The day before yesterday, I had to take my four-year-old son to the emergency room. He was playing at school, fell and hit his head on the corner of a table. It opened up a gash on his forehead that was less than an inch in length and it bled quite a bit. He's fine. There is no major injury, no long-term effects and he handled the whole thing as perfectly as you could possibly imagine. Then we got our bill.
$1100. Now, we have Blue Cross/Blue Shield insurance, so that total is knocked down to $300, which is the deductable. It's okay, we can handle that. It's much, much higher than we would've paid for the same procedure at our HMO in Tallahassee, where the whole thing would've cost us $15, but we live in a more rural area now and we understand that things work differently here. That's not really my issue (although I'm upset that the $300 deductable is per person and these bills could easily rack up if more than one of us had problems).
My real problem is with that $1100. Our time with the doctor totalled about five minutes. Similarly, we got about five minutes of time with a nurse. And the only supplies that were used was a tiny little stick of Durabond, which looks like a chapstick. The doctor looked him over, held him down and put the chaptstick on his wound. I could've done the procedure. You could've done the procedure. Anyone could've done the procedure. The bill had a breakdown on it. $400 for the doctor. Which at five minutes, works out to $22,000 per hour. That's a bit high I'd say. I understand that she has expertise and skill and all that, but we didn't really use any of that and she didn't do anything that anyone else couldn't have done just as well. Next up was another $400 for the nurse. Who did nothing. She helped hold my son down while the doctor put the Durabond on. She wasn't necessary. He only squirmed for a second and then both I and his mother were there to help hold him down. The nurse was not necessary. Now I'm all for nurses getting paid what they deserve and I know that quite often nurses work harder than doctors, but you and I both know that the nurse isn't getting all, most or even much of that $400. The other $300, obviously, went to pay for the Durabond. The amount used maybe added up to a fifth of an ounce. And that cost $300. And they'll still be able to use the rest of the container of Durabond. There is no way such a small amount of such a simple substance is worth $300. So somebody gouged us three times. My thought is that it is obviously the hospital that is overcharging. And for the most part, that doesn't bother me personally, since I have insurance that will cover it.
But here comes the real problem. The insurance company isn't going to pay the full $1100. They recognize, to an extent, that the hospital is overcharging and they're going to refuse to pay the full amount. What happens to the remainder? For someone like me who is insured, it will just go away. The insurance company won't have to pay it, I won't have to pay it and the hospital won't attempt to collect it from anyone else. But what about those people who don't have insurance? Those people who use emergency rooms for their full medical care because they are poor? They have to pay the full $1100 out of pocket. Me, who is insured, pays only my deductable and the hospital basically reduces the amount they will take for the procedure. But the poor person without insurance is liable for the full "cost" of the procedure. That is bullshit! It's unfair, it's unAmerican and it should be illegal. Our medical care in this country is regressive, hurting poor people the most and benefitting rich people the most. And who do you think gets better care, Bill Gates or the homeless guy? The poor in this country pay more for their health care and get worse service. No wonder they default on the payments so often. They can't afford it and still do crazy things like eat. Fuck the hospitals that do this, they are wrong and they should be punished and prevented from doing this in the future.