Friday, May 8, 2015

The High Cost of Healthcare – A Personal Experience

Photo courtesy of
          I’ve been putting off writing about this while I waited for all the medical insurance claims to come in. Hopefully nothing more is forthcoming.

          Remember when I was hospitalized in mid-February of this year? No? Well you can read about my experience here: and here:

          I’ve been working in hospitals for more than 30 years and was never aware of the financial side of healthcare. We’ve admitted innumerable patients and never questioned how much it cost them or the insurance company. Sure, I’ve been hospitalized twice before but was never presented with a detailed bill by the insurance company until my less than one day confinement last February. The medical insurance I now have from my job sends me an email each time I receive treatment at a doctor’s office or a hospital and when I log on at the insurance company’s website, it shows an Explanation of Benefits or a statement which says what the hospital/doctor/Emergency Room/X-ray/CT/EKG/MRI/ambulance/paramedics/etc., billed the insurance company, what the insurance company paid, and how much I have to pay out of my own pocket.

          Almost $40,000 for being in a Cardiac Care Unit. What?! But I was only there for about 15 hours and the nurse didn’t even have to wipe my butt! Well, ok, so the insurance company’s contract with the hospital “only” let them pay about $6,500. Still a large amount if I had to pay it out of my own pocket. My copayment for this 15 hour stay was supposed to be $250. I’m still waiting for the hospital bill which I hope never comes.

          Another example was the ambulance bill from Long Beach to Whittier: $3002. Higher than a routine ambulance ride because it was a cardiac care run where there had to be a registered nurse present in addition to the usual 2 paramedics. Otherwise, it would “only” have been about $2000. My 3 mile routine  ride from home to the emergency room? “Only” $1937.70. Use of the pulse oximeter alone cost $88. Heck, I can buy my own pulse oximeter from CVS or Rite Aid pharmacy for almost half as much!

          Just a visit to the doctor’s office costs the insurance company $225 plus a $20 co-pay from me. It took about 10 minutes of the doctor’s time.

          It’s not that I’m complaining since the insurance company covered most of the cost. It’s just a shock how much healthcare costs in the U.S. Without the insurance contracted payments, for the first two months of this year my medical bills would have cost $56,502.42. OMG, I don’t even have that much in my saving and checking accounts!
Here is a photo of a summary of what the insurance company sent me:

          Now I’m wondering how Medicare and Medicaid (Medi-Cal in California) can afford to pay all the bills of the patients I take care of in the psych unit who get admitted, discharged, and readmitted several times a year.

          Come to think of it. Those hospital bills which the insurance companies pay, in turn pays for my personal bills since I work in the healthcare field, which I’m finding out is very expensive. How people can afford to be sick, I don't know. The more reason to try your best to stay healthy. Happy Nurse's Week and Happy National Hospital Week indeed!

Well, I spoke too soon. This afternoon I got a bill from the City of Long Beach Fire Department for the portion of the ambulance bill that the insurance company didn't pay, which amounted to $295 and included a $5.00 late fee. More ouch to the pocketbook :(

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