The Uninsured are Special
Last night’s 60 Minutes lead story was just a tiny peek at a scandal that has remained almost entirely hidden: the way the uninsured are charged if they find themselves in the financially awkward position of needing hospitalization. Two examples were interviewed. The first was a family man who repairs gutters for a living, doesn't make enough to purchase health insurance, and fell off a roof. He owed nearly $250,000 for his hospitalization.
Another entrepreneur, darling of the Bush idea of the American Spirit at work, developed diabetes causing him to become uninsurable. He then had a mild heart attack and received two cardiac stents during a 72 hour hospitalization costing him $41,000. The complaint here was not the cost of the hospitalization per se, but that he was charged $19,000 for stents costing the hospital $4600.
Lest you think this only applies to big ticket items, think of an IV solution costing the patient $175 when the same solution is available to be purchased for $12.36, or a standard non-prescription item marked up 100 times what it would cost if I bought it at my local drug store, or my personal favorite, $53/pair for non-sterile disposable vinyl gloves. If the bills of these two individuals had been reviewed, there is little question these sorts of mark-ups would be found.
I called a local hospital to find out their policy for the uninsured: if the patient made less than $18,000 per year, they were eligible for Medicaid; other wise it was full price.
And I wouldn’t want you to believe this is only a hospitalization problem. I’ve seen providers billing for a surgical procedure at four or five times what an insurer would pay for the same service, and ten times what Medicare would pay. Negotiating with the doctor’s biller is like talking to a stonewall, so even if the hospital relents and gives the uninsured patient a break, the doctor simply says they won’t negotiate; the price is what it is. Without a finding of outright fraud (which I find with regularity, BTW), “negotiating” with a doctor earning in the mid six figures for a patient making $50,000 is nearly hopeless. They must, you understand, pay those high malpractice costs.
CrossPosted at http://www.signalhealth.com/node/617
Another entrepreneur, darling of the Bush idea of the American Spirit at work, developed diabetes causing him to become uninsurable. He then had a mild heart attack and received two cardiac stents during a 72 hour hospitalization costing him $41,000. The complaint here was not the cost of the hospitalization per se, but that he was charged $19,000 for stents costing the hospital $4600.
Lest you think this only applies to big ticket items, think of an IV solution costing the patient $175 when the same solution is available to be purchased for $12.36, or a standard non-prescription item marked up 100 times what it would cost if I bought it at my local drug store, or my personal favorite, $53/pair for non-sterile disposable vinyl gloves. If the bills of these two individuals had been reviewed, there is little question these sorts of mark-ups would be found.
I called a local hospital to find out their policy for the uninsured: if the patient made less than $18,000 per year, they were eligible for Medicaid; other wise it was full price.
And I wouldn’t want you to believe this is only a hospitalization problem. I’ve seen providers billing for a surgical procedure at four or five times what an insurer would pay for the same service, and ten times what Medicare would pay. Negotiating with the doctor’s biller is like talking to a stonewall, so even if the hospital relents and gives the uninsured patient a break, the doctor simply says they won’t negotiate; the price is what it is. Without a finding of outright fraud (which I find with regularity, BTW), “negotiating” with a doctor earning in the mid six figures for a patient making $50,000 is nearly hopeless. They must, you understand, pay those high malpractice costs.
CrossPosted at http://www.signalhealth.com/node/617
posted by
at 11:04 AM
0 Comments:
Post a Comment
<< Home