We got the bill about six weeks ago from my appendectomy. Two nights in the hospital (one mostly in the ER) and a two hour surgery.
Do you see the cost? $50,155.00 All the text you can’t see is the itemization, how much for meds and supplies, etc.
So, a few weeks ago, we got the amount that our insurance paid. Can you guess how much?
About $3700. We paid $150. So, they were compensated for 7.7% of what they billed. And we wonder why there is a health care crisis in America.
My first thought is usually to say “let’s just impose universal healthcare and get it over with.” I did get a little talking to from our friend under the mountain about that one. (And I don’t mean Canadian we-send-pregnant-moms-to-Great-Falls HC, the happy European kind.)
What I want is equity. I want a real sticker price. I don’t want the working poor to pay the price that the middle class never will. This is injustice. I am fine with the idea of privatized health care, as long as the poor aren’t oppressed while we do it. I am not seeing that happen the way the system stands.
I think we should just do away with health insurance all together. If it were not for insurance, followed by lawsuits, etc., we would be much better off in the field of health care costs. I could say a lot more about this, but I will refrain. I am sorry your bill was so high, I truly am. I am sure you guys are working on it, but write your ins. company to find out why they did not pay more. And be glad you have insurance at all.
We have none and a child with special medical needs whose weekly medical bills are about to bankrupt us, literally.
Wow. Jaw on floor. Usually we saw some minor adjustments on our bills (ER visits for childhood mishaps and such) but never to that extent, but we never had such a large bill either.
It’s also interesting where the “money is made” in medicine. My dad is dating a very successful doctor who works in internal medicine… apparently they make the most $$ for the initial intake visit, and much less for each subsequent visit. And then there are things that take hours she needs to do (like fill out admission papers for a nursing home) and she doesn’t get paid at all… but it seems like the system is structured in a really odd way that doesn’t really encourage good on-going care.
I was most struck by the differences in cost of birth… my first child was a hospital birth, induced labor, and the bill was $12000, we paid $1000… The second was a homebirth, not covered by our insurance provider, and it was $2000, out of pocket for us. Which makes me curious about Samaritan Ministries because they do “publish” the cost of homebirths I believe, though I would need to find out more…
very disturbing.
I’m speachless. I am sorry it is so much. We are still dealing with insurance for Leah’s 2 ER trips over the shingles she had in April. It is minor compared to what you’ve got to deal with though.
wait, you’re saying the difference between the $3850 you and the ins paid and the $50,155 billed was all written off, right? so the hospital doesn’t collect that? (just making sure I understand!)
Um. Seeing such a huge number has left me panic-stricken. Please tell me you don’t have to pay $45,000 or whatever the unpaid amount is. Please?
I saw the quads thing this morning on the news and wondered if anyone would understand WHY Canadian hospitals were too full to take on their complicated birth. good girl ;-)
As far as American healthcare is concerned, I have lots of thoughts, but I haven’t been able to completely put together the pieces, except that the gov’t shouldn’t be involved. My favorite theory lately (most of which was proposed in an editorial I read several years ago) has been for employers and those who self-insure to buy only simple, high-deductible plans (i.e, $5,000) and set aside the premium savings for everyday office visits and perscriptions, and to build up a savings account with $5,000 for the emergency appendecomies and other suprises that come our way. The insured would then talk with providers about discounts for paying all costs (office visits, bloodwork, etc) up front since they won’t have to file insurance claims, but only report paid in full bills that would slowly add up the deductible balance (something we could do for ourselves, really). If everyone had similiar plans, the insurance companies wouldn’t be the monsters they are, most of the reason, imho, that healthcare is in the unaffordable condition it’s in now. That still leaves a lot of problems for the poor, but I’d like to think that tax breaks for donating to free clinics, long-term disability care funds, etc, could go a long way… not to mention what the church should be doing to help.
There are other problems, but I’m still working all this out. My idealism tends to take over sometimes :-)
TO CLARIFY:
We don’t owe any more. The rest of the bill (92.3%) is just written off.
given that i live in the outer orbit of the great falls area (110 miles away), there’s been a quad story in the papers at least daily for the last week and a half.
at least mom and the babies were able to go back to calgary last week…
Hospital charges are very strange. In fact, sometimes the contractual amount works out to be substantially more than the amount billed (not often, obviously, but even in those cases the insurance pays according to the contract). There are all different sorts of reimbursement methods, but you are certainly correct that health insurers get a substantial discount at their network providers (usually, though I know of some exceptions). However, medicaid/medicare (I believe they’re usually close, if not the same), being a government program, pays considerably less than private insurers. Certainly there are people stuck between the two, though (my brother’s family, for one). I would think there is catastrophic coverage available on the high-deductible health plan model. We’ve got a HDHP this year, and I’m a little nervous about how much these OB visits are going to cost!! Part of the problem is that we’re not used to talking with our healthcare providers about cost. We’ve got to bring money back into the conversation, which is supposed to be encouraged by these HDHPs. Old habits die hard!
It’s really easy to mistakenly believe, from looking at your bill, that someone without insurance would pay that full $50,000. But they wouldn’t. At least not at a public hospital.
I’ve done a lot of looking into this subject, and GENERALLY SPEAKING, families who cannot pay their bills get them written off, if not totally, then a significant amount. So depending on what the bill comes to, a family without insurance might only pay a very small percentage of the actual bill.
In fact, one of the reasons the original bill is so expensive is hospitals playing the numbers games. Insurers base their “usual and customary” amounts on what they are billed…so the more they’re billed, the more likely their “u&c” amount will be higher.
make sense?
Well, yes and no.
We know that around 2 million Americans file for medical bankruptcy every year. (google it, there are a number of studies.)
Of them, many were initially insured. Some had bad insurance. Some lost their insurance. Some were uninsured.
I can’t believe that over-inflating costs don’t contribute to this problem.
Did you look through the itemization of the original bill for errors (or ask for an audit)? That seems a lot higher than it should have. What your insurance company paid seems to be more in line with what it should have been-which makes me think that it was a hospital billing error-and perhaps the insurance company caught it. I had major abdominal surgery (not just laproscopic) a few years ago and stayed two nights in the hospital. My bill from the hospital for everything came closer to what your insurance company paid out than what you were billed. Contracts for services do write off large amounts of the bill oftentimes-but I’ve never seen one write off quite this much.
Kitty, I think you might be right. In my experience, the discount is generally between 40 and 60 percent. That’s still a lot, but 92 is definitely way out of the norm. Of course, the 40-60 percent is an average, and there’s got to be something to counterbalance the negative “discounts”…
Jason’s laproscopic appy was in the $20,000 range (I don’t remember how much we paid, but it was in the $500-$700 range I think) Our insurance was originally not going to pay because we didn’t pre-certify (ha!) and went through the ER (where else do you go … no one plans an appy do they?) The doctor’s office didn’t bill it that way. So because the wrong code was used, it was originally denied … then reprocessed for payment. Crazy, let me tell you.
the most important information to learn from all this is DON’T REACT EMOTIONALLY to hospital bills when you receive them (they are a bunch of numbers on a page.) DOCUMENT every conversation you have with the billing dept. when you are untangling your bill with the name of person you talked to, date and time of the conversation (and what they told you), keep a conversation going with them if it turns out you owe money and set up a plan to pay…but don’t easily agree to a huge bill without considering every other alternative…chart/bill audit (only if you can’t seem to get anywhere), coding errors, errors at insurance company, etc. it often takes months for the final bill to be correct depending on how slow your insurance pays. sometimes you have to set up your payment plan b/f the final amt. is lined up, depending on the policies of the hospital. this is something that requires patience and perseverance just like anything you are working on that relates to customer service. don’t call at a time when you are upset. these people are used to dealing with upset all the time. they are not affected by it. you will just get yourself in a twit and the problem won’t be resolved.
i worked in a dr’s. office for 10 yrs. during the time when many of these changes took place in our medical care system. it was hard on everyone and it didn’t solve the problems it set out to fix.
b/f a dr. could give free care to his own pt. if he wanted to. how he can’t. the new system has left a lot of medical decisions up to insurance companies! that should be up to drs. i could go on but must stop….m
Wow. That is a lot of money. Working as a new physician I don’t always know or even think about how much things like cost. And I do agree with the assessment that at least PART of the problem is insurance. Another part, I’d say is Medicare and Medicaid. I think it’s great that the government has systems to help those who are unlikely to be able to afford health care so get it, especially children and the elderly, but let me tell you – they will pay doctors almost NOTHING. My dad is also a physician, and he is often frustrated because sometimes, medicare or medicaid decides how much they will pay for certain things (shots, procedures, office visits) and it actually ends up being LESS than the actual cost to provide this service. As in the doctor LOSES money for doing certain things. Which is definitely why they then have to charge for every small thing they do so that there is hope that they can make a living. And in my somewhat biased opinion as a family practice doctor, insurance companies and the government reimburse very poorly for lots of preventative services that primary care doctors provide. Even though good diabetic education can go a long way in helping keep something with newly diagnosed diabetes have fewer health problems from their disease and stay out of the hospital, insurance companies just don’t pay for the time it takes to do that in an office setting. Another issue this leads to is the paucity of new physicians who want to go into primary care, which is arguable the most important field of medicine, because they have a huge debt (average for a med school graduate is over 125,000$) and go instead into more lucrative fields where you can make more money.
Sorry this is so rambling. I have many other thoughts but since I was on call last night, my brain isn’t working very well. :)
I just reread that and realized there are multiple typos. Apologies. Again, staying up all night (I did come home and sleep for a little while) makes my brain function noticeably worse.
Praise the Lord for Resident work hour limitations.
I’m not surprised. Our insurance is an 80/20 plan and when Caroline was in the NICU for 4 days back in December, we’ll be paying 20% of that horrible, inflated price for years to come.
It’s insane. And it happens of course when you are at their mercy and in no position to negotiate.