They’re three bucks a box at the grocery, but how much is a Popsicle at the ER?
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I feared the worst. I tend to do exactly that when it comes to unnecessary procedures and for this pain adverse dad, ear piercing has always seemed one of life’s more ridiculous rituals. Why do people voluntarily hole-punch their bodies? At least with paper you get those fun little circles to use as confetti or fake snow or filler for your vacuum cleaner bag. With skin, you get some blood, unnecessary metal in your ear, and possibly a nasty infection. The Bear got the trifecta of those options, with the final horse crossing the finish line on Thanksgiving afternoon.
Our nearly ten-year-old girl’s earlobe had ballooned to about 5x its original size and became the color of the cranberries that would be served later. It pretty much had everyone freaked out – the ear, not the sauce. That ear, despite how gnarly it looked, was not technically ER worthy, but at the instruction of the on-call physician and because we weren’t near home (and even if we were, our family doctor’s office was closed for the holiday,) my wife took our oldest daughter to the ER of the closest hospital near my parent’s house, where my family traditionally gathers to gorge ourselves and give thanks…for the invention of Tums.
After two hours in the ER, 85% of which was spent alone together with no consultation or appearances of hospital staff, one 3-minute doctor visit, a cherry Popsicle, and a single antibiotic pill, they were released with the information that her ear was indeed infected. No shit. There was no statement of cost, no co-pay, no mention of fees, no due dates, no consumer choices. Nothing. Just a pill, a Popsicle and 2 hours of their lives they’ll never get back.
♦◊♦
Yesterday, January 6, a bill arrived from the hospital. $451.14. Not itemized one bit. Due immediately. And with the caveat that “The above balance may not reflect the entire balance due from all accounts with St. Mary Medical Center. The professional services of physicians in the departments of…Emergency…are billed separately from the hospital bill.” So I should expect something else? Another mysterious charge for the 3-minutes of an ER physician’s time? Fantastic. So what exactly does this $451.14 cover then? The Popsicle? That’s one expensive freezer treat. Or is that billed individually too? You know, since nothing is spelled out on the invoice.
$451.14 is the cost of a round trip flight from Philadelphia to Seattle in the summer, plus an overpriced bottle of water and a snack in the airport. The cost of a mini 16GB iPad, plus tax and a case. The cost of a month’s worth of groceries for a family of four, plus a few impulsive pieces of candy at checkout. The cost of a great plumber to spend two hours replacing parts and fixing a year’s worth of toilet, faucet, and water softener issues. And apparently, the cost of 2 hours in an ER room, 3 minutes of one doctor’s time, and a single pill. Oh yeah, and the Popsicle. The physical difference between those five $451 goods & services is startling, of course, but what’s more ridiculous than putting a pair of holes through your skin is that for all but the hospital bill, you are able to know exactly what your financial responsibility will be when the bill comes due. Nowhere else in the spectrum of consumerism does it work like it does in the medical field. Even a car mechanic, one of the world’s most stereotypically shady professions, can quote you an hourly rate for their services, allowing you to shop around to find the blend of value and quality that fits your needs. Not so with in the wacky world of healthcare and I believe that it is 100% wrong for any business, and let’s not pretend that healthcare is something more than a business to consumer relationship, to function in such a way.
I don’t believe my daughter received anywhere near $451.14 worth of service at St. Mary Medical Center on Thanksgiving and as such I will not be paying that full amount that was never once disclosed at any point during her two hour visit to the ER. I’m going to make a counteroffer, because this is a business transaction after all, in an attempt to draw a line in the sand. Consequences be dammed.
—originally posted at OWTK.
I work in healthcare finance – and i’ve got to tell you $451.00 for an ER visit is pretty darn good. There is not one specific reason your bill was so high – it is a healthcare system issue overall. I like to use the example of a car dealership to try to explain: Lets say “Pete” walks into a car dealership. A salesman approaches him and Pete demands a car. He cannot pay, and quite frankly does not intend to ever make any payments going foward either. Due to regulations around access, the dealership is beholden to hand the… Read more »
Well over here in the good ole ‘socialist’ UK that trip would have cost nothing, no bill, no follow up bill no demands etc etc
Sadly though the current government would like to end this ultimately allowing the private sector to take over. It will be a crying shame if it does.
Oh this sounds familiar! I had a similar visit w/ my daughter- but hers was a VERY obvious UTI at 8pm, that couldn’t wait until morning. Although our hospital has a great childrens center, ann we didn’t have an obscenely long wait, it was still long, and the wait in the room was even longer. 1 “test” (as in Oh My, how obvious that it is exactly what you have been screaming at us) that took 20 minutes to confirm, and a prescription later, and we were sent on our merry way. A month later we got a statement from… Read more »
I had 2 surgeries to remove cancer, I paid grand total of $0.00. Bandages actually cost more than the surgery for me, they were about 100bucks all up over a few weeks for special ones. I had my wisdoms removed for free too. The U.S healthcare system is a joke of the modern world.
Your bill reflects one of the big problems with medical billing for uninsured people. What you are seeing is the rack rate for the visit. This is their maximum non-discounted rate. Insurance companies pay a discounted rate. Maybe with up to a 40% or more discount.
The problem is that the people least likely to be able to pay are charged the maximum rate. Why can’t they be given a discounted rate similar to what insurance companies pay?
People don’t realize that all hospital bills are negotiable.
This makes me steamed for a couple of reasons – the first being that these kinds of insane charges (which are *not* even in the slightest unusual) is the primary reason people have trouble affording health care in this country, not issues with insurance. That fact that you need to have insurance to be able to afford health care is in itself a statement about the absurd prices health care professionals charge for five minutes of their time. On the other hand, however, crap like taking the kid to an EMERGENCY ROOM because of a swollen ear doesn’t help matters.… Read more »
Because this is going into this direction, I have to agree with you Steve. What we are now going further into is a “gate keeper” system. As it’s been happening for quite some time with insurance, the “non-emergency” use of ER’s are going to be questioned and in some cases denied. I remember when people here in the Midwest had a fit when HMO’s came into play. The encouragement (and its penalties) for inappropriate use of ER’s was a major issue. My former career evolved from the development of HMO/managed care. I encourage people to take a close look at… Read more »
Actually such a severe infection so close to her brain is cause for concern. I’ve heard of tooth infections that went in the patient’s brain and he died as a result. As I tell my patients, bills are a problem of the living. Better to be alive and filing for bankruptcy than dead.
That’s why obamacare is a GOOD idea
Penokan, help me understand what there is in the ACA that rectifies the problem that’s being discussed?
Insurance companies negotiate rates with hospitals that are significantly below the sticker price (so to speak). Even with a high deductible plan, you may have considerable out of pocket, but it will be at the price the insurer negotiated not the sticker price (which this appears to have been).
My brother’s ear did the same thing when he got it pierced as a teen, and he needed surgery to have it removed. A few years ago I went on a late-night ER visit for pain in my chest while breathing, at the suggestion of my father-in-law who is/was a firefighter and paramedic. I had an eerily similar experience – we spent HOURS in that room completely alone, interrupted by very short visits from doctors and nurses. I did get an X-ray and a CT scan performed, several hours apart, and at no point did anyone so much as mention… Read more »
I understand why it might be hard to get a straight price upfront but the way it works now really needs to change if we are ever going to get healthcare under control.
On my site’s Facebook page, a guy posted rate sheets that hang on the dentist and doctor’s office doors in his hometown, so everything for him his upfront, clear, and there are no surprises. Of course, that’s in France, so…
Ever notice that Catholic hospitals are always the biggest ripoffs? I guess they feel like they dont have to prove what they claim you owe them any more than they have to prove any of the other outrageous and irrational things they claim.
They all have to follow the same guidelines as other hospitals. They aren’t exempt because they’re of any denomination. Many of the bills pts. receive are after the insurance company paid, accordingly what they bill is what’s left over. Believe me when I tell you that many of these bills that are paid are scrutinized by the payer. The other part is that many hospitals negotiate “per diem rates” which are all inclusive set daily rate which includes a variety of services and those bulls are not broken down.
I know this was a fun article and I’m sorry for getting serious. I did have to pay $300 out of pocket for an aluminum bed pan. While my wife was hospitalized in an old wing at Rush St. Lukes in Chicago, I propped a window up with it and it slipped and fell 4 floors. That was 38 years ago.
Jeff, the truth is that some doctors may actually negotiate the bill. My MIL broke her ankle. She didn’t have a pot to pis in. When she got the bill from the ortho, I called them and let them know that she can afford a couple of dollars a month, she had no assets and it would take a real long time to pay off OR I can give them X dollars and consider the bill paid. They took the X dollars.
It’s obscene. The world of medicine is as sketchy as it gets when it comes to the price. Never a “quote” or an estimate. Just the sound of the hammer dropping on your wallet or purse when payment time arrives. And all done with a completely straight face!
Go man go – offer them pennies on the dollar AFTER an itemized bill is sent to you. Holes in the ears, still strikes me as strange too!
cheers
Thanks, Rob! I cannot understand why this isn’t more of a conversation. People freak out about everything these days, but the old manner of mystery charges in the healthcare business that operates like no other is accepted without comment it seems. I can’t make sense of it.