Tales of the Hospital Bill

“There is no illness that is not exacerbated by stress.”
― Allan Lokos

You may remember that I had a little heart episode in January that landed me first in the ER and then the hospital.  Over the past two months, I've seen my internist—who sent me to a cardiologist. Both of them assured me that the hospital tests showed that my heart didn't cause the incident. Nonetheless, Dr. B (cardiologist) prescribed one final test (echocardiogram) to prove what we knew after my horrid weekend in the hospital:  I didn't have a heart attack. I then had another follow-up with my internist so he could assure me that the cardiologist was right and that, while there was nothing wrong with my heart, neither one of them really knows what happened that Saturday morning. Of course, last week the cardiologist saw me again to assure me that the echo showed nothing more and that I really needed to start exercising daily.

It turns out that the hospital tests did show something.  The bottom line is that I did not have a heart attack, but I do have both kidney and gall stones. And I need to cut the stress.  Right. Apparently neither one of the doctors thought of what the hospital bill was going to do to me when I finally saw it.

You might remember that before the hospital discharged me, Mike the Husband told the head nurse, the admitting doctor, and almost everyone else in the good hospital that we were *not* paying for my unnecessary admission.  Since we did not receive a bill—and usually one arrives at the house before the patient can get home—I thought that maybe they actually heard him.  Oh, silly me.

Yesterday, two months to the day that I left the hospital, we got the final-yes-you-are-paying-this-bill-bill.  Let me digress another minute and remind you that I spent 13 hours on a gurney—an uncomfortable gurney—in ER. While I was in ER, I had an EKG, a chest x-ray, two blood tests, a CT scan, and constant telemetry monitoring, Once I got to the room, I had another blood test, more telemetry, that awful stress test that they delayed a day so that they could admit me, and one aspirin because the delay gave me a migraine.  In all, I was in the hospital about 38.5 hours.

Back to the bill... as you can see (below), the total charges were $39,075. . . more than $1000 per hour that I was in that place.  Our insurance paid $4066, and the hospital's insurance discount was $34,290.  We owe $719.  I am going to ask for an itemized copy of the bill because I want to know what the heck they did that cost almost $40,000 for 38+ hours.

Look. I know this whole billing thing is a game.  The hospital charges outrageous amounts and then gives an insurance "discount" (aka write off) so that it can show a huge loss.  What I want to know, though, is how anyone who does not have insurance can ever pay a bill like this?  We once had a neighbor who lost their house because they did not have insurance other than medicare. He got sick and was in the hospital for a long time. He lost everything. Everything.  What are people to do?

I read recently that the insurance companies are the ones who dictate our health care and that doctors merely follow their orders.  Tell us all something we don't know.  My internist ordered two tests for that newly discovered gall bladder problem. "I'm not sure that your insurance will approve both of them, though," he said.  "We can only try."  I ran into the same thing last fall when an orthopedic surgeon wanted to do an MRI of my shoulder.  "No," my insurance company said.  I have had the problem and associated pain for years and have had previous surgery, but the insurance company said I had to take Ibuprophen longer (didn't work for three years, but maybe the fourth will be different), do more physical therapy (made the pain worse), and try more steroid shots (really made the pain worse). Apparently some idiot in an office knows better than the professionals who actually went to medical school.

The obscene fact is that health insurance companies have a choke hold on all of us. Do you realize that the CEOs of the five largest health insurance companies took home salaries of over $10 million last year? Did you realize that Aetna acquired Humana and Anthem recently acquired Cigna? So what?  Less competition means insurers can hike our premiums because we have fewer options available.  If you're interested, read this great post by Robert Reich, former secretary of labor and current professor of public policy at UC Berkley.

Back to my bill: Even though Mike the Husband was adamant that we were not paying for my admission, we will be paying the $719.  I figure that the tests and ER gurney rent were worth that much.  I am going to look at the itemized bill first, though. If I find out they charged me more than 20 cents for that one aspirin, I'm deleting the charge from my check.