Your Wonkette had to go to the hospital about a year ago for a two hour long procedure. We had a good friend come pick us up, and as we left, she indicated a desire to take the brown paper bag of basic first aid supplies that the doctor had left for us to bring home for after care. DO NOT TAKE THE BROWN PAPER BAG, we yelled. DO NOT TAKE IT! But our friend was worried, so she took the brown paper bag anyway, and we were charged $20 for a bunch of gauze and a couple Tylenol. Whatever, this was small potatoes, since the entire bill was over $2500 for this two hour procedure, and it was tough to get particularly excited over $20, but still, it was the principle of the thing!
And in the grand scheme of it all, we got off easy! $2500 for a two hour procedure? And we got to pay for it a month or two later, after it was all over? Pfft, we had hit the jackpot! Here, let Time magazine tell you about all the ways you could suffer at the hands of our corrupt health care system:
When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. …Because Stephanie and her husband had recently started their own small technology business, they were unable to buy comprehensive health insurance. For $469 a month, or about 20% of their income, they had been able to get only a policy that covered just $2,000 per day of any hospital costs. “We don’t take that kind of discount insurance,” said the woman at MD Anderson when Stephanie called to make an appointment for Sean.
Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance.
We should be very shocked by this, and yet we are not. Let us indulge ourselves by sharing another personal experience with our health care system: six months ago, two of our close friends were in a car accident with an uninsured, underage drunk driver. While one of them was in the ER hooked to an IV and waiting to go into surgery, a lady with a clipboard came over to him and started discussing payment options and payment plans since he had no medical insurance. Isn’t that nice? Killing time before surgery by discussing the fact that you are now tens of thousands of dollars in debt due to an injury that was not your fault?
But back to Sean, who needed $48,900 so the doctor would see him about his cancer.
Beverly Hills surgeon explains at home fix for crepey skin around the arms, legs, and stomach.
The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900…The first of the 344 lines printed out across eight pages of his hospital bill — filled with indecipherable numerical codes and acronyms — seemed innocuous. But it set the tone for all that followed. It read, “1 ACETAMINOPHE TABS 325 MG.” The charge was only $1.50, but it was for a generic version of a Tylenol pill. You can buy 100 of them on Amazon for $1.49 even without a hospital’s purchasing power.
Dozens of midpriced items were embedded with similarly aggressive markups, like $283.00 for a “CHEST, PA AND LAT 71020.” That’s a simple chest X-ray, for which MD Anderson is routinely paid $20.44 when it treats a patient on Medicare, the government health care program for the elderly.
The article goes on like that, talking about what Sean was billed for each item and what each item should probably have cost without the enormous mark up.
And mark ups are certainly a problem! But let us add this to the discussion, from another friend of ours, who got her PhD in Social Science and did her dissertation on electronic medical records: making a long and complicated story short, our medical system pays on a per-procedure basis. This can be traced back to the invention of Medicare, wherein a person from each specialty was represented in the framework of a discussion about physician reimbursement. Having one representative from each specialty sounds like a great idea, but the problem was that surgeons were over represented. As a result, the payment scheme became oriented around procedures. Doctors have figured out ways to break a procedure like, say, stitching up a wound, into several mini-procedures, each with its own code, that they can then charge for.
There are other problems, of course, like the fact that CEO salaries don’t grow out of thin air and medical centers won’t build themselves, so here we are, with people like Sean paying $15,000 for tests that would have cost hundreds of dollars if he were on Medicare.