New Orleans ACORN, Local 100 United Labor Unions, and the Labor Neighbor Research & Training Center have been studying hospitals for some years now. First, we looked at charity care in Arkansas, Louisiana, and Texas, and found that if nonprofits with tax exemptions simply hit the average of 4% of gross income as charity befitting their privilege, another billion dollars in health care would go to lower-income families, including in Texas where Medicaid has not been expanded. More recently, we have looked at hospital compliance and pricing in line with the new regulations finding that between 30 and 50% have not complied, and the range of prices for the same procedures is absurd, as our forthcoming report will indicate. All of which left me both concerned and curious about my personal experience with a 19-hour field test with the giant Baptist Hospital in Little Rock, after I had been bitten by a copperhead snake.
Lesson one, it takes the giants a while to get their billing to you, and it comes it spurts. My first bill was minor about three weeks after the fact. Some $33.74 for a named doctor. Who knows? I started to think I had escaped the experience easily! My second bill was for $75 for the walker, I needed for three days, and that the nurse has assured me that insurance would cover. It didn’t, so that was a check to some Florida company. Finally, after seven weeks, and likely after they had shaken down all of my insurers, I saw an envelope from Baptist and opened it to find that they had priced my bite and the thrill of it all at $33,698.18.
As a researcher, this was fascinating to me. Snakebites aren’t exactly on the required list of 300-odd procedures that hospitals have to list. Hospital staff could only remember one or two during the whole year that had come through this Arkansas hospital. As an individual healthcare consumer, I was flabbergasted though. I’ve bought a lot of cars and one house for less money!
But, here’s the real deal. The “sticker” price that hospitals use is nowhere near the real price that they hope to collect from the consumer. Reports indicate it is often 50% or more less. The big bill price is what they use to get paid by Medicare and Blue Cross in my case. Against that $33,000 plus, they said they had collected $10,689 and change or about 31% of the total bill. They had a figure on the bill called “total adjustment” where they essentially wrote off $21393.83 or 64.5% of the bill. Do a bit of math in your head and you can see where this is going. My actual bill was going to be for the difference 4.8% or $1615.35. I might not be happy, but the point of this kind of wheeling and dealing bill and business model structure, is that you feel lucky when the last bite is only $1600-ish on a $33,000 “bill.” I read today about a family who lost a child and still get bills for over $250,000 from the hospital. There but for good fortune….
Baptist is no better or worse than others. In fact, on our charity study, they were by far the best in Arkansas and among the best in the three-state region. The internet had told my family that the anti-venom serum would have retailed at $7000, another example of why our drug prices are 250% more than other industrialized countries.
On the whole I received excellent care there. Nonetheless, none of this is any way to run a healthcare system, and it all explains why healthcare is so crazy and ridiculously expensive in the USA.