30 August 2010

The cost of removal of a ruptured appendix

This for an event that's not the person's fault - not caused by smoking or obesity or lack of exercise or alcoholism.  It can happen to anyone at any time.  Mine ruptured while I was raking leaves in the north woods of Minnesota and I drove back to southern Wisconsin to get the abscess resected.

The image above is not my bill; it's one that was posted at Reddit, where there is a lengthy discussion thread re the American health care system.  (Note: the bill had been adjusted down from $96,000 because the family didn't have insurance).


  1. De-lurking to note that "hemotology" is spelled incorrectly on the bill - it should be "hematology" (even google will auto-correct to "hematology" if you type in "hemotology").

    So not only is the healhcare system in the toilet due to cost but we've demonstrated that the average pencil-pusher is borderline illiterate.

  2. How could it not be your fault? Maybe "fault" is the wrong word or concept. You are definitely RESPONSIBLE for it though.

    you seem to be making a plea for univ. health insurance, which is fine, but you're still responsible for voting that bill into legislation and you're still going to pay that amount of money in taxes.


  3. I'm delighted when readers "de-lurk."

  4. I'm a doctor from Ireland and have worked in the UK, US, and mainland Europe. From what I've experienced, medical care in the US is outrageously expensive. It's often very good care, but rarely good value.

    At a wedding in Texas a few years ago, I had an asthma attack and had to visit the ER I knew that I did not need much treatment but my flight home was in a few hours, and I didn't think it would be too pricey.

    Well, my 90 minutes in the ER cost almost $3,000, including 2 chest x-rays (I have no idea what the second was for), 2 doses each of 2 cheap medications, about 40 seconds (maximum!) of discussion with a doctor, and some oxygen. Before I was even assessed, I had to give a copy of my passport and my credit card details. I offered to pay in cash, but they couldn't tell me how much I owed on the spot, instead insisting on billing me in Ireland as it would take a number of weeks to process. Fair enough.

    Fast forward 6 weeks and I begin to receive threatening calls and letters from a debt collector, something I had never experienced. No word at all from the hospital. It turned out the hospital had incorrectly recorded the 2 addresses, 3 emails, and 2 telephone numbers I had provided! Luckily the debt collectors were more resourceful.

    I offered to pay the collectors in full, which seemed to confuse them as they then offered to slash the bill. Strange tactics.

    Long story short, I had to deal with 4 separate companies for the doctor, the radiographer, the pharmacy bill, and the hospital itself. Grand total of $1,500, of which my insurance company paid $1,420.

    A few weeks ago I had a similar attack. The cost to me on the day? About $70.

    No public healthcare system is perfect, and we obviously pay via taxes, but the prices for tests and services are much lower. Universal healthcare is surprisingly efficient.

  5. Very interesting. Thank you for the info and the insight.

  6. Prices has sure gone up. Eight years ago, in upstate new york, my son had his appendix burst and we had to take him to the hospital while on vacation. There was a three day stay in the hospital for less then 1/30th of the original bill in this post, and we had insurance.

    People also don't realize, the Bill with insurance is often LOWER then without insurance because regardless of what the silly ass hospital charges there is a maximum the insurance company will pay for procedures as they have contract agreements with providers.

  7. I wish we were a civilized nation withuniversal, single-payer health care.

  8. For comparison, the same trip to the hospital in Portugal cost my parents about 15 euros in fees. Makes you think, right?

  9. Here in Sweden we have almost free health care. I did an operation a few years ago and paid 50 dollar!

  10. BoingBoing had the same thing a couple of days/weeks ago, someone in the comments section provided photos of invoices totallying 2 mio Dollars for something his son had to be treated for.

    So many broken things in the states. Just yesterday, I read the figure of how many people are serving life sentences (which is a mandatory 15 years, plus some more, plus lifelong probation) in German prisons: About 2100 altogether.

  11. Wow, I had no idea it was this bad in the States. I was wondering the other day how common it is for people to die or worse because they ignored warning signs (i.e. symptoms of pending heart attacks) in hopes that it would be a false alarm.

    Also, forgive my ignorance, but what happens when a surgery is too expensive for somebody to afford? Do you simply go into lifelong debt?

  12. @Melissa- Good catch. Makes the whole thing suspect actually.

    The customer should ask for a new correct bill with every charge noted not simply grouped charges.

    I never paid for the birth of my 1st son because the hospital was unable to send me a correct bill.
    The bill included a vast array of incorrect charges, errors and contract violations.
    Contract violations included being charged for drugs being administered to the wife while she rested when it was clearly supposed to be covered by the room fee.
    Errors included being charged 3 times for the same visiting Dr. walking into the room during the same minute.
    There were dozens of erroneous charges on the bill time and again and the hospital could never present a correct itemized bill.

  13. JDJarvis - at the link it's explained why this isn't an itemized bill. It's not a post-surgical bill for services rendered; it's a pre-surgical estimate of costs involved.

    More at the link.

  14. oh pleeeze, like it really cost 50 euros to have your appendix taken out in Sweden - so your surgeon was making 15000 euros a year and he did the whole thing without any assistance from his 5000 euro a year (each) nurses and interns.

    Our system is wack, but there aren't any good systems. Stay healthy my friends.

  15. Between my free healthcare under the NHS in England and the likes of what I have heard about the US system, I know for certain that I'm happy where I am.

  16. Two things come to mind, having gone through surgeries that "weren't my fault" before.

    1. Fault or not, if you need the surgery, the care providers will get you.

    2. Once you've been cared for, they can't get blood from a turnip.

    Point being, on many occasions, I've simply asked the care provider to work with me to lower the bill voluntarily so I can pay them in cash, and often they will. Cash prices are actually often lower than "contract" prices because of the fact that the provider doesn't have to deal with the ridiculously complex insurance process.

    I'm not sure how it all works out in the long run, money-wise, but I'm sure that doctors are paid about the same all over the world. So if you pay US$15 to have surgery, my thought is that you're paying a bunch more elsewhere (tax is the most likely culprit). Big difference is that in the US, the insurance companies make a lot of money, and I'm guessing that the governments with single-payer systems don't. That most likely means that the cheap system is not sustainable without changes over the long haul.

  17. @Bub

    Nurses don't get €5000 a year, its closer to €55.000 a year. Doctor's get €110.000 a year, depending on qualifications of course. These are before taxes by the way, so remove around 50% and your have the money available.

    I myself have, what is considered a shit job by many, and I make €36.000 a year without any qualifications within that area of work.

    From the second you enter the hospital here, everything is for free, even someone visiting might get a bit to eat, even a bed to sleep in if the patient doesn't want to be alone. Have to pay a bit for the medication that you have to take when you get home, but government gradually pay a bigger part of that the more medication you need during a year. The discount is reset once a year. As far as I remember, discount gradually grows from 10 to 90%.

    /Danish citizen


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