There are health care nightmares and then there is what happened to Eric Fergusan, 54, in North Carolina. Fergusan was bitten by a snake on the foot while putting out trash last August. He drove himself to the hospital and was given anti-venom medicine that can be purchased online for as low as $750. The bill” $89,227 bill for an 18-hour stay.
He is fortunately insured but it is the latest example of the how medical bills have become little more than openly fraudulent billing by hospitals. Drug and treatment costs have soared in this country because members of Congress and the Obama Administration yielded continually to this powerful lobby that hires former members and staff members and contributes mightily to campaign funds. The result is that citizens are being sheared like sheep as politicians fall over each other to help these lobbyists.
The Lake Norman Regional Medical Center is responsible for this outrageous bill. Blue Cross and Blue Shield reduced the total bill to $20,227 and the couple paid $5,400 out-of-pocket to cover their deductible and co-pay. So how does that work? The hospital charges roughly $90,000 and then suddenly drops to $20,000? In most other fields, that would be called fraudulent billing but, in the United States, it is considered standard billing procedures.
What is really amazing is the frank response of the hospital: “Our costs for providing uncompensated care are partially covered by higher bills for other patients.” In other words, we do not actually charge what your care cost but instead gouge anyone who can pay more to cover losses on other patients. Consider other industries following this practice. “Yes, your car was $40,000 but you have been charged $90,000 because we had some car loans fail with other customers” or “Yes, I agree to represent you for $100,000 but I have a hit-and-run defendant disappear without payment in his case so I am charging you $150,000.” What is equally alarming is the matter-of-fact attitude of the hospitals who first try to overcharge and then shrug and take, in this case, almost one-fifth of the original demand.
These abuses are reported everyday but you hardly see a member of Congress rushing to the floor to demand reforms. Why? Just look at who the former members are working for?
Source: Yahoo
NY Times:
Hospital Chain Said to Scheme to Inflate Bills
By JULIE CRESWELL and REED ABELSON
Whistle-blower suits claim Health Management Associates tried to inflate its Medicare and Medicaid payments by admitting more patients.
http://www.nytimes.com/2014/01/24/business/hospital-chain-said-to-scheme-to-inflate-bills.html?nl=todaysheadlines&emc=edit_th_20140124&_r=0
“While politicians and pundits alike inside the beltway beat up the White House over computer system glitches, health insurance companies still project robust revenue growth and profits from a boom in business from newly insured Americans under the Affordable Care Act.” Bruce Japsen
When Obamacare Exchanges Launch, Premiums Will Be Low, Deductibles High 152,333 views Bruce Japsen
“I’ve written about health care for more than two decades, starting from my native Iowa where I covered the presidential campaign bus rides of Bill and Hillary Clinton through the Hawkeye state talking health reform and the economy. I have covered the rise, fall and rise again of health reform, chronicling national trends as well as the influence of Barack and Michelle Obama from Chicago’s South Side on changes to the U.S. health system from my base in Chicago. I was the health care business reporter at the Chicago Tribune from 1998-2011 and previously wrote for Modern Healthcare magazine when first arriving in Chicago in 1993.” Bruce Japsen
Health plan CEOs like Wellpoint’s Joe Swedish project robust revenue growth and profits from a boom in business from newly insured Americans under the Affordable Care Act. Bruce Japsen
http://www.forbes.com/sites/brucejapsen/2013/10/26/despite-glitches-obamacare-profit-windfall-to-insurers-well-underway/
IndyRes wrote:
“The veteran’s home is currently charging him about $8700 / month for his housing and food. He isn’t receiving therapy and he receives minimal doctor’s care so I questioned why is he billed over 100K / year. The veterans home responded that they charge him more because he can afford it.”
That is terrible. In my view the veterans hospital should treat all patients with the same care and not go after the money like this.
http://www.huffingtonpost.com/2014/01/27/health-insurance-obamacare_n_4661164.html
These Health Insurance Companies Are Winning At Obamacare
By Jeffrey Young
These Health Insurance Companies Are Winning At Obamacare
Posted: 01/27/2014
“A central promise of Obamacare was to spur competition between insurance companies to drive down health care costs and give consumers more choices. The results…”(Read on).
“Thanks to a Supreme Court ruling and staunch Republican resistance, Marc Alphonse, an unemployed 40-year-old Marine veteran who is essentially homeless, cannot get health insurance under Obamacare.” (read on…)
BY Jeffrey Young
Millions Are Now Realizing They’re Too Poor For Obamacare
Posted: 01/31/2014
http://www.huffingtonpost.com/2014/01/31/floridamedicaid-uninsured_n_4680566.html?utm_source=Alert-blogger&utm_medium=email&utm_campaign=Email%2BNotifications
Of course your grandfather took Social Security; he had been forced to pay into it. To suggest that Social Security is an entitlement, is like saying that filing a claim for an auto accident is an entitlement, too.
Just as you think $89,000 for a snakebite is outrageous, I think $100,000 is outrageous for care. My question was sincere and legitimate. Me, I’d bring him into my home and hire necessary help; certainly it wouldn’t cost $100,000. Then there is the healing and emotional benefit that comes with being among family. Obviously, your bigotry is showing. You only respect someone else’s view if it happens to coincide with yours. Even then, you still run your thoughts, as your previous posts demonstrate. Keep posting, so we can see you step on your body parts again!
It would seem, samantha, you will be in for quite a rude awakening should you ever have to deal with caring for a family member and also negotiating with insurance companies, the government, and care providers.
Hopefully by the time you need it our Medicare, Medicaid, and Social Security and Veteran’s Administration will run more sensibly, efficiently, and humanely. If profit were removed from the cost of medical necessities, we would ALL pay less, get more, and options you seem to think are available now will be a reality.
Medical care is even less of a commodity than food, which also is not when reduced to the basics for survival. When you need food, it is not an option or luxury, it’s survival. Heaven help you if you’re hungry and out of money, and if there were no food stamps available because people like you would have killed them.
My grandfather also didn’t like the idea of Social Security when it was initiated. But when he retired, he took it and changed his mind. Things change. Our grandfather’s world has CHANGED. The market s for necessities like food are NOT a free market model nor have they ever been nor should they ever be. Laptops and bread are different. The opportunities created by drought are the theoretical ones armchair amateur economists spout from the comfort of their homes with full larders. Just as the proverbial liberal is a conservative who hasn’t been mugged yet’, so is a libertarian a progressive who hasn’t gotten a devastating illness yet. [example: Ron Paul’s campaign manager Kent Snyder http://gawker.com/5840024/ron-pauls-campaign-manager-died-of-pneumonia-penniless-and-uninsured ] Hope this doesn’t have to happen to you for you to investigate what is really going on, why, and how, and form more sophisticated reality-based opinions. Then posit some realistic possible solutions.
It’s not just hospitals who use this flawed logic for billing it’s also the Veteran’s Administration. My older brother had a severe stroke about six years ago and is now in a veteran’s home. The veteran’s home is currently charging him about $8700 / month for his housing and food. He isn’t receiving therapy and he receives minimal doctor’s care so I questioned why is he billed over 100K / year. The veterans home responded that they charge him more because he can afford it.
Why doesn’t your brother just pay you to take care of him, keeping all that money in the family?