I thought it was all the insurers fault?

[Darwin333]

A snakebite victim who was treated at a North Carolina hospital came away with more than just fang marks when he received an $89,227 bill for an 18-hour stay.

Eric Ferguson, 54, from Mooresville, N.C., told Charlotte Observer medical writer Karen Garloch that he got the staggering bill for his visit to Lake Norman Regional Center after a snake bit him in the foot while he was taking out the garbage.

According to his bill, the hospital charged a whopping $81,000 for a four-vial dose of anti-venom medicine.

For comparison, Ferguson and his wife found the same vials online for retail prices as low as $750.

Ferguson, who is insured, told the Observer his care was "beyond phenomenal."

"It was just the sticker shock," he said.

The hospital reduced the bill to $20,227 because of a contract with Ferguson's insurer. In the end, he paid $5,400 of his own money for his deductible and co-pay.

The hospital defended its prices, saying it has to charge prices higher than retail because of the various discounts it is required to give insurers.

And yet we continue to focus most of our time on health insurance instead of where the money is really going. Even the insurance company got screwed, they paid at least double (probably closer to 3 times) what the treatment should have costed MAX and that includes an absurdly generous overhead and profit margin. If this happened in ANY other industry people would be going to jail. That goes 10fold due to the fact that almost no hospital, and I would bet a months pay the one in the story is included, will even tell you what they are going to charge before they treat you. Yes I know that they can't give you an absolute hard number due to variables that are often impossible to foresee but they damn sure could have told the poor bastard in the story what they were going to charge for the anti-venom but they won't.

Why is that? Why is it that we give them special treatment that exempts them from black letter law that every other industry in the country must follow? Why isn't this issue front and center of the conversation? Sure health insurance is what we personally see as the growing cost but when they have are billed $90,000 and end up having to pay $15,000 for $750 worth of injections and less than a 24 stay in the hospital its not to difficult to see why.

 

[glenn1]

How many other industries are required to give away free product and services if someone shows up and needs them, but has no ability to pay?

 

[senseamp]

How many other industries are required to give away free product and services if someone shows up and needs them, but has no ability to pay?

Thanks, Reagan

 

[ivwshane]

Sounds like a simple solution could solve all of this.

Too bad the solution is something that's never been tried any where else in any industrialized nation/s

 

[senseamp]

BTW, North Carolina is not expanding Medicaid, so someone has to pay for all those uninsured showing up at the hospital. So it's a self inflicted wound on the NC GOP's part.

 

[Anarchist420]

if anti-venom isnt over the counter, then i guess the State issuing prescription privileges to those doctors is the culprit in this case. as for hospitals charging a lot, that is because 1) 80% or so of hospitals receive funding from the State so they get regulated (made regular) which means they all charge about the same thing; 2) State licensure... many doctors cant think outside the box, so they start charging patients a lot of greenback dollars. that is, they charge a lot of fiat currency. they dont know how to spend it wisely because all they know how to do is practice medicine. and of course, they have to spend too much on medical school thanks to licensure and the fact that most private medical schools receive federal funding normalizing high costs, creating a barrier for entrepreneurs; 3) it is largely due to the insurance mandates from the State that hospitals have gotten so big and are run by corporate execs who dont know what they are doing rather than physicians running things from their own places.

anyway, Rothbard's Law applies. that is, specialists just usually arent all that good at what they specialize in and i guess that is because career specialists do not see all the possibilities... they think what they were told by someone else at an ivy league university is enough.

i understand that those who smelled rude would pay more if there was no State, but that isnt the fault of the productive.

 

[Darwin333]

BTW, North Carolina is not expanding Medicaid, so someone has to pay for all those uninsured showing up at the hospital. So it's a self inflicted wound on the NC GOP's part.

Since this is most definitely a nationwide issue, whats the excuse for California?

 

[Doppel]

The whole thing is a racket.

 

[dank69]

Free market at work. Supply and demand. Even if they told the guy up front $81000 what's he going to say? No thanks? I don't know what you are suggesting Darwin, but I do know that more government intrusion is not the answer. These medical professionals have developed life saving procedures and it is their God-given right to get rich off their hard work.

 

[drebo]

Free market at work. Supply and demand. Even if they told the guy up front $81000 what's he going to say? No thanks? I don't know what you are suggesting Darwin, but I do know that more government intrusion is not the answer. These medical professionals have developed life saving procedures and it is their God-given right to get rich off their hard work.

..... The health care market is about as free as the telecom market. Try again please.

 

[cubby1223]

Free market at work. Supply and demand. Even if they told the guy up front $81000 what's he going to say? No thanks? I don't know what you are suggesting Darwin, but I do know that more government intrusion is not the answer. These medical professionals have developed life saving procedures and it is their God-given right to get rich off their hard work.

It's not so easy.

Whenever the government mandates that something must be done, something must be purchased, prices often tend to skyrocket.

It's the exact same situation you describe, just different entities. If government law says you must treat people, what are you going to do as a hospital? Not pay the $81k?

If government law says insurance companies must pay the claims, what are they going to do? Not pay the $81k?

That's how prices skyrocket throughout the whole system. It's fucking great to be a vendor! It sucks to be anyone else in the system.

It's not confined to the medical industry. It happens to pretty much all businesses that have to conform to government regulations, the cost of the goods required to conform to regulation become obnoxiously expensive just for the simple fact that government requires it.

 

[senseamp]

Health care should be regulated as a utility.
It's obvious to anyone that if you are bitten by a snake and your alternative is dying, you will pay anything for anti-venom, so the "free market" price could be anything the hospital decides to charge. Free markets don't work in health care, and they never will.
Trying to fit a square peg into a round hole is how we got our health care mess, which costs twice as much to deliver mediocre results.

 

[TheSiege]

How is it that I can get 30 pain killers with a prescription for $10. But if I was in the hospital I have to pay $80 per pill. I would like to see this change. That prescription are given at hospitals and they use the prescription rate.

 

[dank69]

..... The health care market is about as free as the telecom market. Try again please.

Exactly. Get the damn government out of healthcare altogether and watch prices plummet.

 

[Matt1970]

Exactly. Get the damn government out of healthcare altogether and watch prices plummet.

Right. I mean all you have to do is look at what our government has done for education. Highest per capita expense and not even rank in the top 20. Or how it costs over $30,000 a year to stuff someone in a 5X10 cinderblock cell and feed them crap. There are going to be so many great things in store for us with the total takeover of our healthcare system. I can hardly wait. We have already seen so many great things so far with the ACA and that is just dipping our toes in the water.

 

[ivwshane]

Exactly. Get the damn government out of healthcare altogether and watch prices plummet.

Lol, based on what? The fact that insurers would be able to drop the sick from coverage? Based on the fact that you think demand would some how be lowered? Or do you think having the ability to get knock off drugs would magically solve a bunch of problems? Or do you think that without regulations supply would start increasing quality alternatives and not an influx of crap. Or is it that you think, the black market of health care would take off and force legitimacy health care providers to compete?

 

[cubby1223]

Lol, based on what? The fact that insurers would be able to drop the sick from coverage? Based on the fact that you think demand would some how be lowered? Or do you think having the ability to get knock off drugs would magically solve a bunch of problems? Or do you think that without regulations supply would start increasing quality alternatives and not an influx of crap. Or is it that you think, the black market of health care would take off and force legitimacy health care providers to compete?

Based on the fact he's writing sarcastic parody responses.

There is no easy answer. If this anti-venom is so rare to obtain as they claim, the other side of the argument is you want to make damn sure it doesn't get wasted on people who don't need the anti-venom, so it is available to those who do need it. And the best way to do that is to price it sky-high.

There is no perfect solution.

But to have the hospital bill almost immediately negotiated down 75% is a clear sign the system is broken. Last time I was in the hospital, couple weeks later hospital calls for payment, and before I have a chance to do anything they're chopping the price in half (the price after my insurance covered their portion). It's like, glad I didn't pay the bill immediately when it arrived in the mail! You're getting royally screwed if you do that.

 

[Incorruptible]

Health care should be regulated as a utility.
It's obvious to anyone that if you are bitten by a snake and your alternative is dying, you will pay anything for anti-venom, so the "free market" price could be anything the hospital decides to charge. Free markets don't work in health care, and they never will.
Trying to fit a square peg into a round hole is how we got our health care mess, which costs twice as much to deliver mediocre results.

Yes they do. Government needs to get out of healthcare.

 

[WackyDan]

How is it that I can get 30 pain killers with a prescription for $10. But if I was in the hospital I have to pay $80 per pill. I would like to see this change. That prescription are given at hospitals and they use the prescription rate.

I would like to see line item by line item tallies of what is billed and then extrapolate that against their operating costs.

I can see prescriptions being higher, but at what amount? They have to have their own in house pharmacy and buy the pharma dispensing carts that are on nearly every floor (They aren't cheap - I know how much they can cost).

That said, one would assume your average size hospital is getting a discount on the meds anyway.

I get that they have to keep the lights on 24/7 and treat people who will never pay, or take forever to pay in full...

However, I was once pleasantly surprised by a bill. My daughter spent 79 days in the NICU after she was born severely premature. The total bill for that stay and round the clock care? $350,000. My wife's bill for 9 days in the hospital + C-section was $59k.
I was expecting a bill potentially totaling as much as $1 million dollars based on some lite research. I had maintained COBRA while being laid off, and the plan I had from my previous employment was exceptional... I think I paid in the neighborhood of $2000k out of pocket for both bills... There was a couple nickel and dime bills that were also out of pocket but really didn't amount to much. We were lucky and I think an exception to the rule.

 

[Fern]

BTW, North Carolina is not expanding Medicaid, so someone has to pay for all those uninsured showing up at the hospital. So it's a self inflicted wound on the NC GOP's part.

What's the difference?

Taxpayers paying their freight through Medicare or paying it another way?

Fern

 

[LunarRay]

You have to look at the total cost structure of a hospital... or anything for that matter.

The direct cost of the anti-venom vials and the other bits and pieces that are consumed are a tiny fraction of the entire cost that is loaded into the billing process.
You have the Residents, Fellows, Attending, nurses and other helpers along with the Called in Specialists who get paid regardless of how many paying admissions occur. Then there is the Facility costs and on and on...

The hospital budgets for these costs and then assumes a certain number of paying patients and that becomes the overhead attributed to the individual patient. Spread the fixed costs over more patients and the per individual billing goes down.... or the hospital racks up a bigger profit

 

[LunarRay]

How many other industries are required to give away free product and services if someone shows up and needs them, but has no ability to pay?

While the point is well taken the reality is that the actual cost to the hospital for folks who can't or won't pay for the services received amounts to nothing more than the direct cost to the hospital for the items consumed. Pennies actually. The only aspect that is troubling is the added wait time endured by the paying patient.

 

[senseamp]

What's the difference?

Taxpayers paying their freight through Medicare or paying it another way?

Fern

North Carolina is doing BOTH. Paying for Medicaid expansion in other states through taxes AND paying for its own uninsured in hospital bills.

 

[IGBT]

it's your neighbors fault for not working 24 / 7 to provide parasites with all their wants and wishes and free medical dope of their choice.