xray - $342.00
* Emergency Care- $952.00
* Surgery - $570.00
Total $1920.00
Sounds right to me... I don't think that is "unreal" at all. My health is the most important thing to me. People pump thousands of dollars into getting their cars fixed by reputable mechanics and people don't complain at all. Why shouldn't we do the same for our health? Mexico has cheap medical care... don't you think the saying 'you get what you pay for...' applies?
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The problem with speculation is you make a spec out of you and some guy named lation, which really doesn't affect me at all!
The question as to whether hospitals are overcharging can be answered by seeing their bottom lines. Do most hospitals have a big profit at the end of the year?
It is my understanding that they do not -- in fact, they generally have to seek other sources of income (donations, grants, etc) to simply cover costs.
Those costs are not always obvious. In the case referred to by the OP, how much of that bill covers malpractice insurance carried by the hospital and the medical professionals involved in the treatment? How much of it went to pay for doctors, nurses, etc, who were not actually working at the time of the treatment but had to be present in case of an emergency? How much of it was to pay for the care given to uninsured patients who never did pay their own bills?
Yes, there are alternative methods to fund hospitals but, in the end, either their costs have to be reduced or somebody is going to have to pay. The only other alternative is to shut them down (and not replace them with other money-losing facilities).
The answer can not be that "the government will pay". The government pays for nothing. It merely acts as a middleman between those who pay and those who receive the money -- and like any other middleman, it charges additional fees to cover its services.
So, what is the answer? Is it to raise taxes? If so, I am going to guess that the doctor quoted in the OP is going to wind up paying a lot more at the end of the year than the treatment for his daughter cost.
Is it tort reform? That would undoubtedly lower costs dramatically. Not only would malpractice insurance costs drop but hospitals would no longer feel obligated to make tests which are medically unecessary or to give treatment which is not really required simply to cover themselves from possible lawsuits.
Of course, tort reform is not an idea which trial lawyers particularly like, and they tend to be heavily represented in Congress.
How about reducing salaries for doctors, nurses, et al? How well will that go over? Will a sufficient number of qualified professionals be available 20 years after young students see that the years (and money) spent in medical school is no longer being financially rewarded?
Sounds right to me... I don't think that is "unreal" at all. My health is the most important thing to me. People pump thousands of dollars into getting their cars fixed by reputable mechanics and people don't complain at all. Why shouldn't we do the same for our health?
Reading further into the blog:
Quote:
Originally Posted by Toni Breyer in Everything Health blog
Take a look...surgery? There was so surgery, no procedure. There was no break in the skin. The doctor component of the visit was about 7 minutes
Yes, your health is important. But do you want to be billed for a service that never happened (or was not necessary)?
Quote:
Originally Posted by United737522
don't you think the saying 'you get what you pay for...' applies?
In both medical care and car repairs, it is unfortunately very easy to get much less than what you pay for.
Is it tort reform? That would undoubtedly lower costs dramatically. Not only would malpractice insurance costs drop but hospitals would no longer feel obligated to make tests which are medically unecessary or to give treatment which is not really required simply to cover themselves from possible lawsuits.
Of course, tort reform is not an idea which trial lawyers particularly like, and they tend to be heavily represented in Congress.
I have to disagree with you on this one point.
I think tort reform would lower the incomes of (some) trial lawyers, but I seriously doubt there would be any drop in malpractice rates. I think we'd see higher profits for the insurance companies and if anyone questioned the rates, the answer would be 'without tort reform, the rates would be much higher'.
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Can someone explain to me why conservatives like tort reform? Since when are conservatives big on the government intervening in who can sue and under what circumstances?
During my recent outpatient procedure a doctor came into my room, asked how I was doing and said "By the way I love your work on television." He left without touching me and a couple of weeks later when the bill came, it turned out his visit cost my insurance company $250.00.
Can someone explain to me why conservatives like tort reform? Since when are conservatives big on the government intervening in who can sue and under what circumstances?
That is a great question! I am not opposed to reasonable reform, but I don't want to see victims of botched surgery or misdiagnosis to lose their right to get compensation.
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How about reducing salaries for doctors, nurses, et al? How well will that go over? Will a sufficient number of qualified professionals be available 20 years after young students see that the years (and money) spent in medical school is no longer being financially rewarded?
What is the health care system in Israel? What do you like or not like about it?
I remember that you are a US military veteran; are you on medicare, SS payment, and/or VA benefits? Again, what do you like or not like about the care you receive from the US system?
Hope you don't mind shedding some light, but I think our media is too focused on the internal partisan debate, instead of educating more on what other countries' healthcare systems are, so that Americans can learn and implement a better solution.
Sounds right to me... I don't think that is "unreal" at all. My health is the most important thing to me. People pump thousands of dollars into getting their cars fixed by reputable mechanics and people don't complain at all. Why shouldn't we do the same for our health? Mexico has cheap medical care... don't you think the saying 'you get what you pay for...' applies?
I think the OP's point is that there was no surgery. We all need to be diligent in checking the bill, but that's easily said than done. I've been to the hospital twice, and one of them was a surgery. For months afterward, I received multiple bills from different "service providers". I decided to wait a while before paying the part that says "Patient pays" because these bills, aside from listing a lot of charges, didn't really do a good job to show me a combined status of the cost of the entire surgery & hospital stay, nor could it show me a real-time status of what's been paid by insurance and what's not. And, needless to say, most of us do not understand the bills. One blood test could actually show up as 5 different entries.
Something definitely needs to be revamped in our system. I eneded up paying the balance on the bills because I was recuperating and did not have the energy and didn't know where to get a second opinion on the bills.
Did I get good care? It was probably good, but I don't really know if I got what I paid for. Let's use your car example again: Some people know how to negotiate to get a great car for less price than others. I am not a good negotiator; I just want a fair, standard price to buy a reasonably good car. And, if I have the money, I could buy a high-end car (i.e. medical service) if I choose to. But, there needs to be a middle-of-the-road, value-priced service that most people can go to without having to search around in the limited time they have.
BTW, one night of hospital stay was over $20,000, and that's not including the doctor, lab tests, x-rays, etc. My surgery was not major and all the nurse did was to come check on me, take my temperature, and helped me to go to the bathroom. The food was pretty good for a hospital.
I remember that you are a US military veteran; are you on medicare, SS payment, and/or VA benefits? Again, what do you like or not like about the care you receive from the US system?
The only VA benefits I ever received (or sought) were for my education. I am not, and will not, be on Medicare. I worked for 16 years in the US (including three in the Army), which is 6 more than is required for Social Security retirement benefits. Having paid in all those years, I would be a fool not to accept a retirement check. However, since I did not work in the States after 1979, my monthly benefits will be the minimum payable.
I can't tell you what I like or dislike about the care I receive in the US because I haven't been to a doctor there in 30 years.
Don't they have to overcharge on the patients who can pay, to make up for those who don't, but who have to be treated in ER regardless? Somebody, somewhere has to pay for those... and that would be those Americans who do have insurance, many of whom are arguing against universal coverage...
For people with insurance, like this doctor, the amount of the bill he sees and the amount that insurance pays are totally unrelated numbers. He would certainly know that, indeed in the story he says
This bill is unreal and is comprised of unreal health care costs. The insurance paid a component of the bill. They have a cap on what they will pay for each element.
This is a total non story, as what is billed has no bearing what so ever on what is paid, the dollar amounts on bills, where insurance is involved, is total fiction.
There are a lot of people who don't read the bills or care, provided their insurance picks up the tab. I guess I am a bit guilty of this, too. I'll give you an example:
Our community hospital has what's known as "Urgent Care." It's very hard to get an actual appointment with my PCP (primary care physician), so if I'm really sick, I can go to the hospital, be seen in the ER, and pay my same $15 co-pay.
At some point, certain cases have to be transferred to the actual ER. They are supposed to tell you and have you sign a piece of paper saying you agree to this. The difference for me is $85 as I have a $100 ER copay. The difference for my 4-year-old is $100 as there is no PCP
Twice now I've received bills for ER services -- one for me and one for my daughter. $200 in total this year for which I should've been billed $185. And I made multiple phone calls and finally they called back and said they were going to write these bills off as they shouldn't have been billed without my consent.
And then I got to thinking: The insurance company was probably still being billed at the astronomical ER rate. And I wasn't paying and won't complain, so it benefits the hospital financially to mis-code the bills and either (1) I'll not pay attention and pay or (2) I'll call and not pay. Either way, the hospital wins.
I like Medicare, BTW. I've seen the benefits my mother-in-law gets and also my parents -- my mother who was forced to retire early had to put off some much needed health care and deal with some pain that has now been surgically repaired -- until she turned 65. The challenge is implementing such a system for everyone and not reducing the level of care people with insurance now currently get. I'm not sure that's possible.
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