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Belly of the Beast Part 3: Details of the Cost of Hospitalization PDF Print E-mail
Written by John Weeks   

Belly of the Beast Part 3: The Cost of Hospitalization with a $5000 Deductible

Summary Integrator interviewees are typically asked for data, if they have it, to ground the qualitative aspects of an interview. It will mean more to readers, I tell them. Well, what is asked of the goose must be asked of the gander. If you thought the picture of the appendix that accompanied the two postings on my September hospitalization was ugly, wait until you see the gruesome economic details of my four day, complicated hospitalization for a burst appendix. Here is an education of what a $5000 deductible plus 30% co-insurance plan can mean to those who are choosing, or being forced to choose, this type of coverage in "consumer-directed" health plans ...
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for publication in a future Your Comments article.

Image About three weeks after I left the hospital on September 19, 2006, following my four-day stint for an appendix removal plus complications, we began to receive regular correspondence from our insurer, the hospital and the hospital's nearby surgical and radiology suites. Bills, of course.
(See initial story on my hospitalization.)

Happily, my recovery had been rapid, and my immune system bolstered, before this news began quantifying the toxicity level of the economic sequelae. For awhile, we thought it the best medicine to not add up exactly what the services (and thank the gods of the surgical suites for them) would cost us. We put off the addition, subtraction and division which would put a number on the outomes of our $5000 deductible and 30% "co-insurance" gambit. (See Part II pf the story on ER timing and cost implications of "under-insurance.")

Lesson 1: Request the Details ...

So what do you think 4 days in a hospital
with a relatively clear-cut condition would cost?

By prior agreement of two consenting businesses - the hospital and insurer - we did not initially receive the details of the big ticket billing from the hospital. Instead, they just hit us with a single, roundhouse punch. Like most on high deductible plans, there is no manner of parrying that can ward off the big one: $24,965.50. Our piece was $9925.78. And the surgical and radiology services were not yet in.


Image We requested an itemized hospital bill.
As it happened, two colleagues who co-founded an integrative clinic, One Sky Wellness Associates, Christy Lee-Engel, ND, LAc, and Chris Adams, MD, happened to be over for lunch the day the itemized bill arrived. I opened the bill, with all the excitement of a would be surgeon to explore a first cadaver.

The four of us stood in our entry way and surveyed the 3 pages of itemized billings. Christy, who'd read my previous posts on the hospitalization, put the question: "So, are you going to share it?"

Justice demands it. I am forever asking interviewees to share any kind of internal data on their businesses, their profits or losses. Besides, many of you have probably never seen the itemized costing of the kinds of significant hospital bills that float our tertiary care system. And more of you each year are selecting only catastrophic coverage, as we did. So, for you, here it is.
_____________________________

Costs of a Four Day Hospitalization

For prior articles on the hospitalization, search with keyword "Appendix."


 Recovery room
9/16  $13/min  57 min  $741
 Hosp. Room
9/16-18  $1,613  3 day $4839 
Anesthesia
service
 9/16 $19/min  107 min $2033 
Hosp. care,
surg., initial
9/16
 $253  --  $253
Drugs/Pharmacy
9/16-19
--
--
$587.95
Non-sterile supply
9/17, 19
--
--
$438
Sterile supply
9/16
various
--
$2662
Supply implants
9/16
GIA 30
cartridge +
--
$3,494
Lab/chemistry
9/19
--
--
$73
Lab/bacteria micro.
9/16-17
--
--
$95
Lab/urology
9/17
--
--
$60
Total pathology histology
9/16
--
--
$123
Total xray/radiology
9/18
--
--
$389
Total drugs/detail code
9/16-19 various
--
$2167
Total drugs/self
9/16 various
57
$344
2 staff operatings time
9/16 $63/min
107 min
$6741

Non Hospital Services

       
 Surgery
 9/16  $1,183 --  $1436
Surg. Path  9/16  $103 --  $103 
Anesthesia emergency
 9/16
--   --  $156
Anesthesia,
appendectomy
9/16
--
--
$1014
 Ambulance(1)  9/16 
 --  -- $734
 Radiology 9/18   --  -- $82 
 Pathology 9/16  --  -- $103 
(1) We discovered that the hospital whose ER we used was no longer providing appendectomies, and that I would have a ride of less than a mile to another hospital, owned by the same company, for the surgery. We would have gone in our own car but the ER doctor assured us that the hospital would be responsible for this bill. We are in discussion with the ambulance company on this.
_____________________________

1. See Engel's comments on the importance of collaboration in an integrative clinic here.)

Comment:  The itemized bill that the hospital eventually sent - a three page, detailed printout - had no dollar signs on it. Not one. I figure this might have been a cost-savings to reduce the expenditure for ink. Then again, it may be that the Centers for Disease Control has sent out a prevention pamphlet urging that the actual dollar signs be removed from bills to lower the incidence of hospital bill-induced myocardial infarction. Don't worry, they are just numbers on a page ...

We still don't have everything worked out. When we told the hospital we had insurance, but a $5000 deductible, a raft of bills came back, first, indicating "no insurance." We've sent them back for the calculations of reduced fees, insurer share, and our share, and haven't heard back yet. Our best calculation, over-all, is that the cost to us for the hospitalization and associated fees will be roughly $11,000.

I hope you find my publishing these numbers interesting, if not of an altogether prurient nature. As more individuals in their "consumer-focused health plans" opt for, or are forced into, benefits plans with high deductible and catastrophic benefits, accountings such as these should be part of the consumer's education as they take the additional risk.
Caveat emptor!

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for publication in a future Your Comments article.


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