I am NOT mortified by the $30,000 hospital bill UCD Med Center sent to Scott Hawkins’ family for his brief emergency room stay, as reported by the Sacramento Bee today. I was mortified by the brutal nature of Scott’s death, and I was mortified by the response to Scott’s death in some circles, but I was NOT mortified by the $30,000 hospital bill. If you were, it’s time to pull your head out of the sand.. if not for the good of society, then for your own good, and the good of everyone who depends on you.
While admittedly I have not supported health care reform in the past, a recent hospitalization reminded me of a few things: 1) How delicate and precious a person’s health is; 2) How important the jobs of our medical professionals are; 3) how downright scary it is to be checking one’s mailbox every day in anticipation of a hospital bill.
In today’s Bee article a doctor is quoted as making some–in my opinion–alarming statements that truly underscore the need for reform. Among them:
“[the doctor] said the public simply doesn’t understand how expensive it is to run a sophisticated emergency room and trauma center like the one at UC Davis”
Dear doctor: we, the public, don’t essentially care how expensive it is to run a sophisticated emergency room any more than we care how expensive it is to run a, e.g., sophisticated car repair garage. Frankly, it’s none of our business. Actually, it shouldn’t be your business (or burden), either. The truth is: it’s NOT ok that the minority of citizens who need your sophisticated emergency services are forced to pay for your equipment, your salaries, your operational costs, and every single item in the kitchen sink to keep your business afloat. I’m not pointing a finger, and God knows I value what you do, but the bottom line is that something MUST give because we, the public, can not afford your sophisticated emergency services any longer. Hence the cost of doing business is no longer important, because your business model is 100% unsustainable. Period.
“If he [Scott Hawkins] survived, we wouldn’t be even talking about the cost. We’d be saying: ‘That was money well spent”
Doctor, doctor, can’t you see we’re burning, burning.. our money? [80's pop music reference trivia]. Apparently not. Of COURSE we’d still be talking about it had he survived! In fact Scott himself would probably be writing a letter expressing his outrage over his own hospital bill, as millions of Americans do every month. Furthermore, if you really want to get down to brass tacks, the fact that he DIDN’T survive makes the $30,000 bill even more outrageous! That is, in most commerce circles, if the services rendered are not deemed successful, the customer does not get charged. (That is NOT to say anyone on your staff did anything wrong–or, God forbid–should be held accountable for Scott’s death in any way, it’s just to provide some contrast to reveal how illogical your rationale is).
“I think people are just uneducated about the cost. … If people actually knew what they were getting – yes, the cost is high, but it’s your only opportunity to save a life..”
Why do we need to be educated about the cost? Do I need to know how much it cost to run a Les Schwab tire store to get a flat tire repaired? Do I need to know how much it cost to run a Sam’s store to buy a cart of groceries? No. I just go to the counter and pay a FAIR price for the products received or services rendered. Then again Sam’s and Les Schwab are probably not analogous here because both have something you (emergency health care providers) don’t: competition.
Granted, saving a life is not realistically analogous to repairing a flat tire, but if your rationale holds any water, we would stand by and do nothing as the quality of an American life deteriorates simply out of respect for the cost of saving one, and to me that is asinine at best. Consumers don’t need education about health care cost, what they need is consumer protection from health care costs.
Another professional said consumers have the mindset of “We want it all, we want it now…And we don’t want to pay for it.”
Oh please! Forgive us for wanting emergency health care services to save our lives in an expedient manner, your excellency! Geez. Not only is this person’s statement categorically FALSE, the caustic attitude that engenders it only serves to widen the chasm of misunderstanding (and animosity), and all but ensures it will prevail for the foreseeable future. MOST OF US don’t want medical services for FREE; all we want is a FAIR price, one that is commensurate with the hourly rates charged for labor in every other service related industry in America. Why is it that health care services are the only services in America that low to middle income earners literally must MORTGAGE to receive? Why is it that health care providers are the only service providers in the country that don’t have a price list to show us what we’re going to pay? This is a HUGE problem we as a country are facing, and attitudes such as the one on display in the preceding comment are NOT part of the solution.
At the end of the Bee article we’re told “There is little debate that the uninsured pose burdens to the country’s health care system.”
Um, the problem is NOT the burden of the people on the health care system; the problem is the burden of the health care system on the people! And that problem continues to mortify even the most optimistic among us.
I’ve changed my mind. The doctor who said people are not educated about the problem is absolutely right: there is a fundamental misconception at work here and it is clogging the arteries of progress. But the misconception is not about the average emergency room’s balance sheet as these defensive health cares professionals would have you believe; it’s about life, liberty and the pursuit of happiness.. three things that are routinely and conveniently dismissed in academic conversations about health care.
God bless all those who cannot afford health care for themselves and/or their families at this moment. Health care should not be a luxury only available to the wealthy, or those who are fortunate enough to work for a conglomerate corporation. Our country is only as good as its citizens. United we stand, divided we fall. That is the ONLY thing any of us need to be educated about.
Source: http://www.sacbee.com/topstories/story/2313228.html
Great statement and well reasoned. I agree, I don’t mind paying for the service, just please charge me a fair price. I’m still paying off a 8000 dollar hospital bill (2 hours and 2 x-rays) from 4 years ago, when I called to negotiate a smaller payment, they said they would deduct the interest (a big 150 dollars).
Geez Matt that is terrible. $8,000 for 2 hours and 2 x-rays!?
O U T R A G E O U S
You know the response to us though, right? Change your diet, they’ll say. Change your habits, they’ll say. Reduce violence. Put people to work. The problem is not at the hospital, it is inside the American homes, they’ll say. And indeed, they will be right; the health care problem is a SYMPTOM of a much deeper root cause. BUT…,
The reality here is that we can not solve this problem by simply educating people. That is ludicrous. We have progressed (actually regressed, but that’s another article) too far to turn back overnight and reverse the course we’re on. Unfortunately we need to address the bleeding before we can address the underlying cause of it. Health care professionals–especially those who work in intensive care and surgery!– should understand that concept better than anyone.
A couple thoughts on this:
It’s completely unclear to me how health-care reform as currently being considered would change the amount on this bill, other than transferring it to high earners instead of the actual guy needing the care. I agree there is a huge need for health care reform, and maybe someday some president can make it happen because what we are seeing in Washington is a huge entitlement program, not a reform bill. 28% of Medicare dollars are wasted, so I wouldn’t be holding my breath for costs to come down when the feds take over.
Secondly, check out the “funding sources” graph at this UCDavis link. Only 0.2% of MedCenter funding comes from “self-pay”. If 1/6th of America is uninsured, it sure isn’t being reflected in the “self-pay” bottom line at UC Davis!. Either these people never pay their bill, the bill gets picked up by state/county agency, or these people never get sick. And remember, hospitals charge much higher rate to self payers as compared to the rates they have negotiated with insurers or the rates defined by Medicare/Medical.
http://www.ucdmc.ucdavis.edu/newsroom/facts_figures/
My guess is that because the rates are locked in tight with insurers and govt agencies, they only area the hospital can raise rates are on the self payers. The graph clearly shows where the money is (and isn’t). So Scott Hawkins bill probably reflects his care with a few other non-payers mixed in.
To me, this is where actual health care reform (not the fake reform in DC right now) would consist of 3 things to start off:
a) Catastrophic coverage so that nobody loses their house due to medical bills. Maybe over $20K? Its pretty cheap, and this is something the government could actually manage well.
b) Health savings account where consumers actually are involved in the “buying” process. This makes it more like a Les Schwab transaction, and less like a faceless bureacracy that magically pays the bills.
c) Savings from actual reform (such as 28% medicare waste) would be used to put money the the health accounts for those unable to obtain insurance otherwise.
My wife is finishing off another nursing degree, and one of the courses she had to take is in Hospital Management. As a requirement for the course, she had to read a book called “Code Blue”. Essentially, it is a novelized teaching tool, designed to give nurses and potential administrators a realistic look at what hospitals have to pay for and where the money is really coming from. I would highly recommend it. Here are my conclusions after reading it:
1. Hospitals don’t often know where they are wasting money.
2. Governments often make the problem worse by not doing accurate cost-analysis of Medicare/MediCal services
3. The average person is not given any care/cost options once they go through the hospital’s doors (Try getting away with that at Acme Body Shop).
4. All the people we assume are getting rich from the medical system, are not. It is those who manufacture equipment, produce medications, and initiate lawsuits that are making all the money. Hospitals, doctors and nurses many times are going broke. So is the general public.
Great points Mike.
Its funny, its open enrollment now and my (large) private employer, which offers about 6 different health plans. Over the years they have added many plans that give the consumer more insight and control of their health care spending. Either high deductible plans that have a low/zero monthly paycheck deduction. Or Consumer driven plans where the employer puts cash in a health savings account for the employee to use as they deem fit, and the cash can rollover from year to year.
Yet Congress seems to be going completely the other direction right now with healthcare, pushing for government plans where by definition the true market driven cost gets completely lost in the in the legislation and bureacracy. I tend to beleive Americans are better off when actual costs are more transparent, whether is car repair, health care, war etc.
It seems the market forces have been so upended by government intervention, that nobody has any idea of what the actual, market driven cost would be for the care given Scott Hawkins.
Don’t forget the drug companies! Drugs are still the big business on the planet!
I don’t have a specific beef with the drug companies. If their profits were in fact obscene, I would have cashed out my 401k and dumped it into drug companies. A quick google search shows that the drug sector does okay but not great, and the vast majority of earnings are rolled right back into R&D. Their balance sheets look more like those of volatile tech companies rather than big bad oligopolies.
And one other thought on drugs. Drug development costs billions, and many drug developments go nowhere (or worse have side effects that kills customers as well as profits). But much of the world doesn’t pay for this drug development. Countries routinely sidestep the development investment by making unlicensed generics. Nobody in China pays $199 retail for Windows 7 O/S, and just the same much of the world does not pay the true cost for the drugs that keeps them alive. And so the cost burden falls on the US and other western countries that respect intellectual property and the rule of law.