The fastest way to go broke in America is to go to the hospital. These days it seems like almost everyone has an outrageous hospital bill story to share. It is getting to the point where most people are deathly afraid to go to the hospital. All the financial progress that you have made in recent years can literally be wiped out in just a matter of hours. For example, you are about to read about an Arizona woman that was recently charged $83,046 for a 3 hour hospital visit. How in the world is anyone supposed to pay a
Why Are Hospital Bills So Outrageous?
By Patrick Follow Thu, 6 Sep 2012, 8:54am 1,276 views 16 comments
In Menlo Park CA 94025
Watch (0) Share
Quote
Permalink Like Dislike Viewing Comments 1-16 of 16 Last » See most liked comments
|
Patrick is moderator of this thread. |
Follow
Befriend
485 comments
Los Angeles, CA
Because that's what you get with health insurance. If people actually had to pay for their own medical care and doctor visits, the market would be set by the actual economy.
Health insurance should only ever have been for catastrophic events and long term illnesses--not teeth cleanings and blood pressure readings.
Follow
Befriend (54)
5,188 threads
6,157 comments
46 male
Menlo Park, CA
We should distinguish between the market for non-essential and non-market for essential care.
Sure, for non-essential things that don't mean life or death, it would definitely help to have people shop and directly pay for what they use. There is a free market there. You can compare prices and you can walk away when the price is too high.
But for essential care, as in "you are having a heart attack and will die right now without treatement", there is no free market and there never can be. A market requires the ability to compare prices and to walk away. Emergency situations have neither.
So in the emergency case, you are a sitting duck and your "caregivers" are 100% guaranteed to put that financial shotgun up to your little head and blow your ass out of the water, even if they are technically saving your biological life for now. There is no mercy in medical billing.
Insurance doesn't help much when there is no upper limit on premiums. Premiums are also 100% guaranteed to rise to the point where they squeeze the rest of the economy to death, because there is no market there either. There are only a few insurance companies, they all charge the same grotesquely high premiums, and catastropic insurance is not optional.
Ultimately the problem is that our laws are made by corporations and lobbyists to extract the maximum profit from foolish people who believe money=speech and corporations=people.
The solution, just like for housing, is publicly financed campaigns and a complete ban on private campaign money and a ban on rotating jobs between lobbying firms and congressional staffs.
Follow
Befriend (9)
414 threads
4,124 comments
Baltimore, MD
Patrick says
No one thing is the solution. We need a combination of things such as:
1. Malpractice reform.
2. Requiring providers to give estimates up front or have a price list, preferably in the internet. Your previous thread for requiring all medical bills in advance is a good start).
3. Don't require prescriptions for medications. Plenty of other countries do this. Mexico comes to mind. BTW, besides going to Mexico, there are other ways to get medicines without prescriptions, but that's probably better suited for a different thread.
4. Along the lines of the single payer issue, how about a single insurance form that every company uses, along with unified codes? Won't something like that help?
5. Allow medical providers to not treat people who don't have insurance or money.
6. Repeal law requiring all medical providers to speak any language of anyone who shows up.
OR
Just imitate Singapore's health system.
Follow
Befriend
41 threads
905 comments
Ross, CA
zzyzzx says
Won't that lead to trip hazards on city sidewalks?
Follow
Befriend (5)
31 threads
2,239 comments
Premium
Patrick says
It's also one of the fastest ways to get killed slowly and miserably by malpractice and nosocomial infections.
The bills are outrageous because both major parties are working for the revenue recipients, so their platform is like a beer commercial: "tastes great" vs "less filling," i.e. "more $ and power for mandatory subsidized insurance" vs "tort reform so negligent practitioners can butcher and poison for power and profit without fear of accountability." True emergencies are less than 10% of total spending, in fact actual emergency departments are only 2%, but you can't buy a policy to cover just those because PhRMA and APA lobbied Congress to mandate full coverage of toxic SSRIs advertised on TV and the prescribers who push them.
Follow
Befriend (9)
414 threads
4,124 comments
Baltimore, MD
I swear, if I were a mechanic or home improvement contractor, I'd charge doctors several times as much as anyone else if I thought I could get away with it.
Follow
Befriend (4)
52 threads
4,416 comments
Corning, NY
Premium
Patrick says
Correct. It's not much different than a guy with a gun walking into a bank demanding money. Pay up or die!
Follow
Befriend (4)
52 threads
4,416 comments
Corning, NY
Premium
Patrick says
As American as apple pie and fireworks. In America, might makes right.
Why do you hate America? Why do you hate freedom? ;-)
Follow
Befriend
2 threads
645 comments
It's a game. They charge that much hoping to get so little. The medical establishment is free from any other rules that apply to the rest of the world. They restrict entry into their field via extreme licensing and educational barriers. They don't have to post prices or even tell you how much they will charge if you ask. Then, they overbill you hoping you pay 10% of what they bill out. They do the same thing to the insurance companies. I used to work in medical billing. When you are presented a bill for 5 figures, you plead poverty and tell them, you can pay them $10 a month or you can pay them $300 bucks up front. You watch how fast they knock down a 5 figure bill to what they actually should have charged.
They tried charging my friend $22 k for an emergency room visit where they gave him an IV for food poisoning. He offered them $250 saying, while telling them he's in debt and has no money to give them. 1 day later, $250 was accepted as full payment.
Think about it, if doctors ever collected what they billed out, they would all be grossing 10 million a year. Instead, they bring in $150k a year if they are lucky at this point.
Follow
Befriend (4)
990 threads
1,125 comments
San Antonio, TX
jvolstad's website
As someone who works in Healthcare IT, administrative costs are very high in hospitals. The electronic medical record is supossed to reduce some of these costs.
Follow
Befriend
41 threads
703 comments
Monterey, CA
jvolstad says
That's laughable. I deployed several electronic medical records systems spanning 3 counties - and it was a joke. There are so many vendors,and no (minimal) standards, that it's destined to fail. HUGE profit potential though.
Unless the EPCR systems are standardized, and dropped under one umbrella, it's not going to work.
What I didn't get, was that it was easier to locate a file, or call the primary care provider, fax the old records, and then write up a new patient care record by hand. Than it was to work with some of the newer, computer based systems.
Even as an IT professional, most of the paper based systems made more sense. It seems like a lot of people have lost focus - and want to make everything computer/tablet based - when it actually makes things worse.
Follow
Befriend (5)
31 threads
2,239 comments
Premium
joshuatrio says
In theory, electronic records should be better and more efficient at doing what they are programmed to do, but in practice, the current mandate is about maximizing revenue and centralizing power. The cost of switching to electronic records counts as part of the "medical loss ratio," so it's like the "cost plus" pricing in military contracts, i.e. the profit margin is a % markup over the "cost" side. Electronic records would reduce costs if that were the intention, but it isn't; it's like a scene from the movie 2010: the computers are doing what they are programmed to do, which in this case is to maximize spending and control.
Follow
Befriend (9)
414 threads
4,124 comments
Baltimore, MD
theoakman says
I think doctors are making more than 150K per year. More like a lot more.
Follow
Befriend (28)
149 threads
1,398 comments
They aren't so bad in Japan. I paid cash for a CT and it was about $185.00!
I don't think that the technology was any worse...What do they cost in the US now?
Follow
Befriend (9)
414 threads
4,124 comments
Baltimore, MD
American in Japan says
http://www.comparecatscancost.com/
What Does A CAT Scan Cost?
Not all hospitals and imaging centers charge the same amount for CAT scans. You have a choice of where you get your CT scan performed and you will most likely save a significant amount of money. By doing a little homework and shopping around you can save hundreds and possibly thousands of dollars. CAT scan procedure costs can range between $270 and $4,800.
I think I recall someone posting a price here. I think the couple of hundred dollars if you shop around and thousands if you don't.
Follow
Befriend (5)
31 threads
2,239 comments
Premium
zzyzzx says
Definitely. I have seen 10:1 variations on identical items, including CT scans.
CT scan machines also vary in terms of radiation:
"FDA had faultily approved medical imaging devices for colonoscopies and mammograms that endangered patients with high levels of radiation... One CT colonoscopy device that they exposed made it onto the market, 600 to 800 times the radiation dosage of similar devices that are more effective."
The first question to ask about a CT scan is whether it's even necessary:
"CT is being marketed as a preventive or proactive health care measure to healthy individuals who have no symptoms of disease [but there are] No Proven Benefits for Healthy People"
Aside from financial cost, there is also the human toll, with hospitals injuring 20% of patients every year:
"Hospitals as a whole also tend to escape accountability, with excessive complication rates even at institutions that the public trusts as top-notch. Very few hospitals publish statistics on their performance, so how do patients pick one? As an informal exercise throughout my career, I've asked patients how they decided to come to the hospital where I was working (Georgetown, Johns Hopkins, D.C. General Hospital, Harvard and others). Among their answers: "Because you're close to home"; "You guys treated my dad when he died"; "I figured it must be good because you have a helicopter." You wouldn't believe the number of patients who have told me that the deciding factor for them was parking."
Always do your homework when choosing a hospital: the best predictor of longevity is education, not health insurance.