This is what's wrong with healthcare.

[MarkXIX]

Anesthesiologists are some of the most trained physicians there are. They are typically the "go to" guys for oncall/code stuff happening at a hospital. Especially at smaller community hospitals. Depending on the system they also have a huge role in the recovery and medical management post-op. It's more than turning a knob on a gas machine. Nurse Anesthetists do that at a lot of places anyway

Health care is more than physically laying hands or administering. There's also a huge amount of accountability and responsibility. These guys have their license on the line for decisions that a machine won't make. A computer can recommend, but humans are still required for approval to move ahead.

Then, as I understand it, much of their pricing is based on lawsuit mitigation and insurance because people insist on becoming millionaires when the slightest thing goes wrong.

 

[Fanatical Meat]

Then, as I understand it, much of their pricing is based on lawsuit mitigation and insurance because people insist on becoming millionaires when the slightest thing goes wrong.

I used to think this and I believe at some point it was true now I don't believe its much of an impact its an excuse.
Do you know anyone without a google search who has instant millions because of a minor medical mistake. Even the people you see get awarded big judgments in the news are usually due to unneeded procedures or flat out fraud like being treated for a disease they didn't have.

 

[Mike64]

It's a lot like going to Kohls or J.C. Penny's for clothes.

Retail price for a shirt: $79.99.
Sale Price $49.99
Special weekend deal: $24.99
Oh here's a coupon in our flyer for another 20% off...

You only pay: $20!!!

That's how it works with Insurance. They'll reimburse like $500 of that $3700 bill.

Exactly. The system is totally geared to insurance reimbursement and completely and utterly screws the relatively few poor schmucks who end up having to pay "MSRP."

 

[dank69]

$3800 is fucking NOTHING for an ER visit. Go to a walk-in clinic next time if you don't want to pay for wasting emergency personnel's time.

 

[Sho'Nuff]

That's pretty insane. I had a surgery a few yrs ago, where I was in and out of the hospital in about 2 hours. Total bill was about $6k. That was for a 45min surgery, plus anesthesia.

Was this billed directly to you, or was it the invoice from your insurance company?

I had a similar experience, but the bill was for 18k. Was for a small ventral hernia repair. I was in the hospital for less than 2 hours, half of which was spent watching Cosby reruns.

I requested an itemized bill and was surprised to learn that my local hospital bills OR time at $103 per minute. PER MINUTE!

 

[Slew Foot]

There is actually a bit more to it. Calculation of the surgery time with body mass, allergies, stroke and circulatory history and gender all goes into dosages and women tend to experience waking paralysis. A lot of responsibility rests on the anesthesiologist's shoulders as far as the patient care goes. Granted, they don't have to be familiar with as many nuances as pure doctors go, but it is a lot more perilous than it appears. Patients can wake up during being cut wide open or they can go into cardiac arrest at any given moment. I would be stressed TFO.

Anesthesiologists are some of the most highly trained specialists. Not only do you have to know everything about surgery and how to keep the patient alive while someone is cutting stuff out and spilling liters of blood on the floor, but you ave to do it in the context of the persons medical history as well. Hypertension, CHF, diabetes, kidney/liver failure all have different effects on what the medications do and how the patient will react, and you usually dont have a lot of time to figure things out. There are plenty of places to cheap out on health care (most of them are located in the business office/executive suite), your anesthesiologist isnt one of them.

 

[Sho'Nuff]

Doctors and nurses don't get much of the money pie. You should see the executive suites for the executive staff. It's as nice and spacious as any luxury hotels. Doctors get a shared closet to do their work.

QFT.

Example 1: My next door neighbor is an anesthesiologist who only does cardiac cases. He said that in most cases the hospital bills 5-7k to insurance for anesthesia, of which he sees about $1200.

Example 2: My daughter had open heart surgery at Boston Children's hospital when she was 2 months old. She was in surgery for 7 hours, the cardiac ICU for 7 days, and then a lower intensity unit of the hospital for another 5 days or so. Total bill was $89,000. On the itemized bill, the amount itemized for the surgical team (i.e, the folks who actually saved my daughter's life) was only $11,000. That team included the cardiothoracic surgeon, the anasthesiologist, and a team of 6 or 7 nurses.

 

[Raizinman]

I cut my finger, kind of bad. I did not go to the emergency room.

Schmeared on some anti biotic ointment, slapped on a piece of duct tape and was back to work in 10 minutes. Yes, probably could have used 7 or 8 stitches.

Wife wanted to know why the kitchen sink was full of blood.

Healed nicely, small scar. Total cost: About $0.75

Yes, I have health care and could have gone to the ER and spent half a day or more there and then been pissed about a $3K bill while missing a half day of work.

 

[Humpy]

Valid point when/where it is possible to learn the price upfront. When medical providers simply will not discuss price upfront then the point loses validity. "We don't want price to interfere with the doctor-patient relationship" was printed on one piece of paper we received at the ER.

Go to a different medical provider then, there are options, i.e. private clinics, Mexico, etc. A lot of people shop around for medical services. I might question whether the OP's finger cut was worthy of an emergency room visit but it was his decision.

Hospital emergency rooms have massive capabilities that come at a massive price. There is no way around it. For some reason a lot of people go in there expecting it to be like JiffyLube.

 

[Homerboy]

Go to a different medical provider then, there are options, i.e. private clinics, Mexico, etc. A lot of people shop around for medical services. I might question whether the OP's finger cut was worthy of an emergency room visit but it was his decision.

Hospital emergency rooms have massive capabilities that come at a massive price. There is no way around it. For some reason a lot of people go in there expecting it to be like JiffyLube.

Nah... I at least know JiffyLube is going to use some lube before bending me over...

 

[Fanatical Meat]

Go to a different medical provider then, there are options, i.e. private clinics, Mexico, etc. A lot of people shop around for medical services. I might question whether the OP's finger cut was worthy of an emergency room visit but it was his decision.

Hospital emergency rooms have massive capabilities that come at a massive price. There is no way around it. For some reason a lot of people go in there expecting it to be like JiffyLube.

I understand your point however going to Mexico for a cut finger? Where do you live?
Doesn't it seem strange to leave your country for regular medical care?
In your opinion what is a realistic charge for stitches on a cut finger at an emergency room?

 

[vi edit]

Nah... I at least know JiffyLube is going to use some lube before bending me over...

Nah a hospital is going to use lube. But it's going to medical grade stuff in a giant tub with a pump handle that runs $100 a gallon or about $1 a pump.

 

[Homerboy]

Nah a hospital is going to use lube. But it's going to medical grade stuff in a giant tub with a pump handle that runs $100 a gallon or about $1 a pump.

Excellent point. And I will wait in the exam room for 45mins for a nurse to come in, apply the lube, then tell me the doctor will be with me shortly* to examine if I really needed the lube in the 1st place.



* "shortly" is roughly defined between a consortium of doctors, cable and/or power companies and telephone support/billing staff.

 

[Humpy]

I understand your point however going to Mexico for a cut finger? Where do you live?

New Mexico.

Doesn't it seem strange to leave your country for regular medical care?

No. Thousands of Americans line up every day to cross into Mexico for healthcare service.

In your opinion what is a realistic charge for stitches on a cut finger at an emergency room?

$3,745.15

It is clear to me that it would take a huge amount of money to set up and operate a typical hospital emergency room as a business. The customer invoices would reflect that. It would be far different if I were to set up a Stitches R Us. The costs would be far lower. There is no way around the math.

Hospitals probably shouldn't be run as a business but as a public service. That's another gripe though.

 

[MarkXIX]

I used to think this and I believe at some point it was true now I don't believe its much of an impact its an excuse.
Do you know anyone without a google search who has instant millions because of a minor medical mistake. Even the people you see get awarded big judgments in the news are usually due to unneeded procedures or flat out fraud like being treated for a disease they didn't have.

Oh, trust me, I agree with you on the reality of it all. But, there's an EXPECTATION of our overly litigious society that still results in litigation that costs money to defend one's self from stupidity.

 

[IronWing]

Oh, trust me, I agree with you on the reality of it all. But, there's an EXPECTATION of our overly litigious society that still results in litigation that costs money to defend one's self from stupidity.

The litigation in medical care is partially a function of the high price of care. When faced with life ruining medical bills, a person might begin to look for any way possible to transfer the bill to someone else. Malpractice suits are one way to unload the bill. If the bills weren't so high, would the incentive to find a reason or excuse to sue still be there?

 

[vi edit]

Oh, trust me, I agree with you on the reality of it all. But, there's an EXPECTATION of our overly litigious society that still results in litigation that costs money to defend one's self from stupidity.

That litigation extends beyond just that doctor though. It's the flooring vendor that has to overengineer and make their floors able to hold up to specific testing standards. The instrument company that supplies the stitching materials and instruments has to guarantee their stuff is sterile at time of packaging if they are single use items and come in blister packs. All of the IV bags have to be made up in a sterile and specialized hood and double checked by a pharmacist. The imaging system that shoots your xrays is $500,000, stored and read in system that cost over a million dollars, is overread by a radiologist that is paid $400,000 a year and the orders and results for that are managed by an EMR that cost upwards of $200 million or more to implement and requires a small army of a couple dozen analysts to support for another payroll of couple million a year. Plus informaticists and black belts are involved and making $100,000k a year to number crunch the HCAHP scores that are dismal because during your stay your oatmeal was cold and your burger wasn't delivered on time so you bombed the survey and those bad results actually affect how much money the hospital is reimbursed by the government.

That's why waggy's phantom socks cost $25.

 

[poofyhairguy]

I partially agree, would the cost at a wealthy suburban hospital be 1/10th the cost since they only see insured people and do not see gang bangers or hookers?

No, many hospitals are part of a corporate system of hospitals. So the costs could be spread across the suburb and urban hospitals, or over towns full of hospitals.

 

[edro]

Will hospitals give discounts if you ask?
I want to ask if they can give me a "I pay my bills discount".

I just went to the hospital one a month ago and I have the final bill, after insurance.

New Doctor Visit....... $368.... I owe $165
Ear diagnostics......... $193.... I owe $171

So even with insurance, I have to pay $330 to have a doctor tell me I have hearing loss and I should try hearing aids.

So why would I go back to a doctor for anything that isn't life threatening if I know it's an instant $300.

 

[local]

When our twins were born I setup a payment plan with the hospital of $50/month. We would have paid it off about the time they started to drive. But a year and a half later my wife's appendix exploded and to my surprise they agreed to just add that to our already existing balance. I will do the same thing for the next kid due in a few months.

My plan now is to always go to the same hospital and just keep adding to the bill without changing our payment at 0% interest. I will never pay it off but it is cheaper than just tossing them $20k I don't have anyway. Instead I will pay $600 a year for unlimited healthcare.

 

[umbrella39]

I cut my finger, kind of bad. Went to the emergency room and got 8 stitches.

Fortunately the ER wasn't busy so I was out in about an hour, about 10 minutes of which was actual medical treatment (clean, stitch, bandage).

The bill was $3,745.15. How can this be? That's nuts!

Never go to an ER for that. Go to a Urgent Care center. Save yourself $$$.

 

[GasX]

next time just sew it up yourself if you think the hospital is overcharging you...



you forget the part of the process where she keeps you from dying

I wouldn't jump into anesthesiology personally, though... it's a job that we'll probably see replaced with a machine in our lifetime.

not likely at all, but certain tasks like maintenance anesthesia on a long case could go that route.

Anesthesia doesn't get paid to put you to sleep. They get paid to wake you up at the end...

 

[edro]

When our twins were born I setup a payment plan with the hospital of $50/month. We would have paid it off about the time they started to drive. But a year and a half later my wife's appendix exploded and to my surprise they agreed to just add that to our already existing balance. I will do the same thing for the next kid due in a few months.

My plan now is to always go to the same hospital and just keep adding to the bill without changing our payment at 0% interest. I will never pay it off but it is cheaper than just tossing them $20k I don't have anyway. Instead I will pay $600 a year for unlimited healthcare.

:thumbsup: Nice! That's cheaper than most insurance plans.

 

[KIAman]

My rule of thumb is that if I can take myself then it means it's not as serious, I go to urgent care rather than an ER. My most recent injury was a hamstring tear and I could barely walk but went to the urgent care because I could stand the pain until I got care.

Now, if it were my wife or kids, ER for almost anything serious although a cut probably still would be an urgent care visit unless the cut looks beyond a few stitches or I can't control the bleeding effectively.

Ambulance call for wife or kids if there is extreme pain or loss of consciousness.

 

[LTC8K6]

Neither price is accurate. The $50 in Europe is falsely low, and the $3,500 in the US is falsely high.

The real cost in both cases is somewhere in between.