Society

A Heart Attack And The Numbers

Submitted by Darren Smith, Weekend Contributor

Heart showing MIPresenting a succinct short story of a heart attack and the billing as experienced by a patient

One afternoon a man sitting at home and reading a news article, stood up to walk to the kitchen. He felt a sudden pain in his chest along with shortness of breath. About an hour later the pain returned and this time began spreading over the top of his chest and into his neck. Concerned, he drove to the emergency department of a local hospital.

The hospital admitted this patient and did not initially find any signs of heart issues from blood labs and ECG tests but the Hospitalist ordered an overnight stay for observation.

Around 1:30 AM a blood test revealed elevated cardiac enzymes, and again at 6:00 AM. A cardiologist ordered the patient into a cath-lab at 8:00 for an angiogram, concerned of a heart attack.

What follows is one of many true testaments to some health care issues in America.

In the Cath-Lab, the cardiologist found the Right Coronary Artery was 90% blocked and other areas will require further treatment at a later date to allow the heart to recover from the procedure. He placed a stent and the procedure was wrapped up in a little over an hour. The patient stayed overnight and was discharged the next day.

Two days after discharge, the patient felt very weak, short of breath, and angina pains. The on-call cardiologist ordered him to the emergency room. After an overnight stay, the cause was determined to be a drug interaction that lowered his blood pressure to a worryingly low level. The physician changed the drug regime.

In a follow up with the cardiologist, a week later, he recommended based on the continuance of the patient’s angina and general lack of energy that the patient should have the second phase of the stenting move to the soonest date available. On that day the patient went to hospital and another angioplasty was performed. Three medicated stents were placed and another coronary artery was ballooned. The hospital discharged the patient the next day.

The quality of care the patient received was excellent and the staff and physicians performed their duties to the highest standard. The patient is making a strong recovery and is feeling much healthier and better. There was no damage detected to the heart. The intervention certainly prevented a catastrophic heart attack from occurring in the future.

Now for the other aspect of this story: The cost

06/19/2014 to 06/21/2014
Inpatient HOSPITAL
   
INITIAL OBSERVATION 231.00
SBSQ HOSPITAL CARE/DAY 168.00
HOSPITAL DISCHARGE DAY 169.00
   
Sub-Total 568.00
   
06/19/2014 to 06/21/2014
Inpatient Hospital
   
Cardiology 45,716.53
EKG/ECG 640.29
Emergency Room 2,760.48
Laboratory 2,367.48
Supplies and Devices 11,247.60
Pharmacy 6,304.32
Radiology 412.26
Room and Board 3,461.09
Observation Room 1,053.20
   
Sub-Total 73,963.25
   
06/22/2014 to 06/23/2014
Outpatient HOSPITAL
   
EKG/ECG 213.43
Emergency Room 2,760.48
Laboratory 1,747.63
Pharmacy 458.67
Radiology 412.26
Observation Room 1,579.80
   
Sub-Total 7,172.27
   
07/14/2014 to 07/15/2014
Inpatient HOSPITAL
   
Cardiology 86,472.79
EKG/ECG 426.86
Laboratory 813.78
Supplies and Devices 56,943.56
Other Imaging Services 1,019.02
Pharmacy 9,827.02
Room and Board 2,633.68
   
Sub-Total 158,136.71
   
Grand Total $239,840.23

The patient spent, in total, seven days in hospital, the cost of which was nearly two hundred and forty thousand dollars. This amount represents 94% of what the patient paid for his house years ago.

When a person wakes up in the morning, they certainly don’t expect to have a mild heart attack or that a month later they will get a bill equal to four and a half years’ income for the median American Household. Yet, it happens quite often in the United States, probably every hour at least.

Fortunately he had health insurance. Of the $239K the hospital, cardiologist, and others billed, the patient was only responsible for $1,824.86. He paid the bill, thankful for this new gift of health and that his insurance indemnified him from the tremendous cost of the procedures.

One certainly cannot stress enough the importance of health insurance, for a healthy life and financial stability. Without insurance or government program most Americans would be bankrupted in receiving treatment as our patient has.

Also, though the treatment was certainly first rate, one has to wonder how seven days of hospitalization and a procedure lasting a little over an hour and the second part three, generated an expense of nearly $240,000.00.

Surely the cost is worthwhile to save a patient’s life. But, what is the cost to society in having a system such as we do presently?

By Darren Smith

Source: Confidential
Photo Credit: J Heuser

The views expressed in this posting are the author’s alone and not those of the blog, the host, or other weekend bloggers. As an open forum, weekend bloggers post independently without pre-approval or review. Content and any displays or art are solely their decision and responsibility.

172 thoughts on “A Heart Attack And The Numbers”

  1. Paul C. Schulte

    Dredd – are you denying that if we took 11 million illegals off the free health rolls it would cut the cost of health care?
    ==================================
    No, I was rejecting every sector of your fact-free, false framed assertion.

  2. The GOP among us will find my sourcing horrible, but I have read this on other sites, yet found this link to be the most comprehensive; it shows the differences in hospital charges in the NY metro area for patients with a similar diagnosis, COPD. I think it flies in the face of those who believe that competition will either regulate or bring prices down: none of the hospitals in the pricey category are hurting for business, nor are insurance companies shunning them. I think it’s just an interesting study, one that I really have no answer for.
    It being The Huffington Post, it does advocate for the uninsured, but that’s not my intent for posting, and I really don’t want this thread hijacked, although I know it’s not under my control. I present it to illustrate medical costs!
    http://www.huffingtonpost.com/2013/05/08/hospital-prices-cost-differences_n_3232678.html

    1. Dredd – you are such a silly billy. Logic would tell you that what is say is true.

  3. Competition. Ah yes. Historically there has not been much meaningful competition in the health care industry. Choices, yes. But not real competition based on a transparent “marketplace. ”

    And that makes a degree of sense. With some exceptions, health problems are unexpected. When you don’t know what health problems you will have in the future, how do you “shop around” for the optimal insurance policy for you? Even if you were able get enough information to make an informed choice among “competing” insurance policies based on your anticipated medical problems, surprises happen. Car accidents, and other unpleasant surprises result in unanticipated medical problems. So what you think may be the optimal policy for you (assuming a transparent marketplace ) may turn out to be a less than optimal policy due to unexpected events.

    Competition can be a good thing, but it is not a panacea for all of the world’s problems. And where the competitors obfuscate, lie, and otherwise engage in questionable and improper behavior in order to make a profit, corrective measures are in order.

    1. I worked for a company were we compared competing health insurance policies every year. And they were in competition for our business.

  4. Pingback: A Heart Attack And The Numbers

  5. Great article Darren. The runaway health care costs are amazing.
    bettykath,
    that is a wonderful result for your family!

  8. As critical as we are of the health system, there is no doubt of its importance. But, it has problems, and they go far beyond “let the government fix it.”
    I must also say, I have no idea how to fix it. I do know that there are unnecessary facilitators that compound the problem. But maybe the positive could be there will be a fight over what is more important, budgeting for means to save lives, or for more expensive and complicated ways to kill others in large numbers.

  9. It isn’t just heart disease. I recently read where just about any visit to a hospital for anything is huge. Rattlesnake bite — $50+k. Recently read where a lady was charged something like $400,000 for scorpion antivenom. It was marked up as it came from Mexico. As I have said before, if the costs aren’t eventually contained somehow-government or no government–there won’t be enough money on the planet to pay for them. Of course, it wouldn’t come to that, but something really, really bad would have to happen before that ship could right its course.

    1. slohrss29 – here in the desert scorpions are a regular problem. The overcharging for anti-venom has become an issue. It actually depends on which hospital you go to as to how much you are going to get charge. The highest the local paper found was $60,000, the lowest was around $500.

  10. My nephew was born with a heart problem. He was immediately moved to a pediatric cardiac hospital over 100 miles away. They put in a stent. Two years later he underwent open heart surgery, twice. Drs. had him heart/lung machine, did the surgery, removed heart/lung machine and considered the result. His blood pressure was too high and the “fix” would fail. Back to the heart/lung machine, new procedure, success. Ten years later he was back for the planned replacement valve. Success. We have now had 16 years of enjoying him, a baby that would not have made it if it weren’t for the skill of the dr. at his birth recognizing the problem and the quick decision for transport and for the teams at the cardiac hospitals.

    I’m generally not a fan of the medical system, but I sure do appreciate what they did for my nephew.

  12. Obamacare doesn’t pay the private insurers pay no matter how you want to twist it. (And I did not say my insurance, medicare and BC/BS, did not pay it. My point if you weren’t so blinded by your hatred of the ACA, and this president and therefore anything with his name attached, was the cost which as you may recall was the point of the post.
    I and everyone should be complaining about the runaway costs of healthcare in this country.

  14. I’ve had more than my share of dealings with doctors and health insurers over the last 20 +++ years. Western and eastern medicine have literally saved my life, more than once, where I faced medical issues and conditions that are rarely encountered.

    I have nothing but contempt for the health insurers I have dealt with. They jerked around the hospitals and doctors whose talents and services saved my life. They have jerked me around on those occasions where I paid out of pocket and submitted claims.

    I witnessed what I consider to be gamesmanship and outrageous billings by hospitals which appear to have been done to deal with anticipated gamesmanship by the insurance company.

    And yet I’m caught in a bizarre love/hate relationship because I need my health insurance.

    I wish I had a solution to the state of the US health care system. I know the solution does not involve whining about Michelle Obama or about Democrats or Republicans.

    I can state unequivocally that, if everyone had unfettered access to competent eastern medicine practitioners, health care costs would decline by a noticeable amount. And quality of life would increase. (I would rather watch TV ads for reishi mushrooms than for cialis. )

    My instincts tell me that a Single payer is system, imperfect as it may turn out to be, will be the least worst solution moving forward. But I really don’t know enough to be certain of the optimal solution to the mess we call the health care system in the US. I do know that it will take an earthquake-like event to effect meaningful change.

    1. Don de Drain – without competition there is no reason to excel. Single payer is no good solution to the problem. Government run anything (look at the VA) is no way to run health care.

  15. “Of the $239K the hospital, cardiologist, and others billed, the patient was only responsible for $1,824.86.”

    And you can bet that the insurance company paid half, or less than half, of $237k due to “discounts” and other agreements with the provider. The remainder was written off.

    The $239k is payment that would be demanded from a cash patient, one not covered by insurance. That too would mostly not be paid, The part that is written off as bad debt can then be deducted from the hospital’s profit, reducing their taxes. The patient might have to pay income tax on it, because forgiven debt is taxable income.

  16. Bruce private insurance has been the decider for many years as to whether you get the care your doctor wants. It is called precertification and most insurance companies do it and have been doing it. But thats ok The lies distortions, misperseptions and exaggerations about the ACA show me that those who are against it rarely have legitimate reasons for being against it so instead they rely on their canards.
    Paul Your comment makes no sense.I was talking about a cost way our of proportion to the service offered and the post was about the costs hospitals are charging. That has nothing to do with the ACA. (My ACA sentence related to your blaming it on illegals)

    1. leejcaroll – Obamacare should have paid the 125 and you should not be complaining about anything.

  17. I lived in Germany for 10 years. I would trade the German healthcare system for the US system in a heartbeat. I paid less on my healthcare insurance premium for a family of 4 in Germany than I did for a family of 3 in the US. One of us was “uninsurable” which is a concept that does not exist under the Germany system. I never had to wait for care in the German system. Often I was seen by a doctor the same day I called. Germany spends about $4000 per person on healthcare. The US spends about $8000 on healthcare. For that $4000 Germany covers its entire population. At $8000 per person, the US still – even under Obamacare thanks to the Medicare opt out – does not cover everyone. With paying DOUBLE per person, you might think the healthcare outcomes are much better in the US. Not so. Germany does much better, for example, in infant mortality rates. I could make the same comparisons with other countries but I know the German system. Given that, why can a country we beat in two world wars pay less and receive better healthcare?

  18. No doubt about it. Healthcare in America is excellent, but inefficient.

    I had a somewhat related experience in the VA system, one that did not cost me a dime. I went to the VA ER room, was diagnosed with a heart condition and had the experts recommend I go to another VA hospital about 500 miles away, the closest VA hospital where the necessary diagnostic equipment, some of which is listed in this article, was available. But I was told to not go home for the wait, but to remain hospitalized such that I could be transferred as an “inpatient,” and not have to wait 60 days for an appointment as an outpatient. Sound familiar? I remained in the local hospital through most of the weekend, some 2 additional days, was driven in an ambulance to the airport where I boarded an air ambulance, and together with my dedicated nurse and pilot, I was flown that 500 miles. And enroute, while looking out the window, the nurse, a male, gave me a birdseye view of his favorite fishing holes. Upon arrival, I was whisked via ambulance and that attending nurse/fisherman to the larger hospital. Then he returned. On the next day and as the very last patient, I was seen by the cardiac team. I had no arterial problems and was marked for discharge the next day. This time, I rode in a limousine to the airport and flew commercially back home.

    What did these extra days of VIP treatment cost? I don’t really know. But we can guess. And where was the nearest cardio team with Federal block grant money used to buy that special equipment located? A scant 5 blocks from my local VA hospital! The claim is that it is cheaper to fly me 1000 miles than it is to drive me 5 blocks. Go figure. I did enjoy the trips both ways. I sat next to a veteran who no longer will take healthcare from the VA. It took the VA far to long to recognize that his cancer was agent orange caused.

  19. Schulte, Asians have adopted the Western diet. I thought you would have known this. Your own addiction to Western diet is not unlike that of an alcoholic’s, who cannot recover until hitting bottom first. What’s it going to be, hitting bottom on the bypass table before you wake up? I know 5th graders who can make more sense than you.

  20. two short visits to the dr., one blood test, one quick visit with a nurse. $470.

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