Tuesday, April 3, 2012

hospital bill

We got our bill from the hospital for the emergency room treatment I received the night I got snake bit.

Right here is a perfect example of why I resisted going to the emergency room.  This is also a perfect example of how our health care system in this country is broken. We are uninsured, though that doesn't necessarily mean unable to pay for general treatment as long as it is reasonably priced for value received.

It's the catastrophic things that would do us in, but as I understand it, the catastrophic things undo you financially whether you are insured or not.

We arrived at the emergency room 6:30ish and they started the process of sending me home about 11:30.  During that time the doctor examined my foot, they drew blood for tests and hooked me up to an IV, started fluids, gave me a tetanus shot,  hauled my ass to the bathroom when I had to pee, gave me the minimum dose of morphine, drew more blood, doctor came in and talked to me, more morphine, and sent me home.

Because we are uninsured, they voluntarily brought us the paperwork for the charity that helps pay for medical care and they did, in fact, pay for most of it, or rather, most of the amount was deducted from the final bill. (I don't know if I will get a separate bill from the doctor, haven't so far, but I do know that that is SOP.)

Here's the bill:

Description                               Unit                                 Amount

Tubing admin 2C6537                  1                                     $119.50
I think this must be for act of giving me the IV
Tubing ext 2 N3378                     1                                      $21.25
this is for when they drew blood the second time
SOD CHLOR INJ 10MLAM          4                                     $81.00 (20.25 ea)
they injected a small amount of sterile saline solution in my IV prior to giving me pain meds and I guess they used it the two times they drew blood as well
HYDROCODONE 5MG                4                                     $37.00 (9.25 ea)
contrast the exact same pills we bought at the pharmacy the next day 15 for $12 (80¢ ea)
VENIPUNCTURE                         1                                     $13.39
the needle for the second blood draw
CREATINE KINASE                      1                                     $233.50
blood test looking for an enzyme or the effects of the enzyme important in muscle contraction
TSH                                             1                                     $337.25
blood test looking for thyroid hormone levels because I am on meds for that but when I get my blood test done at the doctor's office, this test with a cholesterol test usually runs me about $150 including the visit to get my blood drawn
CBC W/ AUTO DIFF                   2                                     $428.00 (214.00 ea)
complete blood count including the different types of white blood cells, done by a machine
PROTIME                                   2                                     $231.50 (115.75 ea)
blood test to determine how long it takes blood to clot
ER VISIT LEVEL 3                        1                                      $962.75
apparently if they take you back and put you in a room you've automatically racked up nearly $1000
IV INF HYDR EA ADD HR          4                                      $762.00 (190.50 ea)
intravenous nutritional fluids which they have listed as 4 but they only used one bag so maybe it's not priced by the bag but by the hour
IMMUNIZATION ADM 1 VACC   1                                      $97.75
I think this is the charge for giving me the tetanus shot, for the act of sticking the needle in my arm and pushing the plunger
KIT IV PREP                               1                                      $46.25
the stuff they used to give me the IV
CATHLON 20GA                        1                                      $66.50
I think this must be the tubing that went with the IV and nutritional fluids
TD INJ, 7YR/>                            1                                      $48.75
the actual tetanus/diphtheria vaccine
MORPHINE 2MG/ML TUBEX     2                                    $19.50 (9.75 ea)
the pain meds injected in the IV
SALINE 1000ML 2B 1324             1                                     $171.75
not sure as there is already a charge for saline solution, perhaps this is the actual stuff and the previous charge listed for was the act of using it. seems pricey for sterile salt water
COMPRE METABOLIC PANEL      1                                   $472.50
blood work for kidney function, liver function, and electrolytes
CK MB                                         1                                    $288.25
another blood test for creatine kinase but more specifically involving the heart muscle as it relates to myocardial infarction
TROPONIN QUANT                   1                                      $295.75
blood test for three regulatory proteins of the heart muscle
FIBRINOGEN ACTIVITY              2                                     $287.00 (143.50 ea)
a blood test for the protein that is essential for blood clot formation
PTT                                            2                                      $293.00 (146.50)
another test to see how long it takes blood to clot
TX/DX IVP EA ADD SAME          1                                      $83.00
some sort of re-do of the item listed below?
TX/DX IVP INIT DRUG               1                                      $323.25
if I've decoded this one correctly it means treatment/diagnosis IVP - intravenous pyelogram is a type of x-ray examination specifically designed to study the kidneys, bladder, and ureters by injecting a dye into a vein. They DID NOT do this.
PATIENT PAYMENT CHECK                                             - $100.00

TOTAL CHARGES                                                               $5,720.39
FINANCIAL MEANS ASSISTANCE                                     - $5,148.35

ACCOUNT BALANCE DUE FROM PATIENT                        $ 472.04

So, my father was a pathologist and I know that these standard blood tests are done by machines. Yes, they need the lab techs to put the blood in the vials or tubes or whatever and put them in the machines and push the start buttons, but these are basically automated actions. There is no legitimate reason for these common tests to cost so much. Judging by the fact that they charged me $9.25 for a pill we paid 80¢ for at the pharmacy and the almost $150 for the tetanus shot and the $337 for TSH (thyroid) that costs me less than half that and includes a cholesterol panel as well when I get it done at the doctor's office, I think I can say with certainty that these charges are way over-blown.  Not to mention the $400 in charges for something I don't think they did.

And they wonder why poor people can't pay their medical bills.


  1. One thing that surprised me from working with executives and doctors (I was the assistant) was how much welfare these guys receive. One man was mad that he had to pay a portion of not the tuition, but the living costs, of his son who was going to MIT. Another was upset because he paid $40 in taxes one year, saying he usually paid nothing. This was with a $400,000 yearly salary and only two kids. While he paid only $40, I paid almost $2000 on a $60,000 salary. Oh, I could go on but the point is the system certainly sucks.

  2. We're broken. And some of us are just broke because of it.
    This is truly and honestly a travesty.

  3. This is just an example of the whole total brokenness not only of the medical system but the whole song and dance.

  4. Well, you got me beat. Last emergency room visit I had cost me $2700, and the attending physician's bill was $700. I had pulled a muscle in my back, after two weeks couldn't handle not sleeping and couldn't stand the pain anymore. Resisted going in because I knew the bill would obscene. All I wanted was a Vicodine and a muscle relaxer so I could sleep and let my body heal itself.

    Well, they figured kidney stone, put me through the CT scanner (gave me a good dose of radiation), blood and urine test, etc. Doc spent all of two minutes asking me questions, told me I pulled a muscle, wrote a scrip and sent me home.

    It doesn't help that I already have a very low opinion of doctors, I mean, how much credit can you give a mechanic that works on self-healing machines?

    Nurses, though, they are the best. Replace the doctors with cheap robots as far as I am concerned, but you need those nurses.

  5. They should only charge what the price that would be negotiated with an ins co. Not full price.

    Then, get the discount.

    I don't think they did that. I think they did full with you.

    Absolutely terrible ...

  6. it is truly a travesty. those that pay cash are penalized for not being a 'managed care' plan - totally bogus. i hate it all...

  7. NO argument that it's a travesty. What you're paying for are all the charges and profit margin NOT being paid for by managed care plans, medicare/medicaid and everyone else that the hospital treats under negotiated rates.

    So...when I was out of work, paying for my own healthcare insurance and bills on my own, a routine doctor visit with some tests (bloodwork, an X-ray) cost me $1,100. Six months later, employed again and on my company's health plan, the identical visit cost $35. An emergency auto accident patient who came in about the same time, and had no insurance OR money, paid $0, according to the accounting clerk.

    Two guesses as to who makes up the difference? And nope, they only negotiate to get the business, and make up the profits on volume. Individual insureds don't get that...unless they want to join an HMO and pay a few hundred more per month.

    The day that health care became profit-managed (and often publicly traded) organizations was a very sad day.

  8. I'm glad you're OK. Blood tests are expensive. Even for pets. It's kind of silly really. The problem is they can charge the insurance company for it, so the costs get inflated. When we were off of insurance for awhile, it was cheaper to see the doctor and just pay for it directly vs. what they charged the insurance company. Sure while we were insured, $10 came out of our pocket vs. the $70 we were charged when we weren't insured. Still, the charge didn't look like the $100 that she had been charging our insurance. Sigh.

    You think this is bad. My dad's neighbor had the money to pay for his wife's cancer treatment, but the hospital said he couldn't do it directly. They would only take the payment from the insurance company, but they refused to pay for it. That's broken.

  9. Whoa.. that's outrageous. I feel very lucky to be Canadian.

  10. Insurance was one of my incentives to go back to work.I get a free single policy which is nice.

  11. I'm glad I live in Australia where it's not ideal but it's not nearly as bad as this bill suggests.

  12. I hear ya. My hubby had a ct scan...cost...$11,000.00. WTH!!!!
    Insurance paid 80%. Sigh!!!

  13. before I finally got the medicare for disabled people I lived in fear of needing the emergency room
    for this very reason
    they're horribly overpriced and unbelievably inefficent and they do nothing to change their practices
    a neighbor is fighting to keep her home right now because of medical costs and she is insured
    it's great that the charity care helped, I was turned down twice and was in the midst of waiting for an appeal hearing when the medicare came through
    of course depending on the results in November I could end up uninsured again before I manage to get one surgery scheduled

    I'm glad you're OK, for so many they're not

    there is a better way but all the powers that be are too busy bickering over positions of power


  14. This is why people who can't afford insurance hesitate to go to an ER when they really need to. You definitely needed to go and I am glad you did, in spite of the inflated bill.

  15. Cynthia's right: What you're paying for are all the charges and profit margin NOT being paid for by managed care plans, medicare/medicaid and everyone else that the hospital treats under negotiated rates.

    But no one knows what it truly costs. I wrote about this April 3rd, too. Do you think that something is in the air?

    As my hand surgeon told me : You can't figure it out. The numbers are all made up.

  16. You have that all down nicely...too bad it cost so much; they think we're all made out of money...

    Next time, tell the snake to bite someone else...Was there any repercussions from the bite? I assume you did not know what type of snake and that is why you went to emergency?

  17. Wow.
    Just wow.
    Bit on the foot, and then bit on the @ss.
    That just sucks, doesn't it?

  18. So glad I live in the U.K.

    The National Health Service sometimes gets a bad Press (Our newspapers sensationalise) but it is manned by dedicated nurses and doctors. It has layers and layers of 'managers' (totally non-productive) who drain the funds by being overpaid but it is still a fine institution.

    It brings peace of mind - how can your country deny you all that blessing?

  19. I am glad I don't live in the US. I'd be dead anyway.

  20. No good.

    I'm glad we have free health care in our social democratic regime. There are good and bad facets of it, but I appreciate the (almost) free health care >:)

    Cold As Heaven


I opened my big mouth, now it's your turn.