At the end of August I had a rash.
I was visiting a relative at Southampton Hospital on Long Island and decided to stop at the Emergency Room to have it checked out.
The rash was making me itch and had lasted a few days. It really wasn't too bad, but wasn't responding to the over-the-counter creams.
After all, I have insurance and it would only cost me a small co-pay. Who cares? it was convenient. I thought maybe they would charge the insurance company $300 or so. Shows what I know.
I felt guilty, but there wasn't anybody there, at 9 a.m. on a Saturday morning.
I told the triage nurse that I thought it was not serious and probably a reaction to an antibiotic I was taking. She thought I was right, but smart to come into the hospital.
After ten minutes later a doctor came in and looked at the rash on my belly. He asked me a few questions and gave me his terse diagnosis, "It's probably a reaction to Cipro."
He gave me a steroid shot, and a prescription for a topical cream, and told me it would go away in a few days. All this took seven minutes, according to my watch.
I told him I felt awkward about going to the emergency room, but he said it's good that I came.
I knew it was going to be pricey, but I didn't care. I have private insurance through Oxford and I wouldn't be paying the bill.
The Cheaper Option
About ten days later I still had the rash and went to a private doctor at the East Hampton Healthcare Center. I didn't have an appointment and the wait was about 45 minutes. Dr. Steven Andreoni looked at the rash and said "Yep; looks like you are having a small reaction." He gave me another steroid shot and another prescription and within a few days the rash indeed went away.
A few weeks later I got the Southampton Hospital bill: $1,227 and another $269 from the doctor who saw me for the seven minute consultation.
Total price $1,493 ..... $213 per minute. ..... $12,800 per hour.
Actually, I didn't really get the bill. I got a bill for mere $50 to cover the co-pay for the hospital. I had to make a couple calls to get the real bill. The woman, who answered the phone, seemed surprised that I would be asking. "Nobody ever asks for their bill. It's being paid for by the insurance company"
I never got a bill from the private doctor at the East Hampton Medical Clinic, who gave me the exact same service as the hospital. They too seemed surprised that I was asking for a bill. They faxed me an invoice for $127 for the same service that hospital had charged.
I don't think Southampton Hospital is getting rich (they have nearly gone bankrupt several times) but just that there is something terribly wrong with the health care system and what their priorities are. (I remember going to an emergency room in Jamaica for a cut and they charged me 50 cents for a tetanus shot.)
An estimated $700 billion is being wasted annually in the US according to a recent report by Thomson Reuters Healthcare Analytics. This amounts to one third of the nation's health care bill.
This figure could be more than double, if my one experience is any guide.
How can the exact same service delivered by doctors in adjacent towns cost ten times as much?
Why does it cost two and a half times as much to treat patients in Florida as in Minnesota, according to a Dartmouth study?
It is totally insane anyway you look at it. Oh, I know about overhead and emergency room costs, but, really, how can this be rational? Imagine a Toyota dealer selling a Prius for ten times as much as the dealer in the next block charges. He would be out of business in a flash.
But this kind of thing happens all the time in the health care field.
The problem is, in most cases, we don't get the bills for our health care. The costs are not transparent and even when you get bills, they are hard to decipher. So most people with insurance have no idea of what the costs are, and really don't care.
Free enterprise is a cruel joke as far as health care in this country is concerned.
After some digging, I found that the hospital bill of $1,227 was actually settled with Oxford for $702, the contracted rate.
How come Oxford-Unitedhealthcare, a $80 billion company with annual profits of more than $4 billion, gets a 42% discount, while ordinary middle class people pay the full bills?
What does this mean? If I couldn't afford insurance, would I have been charged $1,227? How screwy can this be?
Everyone knows this...It's like the fable of the Emperor's New Clothes, yet -- nobody says a word about the nakedness of our dysfunctional health care system. We have let this madness go on for so long, that people just assume that's the way it is.
Doctors often operate on intuition and not proven scientific principals, with regard to costs, as an excellent article by David Leonhardt points out in this Sunday's New York Times Magazine. There are no universal standards for health care. Why do doctors in Sioux City use far fewer stents for heart patients than doctors in Davenport? Which treatment is better? They can't both be right.
The rest of the developed world doesn't put up with this lunacy, which is why their health care bills average about two thirds less than the costs in the US, and their outcomes are often twice as good. US health care ranks 37th in the world. Life expectancy is 31st, tied with Kuwait and Chile. (See "Cuba has Better Medical Care Than the US".)
That's why national health reform is so important. The Republicans rail about how the free enterprise system will fix everything ... How our health care system is the best in the world.
Sure, that's why an American woman is 11 times as likely to die in childbirth as an Irish woman, according to Nicholas Kristof in yesterday's New York Times.
So really, what planet do these Republicans live on?
write to: jfleetwood@aol.com
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I've been on several HMOs, PPOs and indemnity plans and each has made an EOB available to me with a full detail of charges, settlements, payments to providers and payments to me. It has been as a matter of routine rather than some strange thing that the medical office workers have never heard of.
Call me skeptical.
I never even considered the cost of hospitals before moving here some 10+ years ago.
Now I am terrified of becoming ill and so I keep enough funds to get me on a plane to the UK.
And if I hear anybody else spit out the words "socialized medicine" as if it were the plague I may well hit them - hey if I go to prison I get free medical treatment?
I can cite many stories about family and friends getting the most excellent treatment in the British National Health Service. OK nobody would claim it is perfect but then nobody in Britain (or most other civilized countries in Europe) went bankrupt in the last 50 years because they could not pay a hospital bill. And if there is a wait for your particular treatment you do always have the option of going to a private physician at your own cost - simple.
Get real America. Get real you guys who cannot see that private medical care is a big rip-off. Get real you people who oppose a public option - what are you or your insurance friends afraid of?
They did a great job of fooling you!