This iReport is part of an assignment:
Bitter pill: The cost of health care in the U.S.
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- Posted February 23, 2013 by
- lindawriting Follow
Location
Niles, Ohio
Niles, Ohio
Assignment
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$40.72 Per Minute For Outpatient Surgery
I have a PPO plan offered by my employer, who has increased my yearly deductible to $750. I was responsible to pay over $650 for an echocardiogram—ordered by my cardiologist just to see how I was doing 5 years post bypass. I was still paying this off when I underwent bladder repair as an outpatient. For that outpatient surgery, I was in the hospital’s outpatient unit from 9:30 a.m. to 5:30 p.m. The hospital charged my insurance $17,106.05 for those 7 hours. The insurance approved $7697.72 paying them $6158.18 with me responsible for $1539.54. I have also had to pay my 20% copay on the bills from the anesthesiologist (insurance-reduced charges averaging $10 per minute) and the surgeon (the most reasonable of the three providers). By the way, the hospital charged me an additional $23 for looking at report done on the echocardiogram done earlier in the year at that same hospital. As an interesting side note, of my initial payment to the hospital of $1,000, the hospital applied the entire amount to the balance due on the echocardiogram, leaving me with a $600 credit balance on that account. It then threatened me with collections action on $1,500 balance due on the other account. When I called them to point this out, they corrected the balances but refused to retract the threat of credit action. With $710 still owing on the outpatient surgery, I have to pay $71 a month—instead of the $50 I had budgeted—to avoid going into collections. The hospital not only charges exorbitant fees, it then refuses to work with people. I can see the need to retire the debt in 10 months. But the debt wouldn’t be so high if the hospital didn’t charge so much. They have also not mailed me itemized statements as I have requested.
I see 4 major factors: Costs of CEO salaries, inflated medication costs, exorbitant medical malpractice rates for providers, and high annual increases on insurance premiums.
1. A big problem is the salaries earned by CEOs of health care facilities as well as insurance companies. After all, one of the reasons why health care providers sign up was providers with health care facilities is rapid reimbursement for services provided. These CEOs have base salaries plus expense accounts, stock options, and waiver agreements that put their actual salaries much higher than what you’ll see on an annual report. Even directors and managers are well paid—in this small Ohio city, you cannot get a job at the local hospital unless you know someone to get you in.
2. The cost of medications has ballooned out of control. Decades ago, patients depended on their physicians’ advice on the best medications for their ailments. As we became better, more informed consumers we began asking to participate in our healthcare decisions. Now we are bombarded with advertising and physicians are paid by pharmaceuticals to promote specific meds. The cost of an ad for one month in a mainstream magazine can easily exceed $200,000—and think of how many ads you see per magazine per month. Patients go to their doctors demanding the medications they see without thinking about side effects. Plus, all this information is now available for free on the Internet. I have also heard that with many pharmas headquartered overseas, the citizens of European countries get free meds while the companies make up their profit with Americans.
3. Medical malpractice costs have driven up the fees charged by doctors and hospitals. Nobody has ever come up with a definition of “frivolous lawsuit” because it’s such a subjective thing. For physicians practicing within a community, it can be their biggest single business expense. It further dehumanizes the delivery of healthcare when physicians give up their own practices and sign up as hospitalists with medical conglomerates. Stop the lawyers!
4. The cost of health insurance continues to rise astronomically for employers each year. Employers try to withstand these increases by passing them on to employees via higher deductibles, copays, and out-of-pocket limits. They are also pressuring employees to drop standard PPO plans and choose HDHPs associated with HSAs because they get a better business deduction than with the PPOs or HMOs. However, this leaves the employee hanging out on a limb, because none of their medical expenses are covered until they pay $4,000 or more out of pocket.
I see 4 major factors: Costs of CEO salaries, inflated medication costs, exorbitant medical malpractice rates for providers, and high annual increases on insurance premiums.
1. A big problem is the salaries earned by CEOs of health care facilities as well as insurance companies. After all, one of the reasons why health care providers sign up was providers with health care facilities is rapid reimbursement for services provided. These CEOs have base salaries plus expense accounts, stock options, and waiver agreements that put their actual salaries much higher than what you’ll see on an annual report. Even directors and managers are well paid—in this small Ohio city, you cannot get a job at the local hospital unless you know someone to get you in.
2. The cost of medications has ballooned out of control. Decades ago, patients depended on their physicians’ advice on the best medications for their ailments. As we became better, more informed consumers we began asking to participate in our healthcare decisions. Now we are bombarded with advertising and physicians are paid by pharmaceuticals to promote specific meds. The cost of an ad for one month in a mainstream magazine can easily exceed $200,000—and think of how many ads you see per magazine per month. Patients go to their doctors demanding the medications they see without thinking about side effects. Plus, all this information is now available for free on the Internet. I have also heard that with many pharmas headquartered overseas, the citizens of European countries get free meds while the companies make up their profit with Americans.
3. Medical malpractice costs have driven up the fees charged by doctors and hospitals. Nobody has ever come up with a definition of “frivolous lawsuit” because it’s such a subjective thing. For physicians practicing within a community, it can be their biggest single business expense. It further dehumanizes the delivery of healthcare when physicians give up their own practices and sign up as hospitalists with medical conglomerates. Stop the lawyers!
4. The cost of health insurance continues to rise astronomically for employers each year. Employers try to withstand these increases by passing them on to employees via higher deductibles, copays, and out-of-pocket limits. They are also pressuring employees to drop standard PPO plans and choose HDHPs associated with HSAs because they get a better business deduction than with the PPOs or HMOs. However, this leaves the employee hanging out on a limb, because none of their medical expenses are covered until they pay $4,000 or more out of pocket.
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