UPDATE!- Is $24,000 a reasonable fee to an outpatient hospital surgical center for a 1 hour surgery?

[Nart]

Update- I ended up getting having the procedure at the large clinic’s surgical center instead of at the hospital’s outpatient surgical center yesterday.

The bill from the clinic’s surgical center was $3285 (instead of $24,000 for hospital’s outpatient surgical center) but with the negotiated insurance rate discount and then having to pay 20%,  I ended up paying $313 for the surgical center instead of $3800!  I still can’t believe the difference in the price. Maybe the majority of people using this large heathcare provider have HMO’s so they pay the same price regardless if it is at the hospital or clinic’s surgical center?

I had to pay a dr’s fee (20% of it) which was around $150 and I have no idea if I will be charged for the anesthesia because the anesthesiologist was a clinic provider not an outside anesthesiologist.  
So I think I ended up saving around $3500! Most importantly the procedure went well. It was so much better than being awake the three previous times doctors tried to remove the iud. Also clinic’s surgical center was just remodeled and the healthcare providers were all so supportive. 
 

End of update- what follows is my original post.

I am wondering if this is reasonable.  I need a hysteroscopy to remove an embedded IUD with general anesthesia. The anesthesiologist is in network and my 20% will be $100. The ob/gyn is in network and her fee is around $160. I thought, great that those fees are reasonable but then I called the surgical center. The surgery at an outpatient hospital surgical center is estimated to take one hour and their fee is $24,000. My insurance will pay a negotiated rate of around $19,000 so with my co-pay of 20% I will end up paying around $3800. This just seems so excessive for the surgical center for an easy one hour procedure. 

 

Edited April 6, 2023 by Nart
Update post

[busymama7]

My son's outpatient surgery to reset and pin a broken arm was almost twice that.  So yeah 

[Nart]

2 minutes ago, busymama7 said:

My son's outpatient surgery to reset and pin a broken arm was almost twice that.  So yeah 

It was 48,000? How long was the surgery? That is ridiculous!

[Tap]

Outrageous. Yes. But realize that you are paying for access to all the equipment and skills of everyone there. Not just the skills they are using right then for a straightforward procedure. If something goes wrong, and extra skill is needed, a switch of anesthesia, a defibrillator, all of that is going to be there and will be put to use. You are paying for the cleaning, sterilizing, maintenance etc of everything. All the staff including reception, janitorial, billing etc. 

I was talking to a pediatrician one time about why well child visits are so expensive. She said you aren't paying for them to identify a healthy child. That is easy :). You are paying for the skills, experience and training to identify that there could be something wrong....and what to do about it (treatment, referral to a specialist,  watch and wait etc)

[KidsHappen]

Well according to my medical bills it is. Just this last year I had a $27,000 bill for an emergency room visit. 

[LucyStoner]

Very little is reasonable about how medical care is priced in the United States.  But that price is in line with the unreasonable norms here.  

I had minor, routine outpatient surgery in 2021. Gallbladder removal. Laparoscopic. Checked in at 7AM, headed home with my husband around 10AM (most of that time in checkin/prep and observation afterwards). The bill just for the hospital was more than $20K.  My portion was less than a $1000 but that was because we hit the OOP max on our insurance and didn’t have to pay the full 10% coinsurance rate.  

Edited March 10, 2023 by LucyStoner

[Katy]

Until people vote for price limits and/or Medicare for all, yes, we have to pay however much people want to charge. In almost any other country it would be immoral for the rich to steal from those who need care. OTOH, you have state of the art surgical equipment right there near you. 

[Scarlett]

Why are you using the out of network hospital?

But yes this seems normal pricing to me.  My dh’s small procedure to insert a loop heart recorder in his chest ( just under the skin) was 50k —-and that was done in office.

 

Edited March 10, 2023 by Scarlett

[Eos]

Is it reasonable? No.  Is it the price?  Yes.  I'm sorry you are facing this along with the physical pain of having the issue in the first place.

[Shelydon]

That is the normal price. Even though the surgery is only one hour, prepping, the room with all the special cleaning is the same as if it were a 10 hour surgery. You still need a surgeon, and anesthesiologist, and other surgical team members who all have to be paid for their time. All the supplies are the same whether they're used for an hour or longer. 

[Bootsie]

DS had shoulder surgery last week at an outpatient surgical center and his portion of the surgical center facility bill was about $4000.  The surgical procedure itself was about 1 hour.  His total time in a bed at the facility was about 4 1/2 hours.  

[Nart]

1 hour ago, Shelydon said:

That is the normal price. Even though the surgery is only one hour, prepping, the room with all the special cleaning is the same as if it were a 10 hour surgery. You still need a surgeon, and anesthesiologist, and other surgical team members who all have to be paid for their time. All the supplies are the same whether they're used for an hour or longer. 

The $24,000 fee doesn’t include the surgical fee or the fee for the anesthesiologist. Those are two separate fees but they are reasonable. 

1 hour ago, Scarlett said:

Why are you using the out of network hospital?

But yes this seems normal pricing to me.  My dh’s small procedure to insert a loop heart recorder in his chest ( just under the skin) was 50k —-and that was done in office.

 

This outpatient hospital surgical center is in-network. My insurance supposedly will pay around $19,000 just for the center so I will be responsible for 20% or $3,800. 

[WildflowerMom]

Is it reasonable?   Of course, not. 
is that likely the price you’ll have to pay?  Yes, unfortunately.    You can call financial services at the hospital and they can sometimes get the bill lower for lower incomes or let you pay in installments, something like as little as $20 a month fr however long it takes.  
 

the us Heathcare system is a racket.  I’m sorry. 

[Ann.without.an.e]

Haven't read replies but nothing in the medical realm is ever reasonable. 

DS has an infusion once a month - $22,000 each time.

DD had and abdominal MRI and it came out to $12k. 

 

[Pawz4me]

15 minutes ago, Ann.without.an.e said:

. 

DS has an infusion once a month - $22,000 each time.

 

 

When DH was on immunotherapy for his cancer the infusion was close to $100k every three weeks.

 

[ktgrok]

Yikes. I had a hysteroscopy to remove a partially imbedded IUD with just a cervical block in the office so I just paid my normal copay for an office visit. 

[Corraleno]

People from other countries must read these threads with their mouths hanging open.

The idea that access to healthcare should be controlled by private insurance companies, who can not only charge outrageous fees but also maximize profits by denying necessary treatment, is so dystopian it beggars belief. 

DS was born in the UK. Total cost to me for all prenatal care, ultrasounds, amniocentesis, an ambulance ride, a C-section, 2 anesthesiologists, 2 surgeons, and 3 days in one of the best maternity hospitals in the UK: $0. When we moved back to the US in 2005, I was able to get health insurance for the kids and me, but DH was rejected by every insurance company we tried because of his migraines. He broke his wrist and needed surgery while uninsured and our cost was nearly $20,000 (and that was 18 years ago).

I wish the US would switch to a hybrid system like France, which has one of the best healthcare systems in the world. They spend half of what the US does per person, and yet they have more doctors and hospital rooms per capita than the US and a much higher life expectancy (by 6 years!). Most costs are covered by one of the three nonprofit healthcare funds, and 90% of the population also carries inexpensive supplementary insurance (~$45/month, and even this is subsidized for the poorest people) so 100% of costs are covered. Prices for services and medications are negotiated by the government and are standardized everywhere. You can go to any doctor you want anywhere in the country — no "networks," no referrals needed, no insurance forms, no refusal to approve necessary treatment. Doctors make a lot less money, but medical school is basically free.

The US healthcare system is just insane.

[Rosie_0801]

57 minutes ago, Corraleno said:

People from other countries must read these threads with their mouths hanging open.

I don't read them. If I wanted to read about human rights abuses I'd prefer to read about complete strangers; for the sake of my jaw alignment, you understand.

[Nart]

4 hours ago, ktgrok said:

Yikes. I had a hysteroscopy to remove a partially imbedded IUD with just a cervical block in the office so I just paid my normal copay for an office visit. 

I wish I could just do the same and have the hysteroscopy in office but that wasn't an option I was given by my ob/gyn.

[gardenmom5]

Have you called around to other centers in your area?

What exactly does it include?   Drs?

What does your insurance cover? What is out of pocket?   What is your max out if pocket?   (Some things will have a real high "ticket price"  but is significantly reduced after insurance.)

Are the providers and surgery center in your network? 

[Arctic Bunny]

2 hours ago, Rosie_0801 said:

I don't read them. If I wanted to read about human rights abuses I'd prefer to read about complete strangers; for the sake of my jaw alignment, you understand.

QFT.

@Corraleno 100% hanging open.

My cousin has unfortunately been in the hospital for a couple of weeks. They are doing MRIs of his spinal area a bit at a time. There’s no way he could afford that OOP. And as much as I complain about taxes, it’s really the other ways the money is mismanaged that I object to!

[Scarlett]

8 hours ago, Nart said:

The $24,000 fee doesn’t include the surgical fee or the fee for the anesthesiologist. Those are two separate fees but they are reasonable. 

This outpatient hospital surgical center is in-network. My insurance supposedly will pay around $19,000 just for the center so I will be responsible for 20% or $3,800. 

Oh I see. I think I misread. 
 

Never mind I can’t read.  Sorry. 

Edited March 10, 2023 by Scarlett

[Happy2BaMom]

3 hours ago, Corraleno said:

People from other countries must read these threads with their mouths hanging open.

......

The US healthcare system is just insane.

Hey now, someone has to ensure the health insurance CEOs keep their annual $50 million+ individual compensation packages (note: those packages are based upon the CEOs exercising their stock options)......they are rewarded when the stock price goes up, due to profits increasing. IOW, the more you pay, and the less the insurance pays, the more money the CEO (and other executive levels) earn.

Edited March 10, 2023 by Happy2BaMom

[Nart]

So I spent the day calling to cancel the surgery and researching. If this surgery were for one of my kids I would just go ahead and proceed but I just can't justify spending so much money on me for a medical procedure that isn't urgent. I ended up speaking to a really nice person who is one of the ob/gyn surgical schedulers (of course, I am kicking myself for not catching her name and writing it down). She seemed frustrated on my behalf that it was going to cost so much. She said that there is a possibility that another surgical center that this large clinic actually owns can be used but it is not next to where the ob/gyn offices are. They are across the street from the hospital and the hospital outpatient surgical center. She said it is obviously more convenient for the ob/gyn doctors to just walk over to the surgical center from their office or the hospital to perform the  one hour procedure. 

She explained the ob/gyn department only gets certain blocks of time at their own clinic's surgical center every couple of months. She said she would call over there and ask how much they charged using the same CPT (procedure code) and then called me back.  Using their own in patient surgical center the fee is $3700 for the same procedure! She was appalled that the same surgery costs $24000 at one surgical center and $3700 at another. I kept asking if the $3700 was my copay and she kept saying no- it is the total fee- so since I have to pay 20% then I would pay $740 instead of around $3800!!!!!  So she isn't sure she can make it happen but she said she is sending emails to justify that due to financial reasons I should be approved to get surgery at their own surgical center. So I am praying it can happen! 

[Scarlett]

8 minutes ago, Nart said:

So I spent the day calling to cancel the surgery and researching. If this surgery were for one of my kids I would just go ahead and proceed but I just can't justify spending so much money on me for a medical procedure that isn't urgent. I ended up speaking to a really nice person who is one of the ob/gyn surgical schedulers (of course, I am kicking myself for not catching her name and writing it down). She seemed frustrated on my behalf that it was going to cost so much. She said that there is a possibility that another surgical center that this large clinic actually owns can be used but it is not next to where the ob/gyn offices are. They are across the street from the hospital and the hospital outpatient surgical center. She said it is obviously more convenient for the ob/gyn doctors to just walk over to the surgical center from their office or the hospital to perform the  one hour procedure. 

She explained the ob/gyn department only gets certain blocks of time at their own clinic's surgical center every couple of months. She said she would call over there and ask how much they charged using the same CPT (procedure code) and then called me back.  Using their own in patient surgical center the fee is $3700 for the same procedure! She was appalled that the same surgery costs $24000 at one surgical center and $3700 at another. I kept asking if the $3700 was my copay and she kept saying no- it is the total fee- so since I have to pay 20% then I would pay $740 instead of around $3800!!!!!  So she isn't sure she can make it happen but she said she is sending emails to justify that due to financial reasons I should be approved to get surgery at their own surgical center. So I am praying it can happen! 

Wow. 
 

This reminds me of an episode on NPR where a doctor was the patient and he asked the surgeon how much it was going to cost. Surgeon had no clue. Doctor/patient proceeded to make about 20 phone calls and get lots of run around….it was mind blowing. 

[Katy]

6 hours ago, Corraleno said:

I wish the US would switch to a hybrid system like France, which has one of the best healthcare systems in the world. They spend half of what the US does per person, and yet they have more doctors and hospital rooms per capita than the US and a much higher life expectancy (by 6 years!). Most costs are covered by one of the three nonprofit healthcare funds, and 90% of the population also carries inexpensive supplementary insurance (~$45/month, and even this is subsidized for the poorest people) so 100% of costs are covered. Prices for services and medications are negotiated by the government and are standardized everywhere. You can go to any doctor you want anywhere in the country — no "networks," no referrals needed, no insurance forms, no refusal to approve necessary treatment. Doctors make a lot less money, but medical school is basically free.

The US healthcare system is just insane.

To be fair, this was what Obama tried to accomplish.  But it doesn't work without price limits, and given the artificially low number of physician training spots in the US the market will never provide enough doctors. I don't know the number of slots in France, but I do know someone with a 4.0 college GPA who tried for a few years to get into medical school here & eventually settled for going to school in France.

9 minutes ago, Nart said:

So I spent the day calling to cancel the surgery and researching. If this surgery were for one of my kids I would just go ahead and proceed but I just can't justify spending so much money on me for a medical procedure that isn't urgent. I ended up speaking to a really nice person who is one of the ob/gyn surgical schedulers (of course, I am kicking myself for not catching her name and writing it down). She seemed frustrated on my behalf that it was going to cost so much. She said that there is a possibility that another surgical center that this large clinic actually owns can be used but it is not next to where the ob/gyn offices are. They are across the street from the hospital and the hospital outpatient surgical center. She said it is obviously more convenient for the ob/gyn doctors to just walk over to the surgical center from their office or the hospital to perform the  one hour procedure. 

She explained the ob/gyn department only gets certain blocks of time at their own clinic's surgical center every couple of months. She said she would call over there and ask how much they charged using the same CPT (procedure code) and then called me back.  Using their own in patient surgical center the fee is $3700 for the same procedure! She was appalled that the same surgery costs $24000 at one surgical center and $3700 at another. I kept asking if the $3700 was my copay and she kept saying no- it is the total fee- so since I have to pay 20% then I would pay $740 instead of around $3800!!!!!  So she isn't sure she can make it happen but she said she is sending emails to justify that due to financial reasons I should be approved to get surgery at their own surgical center. So I am praying it can happen! 

That's amazing.  I'm so glad you found a cheaper option. I bet they'll schedule it there for you.

[Katy]

Just now, Scarlett said:

Wow. 
 

This reminds me of an episode on NPR where a doctor was the patient and he asked the surgeon how much it was going to cost. Surgeon had no clue. Doctor/patient proceeded to make about 20 phone calls and get lots of run around….it was mind blowing. 

It reminds me of the state wildlife employee in the Florida Keys who had to get rabies shots... she went to the ER in Key West and it cost like 20 times the amount of going anywhere else in the Keys.  I also heard that on NPR.

[lewelma]

6 hours ago, Corraleno said:

People from other countries must read these threads with their mouths hanging open.

Yup.

I had an IUD removed at an outpatient with anesthesia of some kind. I don't remember if it was a general, but I did have to wake up and recover for 3 hours before being released (someone else drove me home). It cost NZ$3,000 which was fully reimbursed by my insurance without a copay. 1 hour procedure +3 hours recovery.

My kid got 7 (yes 7!) wisdom teeth removed including 2 that were in his sinus cavity and 3 that were behind the basic 4 and into the bone, and it cost me NZ$2800. He was knocked out but without a general. 1 hour procedure. 

[Nart]

10 minutes ago, Scarlett said:

Wow. 
 

This reminds me of an episode on NPR where a doctor was the patient and he asked the surgeon how much it was going to cost. Surgeon had no clue. Doctor/patient proceeded to make about 20 phone calls and get lots of run around….it was mind blowing. 

Yes!!! This is so true. I sent this message through my online chart a couple of days ago:

ME: I am scheduled to have a surgery /hysteroscopy next Thursday for an embedded IUD. While your fee and the anesthesiologist fees are reasonable I just received the  hospital outpatient surgical center fee estimate of $24,000 of which I would pay $3,700. Are there other options besides surgery? Is there a danger of the IUD perforating my uterus if it stays in? Thank you.

I received this response:

DOCTOR: Wow that does seem expensive. Maybe call the Hospital and review this fee? It is a foreign object so there is always risk of it causing an infection and potentially migrating through the uterus. These risks are small.  Please let us know how you would like to proceed.

Take care,

[Scarlett]

21 minutes ago, Nart said:

Yes!!! This is so true. I sent this message through my online chart a couple of days ago:

ME: I am scheduled to have a surgery /hysteroscopy next Thursday for an embedded IUD. While your fee and the anesthesiologist fees are reasonable I just received the  hospital outpatient surgical center fee estimate of $24,000 of which I would pay $3,700. Are there other options besides surgery? Is there a danger of the IUD perforating my uterus if it stays in? Thank you.

I received this response:

DOCTOR: Wow that does seem expensive. Maybe call the Hospital and review this fee? It is a foreign object so there is always risk of it causing an infection and potentially migrating through the uterus. These risks are small.  Please let us know how you would like to proceed.

Take care,

I hope you manage to get it done cheaper.but I wouldn’t mess around with that.

[TexasProud]

Don't know for sure about the surgery center, but hospitals definitely charge more to paying patients because they have many who pay nothing at all.  Most of the surgeries my husband did at the hospital, he never got reimbursed for when he was on call. He just wrote them off.  So those that are paying ( or their insurance is) make up some of that difference.  Also, Medicare reimbursements did not cover the actual cost of the procedures either.  Just FYI.  Now surgery centers should be different as they typically do not have nonpaying patients.  

[ktgrok]

12 hours ago, Nart said:

So I spent the day calling to cancel the surgery and researching. If this surgery were for one of my kids I would just go ahead and proceed but I just can't justify spending so much money on me for a medical procedure that isn't urgent. I ended up speaking to a really nice person who is one of the ob/gyn surgical schedulers (of course, I am kicking myself for not catching her name and writing it down). She seemed frustrated on my behalf that it was going to cost so much. She said that there is a possibility that another surgical center that this large clinic actually owns can be used but it is not next to where the ob/gyn offices are. They are across the street from the hospital and the hospital outpatient surgical center. She said it is obviously more convenient for the ob/gyn doctors to just walk over to the surgical center from their office or the hospital to perform the  one hour procedure. 

She explained the ob/gyn department only gets certain blocks of time at their own clinic's surgical center every couple of months. She said she would call over there and ask how much they charged using the same CPT (procedure code) and then called me back.  Using their own in patient surgical center the fee is $3700 for the same procedure! She was appalled that the same surgery costs $24000 at one surgical center and $3700 at another. I kept asking if the $3700 was my copay and she kept saying no- it is the total fee- so since I have to pay 20% then I would pay $740 instead of around $3800!!!!!  So she isn't sure she can make it happen but she said she is sending emails to justify that due to financial reasons I should be approved to get surgery at their own surgical center. So I am praying it can happen! 

I’m betting they are considered different tiers of surgical center or something?  That’s crazy though! If they can’t make that work definitely ask if it can be done in office. 

[Faith-manor]

17 hours ago, Corraleno said:

People from other countries must read these threads with their mouths hanging open.

The idea that access to healthcare should be controlled by private insurance companies, who can not only charge outrageous fees but also maximize profits by denying necessary treatment, is so dystopian it beggars belief. 

DS was born in the UK. Total cost to me for all prenatal care, ultrasounds, amniocentesis, an ambulance ride, a C-section, 2 anesthesiologists, 2 surgeons, and 3 days in one of the best maternity hospitals in the UK: $0. When we moved back to the US in 2005, I was able to get health insurance for the kids and me, but DH was rejected by every insurance company we tried because of his migraines. He broke his wrist and needed surgery while uninsured and our cost was nearly $20,000 (and that was 18 years ago).

I wish the US would switch to a hybrid system like France, which has one of the best healthcare systems in the world. They spend half of what the US does per person, and yet they have more doctors and hospital rooms per capita than the US and a much higher life expectancy (by 6 years!). Most costs are covered by one of the three nonprofit healthcare funds, and 90% of the population also carries inexpensive supplementary insurance (~$45/month, and even this is subsidized for the poorest people) so 100% of costs are covered. Prices for services and medications are negotiated by the government and are standardized everywhere. You can go to any doctor you want anywhere in the country — no "networks," no referrals needed, no insurance forms, no refusal to approve necessary treatment. Doctors make a lot less money, but medical school is basically free.

The US healthcare system is just insane.

The French medical system saved my sister's life. She has an autoimmune disease, a very rare one, and tens of thousands of dollars later in the U.S system still no diagnosis and doctor's ignoring her, claiming it was all in her head. Eight years of going bankrupt to have NO progress. Moved to France as a college student, bought into the system for a nominal premium (super duper reasonable price as a temporary resident), and within six months she had a diagnosis. It was another six months before she had a treatment plan because her docs had to send her to Belgium to a specialist who is renowned for his endocrinology knowledge and work. All she had to do was pay for her travel because her French endo was able to make the case that she needed this second opinion so the actual medical bills were covered out of country. She paid for the train, and the Belgian doc is so used to patients from out of country that he runs a bed and breakfast establishment and only charges $25eu a night. Sis met a wonderful man in France whom we absolutely adore, and is now a permanent resident.

My mom does not get her dental work done here anymore. It is 1/3 the cost of the U.S. She goes every year to France for 75 days, and sees sis and bil's dentist. So far she has had a root canal, a cap, and a tooth pulled plus an annual cleaning, full set of x rays, and received advice about her teeth, based on new research, that she has not received here and has been invaluable.

I sure wish we could have that system! It isn't perfect. No system will ever be. But is sure is so much more humane, and it takes the insanity of the insurance racket out of healthcare which means many, many more people receive high quality care for their problems, especially like sis, chronic ones. Medical professionals drive the healthcare, not the corporate ceo.

Oh, and mom also received much more in-depth ortho care for her ankle (she had ankle replacement surgery at Beaumont in Royal Oak several years ago and Beaumont docs did and amazing job so not complaining about them at all) because Medicare rejected allowing her to have all the of the essential posts surgical treatment she should have had. When she goes there, she pays $25 to see an ortho doc who not only does a special kind of massage technique to restore circulation and reduce inflammation, but also physical exercises and manipulation she can't get here. She was given a clay foot soak that also does the most incredible job of drawing out inflammation. She goes once per week the whole time she is there and when I fetch her home from the airport, she doesn't limp and her back does not hurt. But it isn't done here, and eventually she runs out of the clay stuff, and she goes back to "normal". Out of pocket for physical therapy here is $160 per session, and basically if insurance isn't going to pay, they won't schedule a cash paying patient. It wouldn't do any good anyway because they don't do what the French doc does. She also can't stockpile the clay stuff to bring back because it is prescription or somethin, and not even carried here in the U.S. The doc did tell sis that the next time she comes home, she will send a tube with her for mom. She is a very sweet doctor.

One other antidote. There is a system in France for in-home doctor visits for the elderly and disabled, people with disabled children. Mom took an over the counter allergy med last time that she was there and didn't know it was one she should NOT take. Her BP went through the roof into stroke range. Sis called her primary and asked if she should go to the ER. He said no, he would send a colleague. 10 minutes later, knock knock knock, and visiting doc was at the door. He stayed 90 minutes with mom, was shocked that her GP had never warned her about numerous decongestants which cause this side effect, got her BP down to normal, told her what she could take for her allergies that was over the counter, and that if she ever had a BP crisis again to call the pharmacist around the corner because their pharmacists can do some emergency care for things like this. $50. That was it. Can you imagine 90 minutes of in-home healthcare for $50? Swoon. Blew my mind! He was so sweet, and very concerned about her health, going into her medical history in great depth, and the next day called her GP about it. I don't know what got said but I suspect it was along the lines of, "What the eff is wrong with you and the local pharmacy that your patient was not educated about her condition?" Only to probably find out that the average doctor visit here is something like 5 minutes or less which potentially made his head explode. I don't think stateside, except for the wonderful docs at Beaumont who never seem to be in a hurry, she had ever been with a doctor for more than 5 minutes since going on medicare.

Sis and I have agreed that if it ever became possible for mom to move to France, Mark and I would make it happen. Her quality of life in that country is so much better, and not just her healthcare either. Happiness. She has so much happiness when she is there. Not here. The U.S. is really falling apart at the seams.

[KungFuPanda]

On 3/10/2023 at 12:45 AM, Nart said:

I am wondering if this is reasonable.  I need a hysteroscopy to remove an embedded IUD with general anesthesia. The anesthesiologist is in network and my 20% will be $100. The ob/gyn is in network and her fee is around $160. I thought, great that those fees are reasonable but then I called the surgical center. The surgery at an outpatient hospital surgical center is estimated to take one hour and their fee is $24,000. My insurance will pay a negotiated rate of around $19,000 so with my co-pay of 20% I will end up paying around $3800. This just seems so excessive for the surgical center for an easy one hour procedure. 

 

You can’t bill skilled labor hourly like that. It’s not how it works. 

[wathe]

On 3/10/2023 at 2:51 PM, Corraleno said:

People from other countries must read these threads with their mouths hanging open.

The idea that access to healthcare should be controlled by private insurance companies, who can not only charge outrageous fees but also maximize profits by denying necessary treatment, is so dystopian it beggars belief. 

The US healthcare system is just insane.

Yes.  It is insane.

The out-of-pocket cost to the patient for removing and imbedded IUD here is $0.  Well, if you park, you would have to pay for parking....

Major surgery:  $0

Emergency department visits: $0

Family doctor visits $0

Specialist MD visits $0

Hospitalizations: $0

Hospitals charge for room upgrades, parking, phone service, internet access and other extra amenities, but the cost of care and basic hospital stay is $0 out-of-pocket.  No forms.  No insurance claims.  You pay your taxes and register for a free health card, which require periodic (free) renewal every 5 years or so.  The card is your ticket to $0 out-of-pocket hospital care.

Canadians love to complain about their healthcare, but it's actually pretty great.

 

[Shelydon]

36 minutes ago, wathe said:

Yes.  It is insane.

The out-of-pocket cost to the patient for removing and imbedded IUD here is $0.  Well, if you park, you would have to pay for parking....

Major surgery:  $0

Emergency department visits: $0

Family doctor visits $0

Specialist MD visits $0

Hospitalizations: $0

Hospitals charge for room upgrades, parking, phone service, internet access and other extra amenities, but the cost of care and basic hospital stay is $0 out-of-pocket.  No forms.  No insurance claims.  You pay your taxes and register for a free health card, which require periodic (free) renewal every 5 years or so.  The card is your ticket to $0 out-of-pocket hospital care.

Canadians love to complain about their healthcare, but it's actually pretty great.

 

My brother in law recently looked at moving to Canada with his current company that has offices both in the US and in Canada. In the US, he of course pays for health insurance. Part of that insurance is paid by his company which is pretty standard. In Canada the company does not offer insurance because it is part of your taxes. After working out the math with an accountant, they determined that they actually have significantly more take-home pay in the US. 🤷‍♀️

 

I'm sure every job is different, but depending on your tax bracket in the United States many people end up paying the exact same annually either to the government for taxes which in turn pays for health care or directly for health insurance and co-pays. 

My brother-in-law has young children who both receive free PT, ST, and OT through the public school system where they live, and that factored into their decision as well. Apparently there is a year plus wait list in Canada. 

[Shelydon]

On 3/10/2023 at 8:11 PM, lewelma said:

Yup.

I had an IUD removed at an outpatient with anesthesia of some kind. I don't remember if it was a general, but I did have to wake up and recover for 3 hours before being released (someone else drove me home). It cost NZ$3,000 which was fully reimbursed by my insurance without a copay. 1 hour procedure +3 hours recovery.

My kid got 7 (yes 7!) wisdom teeth removed including 2 that were in his sinus cavity and 3 that were behind the basic 4 and into the bone, and it cost me NZ$2800. He was knocked out but without a general. 1 hour procedure. 

7 ! That must be a record. Poor kid.

[math teacher]

Someone upthread mentioned paying off a bill even if it was $20 per month. Let me tell you what happened to us. Dh used to go to MDAnderson in Houston for leukemia. We had one particularly high bill, like $4,000 after insurance paid. We were sending $100 a month, and on the third month, they sent it to collections. I don't know if it's still on our credit report or not.

[Frances]

1 hour ago, Shelydon said:

My brother in law recently looked at moving to Canada with his current company that has offices both in the US and in Canada. In the US, he of course pays for health insurance. Part of that insurance is paid by his company which is pretty standard. In Canada the company does not offer insurance because it is part of your taxes. After working out the math with an accountant, they determined that they actually have significantly more take-home pay in the US. 🤷‍♀️

 

I'm sure every job is different, but depending on your tax bracket in the United States many people end up paying the exact same annually either to the government for taxes which in turn pays for health care or directly for health insurance and co-pays. 

It’s not surprising that a well compensated individual working for a multinational company might pay less directly for health insurance in the US than they would pay in taxes for health coverage in Canada. But there are questions remaining. First, what happens if he or a family member needs very expensive ongoing care care in the US, how much will he have to pay out of pocket? And more importantly, what about all of the people in the US who don’t have excellent, inexpensive employer provided health insurance (and I speak as someone who is fortunate to be in this position)? That’s the very essence of the difference between the US and virtually every other developed country when it comes to healthcare. We focus on what’s best for the individual, they focus on what’s best for everyone.

[Shelydon]

2 hours ago, Frances said:

It’s not surprising that a well compensated individual working for a multinational company might pay less directly for health insurance in the US than they would pay in taxes for health coverage in Canada. But there are questions remaining. First, what happens if he or a family member needs very expensive ongoing care care in the US, how much will he have to pay out of pocket? And more importantly, what about all of the people in the US who don’t have excellent, inexpensive employer provided health insurance (and I speak as someone who is fortunate to be in this position)? That’s the very essence of the difference between the US and virtually every other developed country when it comes to healthcare. We focus on what’s best for the individual, they focus on what’s best for everyone.

No idea what's a scenario would be for ongoing medical care above what they already have happening in their lives. 

Their company insurance was about $1,000 a month for five people with a $3500 deductible per person each year. I'm not sure that that counts as inexpensive, but maybe it does. It would definitely be expensive if they had to pay for the therapy services they receive free through the public schools. The services are not available to them in Canada, or at least there's a 12 to 18 month wait. I can't remember all of the exact details. 

[Acorn]

I hope you find a reasonable price location. Ugh, I found out recently that my iud will need to be removed in a similar procedure. I am hoping to wait 4 years; who knows what it will cost by then.

[Nart]

Update in original post.

[Kassia]

So glad it went well and you ended up saving all of that money!  Thanks for the update.

[Miss Tick]

I'm glad it went well, medically and financially!

I was also glad to see that you let your Dr know about the cost of their default option. They often don't know much about actual patient costs because everybody has different insurance and medical needs. However sometimes that leads to those "surprise!" bills that can be staggering. If they could just caution you to check prices I think that would be smart. Often when they make a suggestion or an offer I'm thinking it is no big deal, but then I get a bill for $150 for something I could have done at home with an over the counter kit for $10. Next time a pediatrician says, "want me to freeze that wart off while you're here, it's a quick procedure?" I know to say, no thank you.

[QueenCat]

On 3/12/2023 at 3:31 PM, math teacher said:

Someone upthread mentioned paying off a bill even if it was $20 per month. Let me tell you what happened to us. Dh used to go to MDAnderson in Houston for leukemia. We had one particularly high bill, like $4,000 after insurance paid. We were sending $100 a month, and on the third month, they sent it to collections. I don't know if it's still on our credit report or not.

I'm surprised they did that with an agreement with them to pay it off at $100/month. 

[fraidycat]

I'm glad you were able to get a better rate and that the procedure is done.