Published Jun 16, 2011
OhioCCRN, MSN, NP
572 Posts
A friend recently went to the ER complaining of chest pain and Nausea
They did a chest X-ray, EKG, and blood work ...
Total bill: $2,860.29
Maybe i'm missing something here....
But WOW!!!!! I think that's a little (a lot) steep!
Its tragic tragic tragic that health care cost are so ridiculous...
TheCommuter, BSN, RN
102 Articles; 27,612 Posts
Since certain departments (nursing, environmental services, dietary, maintenance, laboratory, etc.) cannot bill the patient directly for all of the services rendered, the hospital must charge an exorbitant amount for diagnostic tests, supplies, and procedures. The nurses, lab technicians, housekeepers, dietary workers, maintenance people, and transporters are not able to directly bill patients even though they must be paid somehow.
Physicians, physical therapists, speech pathologists, and other professionals provide services that are directly billable to patients. Nursing care is not billable, so where do you think the money to pay us comes from?
Nursing Care = supposedly 'free' and included in the bill
Housekeeping = supposedly 'free' and rolled into the bill
Dietary / Meals = 'complimentary' and rolled into the bill
Maintenance for when your TV breaks or toilet clogs = don't worry, it's included
Phlebotomy / Lab = another supposedly 'free' service that is included
To keep these services 'free,' the patient will be billed $20 for every Tylenol that they take, $50 for each pair of nonskid socks, $100 for every lab draw, $2000 for every XRay, $5000 for every MRI, and so forth. These high costs cover our salaries and wages since we cannot bill patients. The high costs also cover the operating costs of the hospital.
NeoPediRN
945 Posts
That's actually getting off pretty easy, unfortunately.
gettingbsn2msn, MSN, RN
610 Posts
Hate to say it...but...the cost of the uninsured is also billed into that amount. Hospitals have to cover their costs (and make a profit, they hope). If 4 people come into the ER and are uninsured and walk out with out paying anything...you pay. It is that simple. That is why the lab I had recently was 400.00. Absolutely ridiculous. BUT how many other people had labs and paid zero?
danh3190
510 Posts
That's why I was in favor of earlier proposals to require that everybody in the US carry health insurance, rather like all drivers have to have car insurance. Or an alternative would be not to require them to purchase the insurance but to tax them directly the amount and put it into a national health system, but that idea seems unpopular.
AngelicDarkness
365 Posts
A small box of "cheaply" made toothbrushes in bulk costs the hospital 65$ a box. Not sure how. Have a friend in a hospital accounting department. Health care costs are insane.
MunoRN, RN
8,058 Posts
That's actually not bad, one of my relatives went to the ER and left with a 14,000 bill, that's without being admitted. Most of that was $10,000 for a twenty minuted diagnostic heart cath. It wouldn't have been so bad, except Medicare doesn't pay more than $5,000 for a diagnostic heart cath (rightly so), leaving her with $5,000 to pay out of pocket, so consider yourself lucky.
jelly221,RN, MSN
309 Posts
that IS getting off easy. your friend is lucky there wasn't a Cardiolyte stress test on the bill too. I went to the ER early this year for a migraine- 1 bag of NS, 4mg of morphine, and compazine with NO dx tests put me out $1400. Still paying that sucker off.
GHGoonette, BSN, RN
1,249 Posts
Sadly, the cost of establishing and maintaining a hospital is exorbitant. Look at the costs of beds, linen, monitors, multiple computers etc etc ad infinitum, and you're just scratching the surface. Go into the cost of one theater, just one; we don't use trestle tables and chloroform any more. Google theater tables, just a basic one. Then check out anaesthetic machines, surgical instruments, autoclaves, ethylene oxide sterilization units, laparoscopic equipment, the list goes on, and on, and on. You're looking at several million just to establish one theater, and things break and have to be repaired at a premium price or replaced at far more than the original cost. Salaries really comprise a small amount of maintenance costs.
ckh23, BSN, RN
1,446 Posts
Glad to see I'm not the only one who thought $2900 for an ER visit isn't that bad. I mean it's still a pretty penny, but could have been a lot more, especially if you get a doctor that runs everything.
OC_An Khe
1,018 Posts
I agree that cost was not out of line, particularly if youo were in a metropolitian area.
Remember also it is those charges Reduce one and the other will also reduce over time.
elkpark
14,633 Posts
I thought that part of the Medicare rules was that providers aren't allowed to bill clients for additional fees beyond what Medicare pays for a particular procedure -- that that was what providers agree to when they agree to accept Medicare coverage -- i.e., that, if a hospital usually charges $10k for a heart cath but Medicare only pays $5k, the hospital or physician isn't allowed to bill the client for the additional $5k. Does someone here know if I'm wrong about that? (I try so hard to keep up with all this stuff ... :))