Couple billed $89,000 for 18 HOUR snake bite treatment

[tailfins]

http://healthland.time.com/2014/01/29/north-carolina-hospital-bill-snake-bite/

[tailfins]

Here is a 28 page report covering medical price gouging in more detail:

http://livingwithmcl.com/BitterPill.pdf

[Nukeman]

Here is a 28 page report covering medical price gouging in more detail:

http://livingwithmcl.com/BitterPill.pdfAlthough I agree with what you are trying to say here, most do NOT know how the system works.

Lets take for example the "bedside" x-ray. That is more than likely a Chest or KUB since those are the only one's really done bed side. the charge was $333.00. Seems like a lot at face value. CMS (medicare) pays that x-ray at $62.00 a FAR cry from the $333.00. Now that being said if the person has a managed or private insurance they have negotiated down a price to reflect pennies on the dollar. Our BEST negotiated price is 58% that means for that study the insurance payed $193.00 for that x-ray. Still seems like a lot of money however, when you take into account the mobile x-ray unit cost over 400K plus the digital plate to make the image is an additional 80K (EACH) and the technologist time and the PACS (picture archiving system) which runs about 300K a year to store the data, and the SMA (service maintenance agreement) will run an additional 10K on a mobile unit. well as you can see it cost a LOT of money to take a simple x-ray.

Now since that was an in-patient because it was done "bed side" chances are that the person has medicare. 70% of all hospital admissions are for medicare patients. The hospital wont even be reimbursed for the x-ray since the admission creates a DRG (Diagnosis-related group) that dictates how much will be payed and what will be payed for,for that particular visit and will NOT pay a penny more..


So these type of stories are misleading. Lets not forget that the reason the charge is higher for insurance carrying patients is due to the FACT that 15-20% of our clientele will NOT pay anything on a bill... So you get to give them free healthcare.. See how they get it for free, its almost like Obamacare, take from someone else to pay for another... That's free right????????


Just something for you to chew on.

[tailfins]

Why can't patients, especially uninsured patients get a binding estimate BEFORE they get treatment, allowing the ability to shop for the best deal?

[Nukeman]

Why can't patients, especially uninsured patients get a binding estimate BEFORE they get treatment, allowing the ability to shop for the best deal?
They can!!!!!!! They just don't!!!!!!! People are not taught that they can shop around. We did in the past but with EVERYONE having insurance we got away from hospitalization and catastrophic insurance so people stopped and went to what is "in network". This bogus idea that everyone needs insurance is just that, it like everyone "needing" to go to college all it does is DRIVE UP THE PRICE!!!!!!!

Now back the OP are you telling me they should have price shopped for the anti-venom??? That in an emergency they should shop around???

I can only add that it is the consumer that needs to be aware of how this works, unfortunately most Americans are too stupid and lazy to take responsibility for their own care!!!!!!

[revelarts]

Although I agree with what you are trying to say here, most do NOT know how the system works.

Lets take for example the "bedside" x-ray. That is more than likely a Chest or KUB since those are the only one's really done bed side. the charge was $333.00. Seems like a lot at face value. CMS (medicare) pays that x-ray at $62.00 a FAR cry from the $333.00. Now that being said if the person has a managed or private insurance they have negotiated down a price to reflect pennies on the dollar. Our BEST negotiated price is 58% that means for that study the insurance payed $193.00 for that x-ray. Still seems like a lot of money however, when you take into account the mobile x-ray unit cost over 400K plus the digital plate to make the image is an additional 80K (EACH) and the technologist time and the PACS (picture archiving system) which runs about 300K a year to store the data, and the SMA (service maintenance agreement) will run an additional 10K on a mobile unit. well as you can see it cost a LOT of money to take a simple x-ray.

Now since that was an in-patient because it was done "bed side" chances are that the person has medicare. 70% of all hospital admissions are for medicare patients. The hospital wont even be reimbursed for the x-ray since the admission creates a DRG (Diagnosis-related group) that dictates how much will be payed and what will be payed for,for that particular visit and will NOT pay a penny more..


So these type of stories are misleading. Lets not forget that the reason the charge is higher for insurance carrying patients is due to the FACT that 15-20% of our clientele will NOT pay anything on a bill... So you get to give them free healthcare.. See how they get it for free, its almost like Obamacare, take from someone else to pay for another... That's free right????????


Just something for you to chew on.

While i can understand your point to a great extent.
It still seems pretty clear to me that all the prices that you mentioned are inflated beyond whats necessary . I may be talking COMPLETELY out of my asre on some of this but my gut and limited tech experience tell me this tech is "enterprise priced" not market price.

400K mobile x-ray unit cost. X-rays been around for like 100 years, computers for half of that but computers powers and prices have reversed. Why is an xray machine 400K, why not 90K or 40K it's using computer tech and to augment and old process. what factors really make that machine cost that much.

80K (EACH) -the digital plate to make the image- Again why so freaking much. are the plates made of gold. is there an alternative, after 100 years the tech hasn't made the plates less costly? But if it's a digital plate it's just sand right? Sorry i can't say it's not true but something tells me this price is to high for some reason.

PACS (picture archiving system) which runs about 300K OK i know this BS, i work with digital images and for 300k you can Basically buy your own main frame in iron mountain and store whatever you want forever. There's NO reason why it should cost that much to store the images. and that real cost should be CONTINUALLY decreasing over time

SMA (service maintenance agreement) will run an additional 10K
OK, I don't know how to beat these Service agreements they get you by the groin on those everywhere.

the technologist time
OK the ITT Tech grads time.
"According to leading job market trackers, the current average salary for an x ray technician in the United States is $57,000 per year, which is 15% lower than the average for all U.S. jobs. However, certain specialties can make an average above $89,000 per year."
that's reasonable, if not too low.
but Ok this gal needs to get paid.
If she works 5 days a week and averages just 3 x-rays a day and make $70k for the year then that means she's making about $90 per. of course if she's doing more that 3 a day the price is lower per.


Just makes me wonder is all.
the medical industry didn't used to be this way and there's really no reason for it to be as complicated or expensive as they've made it.

A cab and truck driver have expensive tools and insurances as well, but a cabbie can't say "well my new car was 70k the paint, the radio/cell, the digital meter devise, advertising, gas.
sooo $300 per trip..

[jafar00]

If I get sick in the US, please just let me die or something.

I think I prefer socialist style medicine we have in Australia. At least I can have my life saved for free.

[tailfins]

If I get sick in the US, please just let me die or something.

I think I prefer socialist style medicine we have in Australia. At least I can have my life saved for free.

You're fooling yourself. In your case the exorbitant costs just get hidden. They are taken at the gas pump, when you do your income tax, or buy consumer goods such as electronics. The only out I see is to become judgement proof. That means live a rented lifestyle and avoid having assets that can be taken in a lawsuit. Retirement plans and kids trust funds are generally safe. It also means being ready to move to a state than bans wage garnishment. It also means knowing how to make a collection agency leave you alone. It CAN be done. If you get a hospital bill you can't afford, pay NOTHING. Making any payment resets the statute of limitations (SOL) clock back to zero.

[Nukeman]

While i can understand your point to a great extent.
It still seems pretty clear to me that all the prices that you mentioned are inflated beyond whats necessary . I may be talking COMPLETELY out of my asre on some of this but my gut and limited tech experience tell me this tech is "enterprise priced" not market price.


400K mobile x-ray unit cost. X-rays been around for like 100 years, computers for half of that but computers powers and prices have reversed. Why is an xray machine 400K, why not 90K or 40K it's using computer tech and to augment and old process. what factors really make that machine cost that much. X-rays may have been around for 100 years, mobile devices have not. ANY time you place "for human medical use" on a piece of equipment it has to go through YEARS of testing even if you release a new format that only changed a single option. Trust me I just quoted out some new portable units and the going rate is in EXCESS of 400K!!!!!!!!


80K (EACH) -the digital plate to make the image- Again why so freaking much. are the plates made of gold. is there an alternative, after 100 years the tech hasn't made the plates less costly? But if it's a digital plate it's just sand right? Sorry i can't say it's not true but something tells me this price is to high for some reason.The digital plate is a device that receives the x-ray's and converts them into a digital format and wifi's it back to the PACS stations this eliminates the need for film and processors as well the continued chemicals for that service. The plates are VERY expensive due to what they do. Once again that is the cheap side and they are pretty sturdy but can be damaged if dropped which is a very common occurrence when dealing with sick people. I will add again I JUST prices these out and if you doubt any of my prices I will be happy to send you the itemized quotes I received over the last 6 months in a PM.


PACS (picture archiving system) which runs about 300K OK i know this BS, i work with digital images and for 300k you can Basically buy your own main frame in iron mountain and store whatever you want forever. There's NO reason why it should cost that much to store the images. and that real cost should be CONTINUALLY decreasing over time
If you are talking about ONLY storing the images you would be correct. these systems need to be not only encrypted to protect your images but need to communicate with the RIS systems and ordering/tracking systems as well as interface with dictations systems and be available for manipulation of images. They are also web accessible for physicians offices.


SMA (service maintenance agreement) will run an additional 10K
OK, I don't know how to beat these Service agreements they get you by the groin on those everywhere.by the way that is a CHEAP SMA, if you are covering an MRI or CT it is anywhere from 50-120K PER YEAR!!!


the technologist time
OK the ITT Tech grads time.
"According to leading job market trackers, the current average salary for an x ray technician in the United States is $57,000 per year, which is 15% lower than the average for all U.S. jobs. However, certain specialties can make an average above $89,000 per year."
that's reasonable, if not too low.
but Ok this gal needs to get paid.
If she works 5 days a week and averages just 3 x-rays a day and make $70k for the year then that means she's making about $90 per. of course if she's doing more that 3 a day the price is lower per.The technologist get squat as pay for what they put up with, I only include that because everyone needs to know that the person working on them does NOT work for free.... Trust me they do more than 3 a day. My department performs in excess of 65,000 procedures a year...


Just makes me wonder is all.
the medical industry didn't used to be this way and there's really no reason for it to be as complicated or expensive as they've made it.

A cab and truck driver have expensive tools and insurances as well, but a cabbie can't say "well my new car was 70k the paint, the radio/cell, the digital meter devise, advertising, gas.
sooo $300 per trip. NO they charge 3.00 per mile with very little overhead.

[aboutime]

Why can't patients, especially uninsured patients get a binding estimate BEFORE they get treatment, allowing the ability to shop for the best deal?


tailfins. Actually. In nearly every city in the U.S., they can.

Try to go to any EMERGENCY ROOM for any treatment...and tell them you have NO INSURANCE.

They cannot deny you treatment but...YOU WILL SIGN something that is an agreement to PAY.

[tailfins]

tailfins. Actually. In nearly every city in the U.S., they can.

Try to go to any EMERGENCY ROOM for any treatment...and tell them you have NO INSURANCE.

They cannot deny you treatment but...YOU WILL SIGN something that is an agreement to PAY.

You won't get a good deal that way. That will get you sued for full ChargeMaster prices. If you actually plan on paying a negotiated bill, that's the worst choice possible. The above only works if you're judgement proof and decide to pay nothing.

[jafar00]

You're fooling yourself. In your case the exorbitant costs just get hidden. They are taken at the gas pump, when you do your income tax, or buy consumer goods such as electronics. The only out I see is to become judgement proof. That means live a rented lifestyle and avoid having assets that can be taken in a lawsuit. Retirement plans and kids trust funds are generally safe. It also means being ready to move to a state than bans wage garnishment. It also means knowing how to make a collection agency leave you alone. It CAN be done. If you get a hospital bill you can't afford, pay NOTHING. Making any payment resets the statute of limitations (SOL) clock back to zero.

I pay a 1.5% levy for "free" care when needed. It's nice to know I won't be charged for an ambulance ride and the treatment I get at the hospital if I need it. Like when I had appendicitis last year. Whether it gets paid for in taxes or you have to fork out for private health insurance, either way it gets paid for. It's just nice not to get a bill.

[revelarts]

Nukes I'm not saying your pricing is wrong. I'm saying that it seems to me that the expense is not really commiserate with the reality if it all were really just market based. And that in some areas the real prices could be lower. I know that some software can sell for 10k in one biz market but with very small differences sell of $100 dollars to some end users. the product was NEVER worth 10K it's just what that market could bear.
I'm not sure it's possible to do much now, with the medical "industry" counting on Insurance dollars and gov't dollars.
I'm saying those 2 forces have warped the pricing away from what it would be if it were more dr-patient and charity/community based hospitals - patient relations.

[revelarts]

3. The Burger – £95, or about $186
Burger King, West London
http://most-expensive.com/wp-content/uploads/2012/08/burger-king-the-burger-2.png
Surprisingly enough Burger King the fast food giant has decided to live up to its name by producing the then most expensive burger in the world in 2008.. Simply called “The Burger,” this costly hamburger is was available only in the West London branch of the restaurant chain.

The Burger King creation was made with Wagyu beef. It is also decked with white truffles, onion tempura prepared in Cristal champagne and some of Spain’s finest Pata Negra proscuitto. All of this was presented in an Iranian saffron and truffle bun."
http://most-expensive.com/burgers-world

Is that really what we need to make a burger? Can a REALLY good burger be made for less?
Of course.
If we had insurance and gov't back-up to buy our burgers would burger research be more expensive or cheaper. Would burger cost go down with demand or stay high based on the amount of $$$ the burger industry knows is available.
Can you question the burgers maker if Wagyu beef is really necessary for your burger?

[fj1200]

Can you question the burgers maker if Wagyu beef is really necessary for your burger?

I think you're missing part of the equation. Government rules will insist that we all need the Wagyu beef, because it's fair, and that every bit of technology that goes into the burger needs to be tested, and tested again and retested and..., and to top it off it will be insisted that every working individual needs to pay for the burger needs of those who aren't working, and then ensure that most of the burger dollars in this country are spent on those who are in their final throes of life.

[Nukeman]

Nukes I'm not saying your pricing is wrong. I'm saying that it seems to me that the expense is not really commiserate with the reality if it all were really just market based. And that in some areas the real prices could be lower. I know that some software can sell for 10k in one biz market but with very small differences sell of $100 dollars to some end users. the product was NEVER worth 10K it's just what that market could bear.
I'm not sure it's possible to do much now, with the medical "industry" counting on Insurance dollars and gov't dollars.
I'm saying those 2 forces have warped the pricing away from what it would be if it were more dr-patient and charity/community based hospitals - patient relations.
Here's the deal, if and I say IF the govt really wanted to fix healthcare there is a much simpler way to do so. It involves doing 2 things.

First: Make it illegal for any healthcare related facility to be publicly traded or beholden to the stock holders. They should ALL be not for profit.

Second: Establish a set price point not the percentage or "negotiated" reduction. Set a realistic value and PAY that amount and you would see the prices drop like a stone. If you know that is all you will receive that is what you will bill..

I know this seems simplistic but it would work very quickly, you take the stock market out of the equation and place caps on profit for healthcare than you have continued reinvestment and repayment to consumer when too much has been brought in. We used to have this with insurance companies...

I don't believe they should be tax exempt, they should pay their property taxes like everyone else. They should be able to make enough money to pay those taxes and a modest profit of say 6-10% annually to continue offering new and improved services. this allows the Hospitals to continue to upgrade and expand services without having to pay the market first.....

This bullshit healthcare overhaul is nothing but a money grab by the govt for 1/6 of the GDP. They don't want to fix it they want to own it!!!!

[revelarts]

I think you're missing part of the equation. Government rules will insist that we all need the Wagyu beef, because it's fair, and that every bit of technology that goes into the burger needs to be tested, and tested again and retested and..., and to top it off it will be insisted that every working individual needs to pay for the burger needs of those who aren't working, and then ensure that most of the burger dollars in this country are spent on those who are in their final throes of life.

yes and since you bring that up, you know that the Wagyu Beef Growers Council and the Wagyu Workers Union all supported strongly the 1st and the latest versions of the legislation... WROTE it really... and gave contributions to both parties. And generously supplied money for "independent research" showing that all beef, other than Wagyu, is low in nutrition and will harm children.
A few Drs testified in congress on the points. So Wagyu must be the MINIMUM standard.... for the children.
You can't have a burger joint unless it uses gov't certified Wagyu.

[Jeff]

If I get sick in the US, please just let me die or something.

I think I prefer socialist style medicine we have in Australia. At least I can have my life saved for free.


jafar while I was up in Canada, Halifax to be exact the woman I was bragged about her "free health care" all the time. truth be told I think she paid at least double what I did for insurance at the time. They paid way more for a liter of gas than we did for a gallon, food was ridiculous as well, back then we where paying 30 cents for a can a veggies in Canada it was over a dollar a can, see nothing is for free but I guess when you pay for it with every purchase you may get use to the high prices but don't kid yourself y'all are paying for it.

[logroller]

You won't get a good deal that way. That will get you sued for full ChargeMaster prices. If you actually plan on paying a negotiated bill, that's the worst choice possible. The above only works if you're judgement proof and decide to pay nothing.
I ask. The response is 'don't you have insurance?' I do but I'm signing a piece ofpaper that says I agree to pay...however much that is, they don't know.
To borrow from the burger analogy, it'd be like going to Burger King and signing a blank check before you even order.
Of course its not always feasible to shop-around, eg a snake bite, but the handful of times I've asked for prices the office was dumbfounded. Can you think of any other commercial service that operates in this way?


Here's the deal, if and I say IF the govt really wanted to fix healthcare there is a much simpler way to do so. It involves doing 2 things.

First: Make it illegal for any healthcare related facility to be publicly traded or beholden to the stock holders. They should ALL be not for profit.

Second: Establish a set price point not the percentage or "negotiated" reduction. Set a realistic value and PAY that amount and you would see the prices drop like a stone. If you know that is all you will receive that is what you will bill..

I know this seems simplistic but it would work very quickly, you take the stock market out of the equation and place caps on profit for healthcare than you have continued reinvestment and repayment to consumer when too much has been brought in. We used to have this with insurance companies...

I don't believe they should be tax exempt, they should pay their property taxes like everyone else. They should be able to make enough money to pay those taxes and a modest profit of say 6-10% annually to continue offering new and improved services. this allows the Hospitals to continue to upgrade and expand services without having to pay the market first.....

This bullshit healthcare overhaul is nothing but a money grab by the govt for 1/6 of the GDP. They don't want to fix it they want to own it!!!!
HALLELUJAH. Btw its not called 'profit' when its an NPO, it's called 'retained earnings' and its roughly in the range you specified (averaged over several years) . The impetus is that its used to fulfill the mission (healthcare in the instant case) and not distributed to shareholders.

[fj1200]

yes and since you bring that up...

I thought that was implied. :laugh:


Can you think of any other commercial service that operates in this way?

That's A#1 in my massive deregulation platform. :cool: