My8 hr. visit to the ER cost $8,000.

[Amber St. Clare]

A couple of weeks ago I thought I was going to die from stomach pain and finally went to the ER. I was seen in a timely manner and they gave me enough morphine to make me civil again; no blood or urine tests were ordered. The attending told me they had gotten slammed earlier in the day with patients experiencing the same symptoms. He did order a CT scan to make sure my appendix hadn't ruptured.

8 hours later {and 3 shot of morphine later} we went home. Yesterday I got a statement from BS/BC {our provider} and I almost fell down in shock....$8,511.49 {and LOVE the .49}. BS allowed for $2,137.57 and the total I have to pay is $200.

How the hell could three shots of morphine and one CT scan cost $8,000?

 

[Tacori E-ring]

The cost of healthcare is insane. My patient said his hospital stay (2 nights) for a UTI was $127K.

 

[momhappy]

Good question. We had a recent CT scan that ran about $2500. 8 hours is a pretty long time to be in the ER (and ER care is pretty costly) - did they run other tests (bloodwork, etc.). That bill certainly seems excessive, but if you have decent insurance, I can't say that I'm surprised by it. I think when I had my babies (with minimal complications), they ran about $8000 and that was an overnight in the hospital.

 

[Amber St. Clare]

Good question. We had a recent CT scan that ran about $2500. 8 hours is a pretty long time to be in the ER (and ER care is pretty costly) - did they run other tests (bloodwork, etc.). That bill certainly seems excessive, but if you have decent insurance, I can't say that I'm surprised by it. I think when I had my babies (with minimal complications), they ran about $8000 and that was an overnight in the hospital.

No blood or urine tests.

I guess I'm being billed for those who don't have insurance.

 

[momhappy]

The bill still seems excessively high - especially considering that you were specifically told that others came in complaining of the same symptoms (indicating perhaps a virus of some sort?). You'd think that if your symptoms were not unique to you, then they may have done a minimal amount of testing (to rule out major issues), a minimal amount of pain management, and then sent you on your way. Again, my guess is that you have good insurance and they knew that they would get paid...

 

[junebug17]

Good question. We had a recent CT scan that ran about $2500. 8 hours is a pretty long time to be in the ER (and ER care is pretty costly) - did they run other tests (bloodwork, etc.). That bill certainly seems excessive, but if you have decent insurance, I can't say that I'm surprised by it. I think when I had my babies (with minimal complications), they ran about $8000 and that was an overnight in the hospital.

No blood or urine tests.

I guess I'm being billed for those who don't have insurance.

I just spent a little while reading about why hospital costs are so high and my head is spinning. But yes, I think the bolded plays some part in it. As one article put it "it's why you don't see people dying in the streets."

eta: other reasons: cost of running the hospital, cost of new technology (equipment, testing, etc)

 

[smitcompton]

Hi,

There is a simpler explanation for the differences in costs. Hospitals have different fees for the same procedures. Its called capitalism and the free markets. You must comparison shop. Please don't come back at me. Its the truth.

Annette

 

[lyra]

Did you find out what it was? I had very similar symptoms about 10 years ago, plus I had a mild fever. I ended up in the hospital for 5 days, on morphine drip, and was given a multiple antibiotic IV treatment while there. No CT scan because they wouldn't do a challenge test (I'm allergic to contrast dye). They concluded it was an ovarian cyst. (My bill was $0.) I feel like they could have at least done some testing on you, although that might have doubled or tripled your bill. I'd hate to have any bill at all for not reaching any conclusion.

 

[momhappy]

Hi,

There is a simpler explanation for the differences in costs. Hospitals have different fees for the same procedures. Its called capitalism and the free markets. You must comparison shop. Please don't come back at me. Its the truth.

Annette

How is one supposed to "comparison shop" when going to an ER? If you are in an emergency scenario, you go to the closest facility - you don't log on and comparison shop for the best price....
Most of us are already aware of the outrageous costs associated with healthcare and the fact that costs can vary from facility to facility. I think OP was just trying to make sense of it all.

 

[texaskj]

Everything having to do with healthcare in this country is just a complete debacle.
Last October I went to an emergency room early on a Wednesday night in the worst pain of my life. They admitted me and I had my appendix out the next morning. I went home mid-morning on Friday. I went back to the surgeon about two weeks later so he could check on things and take the tape off.
My total bill? A little over $27,000 (almost $5,000 of it mine with insurance.) That's more than I paid for my Honda, forpete'sake

 

[Rhea]

How the hell could three shots of morphine and one CT scan cost $8,000?

Because you live in the States. It's called capitalism. They can charge that so they do.

 

[ksinger]

Hi,

There is a simpler explanation for the differences in costs. Hospitals have different fees for the same procedures. Its called capitalism and the free markets. You must comparison shop. Please don't come back at me. Its the truth.

Annette

The most important prerequisite for the competition and the “rational choice” that is supposedly so integral to a capitalistic market, is adequate access to correct information. Assuming you aren’t near enough to death to have to take your chances with the nearest doc or facility, have you ever tried to get a straight answer about the price of a procedure? Or the actual quality of a doctor? Or even just get a truly itemized statement of charges?

Deliberately keeping patients in the dark about all this stuff is a feature, not a bug.

http://abcnews.go.com/Health/medical-costs-vary-wildly-hospital-hospital-study/story?id=16196700

There is a moral component to situations more complex than buying a washer - situations like healthcare - that cannot ever be addressed by market mentality, because pure markets are inherently amoral. For some, that is their primary appeal: apply market thinking and that will absolve them of having to consider any moral implications via the, "The Market will make the Right and Best decision for all.", as if markets exist and function outside of the humans who created them.

Healthcare is already a horribly failed attempt at a market, as it should be IMO. We should not even bother to keep trying to make it work like one.

 

[ksinger]

How the hell could three shots of morphine and one CT scan cost $8,000?

Because you live in the States. It's called capitalism. They can charge that so they do.

Yes, they can put anything on the bill that they like, but you'll notice that the actual payouts are always a lot less. They never get that $8000. I've always assumed it's some accounting sleight of hand that has some benefit for the hospitals.

The price varies depending on who and when the question is asked. If you're insured, it depends. If you're uninsured, it depends. There is no real price. It's a jello-like moving target and it's horribly frustrating.

 

[Amber St. Clare]

Hi,

There is a simpler explanation for the differences in costs. Hospitals have different fees for the same procedures. Its called capitalism and the free markets. You must comparison shop. Please don't come back at me. Its the truth.

Annette

How does one "comparison shop" hospitals when there is obviously no fixed prices for services? I can guarantee if I had said "tell me how much my CT scan will be before I have one and how much for a shot of morphine?" they would have been unable to give me any information.

 

[smitcompton]

Hi All,

I think its funny you all took me seriously about comparison shopping hospitals. I made a face, as if to acknowledge it was ridiculous. But, after all you are comparing pricing here, so I told you the truth. They price procedures differently. Of course no one is going to comparison shop hospitals, but don't expect to gain any insight in a discussion of hospital costs. I just had several cat-scans. They came in at $6,000.each.

I just got a bill for $16.000 for a surgical procedure that wasn't done and took less than an hour. There is no rhyme or reason.

Hope this clarifies my meaning.

Annette

 

[lulu]

When I had my gallbladder out I spent 3 nights in the hospital and the bill was $89,000. (some of the itemized items were hysterical)
Blue Cross paid them $21,000. So, was the service worth $21,000 or $89,000 or somewhere in-between? It's just a comedy. We need a single payer system.

 

[ksinger]

When I had my gallbladder out I spent 3 nights in the hospital and the bill was $89,000. (some of the itemized items were hysterical)
Blue Cross paid them $21,000. So, was the service worth $21,000 or $89,000 or somewhere in-between? It's just a comedy. We need a single payer system.

I'm impressed that you got a real itemized bill. I don't think I've EVER gotten one - not a real one, and I'm not exactly a novice in the maw of the medical machine. Heck, most places seem to put as many roadblocks as they can, at you simply getting copies of your own records/scans. "Oh, I'm sorry (as you clamber out of the MRI tube), but you have to go over to XYZ building in another town to get the images (on disk) that I just took." Or somesuch nonsense.

Yeah, since they never get what they are charging, what IS a reasonable price for things?

Yes, we need single payer.

 

[smitcompton]

Hi,

The insurance companies, medicare and Medicaid negotiate the fee that they will pay. However the hospital and Doctors bill what is called "usual and customary fees.: This is a very old concept which allows the hospitals and Drs and Dentsts et al, to say, "look here, these are our normal charges.' They negotiate from that point.

So, most of the charges you see will not be paid. Of course, these payers pay different amounts as well.

Annette

 

[packrat]

I'm guessing hospitals are similar to Dr's offices in that they go by what insurances will pay. When we set up our fees, we went by what Midlands would pay b/c they were the ones who paid the most for all the services we offered. If they paid $50, we charged $55, so there would be a $5 write off on that bill if the patient had Midlands. If they had BCBS, who paid $24.98, then we accepted that and the rest was write off (all depending on deductibles/copays etc of course). But we had a bigger write off for BCBC than Midlands. My mom would get so mad "why are they charging all this money and then writing it off? Why don't they just charge the $24.98?" B/c each insurance pays at a different rate and you certainly aren't going to give up that extra money from a company that will pay more.

 

[Arcadian]

Not even an ER visit, but I went to get some vaccinations for an upcoming trip.

Insurance did NOT cover them even though they were recommended by the CDC. nearly 600 dollars for 2 shots.

you gotta be freaking kidding me....

 

[Niel]

I remember when I had my daughter our bill before insurance was 20k. No nicu. No csection....

Last year I fell on my stomach on the ice outside. I was maybe 7 mo pregnant at the time. I stopped in, sat for 20 minutes to listen to the heartbeat on a machine, and left. No medicine, no doctor saw me.... 3k before insurance.

 

[cflutist]

Wow, I feel that I got off cheap:

5 days in the hospital in a private room, pterional craniotomy and neurosurgery to remove a brain tumor was only $107,052.
I wonder how much each of the three titanium plates and 14 screws implanted in my skull cost

The latest MRI of my brain that I did a month ago was billed at $5219 of which insurance paid the contracted rate of $1016.
The radiologists report was billed at $1038 of which the insurance paid the contracted rate of $329. So that was $1345 of
$6257 billed that they were paid. What a racket.

My cost of all of this - ZERO

p.s. the MRI showed no re-growth of the brain tumor so I am happy.

 

[momhappy]

^No regrowth - that's fabulous news!!!!! I'm so happy for you and wish you the best

 

[purplesparklies]

cflutist,

Excellent to hear that your MRI showed no re-growth! Blue skies ahead!

 

[asscherisme]

Wow, I feel that I got off cheap:

5 days in the hospital in a private room, pterional craniotomy and neurosurgery to remove a brain tumor was only $107,052.
I wonder how much each of the three titanium plates and 14 screws implanted in my skull cost

The latest MRI of my brain that I did a month ago was billed at $5219 of which insurance paid the contracted rate of $1016.
The radiologists report was billed at $1038 of which the insurance paid the contracted rate of $329. So that was $1345 of
$6257 billed that they were paid. What a racket.

My cost of all of this - ZERO

p.s. the MRI showed no re-growth of the brain tumor so I am happy.

Glad to hear your good news, no regrowth!

AS for the topic at hand, healthcare costs are absurd!

4 years ago I had an outpatient medical procedure- in at 9am, home by 3pm Bill was $39,000! Thankfully I only paid $100.

My daughter needed an MRI with sedation last year and that bill was $12,000. I paid $0

Healthcare can financially ruin you if you don't have health insurance, and sometimes even if you do. The costs are insane.

 

[LLJsmom]

Cflutist, wonderful news for you! OP, if that $8k was my bill, I would have to pay it all under my new insurance (what insurance?). Lord help me...

 

[wildcat03]

Cflutist, wonderful news for you! OP, if that $8k was my bill, I would have to pay it all under my new insurance (what insurance?). Lord help me...

If you are referring to a high deductible plan, your insurance would kick in to lower it to their negotiated rates, but you'd pay the full amount (approximately 2500).

 

[iLander]

Here's the actual reason


The hospital "chargemaster" sets whatever price it wants. It is arbitrary. They DO NOT expect anyone with insurance to pay that amount. It's just BS. Why?

Because the difference between the amount they charge ($8,000) and the amount your insurance "allows" is marked in their books as "charity". This way, the monster money machines can claim to be "non-profit caregivers".

“The chargemaster can be confusing because it’s highly variable and generally not what a consumer would pay,” Carol Steinberg, vice president at the American Hospital Association, told me when I reported on the new Medicare data. “Even an uninsured person isn’t always paying the chargemaster rate.”

In other words, the chargemaster price is likely irrelevant to most patients. But at Bayonne, Creswell, Meier and McGinty found another reason that may compel hospitals to set the high prices they know they won't get paid.

"Until a recent ruling by the Internal Revenue Service, for instance, a hospital could use the higher prices when calculating the amount of charity care it was providing, Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins," said in the New York Times story. 'There is a method to the madness, though it is still madness,' Mr. Anderson said."

Charity care is incredibly important to facilities like Bayonne Hospital Center, which needs to demonstrate that it provides a high level of "community benefit" in order to maintain its status as a nonprofit hospital. The higher prices that a hospital charges, the bigger amount of charity care its providing.


I wish I could pull this scam off! I would claim my time is actually worth 10x more than I am paid, and declare charitable deductions every year with the IRS. I would never pay taxes if I could get that deal.

Full article: https://www.washingtonpost.com/news/wonk/wp/2013/05/19/heres-why-hospitals-set-high-prices/

 

[wildcat03]

I just wanted to chime in with a few contributions. I'm an ER doctor.

When you go to the ER it is automatically more expensive than if you had gone to your doctor or an urgent care. Why? Because when you go to the ER you are paying (in part) to have care available 24/7. The money to have a CT tech, an ultrasound tech, enough nurses to staff the volume of patients that is expected has to come from somewhere. So care in the ER is more expensive than it would be if it received between 9 AM and 5 PM Monday-Friday. Is 8,000 ridiculous? Yes, but as you point out - the true "cost" of your visit is nowhere near $8,000.

I went to my own ER with a day of vomiting and diarrhea. I was so dehydrated that I couldn't give them a urine sample for a pregnancy test. It took 3 liters of IV fluids and 2 doses of anti-nausea medication. I told the attending I didn't think I needed labs but he sent them (and it wasn't unreasonable to do so). Total bill was about 2500, my insurance paid out about 900 at the end of the day.

 

[ksinger]

Here's the actual reason


The hospital "chargemaster" sets whatever price it wants. It is arbitrary. They DO NOT expect anyone with insurance to pay that amount. It's just BS. Why?

Because the difference between the amount they charge ($8,000) and the amount your insurance "allows" is marked in their books as "charity". This way, the monster money machines can claim to be "non-profit caregivers".

“The chargemaster can be confusing because it’s highly variable and generally not what a consumer would pay,” Carol Steinberg, vice president at the American Hospital Association, told me when I reported on the new Medicare data. “Even an uninsured person isn’t always paying the chargemaster rate.”

In other words, the chargemaster price is likely irrelevant to most patients. But at Bayonne, Creswell, Meier and McGinty found another reason that may compel hospitals to set the high prices they know they won't get paid.

"Until a recent ruling by the Internal Revenue Service, for instance, a hospital could use the higher prices when calculating the amount of charity care it was providing, Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins," said in the New York Times story. 'There is a method to the madness, though it is still madness,' Mr. Anderson said."

Charity care is incredibly important to facilities like Bayonne Hospital Center, which needs to demonstrate that it provides a high level of "community benefit" in order to maintain its status as a nonprofit hospital. The higher prices that a hospital charges, the bigger amount of charity care its providing.


I wish I could pull this scam off! I would claim my time is actually worth 10x more than I am paid, and declare charitable deductions every year with the IRS. I would never pay taxes if I could get that deal.

Full article: https://www.washingtonpost.com/news/wonk/wp/2013/05/19/heres-why-hospitals-set-high-prices/

Ha! Didn't I say I suspected some accounting sleight of hand that benefited the hospital? I confess this has been one of the rare times I've been too lazy (or maybe just fed up with medical bills) to look into something myself, so thanks for digging up that info iLander.