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”

  2. Lee – Sorry. I neglected to include the link. My information was from an Inspector General’s Report from Homeland Security:

    http://www.foxnews.com/politics/2014/08/01/unaccompanied-illegal-immigrant-kids-exposed-federal-agents-to-lice-scabies/

    As for illegal aliens doing a public service, and doing jobs that no “American” wants, that is the same urban legend used to excuse slavery.

    I live in a border state. The construction industry is rife with unlicensed illegal aliens underbidding licensed, trained contractors. People who play by the rules, and pay the exorbitant costs of licensing, bonding, training, work comp, insurance, etc simply cannot compete with a group of illegal aliens with cut-rate prices. Of course, their jobs are not up to code, and many homeowners have no idea who they’re hiring until the crew shows up and no one speaks English. Or how many mistakes on the job are made when a contractor explains what he needs to one of the other crews on the job, (such as please do not paint in this area because we are going to be using a crane and you could die) who says, “No problem.” When it turns out that “no problem” is about all the English he knows, it’s a complete headache.

    Domestic manufacturers have trouble competing on the global market, because many countries pay slave wages. And that’s what happens here. Illegal aliens bring wages down for all.

    And if there were no illegal aliens, do we really think no produce would ever get harvested again? Isn’t that what they used to say about slavery? I go to organic farms, and I see all races and creeds out there working. It’s not a matter of there are jobs only illegal aliens will do.

    Why is it rude or unreasonable or impossible to expect and require people to follow the law to come here? Or to determine what quantity of people we can easily absorb into our infrastructure every year? If the system needs to be improved, then you improve it. But you don’t say, well, if you can walk here you can stay here and get all the benefits you need. Who cares if you’re a gang member, murderer, pedophile, or drug cartel member who just strung a female journalist up by her entrails? (True story, by the way.)

    All those hundreds of dead children are an unintended consequence of the Dream Act, and an open appearance of the US refusing to enforce the border. It gave a clear message to parents that their best chance was to send their kids unaccompanied with complete strangers, on a harrowing crossing across a wide river to the US. Many kids died, some were murdered, drowned, or sexually assaulted. And all because once they became accepted in the US, they would be able to bring their parents across. We tempted them to make this insane risk. The increase has been 500% this year alone. Nothing has radically changed in Mexico and South America, no nuclear bomb suddenly dropped to make it an emergency. The challenges there are the same this year they were last year. It was our policy changes that led to the increases, and the dead kids.

    So when we see footage of crying kids, among strangers in quarantine, or the corpses of kids on a river bank – these are the consequences of our votes that should inform our future decisions. The unintended consequences can sometimes be the most important. But if people refuse to learn from their past mistakes, and plow forward on the same path, this will continue. There will be MORE dead kids next year.

    2. Karen – Drudge is reporting that signs are now being written in Chinese for illegal aliens on the Mexican border.

  3. Thanks Paul but it does not make your point.
    He says: “After they have been cleared of any diseases and are registered with the government, transportation comes to take them to a more permanent facility or some are released to a family member and will join the general population.”

    re diseases he says I can “almost guarantee”, this is his opinion, not fact. He says some have respiratory illnesses they “believe” came from their job. Not proof but their unsubstantiated belief. Also uses the word “potentially” , they could “potentially” get sick .
    The article should have been labeled opinion or commentary. The author’s bias is unmistakable.

    1. leejcaroll – he works for the government. Double-speak is part of the course.

  6. @EscapePlatoCave

    It’s encouraging whenever there is another person who does not worship before the altar of the healthcare system, which in the very near future will be looked back on, by a more enlightened populace, mostly as a criminal organization responsible for looting consumers, taxpayers, and the Treasury.

    What you say is absolutely fact, that these procedures do not prolong life, unlike a healthy diet, which absolutely will.

    Cholesterol is a healing hormone, which is synthesized in response to inflammation. It’s not unlike a scab, which protects the skin while healing is in process. You reduce cholesterol by reducing the inflammation caused by Western diet. Doctors reduce cholesterol by prescribing statin drugs. That makes about as much sense as taking a drug that will dissolve the scab from your arm, leaving an open wound. But doctors and the pharmaceutical industry have already been found out, under attack by law firms throughout the nation, armed with medical studies that prove statin drugs are harmful and lethal.

    I’ve never understood the insane combo for wearing one’s seat belt, ostensibly motivated by the desire to avoid injury or death, while at the same time feasting on restaurant, fast food, and processed meals, all of which lead to premature death and injury no differently than a car accident. Their capacity for reason is limited: If it kills you all at once, that’s bad. If it kills you a little every day, that’s not bad.

    Personally, I don’t care who wants to kill themselves, so long as I’m not forced to pay the costs of their reckless lifestyle.

  8. Plato glad you could do the hike.
    Just anecdotal, while I waited for my disability determination from soc sec. I had to be on assistance. I paid 7$ for a visit to the clinic and my meds were free. No insurance so the hospital had to find the funds somewhere.
    When I had insurance I went to a pharmacy that was not aware I had insurance. They told me the drug would cost me $500.00 I said wait I have insurance, I don’t pay cash. Suddenly, because I had insurance, the cost came down $200.00
    I was an emergency room ward clerk many years ago. We did not have illegal immigrants (it was in Pa suburb) but we had those who were uninsured/welfare. They added to wait times because they did not have GP’s so used the ER as their family doctor. Often they waited until they were very sick, not only taking up more of the ER doc’s time but a lot more medical resources.
    (I don’t know where you got your information Karen re illnesses among illegal immigrants and unfamiliarity with restrooms. I would not be surprised if those who hire them, which is where we should be aiming our ire, since they wouldn’t come if they were not offered jobs (that apparently US folk don’t want) don’t have facilities for them and they for sure don’t vet them on medical situation/conditions.

    1. leejacaroll – there is a new report about the diseases brought in by the illegal children. It is causing no end of problems.

  10. Paul – if we removed all illegal immigrants, it would absolutely cut out the wait times in ERs in border states. Here in CA, illegal aliens make up a large part of ER wait times.

    I just read an article about how TB, scabies, and chicken pox are spreading in the illegal immigrant holding facilities. “Unfamiliarity with restroom facilities” has led to dangerously unhygienic conditions, and apparently, some border patrol agents have brought these diseases home to their own kids.

    This is one of the reasons why we have a legal immigration system: we screen candidates for criminal history, as well as infectious diseases. Antibiotic resistant TB is rampant in some Mexican and South American cities, so we screen for that, quarantine, and treat them before they can be released. But if people just stroll across the border, and don’t get caught, we get drug cartels, human traffickers, and antibiotic TB just walking on in.

  11. Nick – Indigent patients pay nothing. Medicaid and Medical pay less than cost. So hospitals make up the difference by charging insurance companies more. The insurance companies get economy of scale and can therefore limit their negotiated rate. The people who pay the most are those without insurance, but who don’t qualify for aid.

    I’ve often wondered where all the money goes in hospitals, and what their profit margin is. Because most nurses that I know have to work when they’re sick, and they also work a lot of overtime. Since nurses, depending on their specialty, are around sick people every day, I would expect them to get sick themselves equal to or more than average. And I really would not want a sick nurse caring for a delicate patient in ICU. And yet, they all have to when they run out of sick time or have scheduling conflicts.

    Considering hospitals charge 7 1/2 million dollars to tuck in your sheets, you would think they would overstaff, rather than understaff.

    As an aside, this higher cost of hospital care is why private practice is less expensive for non-surgical care.

  12. Paul C. Schulte

    Dredd – the schools I worked at got competing offers every year. You really have no concept of business do you? I am trying to bite my tongue, but your logic is clearly flawed.
    =======================
    Insurance company history schools?

    I haven’t used any logic yet.

    You are confusing logic with common sense and honesty.

    Typical.

    1. Dredd – you are one of the few people I know who can add one and one and get fourteen. Really, dude, get a grip here.

  13. YOU: “I taught history …” (Spinny did too).

    I worked for a company were we compared competing health insurance policies every year. And they were in competition for our business.
    ————————–
    ME: It would not take me long to ascertain why you used past tense (“worked“).

    YOU:
    Dredd – you are such a silly billy. Logic would tell you that what is say is true.
    ========================
    So you taught history at a competing health insurance company?

    Fine, which one did you retire from?

    Keith Alexander just “retired” as a people serving warrior too.

    I am not swayed by plastic and duct tape cognition.

    1. Dredd – the schools I worked at got competing offers every year. You really have no concept of business do you? I am trying to bite my tongue, but your logic is clearly flawed.

  15. I hate to tell people who have been through these procedures the truth, but people who might face these choices need to know:

    Stents and bypasses do not prolong life or prevent heart attacks.

    The large scale studies done show this but cardiology continues to operate much more like a religion intent on raking in the bucks than a science. Pretty much everything we are told about heart disease involving cholesterol, statins, and bypass surgery is not backed up by actual data from studies. Though amazingly as in the Framingham study, that doesn’t stop the authors from issuing conclusions that back up the mythology even though their own excellent data doesn’t support it.

    I’m not going to try to convince anyone but if you are brave enough to question a doctor when they are scaring the crap out of you, do your own research. When I was told I had blocked arteries, I asked the doctor why I was still able to work out and go on hikes, no answer from 4 cardiologists at Cedars, but research told me that the body grows collateral arteries when the major arteries become damaged. Did you know bypass and stents usually re-block within 10 years? Did you know 80% of cholesterol is made by your liver because it is vital to healthy cell function? Did you know the insane increase in bypass/surgery has resulted in no change in the number of heart attacks? Doing research I found almost everything we are led to believe is not supported by study data, although a brief superficial internet search will yield tons of stuff supporting bypasses, stents and cholesterol hysteria.

    Read some of Nobel Prize winning cardiologist Bernard Lown’s work and studies, it is eye-opening and oh what a better world it would be if doctors observed, listened to and learned from their patients the way he did.

    http://bernardlown.wordpress.com/2012/03/10/mavericks-lonely-path-in-cardiology/

    The data does tell us smoking (and other pollution) damages the heart and major arteries, being overweight is not good (though not a simple metric) and exercise is definitely beneficial.

    People who do triathalons are told to have bypass because they have blocked arteries, it is nuts. Only people who are unable to be active or have extreme angina not helped by meds should have surgery (a surgery by the way which is clearly documented to cause impaired brain function http://www.scientificamerican.com/article/pumphead-heart-lung-machine/)

    Anyway, with my completely blocked arteries and an effective medical treatment, I hiked with my 3 dogs to the top of the hill in Kenneth Hahn Park yesterday, and I’ll be doing biceps and chest at the gym later. Have a nice day.

  17. Dredd – my little silly billy, if you have been following along, I have been retired for 5 years.

  18. maxcat06 – this articles shows you why some hospitals are in your plan and some are outside your plan. Those in the plan will have negotiated for better fees.

  19. For clarity sake these costs described were what the insurance was billed.

  20. Paul C. Schulte

    I worked for a company were we compared competing health insurance policies every year. And they were in competition for our business.
    ====================
    It would not take me long to ascertain why you used past tense (“worked“).

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