$15,780 for a dislocated hip ??

[cl8ton]

Yup Todd agreed it’s outrageous, but hay BO is working on it or so the people that voted him in are telling me.
Please tell me Sophie was somewhere else safe

[Langers]

We, in the US, spend 16% of our GDP on maintenance. Human maintenance, that is. Belgium has a socialized/private system where the government manages the private companies; they make a small profit, but it is completely controlled. Expensive? NO- the Belgian government spends 12% of GDP on this sort of hassle-free coverage each year.



Hello?



N!

says it all really, doesn't it?

[GWN7]

Lets see:

Data entry clerk: to take your personal info (and insurance info)
Triage Nurse: to determine extent of injury
ER nurses: to do whatever the Dr wants/needs
Security: keeps the nut jobs out
ER Doc: licensed to poke & prod you
X-ray tec: takes naked pics
Ortho Doc: to actually fix you
Pharmacist: passes the pills so you don't ache
add in cleaning staff, maintenance staff, building overhead, fixture costs (xray machine, tables, ect) and then the guy who owns the building wants a profit (ROI)

The amount billed isn't out of line if you were the only patient they looked after while you were there.

But if you were a car the bill would have been under $1000.00

[ckissick]

Originally Posted by mossguy

How much of that did your insurance pay?

Best,
Tom

Insurance paid $750, leaving me with a bill of $350 for a tetanus shot. How much can a dose of tetanus cost?

People complain about high insurance costs, but look at what they have to pay for simple little procedures. I think I know why insurance premiums are so high. What about hospital costs? $1,100 for a tetanus shot is just assinine.

[mossguy]

Obviously, Charlie, there is a lot more involved than just the cost of the shot. In any case, that is expensive, but I imagine if you had looked around the waiting room while you were there, you would have seen two or three other people that you were paying for.

Best,
Tom

[Noah930]

It's a little unfair to compare ER charges to the rest of non-emergent medical care. Not that the above prices aren't ridiculous. They are. But when you go to an ER, you're paying for emergency level services, whether you use them or not. That's how the ER is staffed. That's how it's equipped. Whether you use that defribrillator, ventilator, or thoracic surgical tray or not, to a certain degree your visit is going to have to cover their costs. Plus the costs of those who don't pay.

A more fair review of medical pricing would be what you get charged in a non-emergency (elective) setting such as your primary care physician's (or orthopedist's, in the case of the OP) office.

When the billing people get in today, I'll ask them what Medicare (for example) pays for a tetanus shot or closed hip reduction.

[Dueller]

Interesting thread...and many of the anecdotal stories reveal the problems of accessibility and affordability in the U.S. healthcare system. But the problem is not systemic alone...it is attitudinal. As to the tetanus shot issue, I personally keep tetanus vaccinations up to date because a) I'm a klutz and b) I own and work on old rusty motorcycles and german cars. I paid about $30 for a tetanus vaccination a few years back at our local health department and its good for what...10 years? That is a minor example of me taking some responsibility for my personal health care needs and knowing I won't need to go to the ER when I stab myself with a rust encrusted cotter pin.

Before I get all stove up patting myself on the back for personal responsibility, look at the systemic problems in our health care models. For example, IIRC Medicare will not pay for a tetanus vaccination unless it is necessary as a result of an injury. Right there is a small example of why our system is broken...we've become accustomed to treating the injury/illness rather than prevention. We, individually/collectively/institutionally, fail to see that prevention is cheaper than treatment. Medicare/insurance companies would rather deny preventative measures as cost saving rather than see that treatment after the fact is much more expensive.

As to ER care being so expensive, the following is an assessment from someone who obviously understands why it is so expensive. They were responding to a question about a high priced tetanus shot in an ER. Again it comes down to acccessibility vs affordability...two concepts that seemingly are intertwined but in reality are very separate issues.

"You're not being charged for "just" a tetanus shot. If it were just that, you could mail order it and give it to yourself. You are paying for a tetanus shot in an emergency department.

You're also paying for access to care - the ability to get a tetanus shot 7 days a week, 24 hours a day, holidays included.
You're also paying for access to advanced care - not just the ability to get a tetanus shot, but to get lifesaving care from a trained and licensed team of professionals at any time. This means access to a full service pharmacy with pharmacists, radiology department with technologists and radiologists, laboratory services . . . all 24 hours a day, etc, ad nauseum.
You're also paying for everyone else's access to care - all those people who don't pay but use the ER for their emergent and non-emergent problems.
You're also paying for the malpractice exposure associated with both your injury and every other person's injury.

It's not cheap to run an emergency department because they have to build in the capacity for every major life-threatening event, whether or not it happens. You pay for the existence of this capacity.

Example - every ED should have a cyanide antidote kit on hand. These expire every 3 years or so, and are killer expensive. Cyanide poisoning is extremely rare, but when it does happen the victim can be saved with the kit - and you have to have it there. It doesn't help to order up from Eli Lilly the next day. So, who pays for that? Do we keep a running tally of how many kits have expired before we use one, and then charge the first person who needs that particular medication the cost of all those other kits? Instead, we spread around the cost to everyone else who comes through the door.

Who pays for our decomtamination showers, to be used in the event of a chemical accident or attack?
Who pays for the homeless guy who fell down and cut his hand, and needs a tetanus shot?

You, that's who. "

[ckissick]

Originally Posted by mossguy

Obviously, Charlie, there is a lot more involved than just the cost of the shot. In any case, that is expensive, but I imagine if you had looked around the waiting room while you were there, you would have seen two or three other people that you were paying for.

Best,
Tom

Funny thing is, it's a rural location with very little activity. I was the only one there. There are a lot of hispanic farm workers in the area; they just weren't injuring themselves at the time.

[ckissick]

Dueller, what you say is all true. That said, do you think a ten-fold cost increase should be sufficient? An order of magnitude is a pretty hefty increase. So your $30 shot would become $300. I'd have no problem with that. But $30 to $1,100 stills seems excessive to me.

[Dueller]

Originally Posted by ckissick

Dueller, what you say is all true. That said, do you think a ten-fold cost increase should be sufficient? An order of magnitude is a pretty hefty increase. So your $30 shot would become $300. I'd have no problem with that. But $30 to $1,100 stills seems excessive to me.

No...it comes back to accesibility. You should be able to avail treatment for a simple tetanus shot somewhere other than the ER. The ER has more important things to respond to than that. Not beating up on you, Charlie...it likely was the only place you could go. Yup...$1100 seems steep.

IIRC the price Medicare fee schedule (only as one benchmark for what is reasonable) for an emrgency tetanus shot is something like $120-150...but I'll defer to Noah930 to confirm.

[masraum]

someone's gotta pay for all of the illegals that get free care.

[Deschodt]

Interesting topic... I have also received care in European countries for many years for "free", and been shocked by the higher costs in the US (10x easy, even dentistry is at least 3 or 4 times costlier), but then again most people don't realize how heavily subsidized medical care is "over there"... And how much more heavily taxed you are for the privilege. Personally I think it is worth it, but not all agree (people in the US are terrified of "socialized medicine" - not sure why , it's been wonderful to me)...

There's got to be a middleground somewhere... but congress is yet to find it ;-)

I have a friend who's an obstetrician/surgeon, whatever, his malpractice insurance premiums alone would pay *my salary* !!! I imagine if those could be brought in line, as well as other frivolous premiums for hospitals, we'd be onto something, assuming savings are passed on...

Then I wonder how *Real* that cost is... I'm making up numbers now, but I think the hospital charges $15000 but in this case will only recover say $2000 from your insurance company, $350 from you, and that's all she wrote. Not sure how real those numbers are...

Last question in my mind, why are insurance companies not all not-for-profit ? a company that wants to make money cannot have your best interests at heart...I'm cool with that for most ventures, but this is healthcare.. people's lives... Curious...

[Noah930]

Medicare allows for $134 for the tetanus toxoid medication, itself. It also pays a physician $25 to give the shot. I don't have access to a catalog to see how much a vial of tetanus toxoid goes for, but I'd hazard a guess that it's not more than a few bucks.

[teenerted1]

just be glad you didnt get the ski patrol and the air lift service involved.

[ckissick]

Originally Posted by Dueller

No...it comes back to accesibility. You should be able to avail treatment for a simple tetanus shot somewhere other than the ER. The ER has more important things to respond to than that. Not beating up on you, Charlie...it likely was the only place you could go. Yup...$1100 seems steep.

I had nowhere else to go at the time. It was Saturday and the regular clinics, which are kind of far away anyway, were closed. Our local, rural, ER is always very quiet so, in fact, they had nothing to do until I got there. It's the kind of place you'd expect to see Aunt Bee and Floyd the barber.

[shbop]

Originally Posted by masraum

someone's gotta pay for all of the illegals that get free care.

Not to worry. Obama is going to fix it. I'm curious: Is the Dr.'s secretary going to turn you in when you call for an appointment, and don't have insurance? Is the hospital going to turn you in, when you don't have insurance? What happens when you get turned-in..do they arrest you on the spot, or send you a bill for Obama-Care? What's bail going to cost for a non-compliance health-care violation? If you secretly turn in three of your friends, can you get a pass on your first violation?

[H.G.P.]

Originally Posted by shbop

Not to worry. Obama is going to fix it. I'm curious: Is the Dr.'s secretary going to turn you in when you call for an appointment, and don't have insurance? Is the hospital going to turn you in, when you don't have insurance? What happens when you get turned-in..do they arrest you on the spot, or send you a bill for Obama-Care? What's bail going to cost for a non-compliance health-care violation? If you secretly turn in three of your friends, can you get a pass on your first violation?

....and are we gonna get the "Health Care Inspectors" down the line? Knocking at the door? Turn away em away...and the next time the white coats show up with her/him? (And how about alittle "psych" profiling? Gotta fit right in with the engineering.)

And after the inspections (how many per year?/ bi-annually?, per/month? And are we gonna have to post that health care certificate on the door, at the office, just like meat? Show the papers on demand?

And how about that little spy on the bank account? The database report? The "red button alert" on "this one."

Whip out the "YOU CARD"

[Wrecked944]

Hey Todd, I left PP years ago because of the trolls. But I saw your post and tried to send you email. But your alpinemotion.com email address no longer works. So I am posting here. I read about the $1500 that your health insurance company tried to bill you and I think you should be LIVID and fire them right away. Get a better insurance company. NOW. If my insurance company ever sent me a BILL I'd close my account in an instant with middle finger shoved firmly in a bad place. May I recommend my insurance company? I pay $164 per month TOTAL. My co-pay is just $60 for a cardiologist office visit. They knew about my congestive heart failure and did not consider a fatal incurable illness to be a "pre-existing condition." So I got covered on day 1 and can't ever be cancelled. They run a cardiac clinic in my local hospital which is why I selected them. I LOVE my health insurance company. LOVE. They also do "regular" insurance. In other words, you don't need to use their clinics but they are available if you want them. In your case, I doubt they have a clinic in your area. So I'd ask for the regular insurance option. It is called "Fallon Community Health Plan" and their number is 800-868-5200. Your $1500 bill alone costs almost as much as I pay for health care in a YEAR and I have CONGESTIVE FREAKING HEART FAILURE. Hello? You are getting ROBBED. Please fire the bastards immediately and get a better health insurance company!

[sammyg2]

Someone has to pay for the free health care for illegal aliens. it was just your turn.

EDIT oops, masraum beat me to it.

[RWebb]

Originally Posted by svandamme

The big deal is that they charge so much because they know insurance takes care of it, and because all of them do it this way, insurance keeps going up...

* * *

In most countries it would have been just a fraction of that price.

partly, yes

the charge also covers something for all the people who wander into the ER with an earache, stuffy nose, or desire to have someone talk to them

in the US, the ER is where everyone with no ins. goes for treatment - and there is a certain level of treatment that must be provided by law; after that, they can be kicked out (released) but may not be, depending on policy