Hospital charges man $55k for a cat bite

To be clear, there was an infection and surgey involved. But there's a larger point here about runaway health care costs in our country...

Quote : First the cat, now the health system puts the bite on me Case in point: My cozy hospital room at UCLA Medical Center in Santa Monica was priced at $4,000 a night. Four thousand. You can book a 1,400-square-foot Premier Suite at the Beverly Hills Hotel for less than that... Here's the long and short of it: Insurers demand discounts from hospitals in return for bringing them lots of patients. Hospitals, in turn, ridiculously inflate their prices so they can still turn a profit even after the insurer's discount kicks in. Hospitals also pad people's bills with the cost of providing treatment to the uninsured or to patients who require months of care... One little-discussed aspect of President Obama's healthcare reform law is a switch from the current reimbursement system, which rewards hospitals for treating sick people, to a system that provides incentives to hospitals and doctors to keep people from getting sick in the first place. This is a seismic shift," Feinberg said. "It will allow us to stop sending out all the crazy bills. It will be all about what it actually costs to keep you healthy." FULL ARTICLE: http://articles.latimes.com/2013/...s-20130115

DEBATE QUESTION: Will Obamacare bring exorbitant health care costs down or will it just be another government handout?

Man with insurance fails to seek care for wound which leads to serious infection requiring expensive treatment. I don't see how health care reform can fix this.

politics aside for a second, cat bites can be very serious (all bites can be). people can lose limbs or die from infections stemming from untreated bites.

Quote from roughnready : One little-discussed aspect of President Obama's healthcare reform law is a switch from the current reimbursement system, which rewards hospitals for treating sick people, to a system that provides incentives to hospitals and doctors to keep people from getting sick in the first place.

That strategy will work very well for cat bites. Maybe they'll pre-emptively shoot the cat.

I'm anxiously waiting to see the invoice my local hospital is going to send my health care provider. (still waiting)

Couple weeks ago my (almost) 2 yr old bumped his head into the 1 corner in my apartment not protected by a little foam corner piece, and the resulting cut was just large enough I thought it just might warrant a stitch.

Wonderful service at the hospital. 30-40 minutes total. No stitch, just some water (which was from a plastic bottle I joked that it probably costs $400 because its '.9% Sodium content'), the stuff you clean a cut with, and some super glue. That's it.

Looking forward to seeing what they will charge for it.

Quote from Danman114 : I'm anxiously waiting to see the invoice my local hospital is going to send my health care provider. (still waiting) Couple weeks ago my (almost) 2 yr old bumped his head into the 1 corner in my apartment not protected by a little foam corner piece, and the resulting cut was just large enough I thought it just might warrant a stitch. Wonderful service at the hospital. 30-40 minutes total. No stitch, just some water (which was from a plastic bottle I joked that it probably costs $400 because its '.9% Sodium content'), the stuff you clean a cut with, and some super glue. That's it. Looking forward to seeing what they will charge for it.

That kind of thing could probably be done at an urgent care center for half the cost.

Quote from Krazen1211 : That kind of thing could probably be done at an urgent care center for half the cost.

Hah. I had no idea what an 'urgent care center' was, so I had to Google it:

Urgent care centers [bostonglobe.com] run by entrepreneurs and doctors to treat emergencies that are not life threatening, especially during off hours, have been far less common in Massachusetts than in Florida, California, and some other states. That is partly because health insurers here have typically required many patients to get referrals from their primary care doctor, which would be impractical when trying to get treatment on a weekend for a broken ankle or high fever.

This would be funnier if I didn't live where I live.

I shouldn't be surprised really, this is the state where Boston won't even let a Minute Clinic inside its city limits because it might adversely affect the other hospitals (You know, by providing a service to customers they may or may not ever get).

Because the profits are limited as a percent of medical cost, there is no incentive for insurance companies to attempt to bargain with hospitals. The higher the payment the insurance company has to make, the more money they make. Premiums go up. Hospitals win. Insurance companies win. Premium payers will lose.

Quote from Xygonn : Because the profits are limited as a percent of medical cost, there is no incentive for insurance companies to attempt to bargain with hospitals. The higher the payment the insurance company has to make, the more money they make. Premiums go up. Hospitals win. Insurance companies win. Premium payers will lose.

If I can choose between Blue Cross and Aetna, an the Aetna policy is $200/month less for the same coverage, don't you think I'll pick Aetna? Don't you think employers will, when they have to pay for 200 policies?

Quote from Rebound : If I can choose between Blue Cross and Aetna, an the Aetna policy is $200/month less for the same coverage, don't you think I'll pick Aetna? Don't you think employers will, when they have to pay for 200 policies?

I'm surprised you trust capitalism to work in a system so totally ruled by oligopoly and frustrated by regulation.

Quote from Xygonn : I'm surprised you trust capitalism to work in a system so totally ruled by oligopoly and frustrated by regulation.

Yeah, it doesn't really work like that. There's a very limited market as things stand and I don't see anything in the changes that's going to affect that much for the better.

I recently got the notice that my individual, high-deductible policy is going up from $325/month to $433 next month. Nothing specific to me, just a general increase. The obvious consumer/market response is to look for another more competitive provider.

Unfortunately, there's really nowhere to go. Rates are set by the state insurance boards so the floor-level costs are basically the same at the low end for the same levels of coverage/deductible/etc. I can go up to an equivalent Kaiser policy at ~$550 (or better if I wanted into the +$1,000/month range) and get more, but I can't really go down. Same with hospitals, specific medications, etc. Although they may compete on some bases, it's typically not cost and you don't have a whole lot of choices. It's a cost-plus model operating across a limited network of suppliers.

If you read the story you can understand the tone of the writer. In fact it is the tone for the majority of people that use medical services.
It goes something like this: "I expect you to diagnose me, remedy the problem(s) and make sure the treatment works. If it doesn't, I will cry foul as far as my voice will allow and as often as possible."
There is such a culture of legal repercussions, pharmaceutical pressure/advertising, old wives tales and modern phobias that it amazes me that MD's, RN's, or any medical professional wants to even work in the medical field. Yes there are the same people that you work with, some work hard, some are lazy, some make bad judgements, some make great team players, etc. Yet if you have a genuine want to help people and take care of those in medical need, what else would you do?
The writer's first article about this event [latimes.com] takes notice of this and commends our health care system. He is grateful he still has use of his hand and recognizes the efforts of those who helped. He then gets into the need for reform of our health care system. Personally I know many doctors and nurses; they do not and should not have any effects on costs of various treatments.
It is the hospital/medical facility and the insurance that determine ALL of that. Both are businesses. Both need to at least break even.
Whatever amount you see on YOUR medical bill, should you have insurance, is not the actual amount paid. It's all negotiation between Insurance Cos and hospitals after factoring in operating (not surgical) costs, losses on underpaying programs and uninsured patients. (Plus some other items)
Which I believe is where it should take place; but yeah how do YOU really know what something should cost? There could be some basic guidelines for certain procedures, but ultimately I think it is more about the service/care provided.
Some people are OK with going to Supercuts or some other $5 haircut place. You will get $5 worth of service. Others prefer a salon with an established reputation and a certain level of training. You will pay more and you'll get better results (usually). I fear that if too much is standardized and "fixed" as far as pricing, that you will have the $5 hospitals and the salon hospitals. I don't think everyone will get access to the quality of care everyone deserves.

Quote from Danman114 : Hah. I had no idea what an 'urgent care center' was, so I had to Google it: Urgent care centers [bostonglobe.com] . . . That is partly because health insurers here have typically required many patients to get referrals from their primary care doctor, which would be impractical when trying to get treatment on a weekend for a broken ankle or high fever. This would be funnier if I didn't live where I live.

Call your insurance company first. Tell them your doctor's office is closed, but there is an urgent care facility available, and will they cover reimbursement and just charge the normal PCP copay fee. You'd be surprised how many policies have a clause to cover this very event, and getting what is basically a prior authorization directly from the insurance company goes a long ways.

I have given (and taken) this advice to many of my patients, and have yet to have one come back and say they got screwed.


As to the OP

Quote : Hospitals also pad people's bills with the cost of providing treatment to the uninsured or to patients who require months of care...

Um, duh? Hospitals cannot legally turn away a patient with a life threatening situation. Which means all the uninsured or underinsured patients they are forced to see have to be paid by someone. You take a loss on some, you make a profit on others.

one of the main goals of the ACO is to try and get these health care systems to focus on prevention more. Its a lofty goal, one that would be fantastic if it works, but the reality is that the culture in america is one of excess. People are well aware of how to stay healthy, doctors do not have any secrets to tell you.... people choose to live very unhealthy lives. Very little doctors can do about that.