Hospital Billing Is Out Of Control

Hospital billing is out of control with creative coding that legislation needs to reform hospitals.
Total Hospital charges: $23,345.90

My friend went to the emergency room complaining of chest pain. They immediately ruled out that it was not a heart attack. He did not have insurance so the only obligation according to law is that they stabilize the patient and release him. That did not happen and here is what followed:

He arrived at 12:00 AM on 2/23/2016 and was released on 2/24/2016.

The hospital charge an emergency room charge of $3156.50 and $2550.00 for the observation room on 2/23/2016.
Four Physicians saw him and they charged:

Emergency visit for $1485.00

Initial Observation Care on 2/23/2016 and Observation Discharge on 2/24/2016 in the amount of $422.00

Initial low complex and a subsequent care, both on 2/23/2016 for $255.00

2 physicians charged for After hour service charge on 2/23/2016 for $100.00 each

Additional charges by hospital:

Lab work: $2150.10
Chest X-ray and EKG: $889.80
Nuclear Med Stress test: $9769.30
Pharmacy: $1612.30
Vaccine and other RX services: $725.90

He was released and they gave him a script for aspirin and iron tablets. There was nothing wrong with him.

 

Medical expenses are one of the top reasons people in the US go into bankruptcy. Why medical care is so expensive is another topic, but that EKG ($889.80) and Nuclear Med Stress test costs ($9769.30) seems unreasonable. I'd contest those costs, unless there was some unusual circumstance.

I'm not going to address the fact that this person didn't have insurance, but I would have to assume it was a choice and he paid the fine for not doing so, and will now pay a much bigger fine for not doing so. This kind of thing is exactly why people buy insurance.

 

If he was so sure at that point that he did not have a problem as you seem to be implying, especially being that he doesn't have insurance, why did he not leave immediately? Was he handcuffed to the bed ?

 

My friend is not a doctor so he trusted them to know what he needed. He has a 401K that will pay this bill.

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There was no reason for these tests but greed on the hospital's part. My argument is the excessive cost of these items.

 

Time for a complete overhaul and reform of the medical system in this society.

It won't be completed overnight by any means... but work on the same is long overdue.

 

You are not a doctor either, but when you are implying there was no reason for him to stay, you are disingenuously playing the role of one.

If he has a 401 k that can pay that bill, then I would say that was a REALLY stupid move on his part NOT to use that 401k to purchase health insurance. It seems like your friend decided to gamble...and he LOST. That isn't society's problem. He made his bed, now he has to lie in it. That's is no one's fault but his own. He had the means to insure against such an occurrence, but he chose not to.

 

If you present yourself at the emergency room with symptoms of a heart attack or complaining of something that seems like a heart attack, they're going to rule out a heart attack before they release you. Otherwise malpractice lawsuits would end the ability of anyone to go to an emergency room for treatment. I sympathize with the high cost and believe your friend may have a case against some of the costs, as they are exceptionally above the average cost of the procedures, but this very incident is why people get insurance in the first place, not to mention that it is illegal not to have it. Emergency rooms are going to do more than triage and stabilize. Are the costs huge? Yes, yes they are. They're going to rule out the reason you came in or not release you until they know what's going on that sent you there in the first place. They are legally liable if they don't.

 

Thank you, finally a reasonable response to my op.

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They told him within 15 minutes of him being there that he was not having a heart attack.

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The issue here is not him having no insurance. It is the high cost of healthcare that is out of control.

 

There is another aspect you are not aware of, fear of liability. Many tests are done to cover all bases in case of a lawsuit and this country is very litigious. I have a friend who's brother passed away and the wife sued and got a multi-million dollar settlement because they did not do a test.

BTW, according to Obamacare, he should have insurance. What's the deal there?

 

Oh I'm pretty sure his biggest issue is not having insurance.

Your implication that he should not have stayed for more than a few minutes is WAY off base too.

 

Your analysis would hold up if hospitals weren't fraudulently overbilling people under duress 1000s of times a day across the country. Being defrauded under duress and then receiving -outlandish- bills is not how services work in this country and haven't worked for some time in the age of consumer protection. Vendors of -any- kind of service or goods have a moral and legal obligation to disclose material charges before providing them. Hospitals have cruised along in this gray area of contract law and relied on "just sign here" as enough to justify outrageous charges for a long time and it's time for that to end.

Not merely stabilizing, but continuing to pile on expensive services, onto someone under stress/duress, in pain, medicated, etc., and then expecting to collect any old outrageous amount they choose to charge is a policy with no legs to stand on whatsoever in the eyes of our law and common sense morals. OP's friend should have no problem getting this bill reduced massively.

 

My "analysis" as you call it, had absolutely not one thing to do with hospital bills being inflated or not. As such, to say that my "analysis" doesn't hold up if hospitals weren't overbilling people, is WAY off the mark.

She implied that he had no reason to stay and I took exception with that characterization. She also made him out to be the victim because he lacked insurance, and I took exception with that as well.

 

How is the premise possible...we have ObamaCare with mandatory insurance...all is well, just ask the dems

 

So your loving that Obama "change" ?

 

I went to the ER at 3 AM with heart attack symptoms. My BP was sky high and I had severe pain in my neck and shoulder. They got very aggressive in my treatment, nitro under my tongue, aspirin, 2 enzyme tests, EKG, heart cauterization. All the test were negative and heart cath showed a good heart and surrounding arteries. Eventually that afternoon my BP came down to normal and the pain subsided. The theory was that I probably had "nutcracker esophagus". I was told the next time it happened not to worry. My bill was $1600 and I paid $65. But I had insurance. Anyone without insurance these days is either a fool or a millionaire.

 

OK, to drop the politeness, your lack of any reasonable "analysis" in favor of your own assumptions is asinine and myopic. Did you expect every possible detail from OP about the visit? Why? Apparently so because otherwise the assumption in the above, that he could have left immediately, is moronic, especially the "handcuffed to the bed" hyperbole. We haven't heard the entire details of OP's story, nor would we expect to in a thread making the claims it does and using the story in the OP as something called an "example," not a dispositive fact pattern evidencing the claim. OP made a claim about hospital costs and gave an example.

Have you ever been in pain? Not known what was wrong with you? Relied on someone else's honesty to behave fairly towards you in light of your debilitated condition and possibly affected mental capacity? Frankly, trying to sum up the choice of people in ERs in a hospital as being "chained to the bed" or not is childish. Do you think people should be held to agreements they sign under duress just because it's a hospital? I don't. I think all businesses have an obligation to disclose costs as much as or more than risks. Do you know whether this was done or not? I don't, but you apparently do through some Magic 8 Ball powers.

How did OP pretend to be a doctor again? I didn't see it, why don't you -quote- OP's "disingenuously playing the role of a doctor." I won't hold my breath. OP, especially in the interest of brevity on a forum, is allowed to state opinions or summaries of what actually occurred such as "there was no reason for him to stay."

Have we found someone who works in healthcare and thinks it's just hunky dory to charge a person under duress, who may be medicated, $23,000 for a hospital visit? Even though we KNOW on the front end he doesn't have health insurance? Apparently so. Indefensible.

It seems like you are making another bad assumption. How are hospitals' billing policies once they serve uninsured people instead of stabilizing and discharging them of any benefit to society, such that the issue in this thread has anything to do with whether it's "society's problem" or not? I want hospitals stabilizing and discharging patients without insurance as fast as possible, not very obviously using a bad health situation to gin up some deductible operating losses, which is what this is really about.

You're the one offbase here. The only relevance of his lack of insurance is that in those circumstances, a hospital should stabilize and discharge OR be held to a very high unconscionability standard of negotiating an agreement with a near incompetent. OP complains about a large bill that sure looks like it resulted from overzealous ER "care" and bill padding, things hospitals are notorious for. You can try all you like and fail to make it "all about lack of insurance." That is a factor, but there is much more to these stories.

You want to make it all about this guy's choice and lack of insurance, and that's crystal clear from your posts to the thread. You are the biased one, and in all likelihood the hospital is more to blame in this situation. Your posts to this thread are WAY off the mark.

People can read the thread, instantly see your bias, see with their own eyes that you are making as many or more assumptions than OP, and judge for themselves.

 

Medicare for ALL will be cheaper, more effective, and more cost efficient. It's only a matter of when.

 

At both the two hospitals in my small city area, who obviously collude, the charges for that would have been in excess of $10,000 on an insured person and possibly as much as $25k on an uninsured person. They know that the uninsured person is likely not to negotiate like an insurance company, so they rip the F out of them, knowing they will not get anywhere near the whole amount and then getting an operating loss for what they can't bankrupt out of the uninsured. Part of the extremes on each side of this thread could have to do with whether a hospital has enough competition or public pressure to charge reasonably or not.

People forget that healthcare is not a constant across the country, and it's particularly crass to dismiss complaints such as OP's, which looks very obviously like the type of overcharging I see around here, as "caveat emptor," or "it's what you get for not being insured."

 

Medical costs in general and hospital costs in particular have nothing to do with anything, least of all market economics. In fact, the more underutilized a hospital's beds and other equipment are, the higher your charges are likely to be.

 

When somebody like a middle aged man comes into the hospital complaining of chest pains, those tests are certainly necessary, because if he is released and suffers a heart attack, there will be lots of lawyers asking why they didn't run those tests.

As for the excessive cost, you have to understand that doctors and nurses and technicians don't work for free, nor do the people that manufacture and maintain the instruments necessary to run these tests. You're not just paying for the doctors and nurses that actually talk to the patient, but everybody else on up the ladder. The doctor that saw your friend has a boss, and his boss has a boss. That boss probably has a boss, as well. The nurse that popped in to make sure he was still alive has a boss, and her boss has a boss.

None of these people make minimum wage, so if you want medical care, you have to pay a very substantial amount of money. That's just the way it is. Either that, or go without...

 

Amen. (And some without insurance, are just 'unfortunate'.) We need to 'reform' a LOT of things.

 

welcome to the inferior world of for profit healthcare.

 

Of course!! Spreading the financial risk/burden as widely as possible... will likely improve everything (aside from extraterrestrial invasions, meteors striking the planet or nuclear wars). Other than that, we'll probably ALL be better off, with Medicare for ALL.

 

Tell your friend to stop running up $23,345.90 in hospital bills when they cannot pay them and there is nothing wrong with them.

 

Problem solved!