Tonight on AC360: The extraordinary cost of getting sick in America
When you see a hospital bill for close to half a million dollars right there in front of you, it makes you realize the extraordinary cost of getting sick in America, especially if you are underinsured or, of course, have no insurance at all.
It’s not headline news that health care is wildly expensive but taking a detailed look at what many hospitals actually charge for even the smallest items is truly eye-opening.
Our segment tonight on AC360 is the first of a planned two part series we produced in conjunction with a special edition of Time Magazine, called “Bitter Pill.” Correspondent Drew Griffin and I worked with Time Contributor Steven Brill to track down patients like Bob Weinkauf from this Dallas suburb whose bill from two hospitals while recovering from a horrific lung disease was $474,000.
On his bill, and on many others, were various charges of $200 for a warm blanket to $200 for a teddy bear used to help ease coughing after surgery and a $39 charge each time a nurse pricked his finger for blood work.
Especially galling to people like Pat Palmer were charges of $12 for those little paper cups nurses give you when they administer pills. Ms. Palmer runs a company called Medical Billing Advocates, which is in the business of disputing outrageous hospital bills. She says, in her estimation, that she’s saved patients “millions of dollars” over the past 15 years.
Watch our report tonight at 8 and 10 p.m. ET.
UPDATE Watch Drew Griffin's report:
|
|
Post by: David Fitzpatrick Filed under: Health Care • Special Investigations Unit |
About this Show:
Anderson Cooper goes beyond the headlines to tell stories from many points of view, so you can make up your own mind about the news. Tune in weeknights at 8 and 10 ET on CNN.
Questions or comments? Send an email
Want to know more? Go behind the scenes with AC361°
Subscribe to the podcast
On Twitter
Search the AC360 blog
Hey these Doctors have to have some body for their new sports cars what better way to do so then to have some who sick and potentially dying. I had bacterial pneumonia and the hospital did save my life but now I'm in the hole for thousands of dollars which I'll never be able to pay! And just an FYI the doctor who put my chest tube in drove the newest Porsche money could be.
I think that one of the reasons that medical care is so expensive in the USA is that most Dr.'s and hospitals do not reduce their fees so Insurance companies will pay their high rediculous fees, and the middle class that cannot afford to have medical insurance and do not qualify for public assistance; which is so frustrating get stuck in the middle with no health plan. Most people don't know how to shop around and what questions to ask as far as getting discounts from Dr's and hospitals. And in the in case of a medical emergency there's goes your credit. I see many good people get their credit ruined with medical collections. This problem could have much less impacting if the health insurance industry would do something about it and demand that hospitals and Dr.'s justify their fees. Also, reduce the amount allowed to be paid in cases of a malpractice. A person should be awarded a reasonable amount to live within their means plus some extra money for pain and suffering, not turned them into millionairs.
Lena this is a general response so I hope you don't mind. I work for a hospital system in Ohio and we have strict rules regarding standard of care. Most supply items are non billable because they are part of the room charge. We also have financial counselors who will work with uninsured and underinsured patients on payment arrangements or bill review for duplicate charging. It is also a state law that hospital prices be published for patient viewing for room charges and the 30 most frequently billed procedures for radiology, lab and other ancillary care. Where are this hospital's compliance and internal audit departments? We are allowed to charge for a blood draw for a lab test. 190 lab tests during a hospital stay is extreme to say the least. I suggest the patient get the most from this advocate and work with the hospital billing department before their credit is at risk.
Oh I see now. Glucose strip test. Not separately payable by Medicare. A self employed patient should not have to make up for the payment cuts from Medicare, Medicaid and contracted insurance. Find out what the diagnosis related group is and offer to pay what Medicare would pay. If he had a trach and a ventilator, the cost is high and the payment would be somewhere around $120,000 guessing. What kind of insurance is not paying for an inpatient stay?
People shouldn't need a special advocate to get a fair deal. I wish lawmakers would address this. Hospitals are almost a monopoly. Where else is there to go when you have a health crisis? I'm afraid of needing to go to a hospital–between over billing and medical mistakes being the 3 leading cause of death.
There are many countries that have a system based on private health insurance, but in these countries there are strict rules to follow. Since a physician is an expert licensed by the state his decisions are automatically considered the final authority on what is "medically necessary". The insurance company in obliged to pay for services and the doctor cannot just bill the patient because he doesn't like the insurance offer. In American it is common for patients to go to court with both the insurance company and the hospital because the companies are playing a big stakes game of hardball and they have deep enough pockest and full time lawyers on staff to afford the litigation. So for the consumer it's pay the doctor or hire a lawyer – either way you're screwed out of a lot of cash, presuming you had any to start with. In other countries if hospitals and insurance companies start holding out forcing patients to fight for their rights in court, the regulators step in quickly to impose stiff penalties for abusive practices or revoke licenses – which is why it is rarely such an occurrence in these other countries.
Of course many other countries have pretty much taken over their entire healthcare systems, such as the UK, Canada, France, etc. Many citizens do complain about their systems, but if put on the spot and asked if they would rather have the US system, the response is a resounding "no way!". Usually when they complain they are comparing their system to what is available in Sweden or Germany. Nobody every says "why can't you guys run it like the American system?"
This is so true. Have lived, worked in both US and Canada for many years. I would choose Canadian healthcare in a heart beat. Every system has problems, of course, but the Canadian system is tremendously better.
I also have lots of multi-national friends who have experienced the US medical system and various countries in Europe. I haven't met one that feels better being in the US system (and these are professionals with excellent private insurance).
Too many American's just don't know what they are missing and they get conned by self-interest groups that try to breed fear at changing the really crappy US system that just benefits the medical establishment.
To me its always amazing how expensive medical care is in this country, a first world country. In Mexico, a 3rd world country, medical care is more affordable, there are choices. If you work for the federal government, you are covered and use their clinics, ISSSTE. If you work fo the state, you have access to the Social security clinic. If you work on your own, you still have access to the Social Security clinic, by paying a fee. If you have less money, you pay a smaller fee and have access to the Social Security. If you have nothing, there are clinics that you can go to. And in this country, a first world coutry, you are screwed if you have nothing. One actually has to have money to survive medically in this country. At least this has been my experience. WHY? Why has the government let the insurance companies, farmaceutical companies rule this part of our lives? why dont they protect us? Have they fall so low that they prefer to be "compensated" by these companies, than to protect their citizens?
MediBid CEO, Ralph Weber, wrote a book called MEDICRATS, over a year ago, explaining the truth behind our health care system. The truth is: some idiot said hospitals should be "non profit", and they are not required to do the same cost accounting that McDonald's does, so the fat cats at the top of the hospital make millions, while patients are killed with this smoke and mirrors accounting system. California at least has AB774 to protect them. Get politicians out of our health care system and make hospitals run as for profit enterprises, and you'll see a change WITHOUT OBAMACARE.
Went in the hospital back in November that required an overnight stay for a minor procedure. (which I tried to avoid I am a healthy 49 yr old woman but physican required it) Anyway the hospital bill alone for this overnight stay was around $28,000. Through insurance prices (for lack of a better term) the amount they paid was around 23,000. Except for medication one time for nausea and 2 cups of Ginger ale and a sausage biscuit in the morning with a cup of coffee that is all the supplies I used. Once I could get up out of the bed in the middle of the night (had a headache0 went in my overnight bag and got out some ibuprofen and took it. Guess that would have been not allowed (LOL) Doctor bill was 8,000 before insurance prices. I ended up paying 3,500 out of my pocket insurance ended up covering only around 400.00 for this bill. This it totally insane and something needs to change not sure what the answer is.
My emergency apendectomy was a $13, 103.75 hospital stay. EOB shows Insurance paid $12, 728.69. I was personally billed by the hospital for my 20% co-insurance for the amount $2620.75. Which meant the hospital was
collecting $15, 349.44 in payments, $2245.69 over the total itemized charges. When I questioned the insurance company, they said I needed to call the hospital. When contacting the hospital, this was their reply:
"Accoding to the explanation of benefits from Blue Cross Blue Shield, the covered charges for this type of case are $15, 349.44. Again, this was an agreed upon rate between the Hospital and Blue Cross Blue Shield, regardless of our charges and resources. The case rate was negotiated in good faith nad accepted between both parties."
Since the surgery, my insurance premiums have been raised twice, and my deductible has now gone to $5000.
Thanks for the great story from Time and CNN showing it.
But the thing is ... they can get away with this because they know you'll play for it because your sick and you'll do anything to get better ... truly sickening
Tristan, you are so right. Americans believe medicine is a God and 95% have no concept of the realitiy of it.
I have a background in a medical field and have a disabled daughter, now 36, who was a 750gm premie.
It is amazing to watch how the billion dollar medical industry for these chldren fallsoff at 18 because most
become Medicaid and as the Dr. said on the Neil Cavuto show last evening, medicaid has unbelievable sad
results(the essence of what she said)...of course DRs do not get paid that much by medical or medicaid.
my friend in portland had heart surgery.the hopistal bill came up to 300,000 dollar she had health care insurnce to pay for it.i live.it is so cruel.i live in england and the health care is free.people in america donot understand about it.i do not have fare of pay for it
It is a perfect time for us to see this AC360 show. Tonight, I sat in front of computer and just turned on CNN channel. There is a hot topic that many families have struggled to deal with hospital billing as well as our own family . Our son fell off his bike and broke his left arm last August. We brought him to doctor and received temporary splint. His doctor suggest us to get x-ray and went to urgent care at hospital for permanent casting.The Nurse took our son temporary splint off and applied another similar splint to our son. The Nurse kept telling me that she just applied temporary splint and gave us her referred orthopedist for casting. Then later we received the bill that stated the Nurse claims she was diagnosis our son. We contacted billing dept and they told that they would put internal investigation into it. Each time we called staffs at billing dept they told us that they still investigate. At the same time, St.Luke's hospital kept sending us the bill...We went to the customer and patient relationship dept, administrator told us that the nurse claimed is not right because urgent care is not provided permanent casting, and she would take care our bill...two days ago we still received the bill. Do you know how many bills did we receive? Seven bills with few thousand dollars. How can patients prevent some unnecessary services?
You CANNOT prevent the unnecessary services, and the profiteers want to keep it that way.
I twisted my foot, can't get it fix or told what to do. Ten years,bed ridden, $3.3 million in medical bills, can't get my pain controlled, thus heart problems and strokes. I have got no help, advice nor been listened to, can't get my pain managed because some people get hooked on drugs, but I have no problem to end my pain or maybe other things!
Tonight's piece on hospital overcharging, though appalling, featured commentary that was a totally unfair slam at Obamacare. Having just explained that the abused described were usually prevented by medical insurance coverage (and even more stringently by Medicare coverage) because of cost controls and negotiated prices that such coverage brings, they went on to say that Obamacare does nothing to prevent such abuses because, it was said, features no cost controls. Wrong! Obamacare requires that everyone have health insurance, and by your reports own admission, insurance companies (and Medicare) prevent such gouging as is inflicted on the uninsured or, in the case of the featured patient, underinsured. Your reporters should point this out instead of going for the cheap shot.
Agree, he got a bill for health care, it's a start. You can only take what you can! He got more than anyone else had.
The Affordable Care Act does not force people to buy insurance, they can still opt out and pay a fine. It is totally possible for this exact scenario to happen after 2014. Health insurance is expensive and the penalty for not having insurance is nothing compared to the cost of annual premiums for reasonable coverage. For this reason many people turn to "limited-benefit" plans which offer a little bit of coverage for a more reasonable price. However, there is a reason these plans have the label "limited-benefit". They won't help you much with any expensive procedures or hospital stays .
With regards to the Affordable Care Act's efforts to reduce costs...well there isn't much there. The ACA is mainly good for reducing the cost of prescription medications and limiting the difference in costs one person pays compared to another person with comparable age and coverage. However, it does not change the fee-for-service rate that determines a patient's bill. The Affordable Care Act is great in that it extends coverage to a lot of people but lowering the cost of healthcare was a secondary if not tertiary concern.
@Mike Mehney, insurance has nothing to do with it, and Obamacare only makes things worse. This is not the arena to discuss the malice of Obamacare and the fact that it has nothing to do with health and everything to do with a mechanism for taxation.
Mike – glad to hear at least one person had something positive to say. Seems to be a lot of finger pointing and nothing else. We all have equal rights. You can buy insurance, or pay the price of not having it.
I had bill totaling to 30.000 dollars. On requesting for detail billing and all the runaround, the details of charges were unbelievable. Let me dig it out and post it. The hospital in question is Creastwood Hospital lin Huntsville Alabama.
I told them what's wrong, they have done nearly zero, for $3.3 million, for problems that never should have happened
What is going on in healthcare today is absolutely ridiculous. I too had a simliar experience except for the amount of money. I went to the ER for an acute ear infection at night, (urgent care was closed), I was concerned about an ear drum rupture. I was in and out in 30 minutes, used no supplies and was hit with a $3000 bill.
I worked at a hospital in Maine, and I personally knew/saw them recycle the beverages that were unopened from our patients, by just putting them through the sanitizer. We were told to do this, to cut "costs" I'm sure that if looked into, the hospital that I worked for would not be the only ones doing this. I feel that people should know this, because if they are fighting the hospitals with lawsuits over their price gouging addictions, then they should have the knowledge, so that they may make the argument that it should be illigal to sell the same exact item/product twice. Not to mention, the potential health risks that may come from heating up aluminum to very high temperatures, cooling them down, and then serving them again to unsuspecting patients.