healthcare cost

xtxrn, ASN, RN · Jul 27, 2011

my wife just had a baby and the amount of money that my insurance and i were charged for simple procedures was astounding. 75 dollars for a lab draw, 400 for the md to check things out the day after delivery when he was already on the floor with other pts. about a thousand for an ultrasound. i mean i can do an ekg, labs, and ct in under an hour without thinking about it. i just didn't realize how much it actually cost. i mean over 20,000 to have an uneventful lady partsl delivery when we checked out of the hospital early.
what do you all think the cause of this is. part of me thinks this is just insane and the other part is thinking why am i only getting twenty some dollars an hour when somebody is making a ridiculous amount off of my work.

my opinion: uninsured and underinsured patients (and i've been one during the first 2 years of disability), pharmacy companies making prices crazy, attorneys suing for anything - even stuff listed as possible side effects before the patient takes them, greed, and where are we going to go...they have us trapped unless we're wealthy enough to go overseas (can i see the hands of those who can summon their private jet for a quick trip to germany for an appy????? ).

i saw a documentary about healthcare in different countries. in japan, a person staying in a 4-bed ward is charged ten dollars per day to stay...an mri is a hundred bucks. germany was another 'good' example. and i know there were others, but chemo fog has me a bit memory tweaked- lol. canada has been mentioned in a lot of places i've posted on in the past- good healthcare, but not always easy access to it- a brain tumor patient may have to wait several weeks to months for an mri..- but for most people, it was good. england had another good example.....they simply don't make it about money making and greed of ceos, lawyers, and pharmaceutical companies. :mad:

i do like the idea of capitalism for non-life sustaining items (make money on tennis shoes, not cancer- or any other health issue)..... but for the 'privilege' to stay alive with quality of life???? don't think that should be dependent on being wealthy or well-insured. with my cancer treatments (chemo is ongoing), i learned some really nasty lessons- especially about drug companies. my one chemo med is 100k/yr for the first few months, then goes down to half that... if i didn't have a social worker helping me find a good medicare part d plan, i don't know if i'd be alive right now- literally. :eek:

it took until the late 90s for medicare to cover blood sugar testing on any diabetic not on insulin. seriously. they didn't look at how much better diabetes care would be if the patient could know his/her blood sugar and adjust activity/diet/meds. they didn't look at how about 80% of diabetics (type 2) end up on insulin since dm is progressive. i was lucky when i was first diagnosed to be working and have insurance that covered meters and strips (i wasn't on meds for the first 12 years- diet and exercise alone because i had a meter to get feedback on what i was doing)....then some genius figured out it was cheaper to cover meters/strips for all diabetics than lop off a leg or hook 'em up to dialysis for the rest of their life. like, duh ?????

i think that a lot of the bottom of some class ends up in the decision making process re:healthcare. they surely can't be the valedictorians -- unless it's in the phd of greed.....

momto2j's · Jul 27, 2011

I just got an ED bill of 1/2 a liter of IV fluid that my son needed on the 4th of July, following an eventful recovery from having his tonsils removed. More than $3000 for a 3 hour stay, an IV start and a 1/2 liter bag of fluid, a PA visit and the nurse stopping by about 4 times. He needed no diagnostic services and any of our local urgent care clinic's would have done but none of them would see a 4 year old. Our insurance paid about 1/2 as "their rate". But I still thought the original bill was excessive. I have yet to get the bill for the second IV that was done at the ENT clinic.

Esme12, ASN, BSN, RN · Jul 27, 2011

Eerybody wants their piece of the pie.......I agree with xtxrn.....PhD of greed

stefanyjoy · Jul 27, 2011

I handle claims escalations and issues at a health insurance company. I've seen pediatric offices charge $75 for a disposable diaper. Thankfully the contract with the insurance company protects members against outrages charges, but unfortunately, the uninsured are not protected against it. A practice or hospital could very well send the uninsured into debt for thousands of dollars for a very small service. Labs are reimbursed by insurance companies for pennies on the dollar but if the patient has no insurance, they're on the hook for $500, whereas if they had insurance, the lab would have accepted their contractual $16.34 and wrote off the rest. It's crazy. I definitely agree we are in major need of an overhaul.

obenfermera1 · Jul 27, 2011

Aaccck! I just typed out a post and it disappeared into the ether....dang. Short version....I agree with all the stuff xtxrn said, you go sister!

silentRN · Jul 28, 2011

.......

Altra, BSN, RN · Jul 28, 2011

I sincerely regret that more nurses do not have a basic understanding of cost center accounting.

When you are charged $1000 for an ultrasound, this includes:

1. the total cost of purchase, or the total value of the multi-year lease on the machine itself, divided by the number of procedures it is expected to perform during its expected life -- a "per procedure" charge -- with some variability based on the type of diagnostic procedure (how long it takes, etc.)

2. some number allocated to the resources required to keep that machine running -- supplies, periodic maintenance, electricity, etc.

3. the cost of the radiology tech staff

4. the cost of the radiologist or other provider who interprets/reads the images

5. some overhead ... as in, hospital escort or CNA or tech staff who may have transported you to/from your room, etc.

The same is true for any other line item you may find on a hospital bill. A charge of x for a med includes pharmacy staff & resources, nursing staff, electronic delivery systems such as a Pyxis, etc.

BTW -- it can be futile to compare apples & oranges ... but I delivered my child in 1994 at a total cost of ~ $18,000. So your figure, 17 years later, doesn't really faze me too much.

Trekfan · Jul 28, 2011

HOLY CATS ! A few weeks ago I was sent from doc, office to the er and I ended up walking out because of the weight time . the doc. checked my bs 1once and the er did it twice befor i left and i just got a bill for $90.00 for the 3 test are thay out of there mind I could it for free and next time i have to go I will .

Jennybird · Jul 28, 2011

I think it's unfortunate that the new health care reform laws don't target the front-end of the problem--exorbitant fees for services. Like someone above noted, having medical insurance can somewhat protect you from these costs by negotiating an acceptable price with the provider. With Medicare, this is called accepting assignment, where there are huge adjustments (deductions) to bills which brings the fees down tothe contracted/accepted amount. But yes, the uninsured don't have this privilege. BUT--with the new health care reform, I'm hoping that all Americans will eventually have this protection...we shall see.

c.oconnor · Jul 28, 2011

Bad debt, charity care.

Entitlement programs.

Government regulations.

Employee sponsored health insurance.

nola1202 · Jul 28, 2011

I sincerely regret that more nurses do not have a basic understanding of cost center accounting.
When you are charged $1000 for an ultrasound, this includes:
1. the total cost of purchase, or the total value of the multi-year lease on the machine itself, divided by the number of procedures it is expected to perform during its expected life -- a "per procedure" charge -- with some variability based on the type of diagnostic procedure (how long it takes, etc.)
2. some number allocated to the resources required to keep that machine running -- supplies, periodic maintenance, electricity, etc.
3. the cost of the radiology tech staff
4. the cost of the radiologist or other provider who interprets/reads the images
5. some overhead ... as in, hospital escort or CNA or tech staff who may have transported you to/from your room, etc.
The same is true for any other line item you may find on a hospital bill. A charge of x for a med includes pharmacy staff & resources, nursing staff, electronic delivery systems such as a Pyxis, etc.
BTW -- it can be futile to compare apples & oranges ... but I delivered my child in 1994 at a total cost of ~ $18,000. So your figure, 17 years later, doesn't really faze me too much.

thanks for sharing