dagblog - Comments for "How to Charge $546 for Six Liters of Saltwater"

All I can say is it looks

artappraiser — Sun, 15 Sep 2013 23:25:38 +0000

In reply to My wife visited an emergency

All I can say is it looks like your charges were not "bundled," so they are not trying to hide the markup like some in the NYTimes example. Your solutions were only $68.15, but they charged $726.91 for the administering of them.

Of course, all your charges except for the solutions sound exorbitant to me, but that goes way beyond the specific topic of the NYTimes piece.

I have noticed with myself and in reading that lab test charges have seemed to soar astronomically in the last few years. Yours was $1,024 for one test--if it's true there was only one code--I am not surprised by that from what I have seen. I really do suspect a sort of price fixing situation, myself.

I.E., there are the big companies who do the outpatient thing, and match each other on raising prices, and then I suspect the hospital labs are going: well, no reason to keep our prices lower, let's jack em up to equal what everyone else is charging! But that's just my intuition, I don't have any facts to back that up.

Just trying to contact and deal with one of the big ones, Quest Diagnostics, made me prejudiced in that regard. It was clear to me after what I went through that they just ignore any challenges or complaints a patient paying out of pocket might make about charges, that they will only deal with price issues (or overuse of tests by doctors) with insurers. There is no patient control on prices, no way to do that, even in non-hospital, non-emergency situations.

They also do things like bundle tests together and don't make breakdown in smaller individual tests easily available, i.e., the insurer no longer pays for just a PAP smear like they used to, but when a doctor orders a PAP smear, it comes along with sexually transmitted disease tests added (for 4 times as much as a simple PAP test,) even if the patient is not sexually active.

Medicare could have some impact here if they ruled a certain price was all they would pay for a certain test. Then the private insurers would follow suit and try to get the same rate. But I haven't seen much evidence that is happening with tests, thought I am not sure.

Basically, the sad story is that you can be overcharged in sooooo many ways! There is ample room in our medical industrial complex for constantly shifting charges from one place to another, and ample expertise at doing so. The idea that there ever could be such a thing as "fair market" situation (where seller and buyer have all knowledge of relevant facts) becomes laughable when you really have to deal with this stuff up close and personal.

My wife visited an emergency

Anonymous — Sun, 15 Sep 2013 15:02:23 +0000

In reply to How to Charge $546 for Six Liters of Saltwater

My wife visited an emergency room at san antonio, tx for food poisoning. She stayed there less than 2 hours. The hospital charged her over 4000 dollars. The hospital charged her 1024.81 dollars for CBC, CMP (noamylase or CK) tests (Rev. code 272), and 2168.72 dollars for emergeny room (Rev. code 450), and 726.91 dollars for IV therapy (code 260), 68.15 dollars for IV solutions (code 258), . Do you think she was overcharged? The procedures are listed the below:

Procedures performed:

Infusion, Normal saline solution, 1000 CC

Injection, ondansetron hydrochloride, per 1 mg

Supplies&materials above/beyond prov by phys/QHP

Test performed

CBC

CMP (no amylase or CK)

Some amount of markup is

Donal — Tue, 27 Aug 2013 14:59:03 +0000

In reply to How to Charge $546 for Six Liters of Saltwater

Some amount of markup is normal for just about everything, but this reminds me of the famous DoD toilet seat.

Thanks for this. I feel like

Verified Atheist — Tue, 27 Aug 2013 14:29:22 +0000

In reply to How to Charge $546 for Six Liters of Saltwater

Thanks for this. I feel like it's very appropriate to keep these things in mind when debating the causes for the high cost of health care in the US.