Unbelievable hospital markup

[JHZR2]

And I thought that the markup on texting was high!

http://finance.yahoo.com/news/nc-high-court-hear-case-14k-hospital-bill-150904908.html

I dont like this:

"While all patients receiving care are generally liable for payment for services they receive, the practical reality — especially in the current economy — is that hospitals do not receive payment from a significant number of their patients, many of whom have no means to pay," the hospitals said in arguments submitted to the court. "So it is imperative that hospitals are able to collect money from patients able to pay for their medical care without unreasonable barriers to hinder such efforts."


Terrible.

Please do not bring in universal health care, politics, etc. No need. This is a consumer issue, as I see it, so discuss accordingly.

 

[simple_gifts]

That is the reality of the situation whether we like it or not.

 

[Unearthed]

Originally Posted By: simple_gifts
That is the reality of the situation whether we like it or not.


Exactly. Everyone who can pay pays for the 5 who can't. Sucks...but it's broken and it's not going to be fixed anytime soon.

 

[mechanicx]

Good maybe more people will dispute their medical bills.

You go to the Dr. or the hospital and they don't tell you what their billing rates and medication prices are, they don't find out what is really wrong with you, don't guarantee any cure or outcome of services rendered, but here's your humongous, inflated bill (that even a deep pocket insurance company wouldn't pay).

And the fact that some can't pay and is why others are charged more is a red herring. They'd still try to bill huge amounts even if everyone did pay or had insurance.

 

[Trav]

Quote:
The bill from Talford's 2007 hospital stay doesn't include another $5,556 for his room

Quote:
He says the hospital, which he declined to identify, charged 24 times more for the medication than what a local pharmacy would charge


They couldn't have robbed this poor guy more if they hit him in head with a pipe in the parking lot and stole his wallet.
IMO they shouldn't just be in court someone should be in prison for felony robbery. Outrageous!

 

[JetStar]

Then you read stuff like this
http://www.medicalnewstoday.com/releases/11856.php

I tend to take these studies with a grain of salt since we all know you can use statistics to prove whatever point you want, but this is alarming.

 

[Scott_Tucker]

You go to the auto repair shop and if they don't give you a price in advance, you don't have to pay your bill. Why can't medical establishment be held to the same rules.

I went to physical therapy 3 times for pain in my hip. Total amount of time spent with a therapistafter all 3 visits was about 60 minutes. I got the bill from the insurance company. $1400!!! 'Luckily' my portion of the bill is only $297. And you know the therapist probably gets $20 of that. And now I need a new hip so it didn't do any good anyway.

I'm really not looking forward to the bills I'm going to amass even though I have good insurance. It is likely going to bankrupt me. I had spinal surgery on my neck back in 2006. I paid my portion, which totaled about $20k. I'm regretting paying it now. Doing the right thing has totally screwed me.

 

[ClarkB]

Originally Posted By: Scott_Tucker
I went to physical therapy 3 times for pain in my hip. Total amount of time spent with a therapistafter all 3 visits was about 60 minutes. I got the bill from the insurance company. $1400!!!


As if the hospitals themselves aren't charging enough, medical insurers have a profit margin of about 50%!

Clark

 

[Pop_Rivit]

Just one more reason to keep myself healthy. Other than an annual physical and the occasional "comes with age" test such as a colonoscopy, I have no reason to visit a doctor or hospital.

It's disgusting to see people using medical facilities with no intention of paying, and placing their medical cost burdens on those who can pay, and those who choose to keep themselves healthy.

 

[rjundi]

I believe the excessive charges partially stem from patients who do not pay for services and government set rates for Medicare etc.

My wife works at one and unfortunately many of the patients simply do not pay for services. Fortunately they do have some special services that help balance this but its not pretty.

 

[PandaBear]

The problem is mainly due to NO ONE will be able to pay for the large bill on their own (without insurance) at an itemized rate.

When insurance / lawyer / single provider regardless of who gets involved and average out the cost, individual user (patient) no longer feel the need to pay only enough for what he or she need, but opt for the best, the most expensive, the new regardless of cost, because it is no longer their money but someone else' money. It is no longer market economy or capitalism regardless of how you cut it.

For a market driven pricing to occur, you need to bring the price down to something that works for most consumer. You have to be able to cross shop between different providers for each type of visit to be able to make it efficient and drive down price, and sadly you have to have the ability for people to skip certain treatment / visit to counter the inevitable monopoly of certain treatment.

I do not see any solution to this unless the cost is lowered to something in the $10k range max for the most expensive operation and allowing hospital to not accept unprofitable patients, or going into a mandatory or a single payer system. We have neither, so we are in sort of a mess.

 

[bk111]

Hop on a plane and go to India. World class healthcare at a tiny fraction of the cost.

 

[gathermewool]

After a couple of years with out anything major happening (major surgery for an internal issue a couple of years ago, but nothing since) I decided to switch back to the high-deductible plan. Two weeks ago I went in to the doc with stomach pains, so he sent out for some blood work and set me up with the local hospital for an x-ray (warranted, given what happened in the past.)

I paid nearly $500 for everything. I paid it all off Friday, and couldn't hide the frustration in my voice while on the phone with the billing department. I expected a few hundred, but not that much. In hind sight, maybe I should have waited or called and asked for a reduction?

I can't imagine what it'd be like if I didn't have the means to take care of this, didn't have as good of health care, or, worst case, a combination AND it turned out that something was really wrong with me that required more visits. I'm limited to $2k out of pocket, but what if that weren't the case?

 

[Sunnyinhollister]

Originally Posted By: JHZR2

I dont like this:

"While all patients receiving care are generally liable for payment for services they receive, the practical reality — especially in the current economy — is that hospitals do not receive payment from a significant number of their patients, many of whom have no means to pay," the hospitals said in arguments submitted to the court. "So it is imperative that hospitals are able to collect money from patients able to pay for their medical care without unreasonable barriers to hinder such efforts."


I work in several hospitals in the central coast area of California and most of these non-paying "patients" in this area are illegal immigrants. I see it on a daily basis. It's part of the hidden cost of a failed immigration policy. Really don't want to get into the politics of it, but I will say it is a check we just cannot afford to write anymore.

 

[eljefino]

Quote:

The North Carolina Hospital Association and big hospital groups based in Durham, Asheville, Greensboro, Winston-Salem and Raleigh want the Supreme Court to rule against Talford and make it easy for them to collect overdue bills in court without a trial.

"While all patients receiving care are generally liable for payment for services they receive, the practical reality — especially in the current economy — is that hospitals do not receive payment from a significant number of their patients, many of whom have no means to pay," the hospitals said in arguments submitted to the court. "So it is imperative that hospitals are able to collect money from patients able to pay for their medical care without unreasonable barriers to hinder such efforts."



This nugget gets me. I still can't believe the patient is ultimately responsible even if he/she, in good faith, has insurance, but for whatever reason can't figure out how to compel them to pay up. One should be able, IMO, to drag their feet on a bill they feel is improper until the doctor, insurance company, and patient are all dragged into court where it can get settled and the insurance company, more than likely, will be found in breach of contract.

 

[CivicFan]

Originally Posted By: rjundi
I believe the excessive charges partially stem from patients who do not pay for services and government set rates for Medicare etc.

My wife works at one and unfortunately many of the patients simply do not pay for services. Fortunately they do have some special services that help balance this but its not pretty.


Medicare is not an undesirable payer. A hospital can remain financially solvent and prosper if 100% of their patients were Medicare.

The biggest drain on a hospital are the uninsured patients, the patients with high deductible plans and Medicaid patients in that order. Things will get better if all goes as planned for the next couple of years.

 

[Tom NJ]

Originally Posted By: Sunnyinhollister
I work in several hospitals in the central coast area of California and most of these non-paying "patients" in this area are illegal immigrants.


Wouldn't it be nice if the hospitals billed the US government for these unpaid bills, and then our government deducted that total from the massive aid we send to the illegal immigrant's home country.

Of course that is too logical for governments to understand.

Tom NJ

 

[Drew99GT]

Originally Posted By: Pop_Rivit
Just one more reason to keep myself healthy. Other than an annual physical and the occasional "comes with age" test such as a colonoscopy, I have no reason to visit a doctor or hospital.



I said the same thing to myself right before I accidentally shattered my wrist. It can happen to anyone.

The medical industry in the US is a giant monopoly. Or oligopoly. I agree with mechanicx. At a minimum, Congress needs to pass some laws that force medical providers and insurance companies to provide easily comparable prices. As it stands now, there is NO COMPETITION, Heck, in my state, almost every hospital is owned by the same organization (and that organization is owned by the Catholic church).

 

[Sunnyinhollister]

OK = one more nugget for you - if you have insurance the hospital is bound by the agreement they have with the carrier - but, in a lot of cases they do not bill correctly.

If you are in a car accident they do not want to accept the insurance you have - and the one they have a contractual agreement with. They want your car policy information so they can bill (sue) for more at a non-contracted rate. If the accident happens at your house they want your home policy. Starting to see the picture here? They will actually file a lien against any settlement that you may get that they are not entitled to.

They also do not like billing secondary medical or medicare because they will get less or nothing at all. They will tell YOU that YOU are responsible for the copay without ever billing medical or medicare even if you are not responsible for any of it. Unfortunately it is up to you to make sense out of the confusing coverages and insurance responsibilities. I've had a doctor's billing service actual tell me they were not a network provider when they were in order to try and bill us at the non-contracted rate.

I could go on and on about the incorrect billing by providers that range from simple errors, gross negligence, to outright fraud.

Thank God my wife used to do medical billing!

Take care,

Reggie

 

[Sunnyinhollister]

Originally Posted By: gathermewool
After a couple of years with out anything major happening (major surgery for an internal issue a couple of years ago, but nothing since) I decided to switch back to the high-deductible plan. Two weeks ago I went in to the doc with stomach pains, so he sent out for some blood work and set me up with the local hospital for an x-ray (warranted, given what happened in the past.)

I paid nearly $500 for everything. I paid it all off Friday, and couldn't hide the frustration in my voice while on the phone with the billing department. I expected a few hundred, but not that much. In hind sight, maybe I should have waited or called and asked for a reduction?

I can't imagine what it'd be like if I didn't have the means to take care of this, didn't have as good of health care, or, worst case, a combination AND it turned out that something was really wrong with me that required more visits. I'm limited to $2k out of pocket, but what if that weren't the case?


I can tell you first hand that the Hospital is the LAST place I will go for imaging or lab tests because their co-pays and fees are astronomical compared to non hospital affiliated providers. Quest Diagnostics is much cheaper and I know a local imaging center that can do almost everything the hospital can for a fraction of the cost.