How could healthcare be this inflated?

[ScoutTN]

When Ds was 3 days old, he was hospitalized overnight for jaundice. Our insurance covered 100%, but I did read the bill.

 

$47 for a tube of Desitin about half the size of my pinky finger! And on and on and on...2 pages single spaced, for less than 24 hours.

 

 

The system is SO broken!

[farouk]

When Ds was 3 days old, he was hospitalized overnight for jaundice. Our insurance covered 100%, but I did read the bill.

 

$47 for a tube of Desitin about half the size of my pinky finger! And on and on and on...2 pages single spaced, for less than 24 hours.

 

 

The system is SO broken!

 

ScoutTN:

 

Truly a rip-off, and if politicians were really representing the people of the districts instead of corporate interests they would do something about it, but - guess what? - it doesn't happen.

[LMA]

Another part of the healthcare debate.

 

http://www.nytimes.com/2012/01/03/nyregion/nowhere-to-go-patients-linger-in-hospitals-at-a-high-cost.html?_r=1&partner=rss&emc=rss

 

It's not just the lawsuits.

[Impish]

I wonder if the lawsuit idea isn't along the lines of 'blaming the victim'.

 

That it's not the hospital admins, or anyone that works in the system, and actually has something to do with billing practices, it's the selfish, greedy PATIENTS that have caused the inflation...

[WishboneDawn]

This 'mythical Canadian healthcare system' is the one that had my Dad on a waiting list for over a year for heart bypass surgery. Luckily he did not have a heart attack before he had his surgery and is still alive. I am not speaking as an American, but as a Canadian now living in the U.S. I've experienced both systems. And hip replacement is not elective if you can't walk. My grandma has been waiting over three years and is now basically completely housebound and will require a LOT more PT to get back to moving than if she'd had the surgery 3 years ago, simply because she has spent so much time "sitting around" waiting for her surgery. She's that much older now to recover from surgery, and she is still waiting. If she doesn't get it soon, will the hip kill her...probably not. But the depression from the constant pain, and lack of independence and ability to get out and socialize, shop, etc. just might.

 

I suppose this is the issue with anecdotes and why you can't generalize with them. Your experience does not reflect mine.

 

Part of the myth might be that the Canadian system is a the same everywhere and a problem some people face in one place is a universal fault.

[chiguirre]

I'm fine w/waiting a month' date=' 6 wks (my longest wait ever) to see a specialist, vs getting to the head of the line b/c someone else can't afford the medical care they need.[/b']

 

We have plenty of waiting to see a specialist here in the US too. It just depends on the demand for a particular specialty. It's normal to have to wait 6 months to a year for a private autism evaluation. I've had to wait several months and drive over an hour to find an endocrinologist who would take my insurance and accepted thyroid patients.

[cindergretta]

We have plenty of waiting to see a specialist here in the US too. It just depends on the demand for a particular specialty. It's normal to have to wait 6 months to a year for a private autism evaluation. I've had to wait several months and drive over an hour to find an endocrinologist who would take my insurance and accepted thyroid patients.

 

We are on a 9 month waiting list for OT for ds8. My dd6 is on a 6 month waiting list for her eval with a neurodevelopment ped. And I had to wait 4 months for an appt for an eval with a rheumatologist. (I see her at the end of this month based on appt back in September with my primary.)

 

Waiting is not unusual here at all. And I have cancelled plenty of appts with my dr due to inability to afford the co-pay.

 

I also spent several hours in excruciating pain, avoiding the ER one Friday night because I was so hyper-afraid of the cost of going in. I finally went because I was scared it was appendicitis and I was going to die in my kitchen. After 2 hours in the ER, it turned out to be kidney stones. After insurance, our part of the bill? Over $3000!!

 

Somethin' ain't right... :glare:

[4everHis]

When my ds was born 4 years ago, I had an unmediated water birth with a midwife (who was there for about 15 minutes before the birth and 30 minutes after). We stayed in the hospital 1 night. My ds received no vaccinations. The bill was $20,000 for both of us!

 

:eek: I have never said wth. . . . but that was my first thought! How, on God's green earth, can this be??? I paid cash for last ds 6 years ago. Between the doctor and the hospital it was only about $5,000 and that was WITH an epidural, no vaccines.

[Impish]

We have plenty of waiting to see a specialist here in the US too. It just depends on the demand for a particular specialty. It's normal to have to wait 6 months to a year for a private autism evaluation. I've had to wait several months and drive over an hour to find an endocrinologist who would take my insurance and accepted thyroid patients.

 

We are on a 9 month waiting list for OT for ds8. My dd6 is on a 6 month waiting list for her eval with a neurodevelopment ped. And I had to wait 4 months for an appt for an eval with a rheumatologist. (I see her at the end of this month based on appt back in September with my primary.)

 

Waiting is not unusual here at all. And I have cancelled plenty of appts with my dr due to inability to afford the co-pay.

 

 

I find this interesting, b/c 'wait times' is the most common criticism I've heard when ppl discuss Canadian health care (and honestly, usually by ppl that don't have much actual experience w/it, ime)...Impression being that the US has little waiting, if someone is approved by insurance, or has insurance to start with.

[missmoe]

My last birth was $250,000! I was in the hospital for about two months before giving birth. That cost did not include any dr visits or tests. Those were all billed seperately! I recieved a $1350 bill for the peditritian that visited my babies in the hospital. I called to see if I could work out any kind of discount. I was told that the bill was already discounted by 50%.

 

Every time I took an advil or I should say the generic equivalent, I was charged $52! My Dr let me take my own antacid---I was charged a fee for the supervision of that medication! I kept it in my bedside drawer and let the nurse know when I had taken some. That cost me $17 per pop! I guess she wrote it down in my chart. I was charged per bar of soap and toothbrush I used.

 

I was seperately charged for weekly lab fees, for having my Piku line cleaned, for ultrasounds, daily dr visits, ect!

 

We were charged for the neonatalist who was in the room during the birth. My babies didn't need his care. But he was there, so we were charged for his services.

 

It goes on and on! I have kept that detailed bill to some day show my girls how much we paid to bring them into the world!

 

I often wondered if I could have stayed in a post hotel and hired around the clock nurses for less money!

[farouk]

My last birth was $250,000! I was in the hospital for about two months before giving birth. That cost did not include any dr visits or tests. Those were all billed seperately! I recieved a $1350 bill for the peditritian that visited my babies in the hospital. I called to see if I could work out any kind of discount. I was told that the bill was already discounted by 50%.

 

Every time I took an advil or I should say the generic equivalent, I was charged $52! My Dr let me take my own antacid---I was charged a fee for the supervision of that medication! I kept it in my bedside drawer and let the nurse know when I had taken some. That cost me $17 per pop! I guess she wrote it down in my chart. I was charged per bar of soap and toothbrush I used.

 

I was seperately charged for weekly lab fees, for having my Piku line cleaned, for ultrasounds, daily dr visits, ect!

 

We were charged for the neonatalist who was in the room during the birth. My babies didn't need his care. But he was there, so we were charged for his services.

 

It goes on and on! I have kept that detailed bill to some day show my girls how much we paid to bring them into the world!

 

I often wondered if I could have stayed in a post hotel and hired around the clock nurses for less money!

 

mm:

 

Yes, it's clear just how wretched the system is. And it's nothing new. I was reading about how, about a century ago, a young Dwight and Mamie Eisenhower lost a baby in hospital. A family tragedy. Then they were sent the bill for the privilege of the 'care' received.

 

(Not that, years later, the Eisenhower Administration did much to improve the situation.)

[Alice]

I wonder if the lawsuit idea isn't along the lines of 'blaming the victim'.

 

That it's not the hospital admins, or anyone that works in the system, and actually has something to do with billing practices, it's the selfish, greedy PATIENTS that have caused the inflation...

 

I think anyone who says that the only issue is malpractice is blind. However, that doesn't meant that malpractice insurance and the fear of lawsuits is not a significant part of the problem.

[farouk]

I think anyone who says that the only issue is malpractice is blind. However, that doesn't meant that malpractice insurance and the fear of lawsuits is not a significant part of the problem.

 

Ms Alice:

 

I'm sure malpractice isn't the only issue. In fact, it's a pity that conscientious physicians have to spend so much time, attention and resources on malpractice insurance.

 

Also, from a billing perspective, I reckon that the definition of malpractice has somewhat imperceptibly shifted over the years, if not officially, then in the popular mind.

 

For example, families on the receiving end of hugely inflated, yet legally watertight, billing, might well draw comparisons to Kenny Lay's Enron method of inflating offshore subsidiaries' assets by mixing the credit and debit columns in their accounts, at the time not illegal, but in nature predatory upon unsuspecting investors.

 

So the issue isn't just whether inflated billing is technically allowable; it's also whether its ethical shortcomings are being adequately addressed by a political class which defends corporate interests more closely than those of average families. It is this lacuna which is ultimately needs addressing, rather than the mere actions of some physicians (maybe operating under tight margins themselves) in over-billing.

[Tigger]

Ms Alice:

 

I'm sure malpractice isn't the only issue. In fact, it's a pity that conscientious physicians have to spend so much time, attention and resources on malpractice insurance.

 

Also, from a billing perspective, I reckon that the definition of malpractice has somewhat imperceptibly shifted over the years, if not officially, then in the popular mind.

 

For example, families on the receiving end of hugely inflated, yet legally watertight, billing, might well draw comparisons to Kenny Lay's Enron method of inflating offshore subsidiaries' assets by mixing the credit and debit columns in their accounts, at the time not illegal, but in nature predatory upon unsuspecting investors.

 

So the issue isn't just whether inflated billing is technically allowable; it's also whether its ethical shortcomings are being adequately addressed by a political class which defends corporate interests more closely than those of average families. It is this lacuna which is ultimately needs addressing, rather than the mere actions of some physicians (maybe operating under tight margins themselves) in over-billing.

 

I highlighted the above word because in some areas, it's not a maybe, its a without a doubt. For example, in Miami, FL an OB/GYN will have to pay an average $235,000 a year for medical malpractice insurance.

 

Let's pretend he's an average OB, sees and delivers 150 babies a year and does another 1200 GYN patients a year - totals, oh, 5000 patient visits a year. That $235,000 for malpractice insurance means that each patient visit alone costs $47 just for the malpractice insurance to be covered - that's before paying overhead, staff or him/herself a dime. So how much does (s)he have to charge to cover expenses and staff and actually be able to get paid too? Add to this the very real statistic that OB's in the US will be sued, on average, twice in their career, with 85% of the suits being frivolous in nature, but still adding to the cost of their malpractice insurance as it goes up with any lawsuits.

 

The costs of malpractice aren't just the lawsuits - both those that are very much justified and those that are totally frivolous - but also the cost to carry the insurance. There are many areas in the US now that have serious shortages of OB's due to the cost of malpractice insurance, and other areas where doc's go bare - they risk not having the coverage because they can't afford it.

Edited January 5, 2012 by Tigger

[farouk]

I highlighted the above word because in some areas, it's not a maybe, its a without a doubt. For example, in Miami, FL an OB/GYN will have to pay an average $235,000 a year for medical malpractice insurance.

 

Let's pretend he's an average OB, sees and delivers 150 babies a year and does another 1200 GYN patients a year - totals, oh, 5000 patient visits a year. That $235,000 for malpractice insurance means that each patient visit alone costs $47 just for the malpractice insurance to be covered - that's before paying overhead, staff or him/herself a dime. So how much does (s)he have to charge to cover expenses and staff and actually be able to get paid too? Add to this the very real statistic that OB's in the US will be sued, on average, twice in their career, with 85% of the suits being frivolous in nature, but still adding to the cost of their malpractice insurance as it goes up with any lawsuits.

 

The costs of malpractice aren't just the lawsuits - both those that are very much justified and those that are totally frivolous - but also the cost to carry the insurance. There are many areas in the US now that have serious shortages of OB's due to the cost of malpractice insurance, and other areas where doc's go bare - they risk not having the coverage because they can't afford it.

 

It's a pity that millions of over-billed families have to bear the brunt of over-billing because of those 85% frivolous malpractice lawsuits. The answer isn't Enron style creative accounting.

 

Legislators, rather, need to grasp the nettle.

[farouk]

Because of the cost of medicine and the amount of unnecessary procedures AND the fact that we have no insurance; watching House makes me ill.

 

Lara

 

Lara in Colo:

 

Sorry about your difficulties.

 

House almost makes me ill anyway; he and the producer have a way of mocking people's beliefs which is not respectful.

[PeacefulChaos]

I don't know a whole lot about the healthcare system costs, etc - I got the bill when DS7 was born and it was around $20,000 total, and haven't seen much since then. I have NO idea how much DD's month in the NICU would have cost. Probably a lot. :)

I do know that we have a lot of people here who do the 'go to the ER for every little thing' bit. Our local ER isn't very busy, but the local hospital stinks, so... :lol: When we have any 'serious' issues, we go out of town.

I have no personal experience with Canadian health care, however a very good friend of our family worked in the healthcare industry in Canada for several years before moving here. She said it was awful.

[farouk]

I don't know a whole lot about the healthcare system costs, etc - I got the bill when DS7 was born and it was around $20,000 total, and haven't seen much since then. I have NO idea how much DD's month in the NICU would have cost. Probably a lot. :)

I do know that we have a lot of people here who do the 'go to the ER for every little thing' bit. Our local ER isn't very busy, but the local hospital stinks, so... :lol: When we have any 'serious' issues, we go out of town.

I have no personal experience with Canadian health care, however a very good friend of our family worked in the healthcare industry in Canada for several years before moving here. She said it was awful.

 

PeacefulChaos:

 

I guess with any system there are various aspects. One is waiting lists. Another the principle of comprehensive coverage. Another the nature of the partnership/competition between public and private systems in some countries. So some aspects may be awful, but others good: all simultaneously.

[delaney]

One of my babies got an itemized bill:

Diapers(small pack of pampers $19)

Ointment for the Circ(small tube) $25

the stinkin pads they gave me totaled at over $50!

 

If I had to pay these actual costs I would have died. Mind you the stupid insurance would rather me go to the ER for $150 out of their pocket than go to the Minute Clinic for a co-pay of $30. I hate insurance companies.

[Mommyfaithe]

I agree the healthcare industry is wrong! Our daughter completed a stem cell transplant this spring for her relapsed cancer. Finally got the "bill" (statement from insurance company). I was AMAZED!!!! She was in the hospital - isolation unit for 45 days...Total bill was $445,000!!!!! Thankfully, so far insurance has covered ALL!!! But I wonder...what if we couldn't pay - would my daughter have had to die then???? Just doesn't seem fair. It is a system that needs to be corrected. It frightens me greatly at times too when I have to open the mailbox & see what insurance has/has not paid for my little girl's journey thru cancer.

 

http://www.caringbridge.org/visit/ourbanana

 

Weell, actually...probably yes. It is totally unfair, and I am so grateful and happy your dd is ok.

 

My son does not have coverage for his Chronic Lyme Disease because the CDC refuses to believe such a thing exists and the medical boards will not back doctors treating chronic Lyme with long term or even shorter term IV anti-biotics. Long term AB will cost $4000.oo per month over a course of 6-12 or maybe more months. We can not pay that...so ds remains untreated until I can convince a mainstream doctor that he does indeed have Lyme. Rewind 20 years ago and the same thing was happening to AIDS patients. Doctors refused to treat or understand AIDS until it was an epidemic...and there was just too many people to deny it's reality.

 

Now, we wait...and pray...and try to treat in other alternative ways....which are still costly. In the end, he suffers because the medical system is broken. His childhood was already stolen....now his adulthood is being put on hold...as we wait....

 

Faithe

[farouk]

One of my babies got an itemized bill:

Diapers(small pack of pampers $19)

Ointment for the Circ(small tube) $25

the stinkin pads they gave me totaled at over $50!

 

If I had to pay these actual costs I would have died. Mind you the stupid insurance would rather me go to the ER for $150 out of their pocket than go to the Minute Clinic for a co-pay of $30. I hate insurance companies.

 

delaney:

 

Yes, it's an Alice in Wonderland situation, rooted partly in the unwillingness of politicians, with vested interests, being unwilling to grasp the responsibility.

Edited January 5, 2012 by farouk
word missed out!

[pitterpatter]

How about $23,000 for a 15-minute helicopter ride?! :ohmy: At first, our insurance didn't want to cover it all...luckily, we won the appeal.

[farouk]

How about $23,000 for a 15-minute helicopter ride?! :ohmy: At first, our insurance didn't want to cover it all...luckily, we won the appeal.

 

pitterpatter:

 

It's crazy, crazy.

 

It's as if they are counting on their well-paid lawyers to have more intestinal fortitude than the patients' lawyers. Sometimes they miscalculate there, though.

[NoPlaceLikeHome]

It's a pity that millions of over-billed families have to bear the brunt of over-billing because of those 85% frivolous malpractice lawsuits. The answer isn't Enron style creative accounting.

 

Legislators, rather, need to grasp the nettle.

 

I am not so convinced that most medial malpractice lawsuits are frivolous. In our previous state a person needed to get medical certification from another doctor to testify that malpractice or negligence took place in order to bring a lawsuit. I suspect it is that way in most places. Plus I have heard, if I recall correctly, that Texas has had tort reform for some time and still has outrageous medical expenses.

 

I hate frivolous lawsuits as anyone else but I would think requiring medical certification would cut back on them in a big way since a doctor would be putting his name on the line to testify to this.

[farouk]

I am not so convinced that most medial malpractice lawsuits are frivolous. In our previous state a person needed to get medical certification from another doctor to testify that malpractice or negligence took place in order to bring a lawsuit. I suspect it is that way in most places. Plus I have heard, if I recall correctly, that Texas has had tort reform for some time and still has outrageous medical expenses.

 

I hate frivolous lawsuits as anyone else but I would think requiring medical certification would cut back on them in a big way since a doctor would be putting his name on the line to testify to this.

 

priscilla:

 

I was simply using the 85% statistic that someone posted on here.

 

Anyway, bottom line is that corporate lawyers and accountants are not going to act against their own, fairly narrow business interests. If they can, they will usually try to make a profit by more or less any supposedly legal means that they think may succeed.

 

Comprehensive coverage isn't an idea that the business community thought of first.

[Mommy22alyns]

My last birth was $250,000! I was in the hospital for about two months before giving birth. That cost did not include any dr visits or tests. Those were all billed seperately! I recieved a $1350 bill for the peditritian that visited my babies in the hospital. I called to see if I could work out any kind of discount. I was told that the bill was already discounted by 50%.

 

Every time I took an advil or I should say the generic equivalent, I was charged $52! My Dr let me take my own antacid---I was charged a fee for the supervision of that medication! I kept it in my bedside drawer and let the nurse know when I had taken some. That cost me $17 per pop! I guess she wrote it down in my chart. I was charged per bar of soap and toothbrush I used.

 

I was seperately charged for weekly lab fees, for having my Piku line cleaned, for ultrasounds, daily dr visits, ect!

 

We were charged for the neonatalist who was in the room during the birth. My babies didn't need his care. But he was there, so we were charged for his services.

 

It goes on and on! I have kept that detailed bill to some day show my girls how much we paid to bring them into the world!

 

I often wondered if I could have stayed in a post hotel and hired around the clock nurses for less money!

 

 

We kept the bill from Sylvia's birth too. :tongue_smilie:

[farouk]

We kept the bill from Sylvia's birth too. :tongue_smilie:

 

Mommy22alyns:

 

Yes, it can be instructive to the family.

 

But also a witness to the lack of responsibility of politicians supposedly representing the people's interests, and instead, echoing corporate vested interests.

[farouk]

Weell, actually...probably yes. It is totally unfair, and I am so grateful and happy your dd is ok.

 

My son does not have coverage for his Chronic Lyme Disease because the CDC refuses to believe such a thing exists and the medical boards will not back doctors treating chronic Lyme with long term or even shorter term IV anti-biotics. ...

Faithe

 

Mommyfaithe:

 

Hope things go better with your son's need for treatments.

 

Your post reminds me of the way the tobacco corporations tried for decades to deny the link between smoking and cancer.

 

Again, corporate business interests coming ahead of general welfare and people's objective needs.

[KatieJ]

Let me chime in here. Hubby had hernia surgery a couple of weeks ago. Bills are starting to roll in. Looks like about 10,000.00 for about 4 hours in teh hospital.

DH spoke with his HR guy today, because the insurance changed a couple of months ago, and we didn't have all the details worked out yet.

HR was telling him of someone recently who was hospitalized for some kind of surgery and while she was there, a woman came in and sat down and starting asking her questions about how she was feelling, was she depressed..etc. She left after just a few minutes. Later they got a $900.00 bill from a psychiatrist for a consult that no one asked for, nor did she realize that is what was going on during the little chat with this strange woman!

[farouk]

Let me chime in here. Hubby had hernia surgery a couple of weeks ago. Bills are starting to roll in. Looks like about 10,000.00 for about 4 hours in teh hospital.

DH spoke with his HR guy today, because the insurance changed a couple of months ago, and we didn't have all the details worked out yet.

HR was telling him of someone recently who was hospitalized for some kind of surgery and while she was there, a woman came in and sat down and starting asking her questions about how she was feelling, was she depressed..etc. She left after just a few minutes. Later they got a $900.00 bill from a psychiatrist for a consult that no one asked for, nor did she realize that is what was going on during the little chat with this strange woman!

 

KatieinMich:

 

Amazing, yet I guess nothing should surprise me.

 

Talk about ambulance chasers....