maddieeeeeee

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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.

Every time a nurse drew blood, a “ROUTINE VENIPUNCTURE” charge of $36.00 appeared, accompanied by charges of $23 to $78 for each of a dozen or more lab analyses performed on the blood sample. In all, the charges for blood and other lab tests done on Recchi amounted to more than $15,000. Had Recchi been old enough for Medicare, MD Anderson would have been paid a few hundred dollars for all those tests. By law, Medicare’s payments approximate a hospital’s cost of providing a service, including overhead, equipment and salaries.

On the second page of the bill, the markups got bolder. Recchi was charged $13,702 for “1 RITUXIMAB INJ 660 MG.” That’s an injection of 660 mg of a cancer wonder drug called Rituxan. The average price paid by all hospitals for this dose is about $4,000, but MD Anderson probably gets a volume discount that would make its cost $3,000 to $3,500. That means the nonprofit cancer center’s paid-in-advance markup on Recchi’s lifesaving shot would be about 400%.

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Bitter Pill: Why Medical Bills Are Killing Us

If you haven’t read Time Magazine’s in-depth article about the healthcare system, bookmark it and read it soon. Basically, the medical industry is making a serious chunk of money by overcharging you and your insurer for everything.

I’ve seen this happen with my bills. I went to the local walk-in clinic last month when my right ear felt clogged. They did a procedure called a “lavage,” where they rinse it out with hot saline water. The charge for the procedure was listed on the menu at the front of the clinic: Ear Lavage, $25 per ear. When the doctor looked at my ears, she said the left one was partially clogged, and since I had insurance, would I like them to do the left ear as well? Sure. I paid my $20 copay and let them send the $30 bill for the remainder to my insurer.

So imagine my surprise last week when i got a letter from my insurance company about the charges costing more than what I was covered for. The total bill was more than $275 for a procedure that costs $50 up front. There were mysterious charges for supplies and procedures that I didn’t recognize. I bet I’m never going to get another letter about that visit. The walk-in clinic got as much money as they could from my insurer, and whatever was left over they’ll forget about, because it didn’t cost that much in the first place.

Doctors’s offices (ETA: changed from “Doctors are”) are charging as many things as possible to the insurance company to make as much money as possible. So insurance companies raise premium prices to cover costs. So YOU pay more money for procedures that, in many cases, you never even got.

I left my last chiropractor because of the bogus charges. I called his office and said he was defrauding my insurance company and I didn’t want to do business with them any more. So I switched to a new chiropractor, who I really like. And when I got the bill, I found out he (or his office) was doing the same thing. At this point I don’t think there’s a way around it.

It’s unconscionable. And there’s little to no recourse for consumers.

(via stfuconservatives)

Bookmarked for future reading after exams.

(via ohpauline)