Family fights $474K hospital bill
CNN's Drew Griffin and Time magazine investigate what's behind the high cost of medical bills in America. They find a family who was charged hundreds of thousands of dollars for items used during treatment at a hospital, like the paper cup that holds a patient's pills.
Last March Bob Weinkauf found himself in the ICU struggling to breath. After four days of treatment, the hospital was telling his wife Becky that insurance would not even come close to covering the costs of his care. She says she remembers shaking after the conversation, unsure of what to do.
Weinkauf's bills, totaling about $474,000, were listed in broad categories with few details about the specific charges. He decided to find out what exactly made his hospital stay so costly. The answer was in the price tag of every little or big item he touched or was given – tissues, a urine bottle, a cup he spit in, and most other services and supplies he needed.
Pat Palmer has made a career battling hospitals over outrageous invoices like the one the Weinkaufs are facing. She's helping them fight the charges that could ultimately take them the rest of their lives to pay.
Read more on The extraordinary cost of getting sick in America
Watch Part II of the report:
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Post by: Drew Griffin and David Fitzpatrick Filed under: Health Care • Special Investigations Unit |
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Some health costs are unavoidable but others are not. Companies want to make money. Even non-profits are not there to lose money. Want to cut health costs? Then stop smoking, eat right and exercise. How much of these costs are due to people not taking care of themselves and then whining about the costs of their triple bypass surgery or treatments for Type II diabetes. Where's the personal responsibility in all this?
Out health Insurance system is sucks. Period. And no one is serious to fix it up.. everyone is point the political score and that's it...
As a Canadian I cannot comprehend what I'm reading here, it's so foreign to me. It's bad enough having to deal with an insurance company when you car is stolen or you get into an accident, but to have to deal with one concerning your health must be the ultimate stress! You can call us socialists all you want, but at least collectively we take care of each other in Canada.
probably $73,836 to wait in the waiting room. $1,790 for using the right arm rest of the chair. another $7,600 for the pen they used to sign papers. $250 for the actually care.
I know someone who is in sales for a "non-profit" (huge company) medical insurance company in California. This salesperson "earns" a salary of approximately $300,000.00 annually and the bonus this person received for 2012 was $250,000.00. So, someone selling medical insurance policies receives more than $500,000.00 annually. Makes me wonder what the upper management salaries must be. Hmmmm..where does the profit end up?
Here in Canada we have government health care. What is "government"? It's us! I live in Alberta. We pay NO monthly ins fees. We pay No deductible. I see my doctor when I am sick. I don't call my mayor, MLA, MP or the Prime Minister. I call my doctor. What to do is decided by my doctor and me. PERIOD!
I contracted malaria while overseas. It hit when I was back home. Two days of intensive care and 6 more in basic room. Lots of IV's, drugs and around the clock care by some really professional staff.
My bill???....ZERO, Nada, Zip
In Canada, we ALL contribute to our ins program and we manage it ourselves so we don't have to negotiate with hospitals or ravenous ins companies. People have the clout, not the "for profits"
I don't understand how the most powerful country in the world can live it's sick and ailing at the mercy of so called free enterprise.
Thank God there's a 49th parallel between us. I hope you folks sort it out soon.
Sorry to say this, but as a foreigner living in America from yes, a third world nation that has the one of best and cheapest medical care in the world, some of the best doctors, nurses and charity hospital systems, I find that Americans are too naive, and careless about the charade of the joke of the medical systems here in the US.
1. All hospitals are non-profit on paper – yet they charge an arm and a leg, literally.
2. Insurance companies play dubious games with you. They are an unnecessary bureaucracy.
3. Many doctors & service providers are empathetic and carign, but they are stuck in a system with perverse incentives.
4. Lawyer are like hyenas, exploiting the chaos.
5. Medicare pays a 200K for a 91 year old in his last year of life, who himself has only paid half of that throughout his life, yet the govt. can't fund schools or basic medical care.
Wake up America – what is wrong with you all here?
We need to address the "big" issue: medical care is not part of our free market, and therefore the foxes have taken over this henhouse to the tune of billions. There is a huge difference between covering costs and being "not-for-profit" and working in a free marketplace where the consumer can shop for better pricing. If you are in an ER, you are NOT shopping. Hospitals have worked hard to cover their tracks, hide their costs, and prevent patients from having reasonable care at a reasonable rate. And if some political hack cannot see the difference between fair and reasonable charges and egregious, massive overcharging of patients when they are most vulnerable in a life-or-death situation, then shame on them. Every "not-for-profit" hospital showing these kinds of profits, and with payrolls on this level, should be brought up on federal tax evasion charges, and the penalties applied to the outstanding charges they are using that are crushing our population.
Sickness makes money. A cure for cancer threatens the medical gravy train. Socialized medicine is the doctors greatest fear. Doctors in the United States are not motivated by helping people, they are motivated by greed. We need to completely destroy the status quo of the US health industry and start over from scratch.
Nowadays, even having insurance is not enough. Oh well, Republicans don't want regulation of ANY industry. To do so is an assault on capitalism, and regulation is socialism.
Just for starters there should be no such thing as "options" in health care, if you need a service and you have health insurance, whatever you need should be covered. "Options" are just a way for insurance companies to say you don't have the right coverage, how on earth can you know in advance what will happen to you 3 or 4 years from now? These companies have a gun to your head, just like the hospitals that make you sign a form saying that you will be responsible for your bill no matter how much or little your health insurance covers.
got that beat with a $987,429 40 page bill but at least I got a heart transplant to prove it
Re:story about hospital billing. It is not a bad thing for everyone to have coverage, but the bottom line is, who is going to make the insurances accountable for paying for the claims. A hospital has to play games w/the insurance and charge above and beyond what the actual cost are just to have the insurance pay pennies(if anything) on the claim as reimbursement. Even when the ins. does pay, they have no timeline to come back and retract the payment. If the hospital or doctor does not refund the payment, the ins. will deduct it out of the next pt. that has the same insurance. Sometimes it can be years after the payment was made, and the ins. will decide that they made an error in payment and they want it back.This is one of the reasons that pts are seeing the outrageous costs. The ins. companies are happy to take the premiums, but even if they "approve" a surgery or procedure it always states at the bottom "this is not a guarantee of payment" In the end it is the patient that suffers not only physically, but financially. Someone needs to make the insurance accountable
Its easy-get rid of the insurance companies like Aetna, Blue cross, etc , develop more HMOs like Kaiser who own their own hospitals, clinics, pharmacies, and pay the doctors salaries rather than pay-for-service, get rid of lawyers and malpractice (arbitration by independent board).There is no incentive for Kaiser to run up bills, members pay monthly fee half the cost of insurance company/PPOs with twice the service and quality of care (five stars). No $1M bills anymore, no waiting for appointments,and they have strong incentive to KEEP you healthy, since if things go wrong, they have to fix you at there expense.
If the Insurance companies all negotiate lower charges, wouldn't the health insurance requirement lower charges for people that otherwise wouldn't have health insurance? Am I missing something? How does Obamacare increase the cost of healthcare for everyone?
ah yes.. obamacare.. the miracle cure to bring socialism to medicine...
I wonder if you people are beginning to regret your votes yet?
you do realize that Obamacare is available for "catastrophic" cases right? so either the lawyers lied to get the family to pay legal bills, the hospital lied about what they could or would accept, the politicians lied, or I am completely wrong...
It would be awesome if the media would stop referring to the Affordable Care Act as "ObamaCare." That is not the name of the bill and it contributes to the dumbing down of Americans. Interestingly enough, critics of this Act said it was "taking away their freedom" by issuing an insurance mandate, and now here is CNN saying the bill doesn't do enough. You can't have it both ways people, and things just don't change overnight. It took 20+ years to get any kind of health reform through congress.
My 6 week old daughter had a 100.4 fever so we took her to her pediatrician. She instructed us to take her to the West Boca Medical Center emergency room, if the fever exceeded 101 degrees, which it did several hours later. My daughter was examined and diagnosed with RSV and pneumonia and subsequently admitted to the hospital pediatric care unit. She spent a week on a respirator and attached to a blood oxygen level monitor. The hospital bill was $35,750.64, which exceeded my "in-network" deductible of $11,400. A week later I got a bill from a seperate billing agency, Emergency Pediatric Services, for an additional $6,944.40. This bill included $2,115 for "initial hospital care", plus 6 days of "subsequent hospital care" at $728 per day, which I was told accounted for the individual doctor charges. An additional charge of $1,223, labeled "hospital discharge (more than 30 minutes)" was billed, as well. Having already exceeded my deductible, I assumed that this was an error so I called my insurance company. The humana agent that I spoke with told me that these charges were billed using a code by the billing agency that caused it to be billed as an "out-of-network" charge but that emergency room charges and doctor charged at a hospital that is "in-network, should be covered as an in-network charge. She said that she would resubmit the bill. The appeal was denied on the grounds that the billing code used labeled the charges as "out-of-network", so I contacted the billing agency. They told me that they would file the proper forms to adjust the charges. This appeal was also denied, so I called Humana back. Again they told me that they would not pay the charges. I appealed to the hospital to negotiate the charges but was told that they do NOT negotiate deductibles. They have since turned it over for collection and will not allow me to make monthly payments.
Mitch,
You should probably get a lawyer involved for the collection agency and file a complaint with your state's department of consumer affairs which should have an insurance complaint form. Even if you don't get a lawyer involved you can tell the collection agency that you dispute the debt and have filed a formal complaint against the insurance company and the hospital / billing group.
They will do their best to get people who don't fight for their rights to pay what they don't owe, but when you show you're serious if the issue is a billing code problem then they generally back down.
Good luck.
– Jordan
Huh. My mother kept the hospital bill from when my brother was born in 1950. It came to slightly over $50 for the entire stay. The biggest charge was $12.50 for the delivery room. Nursery care was $1.25 a day and the hospital room for my mother was $2.50 a day. There were a few other incidental expenses. My mother had a rough delivery so she stayed a few extra days. My dad's insurance cover 50% and he paid the remainder of the bill with a check when he picked my mother and brother up to bring them home.
How did we ever get from that to where we are now?
While I understand and sympathize with the family portrayed in the hospital overcharging storyline, I have to address a few issues that you failed to point out. First, I think a distinction should be made between large "for profit" hospitals and smaller rural hospitals/health facilities. The smaller hospital coffers are not overflowing with wildly overcharged profits. In most cases these hospitals, while usually one of the biggest employers in their community, are barely making enough "profits" to meet payroll. So, please do NOT paint all hospitals with such broad green strokes. Second, I noticed you never addressed the fact that, while sad, the family still needs to accept some responsibility for dropping what I can only assume was a standard, well-known insurance plan for a "discount" policy. I' ve worked in healthcare for 30 years and I see this happen quite often, where a patient thinks they'll save money by buying one of these cheaper plans only to find out it costs them dearly when they need to use it for an illness. Please be fair when reporting..not ALL hospitals overcharge, just as I'm sure not ALL news programs misrepresent stories.
My daughter broke her neck in a boating accident. We had excellent insurance through my husband's employer. The insurance company still refused to pay thousands of dollars on the bill once we met our deductible. Some of the charges denied were choices made by the doctors and ER staff that we had no say in. The insurance company even questioned how much medication they gave her, as if we had any say in that either. When I called to dispute the charges, a young man, who had no medical background whatsoever, was reading out of a book of codes, which automatically denied many items. He had veto power over thousands and thousands of dollars not covered even though he knew absolutely nothing about medical care. We almost lost our home over this. The insurance companies count on people not disputing charges – and let me tell you it can be a year long process to dispute these charges – so they get off without paying. We finally had to get an attorney and are still battling over this.
That's a lot of BS! Health insurance companies are nothing more than casinos where they weed out anyone who has the slightest risk of costing them money. Hospitals are merely there enablers. It's a corrupt system peopled by staff who are trained to make excuses for their horrible system. I welcome Obama Care and hope it drives a lot of these casinos out of business.
Not everyone has access multiple health plan choices. Many employers are offering only ONE choice: high deductible/co-insurance only plans...Take it or leave it.
Complete fraud, as someone else had posted, how come they are not charged with fraud?