Hi all: We all know that healthcare today is expensive. We rail against it, talk about how expensive insurance is etc....
But we don't really know how expensive it is until we see it in black and white.
Two months ago I had an electrophysiology study with ablation to treat my supraventricular tachycardia. I knew going in that this was going to be spend-y and that I would end up with some bills, and I did. I will actually end up paying less than I expected
My trip to the cath lab, which did not include an overnight stay at the hospital, would have cost an uninsured patient $24,885.00. I actually think that I am missing some charges here. Because of my insurance, there was an automatic discount, before the insurance paid, of $7,807, and my cost is $757.
I received a 30% discount for having insurance. That was money that was not paid by anyone, that the uninsured would have paid by virtue of being poor.
I am not making any statements about "sicko" or universal healthcare, but I do believe that there should be one price.
I had an appendectomy last November; the total bill was $36,000. Because I used my hospital for the procedure, the facility fee was waived. Then insurance covered pretty much everything else. I paid about $200 of the whole thing.
health care isn't fair. I think if a better system was in place for routine things and minor illnesses, then some of the major costs could be decreased. One thing that drives up a hospital's fees are uninsured people using the emergency room as their primary care doctor. While I realize that they might not have a choice, it still drives everyone's costs up.
Some hospitals use people with insurance to subsidize those without. They mark up the costs on things that insurance will cover, so the profit can go towards alleviating the burden of the uninsured. My old hospital, for instance, charged $40 for a digital thermometer, the same kind you could buy at the drug store for $5.
It isn't a fair system. But what's the answer? I don't think socialized medicine is the answer, at least not completely. I also don't think our current system will hold out much longer.
Specializes in MedSurg, Ortho, Neuro, StepDown, Rehab.
People without insurance that have to have a procedure done in an emergency - well then they wonder why the patient doesn't pay - that don't have - the poor are barely getting by with what they have, and how can they come up with this type of bill to pay (another monthly payment). Elderly people have to scratch up the money to pay for their prescriptions monthly that some Doctor has them on (so many meds un-necessary), and you hear stories of elderly people eating pet food cause it is cheaper, no air conditioning nor heat - just so they can pay for their meds each month - what is this world coming too, when we won't even take care (or give a care) about our elderly that have probably worked all their lives - FOR THIS!!!
Ironic that this popped up as a topic today because my sister and I were just talking two nights ago about the basic unfairness of the current medical/insurance system when you look at insured vs. uninsured.
Background: My sister recently was hospitalized recently for 5 days following a nasty fx to her tibia and fibula. Including surgery, her bill came to almost $100K. The negotiated fee? $15K. My sister's share? $1,500.
Now had this accident happened this time last year when she was in the unfortunate position of having no insurance, she would have been on the line for the whole enchilada.
Specializes in Acute Hemodialysis, Cardiac, ICU, OR.
Oh, yeah...
Before I became a nurse, I worked in a hospital business office, and so I had in my hands the EOBs from all the different insurance companies. It's AMAZING the difference, based on hospital negotiated discounts. Medicare of course is the highest, but then they pay based on DRG (Diagnosis Related Group), so if a person is hospitalized for, say, CHF there is a specific price that Medicare will pay to the hospital (for the CHF diagnosis)-- REGARDLESS of what care the patient actually receives. So if Mr. X ends up with total charges of $10,000 and Mr. Y has the same diagnosis (CHF), but his total charges are $25,000 (maybe due to additional testing, maybe he was diabetic and needed more care, perhaps he received dialysis during his stay, whatever) -- the hospital STILL receives the same payment from Medicare (probably about $1000). There are certain situations where specific procedures can receive additional reimbursement, but there are very stringent rules to these situations. Blue Cross/Blue Shield receives the second biggest discounts. I would just shake my head, knowing how much healthcare and ancillary workers' pay was -- how can a hospital even stay afloat when they are receiving so little payment for patient services and have to pay all these personnel, plus purchase the equipment, pay the electrical and water bills, subscribe to cable, etc.?
I've seen many people get stuck with outrageous bills that they can never hope to pay, and I've seen many people reduce those bills by up to 90% if they are having an elective procedure and go to the hospital up front and negotiate a 'cash price.' Of course, this doesn't help in the event of an emergency. I've also seen many people have their entire bill written off.
My personal experience: My first child was born in a military hospital. My cost (as a dependent wife) was $9, which was for my meals. Not bad. A few years later, I had another child at a University Medical center where my husband worked. Before the delivery, he was offered a job in another state, and we had to decide whether to move pre- or post-delivery. They offered to pay the COBRA for us to deliver at the new hospital, but our cost would have been over $2000 out of pocket. If I delivered at the University hospital, my cost would be $0. We stayed. I asked for a copy of the bill a month or so later, just out of curiosity, and at the end of all the charges was a note and a subtraction: University Staff Employee Discount -- they just wrote off all the charges since it was an 'in network' service. EVERYTHING maternity-related was covered in this plan: All office visits, all testing (I was high risk and had 7 ultrasounds). We also had $5 doctor office copays and $3 prescriptions... Gads, I miss that place...
Specializes in Spinal Cord injuries, Emergency+EMS.
the simple answer is a hybrid system
tax funded emergency care - so emergency admissions, cancer invesigations ( current NHS standard = 2 week target to be seen often much quicker, 4 week target for definitive dignosis and 62 day target to start treatment)
nearly tax funded primary care (small , almost nominal fees for primary care consultations, rebated for the old, the young and those on contributory social security, prescriptions charged at a set fee so cross subsidy of prescription only drugs - where the cheap drugs that cost a couple of pounds for a month's supply subsidise more expensive therapies- have a 'season ticket' at a discount for chronic meds / 100 % rebate for certain conditions))
limited elective services where cost of doing it is less than cost of not doing it - but be prepared to wait a few months ( the next year NHS target is 18 weeks for electives referral to procedure), if you want quicker you pay ...
Susan9608
205 Posts
I had an appendectomy last November; the total bill was $36,000. Because I used my hospital for the procedure, the facility fee was waived. Then insurance covered pretty much everything else. I paid about $200 of the whole thing.
health care isn't fair. I think if a better system was in place for routine things and minor illnesses, then some of the major costs could be decreased. One thing that drives up a hospital's fees are uninsured people using the emergency room as their primary care doctor. While I realize that they might not have a choice, it still drives everyone's costs up.
Some hospitals use people with insurance to subsidize those without. They mark up the costs on things that insurance will cover, so the profit can go towards alleviating the burden of the uninsured. My old hospital, for instance, charged $40 for a digital thermometer, the same kind you could buy at the drug store for $5.
It isn't a fair system. But what's the answer? I don't think socialized medicine is the answer, at least not completely. I also don't think our current system will hold out much longer.