January 14, 2006

The state of Health Care today...

As most of you know, my Dad was recently hospitalized for MAJOR surgery to remove a tumor.  Due to some complications (edema and pneumonia), his total hospital stay was 21 days, including 4 in the ICU and 2 more in "telemetry step down", which is similar, but less closely monitored.

In any case, the total bill was (get ready for it) $196,787.63.

Yes, you read that right.

Now, my parents are lucky enough to have fabulous insurance, a PPO plan that includes $0 co-pay for inpatient services and  considers the hospital Dad was treated in as a preferred provider.

The insurance paid $51,975.00.  The hospital considers the bill paid under their PPO agreement.

Imagine if they had no insurance or minimal insurance.  They would have had to sell the house to save Dad's life.

Clearly the hospitals have jacked up the prices so far that they're still breaking even (and probably doing well) taking in just 26.4% of the bill.  And it's no anomaly.  Their insurance plan is one of the major plans in town, as Mom's employer is the largest in the county.  The hospital expects that the majority of their patients will be under a PPO plan.  So why jack up the prices that high?  To screw the poor and uninsured?  To make them choose between saving their life and caring for their family?

No wonder the insurance companies are complaining.  If this wasn't a PPO  provider, and the insurance paid 80% (what my last plan would have paid for a non-PPO inpatient stay), the insurance company would have been out $157,430.104, more than 3 times what they paid....

The system is out of control.   But socialized medicine isn't the answer either.  So what should be done?

Posted by caltechgirl at January 14, 2006 10:24 PM | TrackBack

Clearly socialized medicine won't help. Hospitals will charge more and provide less knowing the government will always pay the bills.

Posted by: Cardinal Martini at January 14, 2006 11:38 PM

No good answer but we saw the same when my dad died. In fact I see it everytime I take my kids to the peditrician.

Posted by: vw bug at January 15, 2006 08:10 AM

My brother had major emergencey surgery (the same thing that killed Maurice Gibb) a few years ago. He had insurance, but there were thousands and thousands of dollars it didn't cover. He was lying in his bed, not a day after the surgery, when some chick from billing came down and started harassing him over how he was going to pay. The nurse had to come in and force her to leave since she was upsetting him. He's still paying off that bill.

Now, if he were here illegally and had no insurance, he'd be worry free. (No, I'm not bitter)

As for what to do? I don't know. You're right, socialized medicine isn't the answer. And then you see things like botique medicine popping up. For $400 a month, you have access to a personal doctor who has a limited number of patients, including house calls, and 24 hour service. They just opened one here.

And even socialized medicine in Canada has a private aspect that's growing. Thier own version of botique medicine. I was just reading an article about a private health center/hospital that opened in Vancouver.

A friend of mine in B.C. took her dad to the doctor for pain. They scheduled him for tests, but he was put on a six month waiting list for those tests. A few weeks later, he was no better, so she cheated -- as she called it -- and took him to the emergencey room, where they did the tests and they discovered her had cancer. He was dead three months later, before he would have even had the tests he was waiting for.

Posted by: Ith at January 15, 2006 11:33 AM