The $474,000 Hospital Bill

CNN and Time Magazine discovered how charges mounted for one family. Nurses pricked the patient’s finger for a glucose test 190 times. At $39 a pop that totaled $7,410. A breathing ventilator generated 32 separate bills, totaling $65,600. There were separate charges for the IV tube and for asking for a urine bottle.

A box of tissues is a “mucus recovery system.” A teddy bear is a “cough suppression device” and can cost between $128 and $200.

Remember those little white cups fast food restaurants give you for free to put ketchup in? In fact there are restaurants giving them away for free in the lobby areas of many hospitals.  In the hospital room, however, these are billed as “oral administration fees” and for one patient they totaled $5,000.

After this patient’s insurance ran out, he was billed off the charge master (list price). In fact, only the uninsured are ever charged list price. Medicare would have paid only a small fraction of those amounts.

Here’s the big shocker for CNN: There is nothing in ObamaCare that will change any of this.

Comments (20)

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  1. kingstu says:

    Mr Goodman:

    Obamacare reminds me of my favorite quote from Bananas, the great Woody Allen film:

    From this day on, the official language of San Marcos will be Swedish…Furthermore, all children under 16 years old are now… 16 years old!

    See how easy government can legislate a new reality. Just say it and it is so!!!

  2. Kyle says:

    Because Obamacare isn’t there to fix anything. It’s a legacy thing for Pelosi and Obama to look back in five years when they’re old and decrepit, enjoying their special politician health benefits, and think about all those people they didn’t help.

  3. Chris says:

    This is why Hospitals hide itemization on bills, you have to go out of your way to ask for it. We were billed once $20 for a single 200mg ibuprofen. At a corner drug store $20 would have bought several thousand pills.

    Next time, we brought our own ibuprofen.

    This is in general a problem with the third party payer system. Someone else is paying, so why bother discussing fees?

    Imagine if car repair worked the same way, no estimates allowed, you go in, they do whatever they want to your car, and then bill you for anything they want in any amount they want. That is basically our medical system.

    In reality, the one government mandate I’d be in favor of is price disclosure. Before any billable activity was conducted the patient would have to be informed of the cost of it and be allowed to decline. No more sneaky billing.

    Do that, and patients, being informed of the cost, will choose to consume less, and hospitals, being embarrassed by their graft, will hopefully have enough shame to reduce it.

    You’ll never have a functioning market if know one knows the cost of anything. Most hospital employees don’t know the costs for the services they provide.

  4. Angel says:

    Our medical system is a joke. Stack up the prices and basically dehumanize the process while you’re add it just because a third party will have to pay the bills. This is all just so ridiculous and corrupt that it makes me sad to live under such a sytem.

  5. Peterson says:

    What unbelievable waste! I would be furious if I was charged that outrageous amount.

  6. B. Popplewell says:

    Where does it all go?!

  7. H. James Prince says:

    Chris, you are absolutely right. Even though we can often have the mindset of “someone else is buying – I’ll have the surf-n-turf”, this is not often the case when expenses sky-rocket. Even the most jaded person, when shown an itemised medical bill, would cry foul.

  8. Buster says:

    A box of tissues is a “mucus recovery system.”

    Had I been the patient I would have informed the hospital that mucus cannot be recycled — thus should not be recovered. I would demanded I only pay for a “mucus disposal system.”

  9. Studebaker says:

    A box of tissues is a “mucus recovery system.”

    I don’t even want to know how they listed toilet paper on the hospital bill!

  10. Bob Hertz says:

    Fortunately no one will be expected to pay this entire ludicrous bill.

    But some patient and their insurer will have to pay part of it.

    California and Colorado and Illinois and CT and MN have the start of a solution.

    Anyone without health insurance and an income under about $60,000 cannot be charged more than Medicare for hospital care

    In addition to laws like this, we need health courts which would have the authority to rescind unconscionable billings.

    Price gouging like this is not capitalism, at least not a version of capitalism that should be defended.

    Bob Hertz, The Health Care Crusade

  11. John B says:

    Do hospitals have to overcharge patients with private insurance to make up for losses due to the uninsured and will the Affordable Care Act help with this? I don’t know. What I do know is that more than 50 million people in our country are without health insurance and 60% of bankruptcies are due to medical bills. I know that even with insurance, one major event can place a burden on a family. I agree with Mr. Hertz, we need some type of health court to control price gouging.

  12. Pamela RIley says:

    Although hospitals should not charge these astronomical prices and many believe that Obama Care is not what it is meant to be, it does have it’s pros. Obama Care puts many hospitals to the test. It requires hospitals to offer the best care possible and if they don’t and can not maintain patients satisfaction, they will not be paid. I believe in the future this will mean everything. How many people want to go the hospital and receive poor care, no one does. To many hospitals, the money they receive keeps the doors open and the staff working.

  13. Bob Hertz says:

    Hospitals and insurance companies are today linked together in what amounts to a protection racket.

    If you do not buy an insurance policy, you are exposed to horrific bills should you need to go to a hospital.

    This is done with nice manners, but it is not all that different from the Mafia guy who tells the dry cleaner that if he does not pay protection, then his store might just have a fire.

    I do not know which is worse — the Obama administration with its mandate to buy insurance, versus the protection racket which we have endured for several decades now.

    Hospitals do need a lot of money to operate, i.e. to pay the nurses and buy drugs and maintain the facility, and most patients do not have very much money.

    Hospitals cannot operate on a cash basis, so the question is, what is the best way to fund them?

    Overcharging some patients to scare the others is certainly not the best form of funding.

    Overcharging some patients to get higher insurance payments is not much better.

    The writing of Uwe Reinhardt is of some guidance here.

    Bob Hertz, The Health Care Crusade

  14. LgT says:

    I agree that the bill is outrageous. However, I disagree that Obama Care does not attempt to improve healthcare costs and quality. True, the Affordable Care Act requires everyone to get and maintain health insurance coverage. However, it is not solely to benefit hospitals and providers, but it is mainly to benefit patients. If healthcare insurance was not required, patients without coverage will certainly accrue more costs and are more likely go bankrupt while healthcare costs for all other patients would increase in order to pay for the healthcare charges of those who are uninsured. Obama Care also attempts to address healthcare bills like the one mentioned above by placing price limits on things needed for healthcare sold in hospitals, such as “mucus recovery systems” and “cough suppressant devices”, as well as prohibiting repeated hospital admittance of patients by providers. Although Obama Care may not address all aspects of healthcare issues, it does attempt to promote healthcare costs improvement. Thus, Obama Care is not just a legacy thing for Pelosi and Obama. Their future political health benefits in my opinion will be well deserved.

  15. Don Levit says:

    The PPACA favors network care over out-of-network care.
    While out-of-pocket expenses are capped on in-network care, there is no cap on out-of-network care.
    Seems to me the cost of setting up and maintaining a network is significant.
    Think of the premium savings if no networks were involved, in which people could see any provider.
    Then, one of these ever-expanding firms which negotiate for patients after the service is performed, would provide a great fee for service arrangement.
    Using actual figures from such services provided by such professionals in the past, could serve as a great starting point.
    With prices all over the place, it behooves one to negotiate!
    Don Levit

  16. D Powell says:

    The problem in healthcare is a problem that involves all different entities in this country. The government did come up with the Affordable Care Act which may not be perfect but if implemented right will definitely help a lot more people to gain access to health care. On the other hand I believe the providers of healthcare should look into the ways they could cut costs down.

    I am a registered nurse and have worked in different hospitals for the last 20 years. If there’s one thing that really shocked me when I first came to the US about 6 years ago is the amount of wastage being incurred in the delivery of healthcare. I’m talking about the use of the supplies like the “oral medication fees” or what I assume refers to what we call the medication cups.I have observed that people here in the States have all been so used to the abundance of supplies that they don’t think twice about throwing things away. But, in countries where you don’t know when you will have supplies again, you think twice about throwing things away.You think twice about wasting anything because you know these supplies might not be there tomorrow when you come back to work. But here in the US, you just know that however much you throw away today, when you come back to work the following day, the supplies you need will be there. If everyone will just start thinking about the importance of each item and how much they cost then maybe, just maybe, we will start cutting down cost in our own little way. Let’s start with ourselves.

  17. Bob Hertz says:

    I suppose that Don Levitt is right that we need to negotiate it, but frankly, I find that depressing.

    Medicine is not supposed to be a bazaar selling rugs.

    The doctor-patient relationship should be in the nature of a gift and loyalty.
    You negotiate with a prostitute, not a doctor.

    I would prefer a system where all fees are negotiated by experts on both sides, and then the issue never comes up at the point of care.

    I hate to see patients used as the kamikazes of health care cost control.

    Bob Hertz
    The Health Care Crusade

  18. dawn says:

    part of the problem….
    health insurance, medicines and healthcare in America is a for-profit system.
    Hard to regulate prices on a for-profit system – but good luck trying…..
    Amtrak is subsidized by the Government and yet tickets are more and more expensive– why would anyone think government involvement make anything cheaper??
    There are cures for many diseases and alternate, inexpensive treatments compared to prescription drugs – but because the drug companies and doctors can only profit from treating you with meds for the disease – you won’t see many cures.
    Sad but true.

  19. John Kumar says:

    These kinds of stories just make me so upset. Why does the health care industry continue to get a free pass for providing ineffective services, this is isn’t present in other industries.