I recently got a medical bill that reminded me just how much I’m looking forward to when all of Obamacare’s provisions kick in.
In December, I found myself suddenly doubled over with abdominal pain. My physician couldn’t see me right away, and since I’d never experienced anything so drastic and debilitating, I went to the emergency room -- one that was in-network. Now that I’ve gotten my bill, I really wish I hadn’t.
It turns out, I only had a virus. Did I feel a bit foolish? Yes. But what if it’d been appendicitis? Wouldn't I have felt more foolish riding it out until my doctor could see me the next day?
I paid $125 when I checked out of the hospital a few hours later. They’d tested my blood, rehydrated me intravenously and given me pain meds. I felt better, if a bit wobbly, and was grateful nothing was seriously wrong.
And then I got my statement from BlueCross BlueShield of Illinois.
The hospital billed the insurance company $8,086.72, although my actual pre-inflation charges were $3,396.47. BCBS agreed to cover $2,317.19. So I owe the hospital $1,079.28. Gee, thanks.
What’s the point in paying so much for health insurance if I’m going to get stuck with a bill like that?
I have to keep reminding myself that I did the right thing, that having pain that forcibly causes you to double over is a legitimate reason to go to the hospital. But how do I really feel? Like I’d have been better off risking my health.
Times Business columnist David Lazurus wrote about his $55,000 cat bite earlier this week. His six-night stay at UCLA Medical Center came to $24,000, which doesn’t include his actual surgery, services and whatnot. He writes:
The surgery on my hand: $12,282. Anesthesia: $780. MRI: $3,290. Assorted drugs: $3,412. Laboratory services: $4,534. Inserting a tube in my arm so I could have an intravenous drip at home: $2,352.
All in all, the various services and supplies I received were priced at $52,660.53. The assorted doctor visits and physical-therapy appointments that have accompanied this mess added a few thousand more to the equation.
My employer-provided insurer, Blue Cross Blue Shield of Illinois, will cover $38,448 of the hospital bill. My total amount due: $1,504.47.
So, Lazarus got all that for $1,504.47, and meanwhile I am on the hook for $1,079.28 for a few hours at the ER, a blood test, some saline and pain meds. How is that fair?
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.
What that all means is that medical prices are being deliberately pumped full of hot air so that more money is changing hands. It also means it's almost impossible to know how much healthcare actually costs or whether you're getting a fair deal.
It’s an answer, but it doesn’t make me any wiser. I still can’t fathom how my virus-caused trip to the ER could cost me approximately the same amount as his hand surgery.
Fortunately, relief is on the way. Under the Patient Protection and Affordable Care Act, insurers will “give medical providers a fixed amount of money per member -- say, $8,000 a year,” Lazarus explains. “If your doctor can keep healthcare spending below that amount, he or she pockets the difference. If you require extra treatment, insurance will cover the true costs of care.”
Truth and honesty in our healthcare system? Imagine that.
Thank you, President Obama.
Follow Alexandra Le Tellier on Twitter @alexletellier