US medical system - A perspective
I had a bike fall on November 8th 2007. I was taking a turn and the roads were really slippery and I somehow lost balance and crashed. The right half of my body took most of the impact, since that's how I landed onto the ground.. I had deep cuts on the right side of forehead, a few bruises on the right cheek and minor abrasions on my right shoulder. I lost consciousness for a few moments, but then was admitted to the University of Washington Medical center, thanks to "American Medical Response", a private ambulance service that has billed me $612.25 for picking me up, ascertaining my whereabouts, checking my condition and dropping me off at the medical center, a kilometer away. Anyway, my "insurance" is supposed to offset such monstrous costs.
The medical center conducted various scans - CT head scan, CT angiography for the neck, CT head scan 2 and Xray for cervical spine to check in detail if vital organs of my body that took the impact during the fall were unaffected. I am told that I am allright - Great. Now, they stitch my cuts up which is wonderful and I am sent off, less than 12 hrs in the hospital. When I reached home, I looked into the mirror and realised that despite the stitches and ointment application, a dressing would have helped, since blood was oozing out here and there and an overall patch up would have made me get on with life. I went back to the medical center and the nurse there was reluctant to give me a dressing. I am baffled, I tell him that the least he can do is patch up the wounds. Finally he gives me a few bandaids and says that he is not supposed to give this, but that he is doing me a favour.
I just wanted to get over this injury and get on with life, so I didn't give much thought to that.
Two months later, I get a bill. Get this: the Xrays and CT scans, etc cost 662$, which is supposed to be "fine" if you have insurance, but I am charged $4283 for "hospital usage"??? What the heck. Even if I were to have insurance(covering 90% of the cost) , how the hell can you charge $4283 for hospital usage, I was in the hospital for hardly 12 hours. Does it make any sense?
Can any one tell me how in the world this cost could probably be accounted for? Assume for the present that there is no such concept as insurance and people pay from their own pocket the costs incurred for medicare. Also assume that the hospital charges came out to $428.3(10% of the original cost), people will find this cost to be simply too much. They can't resort to, "Do you have insurance? It should take care of most of the cost". And if the hospital charges did come out to $4283 as in my case for a trivial treatment of minor injuries (we are not talking of bypass surgeries here), they will instead simply rebel. Insurance just makes the costs look better. As another example, I was asked to come back a week or two later to get the stitches removed. I went to the medical center at 9 pm, since the waiting room seemed crowded I asked the receptionist if I could come at say 11 pm. She told me that there would be an extra charge for emergency room check in beyond night hours. I asked her how much that would be, she just said, 'oh don't worry about it, it would come in your bill and the insurance would cover it'. Well, it was included in the bill and I was charged $120 for that. So if I were to say that insurance would cover 90% of that cost and I need to pay only $12, it makes the overall picture rosy and beautiful, but it fails to explain how they came to charge $120 in the first place.
I recently heard in a lecture that institutions in US including universities and medical centers have to pay negotiation teams hefty fees to prevent people from sueing them million dollar suits for whatever reason (improper medical care, etc). So that, these fees are passed on to people using these institutions, students paying hefty tuitions in the case of universities and patients paying astronomical bills in the case of hospitals. I am not sure on the credibility of this reasoning but I can't come up with a better reason(or let's say other reasons) for the medical center charging me $4283 for hospital usage.
I just came across this article that reflects a trend for American patients seeking medicare abroad for the same reason I posted this blog. Hmm.
The medical center conducted various scans - CT head scan, CT angiography for the neck, CT head scan 2 and Xray for cervical spine to check in detail if vital organs of my body that took the impact during the fall were unaffected. I am told that I am allright - Great. Now, they stitch my cuts up which is wonderful and I am sent off, less than 12 hrs in the hospital. When I reached home, I looked into the mirror and realised that despite the stitches and ointment application, a dressing would have helped, since blood was oozing out here and there and an overall patch up would have made me get on with life. I went back to the medical center and the nurse there was reluctant to give me a dressing. I am baffled, I tell him that the least he can do is patch up the wounds. Finally he gives me a few bandaids and says that he is not supposed to give this, but that he is doing me a favour.
I just wanted to get over this injury and get on with life, so I didn't give much thought to that.
Two months later, I get a bill. Get this: the Xrays and CT scans, etc cost 662$, which is supposed to be "fine" if you have insurance, but I am charged $4283 for "hospital usage"??? What the heck. Even if I were to have insurance(covering 90% of the cost) , how the hell can you charge $4283 for hospital usage, I was in the hospital for hardly 12 hours. Does it make any sense?
Can any one tell me how in the world this cost could probably be accounted for? Assume for the present that there is no such concept as insurance and people pay from their own pocket the costs incurred for medicare. Also assume that the hospital charges came out to $428.3(10% of the original cost), people will find this cost to be simply too much. They can't resort to, "Do you have insurance? It should take care of most of the cost". And if the hospital charges did come out to $4283 as in my case for a trivial treatment of minor injuries (we are not talking of bypass surgeries here), they will instead simply rebel. Insurance just makes the costs look better. As another example, I was asked to come back a week or two later to get the stitches removed. I went to the medical center at 9 pm, since the waiting room seemed crowded I asked the receptionist if I could come at say 11 pm. She told me that there would be an extra charge for emergency room check in beyond night hours. I asked her how much that would be, she just said, 'oh don't worry about it, it would come in your bill and the insurance would cover it'. Well, it was included in the bill and I was charged $120 for that. So if I were to say that insurance would cover 90% of that cost and I need to pay only $12, it makes the overall picture rosy and beautiful, but it fails to explain how they came to charge $120 in the first place.
I recently heard in a lecture that institutions in US including universities and medical centers have to pay negotiation teams hefty fees to prevent people from sueing them million dollar suits for whatever reason (improper medical care, etc). So that, these fees are passed on to people using these institutions, students paying hefty tuitions in the case of universities and patients paying astronomical bills in the case of hospitals. I am not sure on the credibility of this reasoning but I can't come up with a better reason(or let's say other reasons) for the medical center charging me $4283 for hospital usage.
I just came across this article that reflects a trend for American patients seeking medicare abroad for the same reason I posted this blog. Hmm.
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