“Okay,” I said. “Let’s have a look.”
He handed me a bill from a billing company for a local
hospital. The only entry on it was that he owed $170 for a visit to the
emergency room. I knew that his son had insisted on taking him there after a
scratch on his arm from his dog’s claws would not quit bleeding. At the Emergency
Room, they bandaged the arm, gave him a Tetanus shot, and sent him home. The
whole visit took about two hours with the actual procedure taking a mere 20
minutes. “Looks about right,” I said. “A hundred-seventy bucks isn’t all that
bad for an Emergency Room visit.”
“Look at this.” He said handing me a statement from
Medicare.
It turns out the visit had actually cost $2700! Only his share of the bill was $170. A further study of the
Medicare statement revealed that Medicare actually only paid $90 of the
hospital bill. Who paid the difference?
I’m no CPA, but even I could see something didn’t make sense
here. We decided to call the hospital billing company and ask for a detailed
statement to see who paid the difference.
“ We don’t have a detailed statement to send.” I was told.
Well, we chased our tails for several turns while the person at the billing
office kept repeating the same thing.
“You are telling me that the hospital charged my friend
$2700 for the ER visit, Medicare paid $90 and you billed my friend for $170.”
“That’s right.”
“Well this must have something to do with the new math
because my figures show about $2440 floating around somewhere that still
remains to be paid.” I said.
For the third time she said, “There was an adjustment.”
This time it dawned on me what she meant. “Do you mean the
hospital ate the difference?”
“Yes.” She said in relief. “The hospital has a contract with
Medicare that allows them to make an adjustment.”
I told my friend, and he still didn’t understand. “What was
the two-thousand dollars for?”
I looked at the Medicare statement again. They had charged
$1073 for bandaging the arm (actually applying one large bandage), $1136 for
just putting his nose through the Emergency Room door, $197 for a Tetanus vaccine, and $300
just to “administer” the shot.
It looks to me like the government tells hospitals they can
charge whatever they like for services but will only receive a set amount from
Medicare. That’s great! But if the original charges are valid, how can the
hospital afford to eat $2440 in this case? And what do they do with other
Medicare cases?
Questions? Yeah, I still have a few. Like is it valid to
charge a thousand dollars for a band-aid? Why does it cost $300 just to give a
shot, when they give them free at most pharmacies? Then why does it cost $1000
just to set foot in the Emergency room?
Well folks, here’s the bottom-line. If you don’t have
Medicare or health care insurance, you are paying for the hospital to eat the
difference on every visit of this nature. If you are fortunate enough to
actually have healthcare insurance, you are still paying with your inflated
premiums.
Oh, but you have Obama care? Well check out your premiums
and compare them to those who are paying little or no premiums. Yep, you are
making up the difference.
Is there a reason health care has to be so expensive? That is the question we should be asking. Not who will
pay for health care.
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