Sickened at hospital charges

[golfgal]

Come to Australia - out of our taxes DH & I pay about $2k for medical expenses which will cover us for treatment in hospitals, just with no choice of doctor, but if you are in a car accident or severe burns etc the best possible treatment is given with no surcharges.

Dr visits have a copay of about $40, but DD is free.
Medicines are basically subsidised so they are $25 per rx - but free if you are on a pension or very low income. There is also a very wide range of medicines including the chemo drugs etc

We pay another $3200 to get treatment in a private hospital in a private room with $50 copay for first 7 days. Some out of pocket expenses may happen for some procedures, but when I had my daughters tonsils removed and grommets installed, there was no waiting for surgery, overnight stay and minimal costs

Why??? You pay more than we do for all of your "free" care. I can go to any doctor, any time, no referrals needed. We spend about $5800/year on insurance premiums with very little out of pocket costs. Last year we spent $60 out of pocket after premiums. Our prescriptions, if generic, are free, otherwise there is a copay between $10-25.

 

[auntie]

$5,800 a year is a bargain for health insurance and no where near what we pay..and it's not a deluxe type of policy by any means.
We are currently paying $1500.00 a month for a family policy. We are self employed (in business for 35 years) and only offer health insurance to but a very few long time employees. We can't afford to offer it the other 20 employees. We'd be out of business.
We have shopped it around..almost every six months..and the rates are pretty much the same..maybe within a a couple of hundred of one another, but almost always offer less. Maybe it's living in the NY metro area that is the killer.

 

[rgf207]

Here's a good one for you...a few weeks ago my son had macaroni and cheese and a rock in his ear. I was able to boil the mac and cheese out with peroxide, but couldn't get the rock out (at the time I did not know it was a rock, my ds only confessed to mac and cheese). Take him to the peds office the next day so they can flush it out. Literally takes 5 seconds for the rock to come out...

My out of pockets costs, after co-pay and the insurance discount... not to mention my employer is affiliated with this group of doctors and I carry this employers insurance....

5 seconds= $125+

That's $1500/min or $90,000/hr.

Ok I have to ask. How do you get a Rock and Macaroni & Cheese in your ear lol

 

[mhsjax]

Our infant mortality rate is low because our doctors will try to save severely premature or disabled babies, when other countries won't. I'm not saying that's right, but our doctors tend to have a God complex, and will do anything and everything to have the patient live. We have the technology others don't.

Also, look at all the multiple births from infertility. Those babies are high risk to begin with.

 

[sparklynails23]

I had a conversation with my ob/gyn recently. I love her, would lay down my life for her. She delivered both of my boys. She's one of the best. She told me that her practice is having difficulty making payroll, that payments from insurance are way down, and for medicare, she told me that they pay something like $500 for a hysterectomy. That's outrageous. Here is a woman with 4 years of medical school, several years of residency and at least 16 or more years of practice and they pay her a pittance for major surgery? No wonder she's having difficulty.

So some of these drs are not making bundles of money. They are struggling as well. I don't think we need health care reform, we need health insurance reform.

I told my OB/GYN I was shocked at how low the reduced payments are that my insurance (Blue Cross/ BS) has negotiated. He said, "Eh, I do alright." He's a great doctor who does a lot of free clinic work, too.

 

[MouseJunkie]

I work in legal and see many hospital bills. It always floors me how there is a hospital charge, an ER doctor charge and then if there's x-rays a separate charge for that on top of the hospital x-ray charges. What really kills me is the charge for a room per night. I always say if I ever get really sick, just put me up in the best room at the Hilton. It's way nicer, there's good room service and it cost a lot less.

 

[Melmac]

I can't believe the amount of money it costs US citizens to go to the ER (or doctor) If it cost me that much to get something checked out, I would be second guessing on whether I could afford to go. I am sorry for everyone that has hardship due to medical bills.

I have heard the same things, only it was someone moving FROM Canada to here. She had a brain tumor and was told she had to wait for about 6-8 weeks for a Cat Scan.

I am sorry, but we may have a messed up system as far as the cost, but you can't beat the US health care system as far as care goes.

I am really sorry to hear about your friend having to wait for a CT scan with a brain tumor. However, the waits are not that long everywhere in the country (another PP said the same thing about the US) - it must be regional. I needed a CT scan for severe migraines and had one scheduled in 6 days (it wasn't an emergency so I did have to wait), specialist appointments with a neurologist and a rhinologist within 2-3 weeks and surgery within the month after that. Maybe I was lucky since my condition was not life-threatening.
However, my father who needed a hip replacement had it done in the US because they could do it within a couple of months - I believe his wait here would have been 9-12 months.

 

[kidzmom3]

I work in legal and see many hospital bills. It always floors me how there is a hospital charge, an ER doctor charge and then if there's x-rays a separate charge for that on top of the hospital x-ray charges. What really kills me is the charge for a room per night. I always say if I ever get really sick, just put me up in the best room at the Hilton. It's way nicer, there's good room service and it cost a lot less.

and while your at the Hilton, who will take care of you?

 

[ksumn1]

Back to vettechick's original questions....I don't know much about insurance but I do have an interesting insurance company as it relates to baby delivery costs. When I had my 2nd DD I found out about 6 weeks before she was due that our OBGYN was not in network. After calling the insurance company multiple times AND speaking with the office manager at the practice. Something about his tax id # was for his old practice in TN the year previous but not accepted in GA as in network.

We had been paying our monthly estimated costs based on a normal ******l delivery, 2 ultrasounds, no extended hospital stay etc. I received through the mail an updated expected cost of care letter that was 20% MORE than what we were told in the beginning. I immediately called the office and made an appointment with the office manager AND the doctor (right after office hours) and demanded to know why the difference, and how they could justify making me pick up the tab for THEIR and the insurance company's mistake. Initially the office manager claimed it was the insurance company's fault but to me, if she's in charge of the office and billing she should know if they are in network or not.

I did all I could by checking with the office and the insurance company before making my initial appointment. The doctor listened for about 4 minutes and in front of the office manager told her I was right. It wasn't my fault, it was theirs and the %$@# insurance companys' fault. I would pay the amount we originally agreed upon (our deductible and then 20% for in network costs) He apologized to us and later on when I chose to have an IUD inserted and it wasn't covered by insurance he mentioned the incident, told me how much he appreciated my remaining a patient (at this point for 6 years) and charged me much less since I was paying OOP.

So vettechick, I'm sorry to hear about your huge hospital bill and hope your delivery bill is more manageable. I guess my post is to point out that sometimes you can dispute charges if you think they're excessive. Good luck and Congratulations.

 

[disfan07]

All these stories about the long waits in canada etc are what people constantly bring up to scare other people to ge tthem to believe what they want to believe. And it's ironic....it's always the same story....a brain tumor and a CT scan...hmmm

Now lets see....it took me 3 MONTHS to get an appointment with my internist as a new patient. It took me 9 WEEKS after that to get into a neurologist. I had to wait 5 WEEKS for an MRI and 7 WEEKS for an EEG.

Right now I'm scheduled for brain surgery on June 22nd...here's the catch though. It has not gone through our insurance yet. So basically, while I have to have the surgery and it's scheduled already and everything, some idiot at the insurance company can decide that I don't really need to surgery and deny coverage of the surgery. So basically, my life is in the hands of someone who has no idea what the he** is going on but if they have to cover it 100% (I'm at 100% coverage) it's not out of the realm of possibility that they would deny it just because they can. But these people who are in charge of these companies are insensitive, heartless....(not a dis approved word)

ETA: I have a question for everyone who has no problem with the way insurance works here. Have you ever seen bills that total over $350,000 a year for hospitalizations? That's great if you have wonderful insurance. What would happen if all of a sudden you were unemployed with no insurance? What would you say then if you ended up in the hospital with a $50,000 + hospital bill but no insurance to cover it?
Because you know what, we have great insurance. But believe me, it is always on our mind...what if something happens. What if my dad loses his job? What if we lose our insurance? We pay $20,000 in OOP expenses as it is WITH insurance. Without insurance, since last september we have racked up almost $300,000 in medical bills just for me..we have 3 other people in our family...we will be racking up hundreds of thousands more at the end of june (my surgery alone is costin gover $100,000)...Absolutely NOTHING that is wrong with me is because of something I did or because of how I live....I have severe asthma, eczema, allergies, heart arrhythmia, and a brain mass....I eat healthy, I go to the gym 4-5 times a week, etc....I'm only 20...so you're saying that if my dad loses his job we should not get the same healthcare we have now?

But no....there is nothing wrong at all with health care in the US

 

[mhsjax]

All these stories about the long waits in canada etc are what people constantly bring up to scare other people to ge tthem to believe what they want to believe. And it's ironic....it's always the same story....a brain tumor and a CT scan...hmmm

Now lets see....it took me 3 MONTHS to get an appointment with my internist as a new patient. It took me 9 WEEKS after that to get into a neurologist. I had to wait 5 WEEKS for an MRI and 7 WEEKS for an EEG.

Right now I'm scheduled for brain surgery on June 22nd...here's the catch though. It has not gone through our insurance yet. So basically, while I have to have the surgery and it's scheduled already and everything, some idiot at the insurance company can decide that I don't really need to surgery and deny coverage of the surgery. So basically, my life is in the hands of someone who has no idea what the he** is going on but if they have to cover it 100% (I'm at 100% coverage) it's not out of the realm of possibility that they would deny it just because they can. But these people who are in charge of these companies are insensitive, heartless....(not a dis approved word)

ETA: I have a question for everyone who has no problem with the way insurance works here. Have you ever seen bills that total over $350,000 a year for hospitalizations? That's great if you have wonderful insurance. What would happen if all of a sudden you were unemployed with no insurance? What would you say then if you ended up in the hospital with a $50,000 + hospital bill but no insurance to cover it?
Because you know what, we have great insurance. But believe me, it is always on our mind...what if something happens. What if my dad loses his job? What if we lose our insurance? We pay $20,000 in OOP expenses as it is WITH insurance. Without insurance, since last september we have racked up almost $300,000 in medical bills just for me..we have 3 other people in our family...we will be racking up hundreds of thousands more at the end of june (my surgery alone is costin gover $100,000)...Absolutely NOTHING that is wrong with me is because of something I did or because of how I live....I have severe asthma, eczema, allergies, heart arrhythmia, and a brain mass....I eat healthy, I go to the gym 4-5 times a week, etc....I'm only 20...so you're saying that if my dad loses his job we should not get the same healthcare we have now?

But no....there is nothing wrong at all with health care in the US

Sorry you don't believe my story about my friend from Canada, but oh well, not my problem. I am sorry that you have to wait for your MRI and other tests. My hubby had to have one and got his scheduled on the same day as his Dr' appt. Also Insurance companies always need to approve surg. Mine was approved in about 2 days. So it isn't all bad. Seem to my that things in CA move slower than other places.

No one is saying that if your dad loses his job that we shouldn't have healthcare, but really, look at the Gov't. Nothing they run succeeds, I don't want the Gov't controlling Drs and hospitals and Insurance. It won't work. Just look at the situation we are in now. The country is in such great shape financially.

 

[minnie56]

Wow..that is ridiculous. I can't imagine..

 

[MIGrandma]

It's not only hospitals that charge ridiculous amounts, but doctors do as well.

I have to have the pressures in my eyes checked at the opthalmologist's office. The charge for it keeps going up, up, up. This last time I had it done in May the pressures were up, so he wanted to start me on a second medication (eye drops) and had me come back 2 weeks later for a re-check. Then he wants me to come back in July to be checked again. I just can't afford it. Not with what they charge for the 2-minute procedure. I couldn't remember how much I paid the time before, so asked and she said it is $60 each time, but said she wouldn't charge me for the second visit. I told her I really appreciated that.

So, when the bill came I was expecting it to be $60. The actual bill is for $309, "my share" is $169 and $140 is "pending insurance" and I know they won't pay. So they're going to want me to pay $309. I will be talking to them about it this week. Tried to go to the office Friday afternoon, but they only have morning hours on Fridays so it has to wait until this coming week. But I definitely want some explanation, especially since she did charge me for the second visit. I wish I would have gotten the name of the woman who quoted me $60, but I didn't, so that's why I want to go talk to them in person, so that I can hopefully talk to her and not someone else.

I just don't understand how they can charge such high prices for something that only takes a couple of minutes. I just wonder how much they charge for a complete eye exam. Not sure I even want to know!!

 

[DMickey28]

You know you can get flu even if you've had the shot, yes? So it's still worthwhile to check for. In addition, you could easily get a strain that isn't in the vial of additives and preservatives that is injected, even if by chance you did develop an immunity to the ones they put in the vial.


Yes, ERs are expensive. Took us over a year to pay off the ER when DS got a burn. And we weren't even there for 4 hours, and they did nothing but look at it, put on a salve and a bandage, and make sure that we hadn't purposely burned him. That time was superfun as the *day* before we had signed up for a high deductible plan (retroactive to the beginning of that month), so we got to pay it allllll.

Doesn't it always happen that way? We switched to a high deductible plan on April 1st, 2009. I did the math every which way and it did end up being cheaper based on our premiums per month, deductible, co-pays for well child and known visits and our current RX's. Wouldn't you know ... May 2nd my DH lands in the Cardiac ICU for 3 days. Then he left the company in October so it really ended up costs us more because we didn't get to rid out the whole year with the discounted premiums. Fun times ....

 

[Piecey]

I told my OB/GYN I was shocked at how low the reduced payments are that my insurance (Blue Cross/ BS) has negotiated. He said, "Eh, I do alright." He's a great doctor who does a lot of free clinic work, too.

My OB got $2200 for my entire 8 (or so) months of prenatal care, postpartum care, hospital visits and c-section for DS1. Just $2200.
I told DH I felt like I should send her a fruit or muffin basket because I felt that she'd been robbed.

 

[ksumn1]

I paid that much just for half my pregnancy. At the time, our deductible was based on a Jan-Dec yearly calendar. I found out I was pregnant in late October, had to meet the deductible for 2002, basically paying most OOP, then meet the deductible again for 2003.

You really shoul send her a fruit basket, flowers or something.

 

[Disney Doll]

I agree that medical charges can be ridiculous.

However, I have to ask why you'd go to the ER for something like that instead of calling either your regular doc or OB/GYN?

I've never gone to the ER because I know how expensive it is. I'd go to Urgent Care if I couldn't get an appointment with my doctor.

As a nurse, I was wondering that myself. Kind of like the people who have back pain for 2 weeks and come to the ER on Christmas Day...sort of adds to the drama.

And yes, healthcare is expensive, perhaps ridiculously so. Thank your local attorney and elected officials, as well as insurance companies. Don't think it's going to get any cheaper with healthcare reform...it's just that only certain people will be paying for everyone else...

And FTR, most of the time we have no idea what kind of insurance someone has. Nor do we care. If you're sick, you get treated.

And to our Canadian friends...if someone from the United States had to wait 4 weeks for an MRI, they'd have a stroke. We are a "I want it now" culture down here. Heck, people down here get in a snit if they have to wait 4 minutes for a cup of coffee...

 

[lemondog]

My OB got $2200 for my entire 8 (or so) months of prenatal care, postpartum care, hospital visits and c-section for DS1. Just $2200.
I told DH I felt like I should send her a fruit or muffin basket because I felt that she'd been robbed.

When I had my twins I had FABULOUS health coverage...I paid $20 for the ENTIRE high risk pregnancy. Yep, $20. At least to my ob/gyn. I did have to pay another one-time $20 copay to my high-risk ob, and also had to see an endocrinologist due to pg-induced thyroid problems, which was a $20 copay the 4 times I saw him. But that was it. I think I paid maybe $120 total for a very complicated pregnancy and a 34-week c-section and 96 hour hospital stay.

I consider myself very, very lucky! DH has since switched jobs and while we are still blessed to have comprehensive coverage, our oop costs would be much, much higher with this policy. Heck, so far I have paid $700 oop just for DD to get 4 flippin' stitches in her chin, which they did right in the hallway at the hospital and it took less than an hour!

 

[minnie56]

As a nurse, I was wondering that myself. Kind of like the people who have back pain for 2 weeks and come to the ER on Christmas Day...sort of adds to the drama.

And yes, healthcare is expensive, perhaps ridiculously so. Thank your local attorney and elected officials, as well as insurance companies. Don't think it's going to get any cheaper with healthcare reform...it's just that only certain people will be paying for everyone else...

And FTR, most of the time we have no idea what kind of insurance someone has. Nor do we care. If you're sick, you get treated.

And to our Canadian friends...if someone from the United States had to wait 4 weeks for an MRI, they'd have a stroke. We are a "I want it now" culture down here. Heck, people down here get in a snit if they have to wait 4 minutes for a cup of coffee...

You 'might' wait 4 weeks for a non emergency or elective MRI but when it's an emergency, trust me, it will be same day. I have been there.

 

[Magpie]

You 'might' wait 4 weeks for a non emergency or elective MRI but when it's an emergency, trust me, it will be same day. I have been there.

When my son passed out cold twice in one morning - we went to the ER. When they tested his heart in the ER and found something questionable, he went right on the high priority list to be seen at the Heart Institute.

He was in there getting his heart examined, the very next day!

No wait times at all, and all it cost us was a few coins for parking.