Just how much does it cost to visit the emergency room? What about for something as simple as a stomach ache? You may be surprised to find that it could cost over $5,000. A March 24, 2012 article in the L.A. Times by Steve Lopez, "An emergency room story to make anyone ill" outlines exactly how the costs can be so high, including following the story of Ella Moser, an 11-year-old girl whose father experienced this $5,000 bill first hand after receiving a series of tests for his daughter's stomach ache.
When John Moser called his pediatrician one evening about his daughter's stomach pains, the pediatrician advised him to take her to the emergency room, just to be safe, to rule out appendicitis or other serious problems. After a series of tests were conducted, John was later shocked to find the first bill had arrived with a total cost of over $5,000. John stated that the bill was confusing and broke down a number of fees including $1,288 just for entering the emergency room, $1,135 for the ultrasound, $1,212 for a comprehensive metabolic panel (blood analysis), and an accidental charge of $158 for a saline solution, which John decided he did not want (after the medical staff first suggested it, then came to the conclusion it wasn't necessary). Shocking as this was, additional bills arrived later, including $540 for pathology and $309 for the cost to see the doctor.
John had a private health plan which covered just over $2,000 of the first bill, leaving him owing the balance of $2,571.85. When John showed the bill to his father, Marvin Mosler, who is a doctor teaching at Yale and has written several articles about excessive medical testing and overcharging, his father was shocked at the outrageous fees and even questioned the usefulness of one of the tests, the metabolic panel. When Marvin researched the cost for the metabolic tests online, he found some labs charged as little as $39.
The article comes out just as President Obama's healthcare reform act will get a hearing before the U.S. Supreme Court beginning this week, discussing the soaring healthcare costs and health insurance. There is a serious problem with the healthcare system, and many families have used up their life savings and even filed for bankruptcy due to excessively high medical treatment.
Hospitals are on the defensive with these soaring prices, stating these high prices help them offset the costs of services they provide for the uninsured. Hospitals also claim they are not getting reimbursed enough from Medicare and Medicaid. Glenn Melnick who teaches hospital economics at USC says, "by and large, these prices are fictitious numbers." Melnick states that hospitals like Tarzana routinely charge astronomical fees, especially for emergency room services. He does state that hospitals are reimbursed by Medicare sometimes with an amount that is near their actual true cost. For example, while the Moser's were charged $1,288 for an emergency room visit, Medicare would likely reimburse the hospital around $300 which would be far closer to the hospital's true cost.
By raising the fees for emergency room visits, hospitals are not only able to charge the patient's more money, but collect higher amounts from the insurance companies as well. The article states half of all patients admitted to hospitals in California enter via the emergency room. Patient's probably have no idea how much they are getting themselves into with the fees.
It was also determined that hospitals all charge different fees for the same services, so an emergency room blood test being charged $1,212 at Providence Tarzana Medical Center, may cost $786 at Cedars-Sinai Medical Center or $350 at Ronald Reagan UCLA Medical Center. It could cost even more at other hospitals. Melnick found a state website where every California hospital lists its fees, confirming that the prices for similar services are all over the map. The article comes to a conclusion that these price differences are so dramatic that they seem arbitrary, even indefensible. Millions of Americans are waiting to see how the Supreme Court will rule on healthcare and how this ruling will change the way hospitals operate and how patients will receive medical treatment.
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