The cost of a Ace wrap

[psu_213, BSN, RN]

So a bit earlier today I was listening to the NPR program "Here and Now." People accuse NPR of being biased...and usually in a political sense. While I think the are pretty balances politically, the little bit seems very biased against nurses.

The topic was medical equipment (slings, walking boots, etc.) and how much hospitals charge for it compared to how much people would have to pay for the same equipment at the drugstore or online. It started with a man who had elbow surgery, woke up with a sling on his arm. Discharged with the sling...insurance was charges $93 for the sling for which he had a copay. He went home, looked online, and he could by the "exact" sling for $7. The increase in cost, according to the company that makes the sling, was for fitting and education on correct use. The report then said something to the effect of "it's just a sling, everyone knows how to use it...they don't need to add a charge for that." At this point I'm chucking...have you ever seen some people try to 'operate' a sling? They definitely need help with it, especially if they are just fresh from limb surgery.

The next focus was on an Ace bandage for which insurance was charged $115 and cost about 10 bucks at the drug store. Again, the rationale is that part of the charge was for correct application and education related to the ACE bandage. The hostess then chimes in "well, I suppose you can cut off circulation or something like that if it is too tight, but come on, its an ACE wrap, everyone can use it." (not an exact quote by close) The reporter echoes this. So the next time I put on a fiberglass splint, I can just throw the ACE wrap at the patient and they can just put it on, because everyone knows how to use it? If their fingers become necrotic, well, its all their fault, because every knows the correct application and all the warning signs if it is too tight?

What upset me most about this piece was what was unsaid, but implied. They only had this one reporter on...no one from the hospital, no one from the equipment company, no nurse who applies these pieces of equipment regularly. Yet, the piece implied that using these are something everyone knows. The nurse is not skilled....he/she only does things that the patient already knows how to do themselves. The education the nurse provides is only common sense and everyone knows that to begin with. Why do we add a cost to this equipment to have a nurse just recite what the patient already knows? Maybe I'm reading too much into it, but it seems to me just another situation of devaluing the role of the nurse.

[RNperdiem, RN]

Yes, the public does not really understand what we do.

When I hear about how much things cost in the hospital, the more I think about the way things are done in other places.

One nurse I work with says that in her country, when you are admitted to the hospital, your family members are given a supply list of all the drugs and supplies you will need, and then they buy everything at the local pharmacies and medical supply stores, and deliver them to the nurse to use. It is kind of like buying school supplies. The pharmacies compete with each other in prices, so prices are kept more reasonable.

If you are admitted emergently, there are some supplies on hand to be used until reimbursed.

[ckh23, BSN, RN]

That may be the line that hospital is saying, but the reality is that hospitals have to overcharge for equipment and supplies to make money. If they charged face value for this stuff they would not make any money and would end up losing money because of uninsured patients.

[MInurse.st]

In reference to RNperdiem, and if the family can't afford the medicine/supplies, the pt doesn't get them. In the parts of the world where healthcare works like this (developing countries) usually the families can't afford these things, and subsequently the pt doesn't get treated. To be blunt, those with money live and those without die. I'll take our system over that any day.

[classicdame, MSN, EdD]

the cost includes the salaries, building, utilities----------

And if they really "know what to do" why don't they stay home and do it?

[eatmysoxRN, ASN, RN]

Seriously though, I have been shocked by how much I'm charged for supplies at the hospital when I'm the patient. A couple hundred for an IV that was placed in 3 minutes? Geez I wish I was paid that extra money.

[psu_213, BSN, RN]

And if they really "know what to do" why don't they stay home and do it?

My point exactly...

[monkeybug]

In reference to RNperdiem, and if the family can't afford the medicine/supplies, the pt doesn't get them. In the parts of the world where healthcare works like this (developing countries) usually the families can't afford these things, and subsequently the pt doesn't get treated. To be blunt, those with money live and those without die. I'll take our system over that any day.

I remember watching a show years ago about birth around the world, and it showed a man in Afghanistan desperately running from pharmacy to pharmacy searching for the particular suture the OB wanted, knowing that his wife and baby were in distress and waiting on him. Once he found it, the c-section proceeded, and that was one of the bluest, limpest babies I've ever seen. Then the nurse wiped out the baby's mouth with gauze and used gauze as a barrier and did mouth-to-mouth. Our healthcare system may be flawed, but it sure beats the heck out of what some people have. I had a section, and I was desperate to have that kid out by any means, STAT (CPD pain, Pitocin, and no epidural) and I cannot imagine waiting for my husband to run to Rite Aid and CVS to see who had the 3-0 Vicryl in stock.

[iluvivt, BSN, RN]

Hospitalized patients are not traditionally charged for nursing services instead of a very few select procedures, In fact they are no charged for a lot of individual services they receive so they tack them on to items they can charge for. I would sure like that NPR host to come to a busy ED waiting room on a Fri or Sat night and tell everyone to go to Walgreens to get supplies and take care of things themselves.