Hospitals' soaring costs are outrageous

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Recently I went to an Augusta hospital at 5:30 a.m. to have a relatively simple procedure of a stent inserted into the main artery of my right leg. I'm sure the doctor has performed the procedure hundreds of times. They finally called me at 6 a.m. to be "prepared" for the procedure to be performed in the cath lab. I laid there until 8 a.m. and finally got wheeled in.

I was again "prepared" by the cath lab staff and laid on a hard slab until the doctor arrived at 8:30 a.m. He performed the stent insertion successfully, and I was then wheeled to a recovery room where I had to stay virtually motionless for a minimum of two hours to ensure the bleeding at the point of insertion had stopped.

At 2 p.m. the recovery nurses sent me home.

Actual hospital involvement was from 6 a.m. to 2 p.m. -- eight hours. I'm on Medicare with a Blue Cross/Blue Shield secondary. The bill from the hospital: $68,170.80! Unbelievable! That's about $8,500 an hour, of which five hours was doing nothing but lying in bed.

Is this what's ruining Medicare? If I wasn't on Medicare, would the bill still be over $68,000? If so, I'd be broke!

Hospitals are ruining medical costs with extreme overcharging, especially for Medicare patients. If they continue with these enormous charges, I pity the millions of patients who are not on Medicare or other insurance coverage and have to pay the full amount of the hospital's charge. No wonder the country is broke!

The medical world lacks the ingredients that make successful private businesses thrive -- that is, competition and honesty. I'm well aware that medical facilities have very large expenses for equipment, people and facilities. But I for one am very concerned about the future!

Bob Davison

North Augusta, S.C.

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faithson
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faithson 08/03/11 - 12:54 am
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68 grand, you only pay that

68 grand, you only pay that much if you don't have any insurance. wonder why medical bills are the primary cause of bankruptcy in America. perfect case here. How many of you republicans out there could afford this kind of bill if you did not have insurance. People there are a whole lot who don't.

Piperpig
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Piperpig 08/03/11 - 09:14 am
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I do a lot of work with

I do a lot of work with insurance contracts. If you saw the negotiated rates these hospitals have to accept--and they do have to accept them unless they want to end up like St. Joseph when it couldn't reach an agreement with Blue Cross Blue Shield a few years ago-- from these insurance companies (and Medicare, and especially Medicaid), you would actually feel bad for these hospitals and doctors.

Medicare and Medicaid (particurlarly Medicaid) are causing the medical field to go broke. I'd like to see this author explain how much Medicare actually paid of his bill and then how much he owes after Medicare paid. I guarantee you that Medicare didn't pay anything even remotely approaching that amount and I promise you the writer's balance isn't enough to cover the shortfall. The whole thing is a scam. You want to blame someone, blame the insurance companies. They are the ones who rewrite the policies without the insured's consent, exempting certain procedures while putting monetary caps on others. I saw a bill the other day from a hospital for $78,000.00. The adusted rate was $12,500.00. The insured's balance was $2,000.00. Who is getting really getting ripped off here? I don't see how these facilities stay open.

And, myfather15, the physician bill was not $68K. That was the hospital bill. Moreover, at least Democrats tried to pass some type of reform. Either the government needs to be involved in providing health insurance for everyone in this country or it needs to step back and provide it to no one. You can argue over which. If you're poor you get Medicaid; if you're old you get Medicare. If you're disabled you get Medicare or Medicaid. But if you're just some guy who works for a small business (professional or blue collar) then health insurance premiums are almost out of reach. I know a family of five (father, mom, son, two daughters) who pay $1,500.00 per month in insurance premiums, and it's not even great insurance. How can someone making $50K a year afford that?

follower
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follower 08/03/11 - 10:31 am
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I'm not defending the cost of

I'm not defending the cost of medical procedures, but you might consider the expense of the equipment to perform this "simple" procedure. They run in the millions. The cost of the facility itself; tens, if not hundreds of millions. The highly trained personell? And then the malpractice insurance to protect itself from the "John Edwards" types that demand a perfect outcome every time, no matter the circumstance.

Twenty years ago, malpractice insurance for an OB-GYN was over $250K per year, and God forbid a baby is not born perfect.

We'd be much better off on insurance rates if we all had catastophic medical insurance only. If you go for a checkup, pay for it. If you get the sniffles, pay for it. When we decided that somehow medical procedures should be paid for in full by paying premiums to cover every splinter we might get, insurance companies were more than happy for citizens to pay $1000 per month for a family, especially if you're healthy. Just like our federal crisis, it's the folks that have insurance that are paying for those that don't.

Do car companies pay for oil changes? [unfortunately, some now do] But even then, they are just covering their rears by lessening the odds of problems during the warranty period. But the price is built into the car. Nothings free, and neither should normal maintenance on our body.

Many doctors are going to a "pay now" practice, and can charge less than traditional practices due to less overhead in a nightmarish billing process. Take a look at www.medpagetoday.com

willie7
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willie7 08/03/11 - 11:48 am
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I do insurance contracts too.
Unpublished

I do insurance contracts too. The hospital inflated the cost in order to get a negoiated amount to cover at least 80% of the actual expenses.

Weez
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Weez 08/03/11 - 11:51 am
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Piperpig is close on the mark

Piperpig is close on the mark here. The real question for Mr. Davison is what amount he actually paid and what amount Medicare & BCBS actually paid the hospital.
- Did you know - that it's nearly impossible to gauge cost of procedures betweenst hospitals in the same City? Each insurance carrier has a negotiated rate of reimbursement that has a typical floor of 70% off the 'advertised price'. I.E. the hospital may say your bill was X but, per the negotiation, the 'real price', which varies by carrier, will be at a minimum of 70% less than that.
- In non emergent situations (say, a baby being born), you can actually negotiate AHEAD OF TIME a payment price for the services?
- That hospitals rarely see the entire amount of the 'stated' price...from anyone. The major reason that the 'stated price' is 'stated' is to create enough of a buffer zone so that following negotiations with insurance carriers, the end result (ala the 78K to 12.5K reference) that the hospital can still cover their basic operating costs?
- That medicare rates (again, not the $68K stated price) end up being the 'standard' by which all other insurance carriers then move their negotiations towards...

Finally, you want to lambast the physicians as being high rollers and sipping Martini's...have you ever spoken to one, about such matters, outside of the hospital? Ever asked them what their student loan debt looks like (I have knowledge)? Try taking out between 2 - 500,00 thousand dollars in student loan in your twenties to attend medical school. Then go through 3 -8 years of residency (interest, as usual, starts on the day that the loan is issued in most cases) at a non-doctor-like salary (40-50K), and certainly one that doesn't allow any wiggle room to do more than eithe defer your loans (with interest running) till out of residency or pay the minimum amoutn due each month. You're now at least 30 years old (18 + 4 + 4 + 4) or older, have over half a million in medical school debt, of which interest has been rolling on...and, well, hopefully you get the picture.

Trust those who know when they say that, in terms of medical billing, rare is the time that the presented price is the real price, and the real price is rarely one that is ever totally paid in full....

faithson
5531
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faithson 08/03/11 - 12:36 pm
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my point was that the working

my point was that the working stiff who cannot afford healthcare premiums at 12 dollars an hour would have to foot the whole 68 grand. Something wrong with that. Also, the healthcare bill has provisions to allow for experimentation in healthcare cost control, we need experiential data from the field to help the medical community contain costs. An ideological assertion of just let the 'market' work it out does and is not working, have you checked out your premium increases lately ?

john.q.publius
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john.q.publius 08/03/11 - 01:49 pm
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So, there was this guy who

So, there was this guy who called in to fix one of the big mainframe computers out at NSA. The machine is down and won't even power up. He shows up, goes through security and is finally shown into The Room.

He inspects a couple of audit logs, flips a switch, and takes out a small ball-peen hammer. He strikes a plate just off the center of the Cray logo, and a hum fills the air. The machine is back up, and on his way out, the contractor hands the accounts payable office a bill for $86,000.

The AP director chases the tech down and catches him before he exits the building. "86,000 DOLLARS?!?!" he shouts. "You were here for two minutes! You tapped the machine with a hammer! How in the hell is that worth $86,000?!" The tech calms him down and offers to submit an itemized bill that will explain the charges. The NSA lackey agrees, and the tech pulls out his invoice pad. He thinks for a moment, writes for a moment, and then turns in his revised, itemized invoice:


1 Tap with Ball-Peen Hammer........................................$5.00

Knowing Where to Tap.........................................$85,995.00

Because only a certain class of professionals--doctors--has the knowledge and skill to literally save our lives in some situations, they can command high fees to do so. It is to our benefit to ensure that there are many such professionals trying to attract our business in an active and open market, since that drives price down and quality up. When government policy divorces service from cost and ensures limited supplies of the good or service in question, you get higher prices and rationing. This not only makes theoretical sense, it is what we observe. Always, without exception.

john.q.publius
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john.q.publius 08/03/11 - 01:44 pm
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My comment has been "queued

My comment has been "queued for moderation." Wonder why?

Willow Bailey
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Willow Bailey 08/03/11 - 07:54 pm
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We are also seeing higher

We are also seeing higher costs due to socialized medicine.

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