15 March 2013

Here's why American medical care is so expensive

A woman in Arizona was stung by a scorpion:
With the help of a friend, she called Poison Control and was advised to go to the nearest hospital that had scorpion antivenom, Chandler Regional Medical Center. At the hospital, an emergency room doctor told her about the antivenom, called Anascorp, that could quickly relieve her symptoms. Edmonds said the physician never talked with her about the cost of the drug or treatment alternatives.

Her symptoms subsided after she received two doses of the drug Anascorp through an IV, and she was discharged from the hospital in about three hours.

Weeks later, she received a bill for $83,046 from Chandler Regional Medical Center. The hospital, owned by Dignity Health, charged her $39,652 per dose of Anascorp.

The Arizona Republic reported last year about the pricey markup Arizona hospitals were charging for the antivenom made in Mexico. Pharmacies in Mexico charge about $100 per dose.

After the Food and Drug Administration approved the drug last year, Tennessee-based Rare Disease Therapeutics sold the drug to a distributor for $3,500 per dose. The distributor charged hospitals about $3,780 per dose.

The Republic polled several hospitals in November, finding that hospital charges for the serum ranged from $7,900 to $12,467 per vial. At the time, Chandler Regional declined to tell The Republic how much it charged for Anascorp.

Edmonds' insurer, Humana, has paid Chandler Regional $57,509 for the bill. The hospital has asked Edmonds for the balance of $25,537.
Costs are passed through the system, no questions asked.  It make you want to scream. God, I am so tired of reading stories like this.  Where is the adult supervision?

See also some of the comments in this Reddit thread:
I drove myself to the ER and spent 40 minutes sitting in an exam room. I spoke to a Physician's assistant who called an Orthopedist to see if there was anything they could do for me. No tests were done aside from the PA touching my leg for a minute or two. I was given crutches ($59) and a prescription for painkillers.

The bill I was sent was for $2800.

If you think there isn't something wrong then you're a fucking retard.

21 comments:

  1. Not sure if it's available online any more, but Steven Brill's article in Time, http://www.time.com/time/printout/0,8816,2136864,00.html#, was a great investigation in the costs of healthcare.

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  2. "Where is the adult supervision?". It's the adults that got us into these kind of situations in the first place. Politicians, insurance companies, hospitals run by for-profit corporations.

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  3. I concur. What the fuck is going on here? I had to go to the ER when my baby (9 months) fell off a shopping cart and landed on her head. I thought she was probably ok, but I felt I needed to have her checked out. We waited 3 hours in a dismal ER waiting room, and finally got seen by a doctor for about 3 minutes who did nothing but look at her face (no tests). The bill was for about $1500. The insurance covered most of it, but it was still ~$300 for us. I spent more time with the guy collecting my insurance information and getting my credit card information than with the doctor.


    I can see paying a professional (like a doctor) $200/hr, and maybe triple over-time for being at the ER at midnight. Add in overhead (overhead should be no more than 100%). At $1200/hr, for 3 minutes (let's round up to 5 minutes), that should cost $100.

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    1. And this is why I'm lucky to live in the UK. Sure, we pay for medical care through government tax on earnings, but I've never had to get anything on private healthcare except by choice. We took my boy to A&E (ER) after he fell over on his head and got a large lump very quickly. We were seen in about 10 minutes (it was a quiet day), they checked his eyes for signs of concussion, supplied painkillers and as it was just after Christmas they gave him a teddy bear as a present. No forms, no charge.

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  4. There is no such thing as ordering from the menu at the ER. I went one time with pain in my toe (from diabetic neuropathy). For a total of MAYBE 10 minutes of time with the doctor, an X-ray, and a prescription, it was well over $1000 dollars. I understand it's expensive, but this is taking advantage of bad situations, I think.

    I would have felt right to pay, say, $300 to $400 dollars (even though that is expensive, too), but to pay over four times that amount, NO.

    What to do? REFUSE TO PAY. Period. Tell them you'll pay X dollars (based on time you were there, actual time with the doctor--add an additional 10 minutes for research, writing a prescription, etc.) and do just that. Take it or leave it. In my state, if you are paying ANYTHING on your medical bills, they can't take you to court. I'm not sure many of them would want to anyway, since they would then have to defend their outrageous prices.







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  5. No.

    The cost of health care has been determined for decades by complex agreements between comprehensive health care insurance companies and the medical industry.

    At no point in this process is the actual consumer involved in setting price.

    THAT is why health care costs have been skyrocketing for decades.

    As long as we keep using comp. health care insurance to pay for health care, this problem will not be resolved.

    - goy

    http://bit.ly/ziaEkz

    p.s. WHY does blogspot's comment verification need to suck so bad??

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  6. Retard? What a nasty way to end this piece. Shame on you.

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    1. I believe that bit was the conclusion of the quote he was citing, not his own words.

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  7. C'mon, people, we need single-provider health insurance in this country at a price that is affordable that is available to all citizens (and probably emergency care for illegal aliens). The U.S. is the only modern country that does not offer healthcare to all. The infrastructure already exists under the Medicare name and it has been shown to be more efficient than private health insurance. You can call it socialism, but it is for the betterment of all the people, rich or poor.

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  8. Glad to live in Australia, where I am able to go to hospitals or 24-hour emergency clinics at any time of day to be seen by a doctor without fear of any charge at all (even if i need an x-ray or stitches etc), have free access to mental health professionals (both doctors and psychologists), can if necessary be referred by a doctor to see specialists (e.g. podiatrists, surgeons, physiotherapists) for free (up to a point), all with no insurance necessary.

    Insurance only becomes sort of necessary if one needs an anaesthetist, some kinds of surgery, or if one needs to see a dentist more often than average.

    America is terrifying to me, I couldn't live in a place like that.

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  9. When my wife was 3 months pregnant with our one and only son, she was diagnosed with a placenta that was not firmly attached. She was admitted to the hospital and was told that for the rest of her pregnancy she would be laying in her bed and her only mode of travel would be a wheelchair, for fear of the placenta completely coming off the wall of the womb which would mean an emergency Cesarean.3 months in and my wife pulled her blankets back one morning to find the bed was covered in blood and immediately after our son was born via an emergency Cesarean.My wife was discharged a week later however our son weighed only 1,235 grams on August 17,his birthday. A nurse was there to look after him 24/7 until they were sure he would survive. He then spent the next 3 months of his life in and out of an incubator (in the hospital) until Thanksgiving day(slightly more than 3 months)when he had held his weight of 2.3 kilograms for a week and we were allowed to bring him home.(sidebar here, He is now 22, in university studying to be a doctor,is a black belt in Karate and in great health)The bill that was presented to my wife and I at the end of this was $0.00 Nothing Nil Zip. I saw a documentary about a couple in the States with almost the exact same problem and their bill at the end of their ordeal was slightly less than $1,000,000. You Americans look down your nose at us Canadians but from womb to tomb, we take care of those who cannot.

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    1. Damn straight manitoba I totally agree. proud to be canadian

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  10. I live in Canada but lived in the US for a few years. In fact, my daughter was born there. A couple of reflections on our experiences:

    1. Dealing with medical insurance in the US is terribly stressful -- or at least it was for us and we had a routine pregnancy and delivery. I can't imagine the stress of not having medical insurance while dealing with a major illness.

    2. We did some comparisons in tax rates. By the time we paid our California taxes AND our medical insurance (my husband was the only one covered by his company). We paid *more* than we did for taxes (including medical) in British Columbia. I realize that California has higher taxes than many other states but the difference was quite significant.

    3. On a visit back to Canada, my daughter (then only about three months old) became ill because of a virus. We took her to the local emergency. We were handed a bill for $450 -- this included a few hours of observation and a full consultation.

    As much as we enjoyed our time in the US, we eventually left because of the insecurity of health insurance and the vast inequalities of the education system. I sometimes think of the stress of the US system as opportunity cost. We don't worry about or fear health care -- so that "frees" us up to do or be so much more.

    --gem

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  11. In addition, our screwed up system puts the burdon of fighting the insurance companies at a time when you are least able. I've know people fighting cancer, on chemo, also fighting their insurance company to pay the claim they are suppose to. They throw their customers into the mill, and make "mistakes" that somehow always benefit the insurance company.

    I really feel that part of the business plan is to make it so difficult to get them pay what they owe that they hope you will go away or drop dread.

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    1. A number of health insurance providers are non-profit. I know one where the default stance inside the company on claims was "find a way to pay". It did unfortunately require new paperwork but you have to remember the paperwork the insurance companies are getting from the hospitals is often inaccurate.
      I didn't pay for the birth of my first child (nor did my insurance co) because the hospital could never present a duplicate error free bill.

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  12. Reminds me of back in the 1980's when I was bitten by a cat while I lived in Seattle. I went to Harbor View Hospital (one of my fingers had become very bloated) for a couple of hours while they ran tests on me, and then, when they found they could not accommodate me, I went over to Swedish Hospital for a total of six days. The bill from Harbor View cost at least twice what the bill from Swedish (including minor surgery to reduce the bloating) cost! Absolutely insane.

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  13. Cost of medical care varies inasanely countrywiide as well. My six year old had a burst apendix and emergency surgery with multiple surgeons (rare for someone so young it seems) while we were vacationing in pstate NY, there was a 3 day hosptal stay and the hospital provide meals for the wife and I the cost was identical to that of a friend who dislocated a bone in his hand riding a bike in the boston suburbs who had an xray and 10 minutes with Dr while they shoved the bone back into place.

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  14. David - Harborview Hospital in Seattle is a major trauma center, which means it gets a *lot* of indigent patients that can't pay their hospital bills. Therefore, they shift costs over to the patients that *can* pay.

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  15. Dignity Health

    Hilarious. Good name for a private gouging hospital....

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  16. HealthCare in the US is too expensive, which is no better than a third world country. When a country like the United States cannot take care of their people without charging them millions for a hospital visit, the people end up getting poor care because they fear getting more tests because of the costs. America's health system is corrupt with greedy people whom would rather profit than assist someone in need of medical care.

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