Keep This Up and the Frists Are Gonna Be Broke.

Two weeks ago I was in the hospital. It was, of course, an HCA branch. The bruise from my (improperly placed) I.V. hasn’t even healed yet, but I received the bill in a timely fashion.

When they keep you in a room, there are several “goodies” placed there for your comfort. Soap, shampoo, socks with rubber backing on the feet and a tube of vaseline. Let me clarify that the soap and shampoo are actually one all-purpose substance.

According to my bill, these fine things are valued by the Hospital at 38.00. So apparently they don’t get them from Wal-Mart. The same three items there would knock you out of around seven dollars.

The five bags of saline they hung to rehydrate me and administer medicines cost 425.00 each. Pretty expensive salt water. The same amount of sterile saline, when purchased for my contacts costs $7.00 at Target. That’s one bag. All 5 would set me back $35.00.

Now, here’s the wierd part. All these expensive things are added up like the score in some mad Bunko game, but then there’s one minus line. “Contractual Adjustment”. Because of my health insurance they wipe out more than 80% of the bill. Not only do I not pay it, but the insurance doesn’t either. The actual cash they’re gonna get is paltry in comparison.

So why bother? Why charge those high prices at all, when you know you won’t have to pay them? Or are those the real costs of things? Does HCA make a profit on the greatly-reduced amount it receives?

I’m grateful to have health insurance. But I really wonder how high the cost of health care actually has to be.

7 Comments so far

  1. Chris Wage (unregistered) on March 26th, 2006 @ 10:42 am

    A contractual adjustment is the difference between what the bill was and an agreed-upon rate between the insurance company and the hospital.

    The agreement between HCA and the insurance companies ensure that they’re still getting paid — it’s cheaper this way than hashing it out on a per-bill basis.

    HCA is still making money on those things, but yes, probably far less, since insurance companies aren’t suckers, and I’d imagine their negotiated rate would not include marked-up line-items that you see on the actual bill. (this also makes the insured feel better, since they see a substantial “savings”)

    The exorbitant line-items are also advantageous in taking advantage of those who don’t have health insurance at all.

    It’s like when you go to Shoney’s, and you get a meal, it doesn’t cost them much to throw in the salad bar. But if you don’t get a meal, they’re gonna charge you extra for the salad bar, just because they can. The salad bar, see, are the line-items, and the meal is .. health insurance .. er.. Damn, this is the worst metaphor ever.

  2. Jerry Horne (unregistered) on March 26th, 2006 @ 11:00 am

    Look at it this way. Someone was paid big bucks in salary to print that list. Just think of the time it took to research those prices

  3. Busy Mom (unregistered) on March 26th, 2006 @ 10:22 pm

    Are you gonna use that little kidney shaped basin? Can I have it? What about that no-name toothpaste?

  4. Katherine Coble (unregistered) on March 27th, 2006 @ 12:33 am

    You want my emesis basin? What on earth for?

    Actually, Tim claims those (when unused) for bike parts. Oddly enough he also claims the urine strainer (also when unused, Ihope) for cleaning bearings.

    I’m so glad my acute illness can keep him supplied.

    And I actually liked the no-name ($8.00) toothpaste. It reminds me of my grandpa’s Pepsodent.

  5. Busy Mom (unregistered) on March 27th, 2006 @ 12:12 pm

    Kidding. I kind of like the Pepsodent-like toothpaste, too.

  6. David Ortiz (unregistered) on March 28th, 2006 @ 1:53 pm

    Those are the prices you pay if you are too poor to have insurance. Nice racket, huh? I’ve always said it’s cheaper to be rich, and here’s a great example.

  7. Jim (unregistered) on March 29th, 2006 @ 3:27 pm

    And who says we don’t need a national single-payer health insurance system? When the one we have is working so well why fix something that isn’t broken, huh?

    Last time I was in the hospital and they cut the stitches holding a drain for a wound (sorry to get gross) they opened this pre-sealed kit that contained a set of tweezers, scissors, a scalpel-like knife, bandage, tape, ointment and some bandaids. They used the bandaids and asked me if I wanted the rest because they would other wise throw it all away!!! We’re talking actual tweezers, scissors, knife, etc. that was now “disposable.”

    Why they didn’t just open some bandages I asked, and was told because that kit was standard-order for removing stitches — even if it was overkill. I’m sure I was billed a gajillion dollars for that kit which is probably the REAL reason it was “standard order.”

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