It’s an entirely discouraging report Kaiser Health News for those of us who are trying to control our healthcare costs, but it turns out hospitals have no idea how much our hospital and medical bills are going to be either. As much as we can try to get a handle on what our hospital and medical bills are going to be before we leave for the hospital, it’s almost inevitable that those bills are going to be much higher than anyone anticipated.
Why? Well, despite state hospital disclosure laws, hospital charges are almost impossible to nail down despite everyone’s best efforts. Patients’ medical needs vary, and doctors’ approaches to those needs often change with the circumstances. In addition, doctors are usually not hospital employees which can make them a decision-making wildcard.
What does it all add up to? A Kaiser Health News article gives one example of a patient who tried to bargain down his hospital bill to no avail:
When Bill Rose broke his leg in a motorcycle accident, he knew he’d end up paying for surgery himself — he was temporarily uninsured. So he asked the hospital for an estimate and negotiated a 30 percent discount, bringing the price down to $8,260 in exchange for paying up front.
But a month after the operation, the hospital told Rose, an insurance salesman from Defiance, Ohio, that the price had soared: He owed $10,000 more. One reason for the bigger bill was his surgeon’s decision to use a $7,500 bone graft product that is only used sometimes in such procedures, and was clearly not anticipated in the hospital’s estimate, according to documents provided by Rose…
Patients can’t depend on estimates because they’re often based on a hospital’s average charges for treatments. For instance, Tampa General Hospital charged as little as $48,631 and as much as $89,969 for gallbladder removals between July 2008 and June 2009, according to a Florida state website created under a 2004 price transparency law.
When bills come in above the estimate, patients have little recourse. Rose’s attorney, who negotiated a $1,250 settlement with the hospital last October, pointed out in a letter to the Ohio attorney general that state law protects car owners from mechanics’ charges that exceed estimates by 10 percent but does nothing for patients. Rose, 63, who has recovered, says the hospital could have consulted his surgeon about the treatment plan and calculated a more accurate estimate. The hospital did not respond to questions about Rose’s bill.
A growing movement in the United States supports flat rate and other pricing models which would be easier for consumers to understand. Do you think we’ll ever move to a model that’s easier for consumers? Tell us about it at the MyHealthCafe.com Forums.
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