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
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. My comment yesterday which was posted before the Justice Stevens dissent re Citizens United seems not to have been approved….???…don’t know, perhaps poster error.

    My main ?? However, was the “Cardiology” bill was over $120,000?…that’s just the cardiologist charges supposedly for diagnosis, placing of stent, and follow up for a few days. Half of the bill. Ok, so they did it twice.

  2. ” Without insurance or government program most Americans would be bankrupted in receiving treatment as our patient has.” And the cost would probably be a whole lot lower. With a guaranteed payer who is not also the consumer, neither the patient nor the provider of services has an incentive to control costs. This leads to the absurd prices which get negotiated down to slightly outrageous, with the difference often ending up as tax deduction or offset (thus acting as a subsidy). For example, I had some sinus surgery several years ago at a private surgical suite. The standard cost for the use of the suite (not including doctors) was supposedly $13,000. The insurance company has negotiated it down to $1250, which included my out of pocket of $250 (and I couldn’t whip the checkbook out fast enough). That means this for-profit facility would still have made a profit on less than 8% of the standard fee. I asked and was told that a walk-in cash patient could probably have gotten it for $2000. That tells me the real fee is closer to $2000, but because of the games that need to be played between insurance and state and Federal regulations we end up with absurd fees and large tax writeoffs. A real free market would help to lower costs.

  3. I had a temp job at a VA pharmacy in 1990. A drum of Tylenol came in, about the size of a 13″ TV, holding 25,000 capsules. The invoice for it was just over $20.00, including shipping. Tylenol is the one doctors use most because it’s cheap- to the doctor.

  4. “. . . corporations have no consciences, no beliefs, no feelings, no thoughts, no desires. Corporations help structure and facilitate the activities of human beings, to be sure, and their ‘personhood’ often serves as a useful legal fiction. But they are not themselves members of “We the People” by whom and for whom our Constitution was established.”
    ~Supreme Court Justice Stevens, January 2010

  5. Huff is but theirs as noted can be verified. Using O’keefe as a reliable source is just false information from a source that has proven he is untrustworthy and will manipulate the facts to fit his thesis rather then attempt to find the truth.
    I don’t know what you mean about the bad blood between t and repub is cause of the voter fraud.


    I can only find right wing articles, or commentary by right wing that allege this voter fraud existed in Franken election.

  6. Paul that link is to such a biased site that it is not a serious or legitimate site or verification.
    The first example they use is of O’Keefe who had provably faked voter fraud in the past.
    “Beyond these issues, the supposed proof of a “dead voter” ploy was already been debunked earlier this week. It turned out that O’Keefe’s video had been edited to remove an interaction between a poll worker and Veritas “investigator” indicating that Michael Bolton — the deceased voter in question — had been survived by his son, Michael Bolton, Jr. In the raw footage, the election official asks if the man asking for the deceased Bolton’s ballot is Michael Bolton, Jr., who is registered at the same address. ”
    This is from Huffpost but is supported by clicks to proof or that can be verified.

    1. leejcaroll – get past the O’Keefe one to the Al Franken one. And HuffPuff is not biased?

  7. Thanks Paul, Looks like true the vote’s complaint is against the republican party not the dems.
    “On June 25, the organization formally requested that MS Republican Party Chairman Joe Nosef delay certification of the election and share voting records for independent review. Finding no assistance from the state party, TTV and the collected 13 plaintiffs were left no option but to pursue the matter in federal court.”If it was the dems doing wrong I would think the Miss repub party would be all about getting out the info rather thenrefusing to abide by the law and disclose the info.

    1. leejcaroll – there is bad blood between the mainstream Republican Party (which is Democrat-lite) and the Tea Party. Hence the voter fraud.

  8. Leej, nothing like attempts at taking away an American’s vote to get Americans motivated to go out and do just that, vote. All these voter suppression laws may backfire on them.

    1. Annie – Arizona has voter ID and it is held not to be voter suppression, although it may be on hold right now since we are in the stupid (most overturned circuit) 9th circuit.

  9. African American turnout may have been higher but there is no study I found (quick look) that gives a reason why. Perhaps it is a benefit in that in seeing that the repubs are working to restrict minority voter turnout the base is responding by seeing that it does make a difference from them to come out and vote. Ironic that that the efforts at suppression may be having the exact opposite response.

    “Strict voter ID laws are absolutely the wrong policy direction for this country. Voter participation rates across all racial, ethnic and socio-economic are dropping each election year. Georgia has seen voter participation rates in the fastest growing ethnic population over the past decade stay flat or decline. As we consider what is best for America, increased voter participation is essential to restoring faith in our democracy and strict voter ID laws that fail to solve any real problems are wrong for America.” http://www.brennancenter.org/blog/analyzing-minority-turnout-after-voter-id

  10. http://politicalcorrection.org/factcheck/201112190005

    MYTH: There Is Widespread Voter Fraud Due To Undocumented Immigrants Voting

    FACT: There Is “Virtually No Evidence” Of Widespread Voter Fraud And Non-Citizen Voting Is Even Rarer

    During An Aggressive Campaign By The Bush Administration To Go After Illegal Voting, “Only 14 Federal Convictions For Voter Fraud Involving Non-Citizens.” From an NPR segment quoting Lorraine Minnite, author of The Myth of Voter Fraud:

    MINNITE: People who are here who are undocumented don’t tend to go around trying to, you know, bring attention to themselves, especially doing something that is illegal.

    PAM FESSLER (NPR REPORTER): She found that there were only 14 federal convictions for voter fraud involving non-citizens from 2002 until 2005, when the Bush administration had an aggressive campaign to go after such crimes. Minnite says often immigrants are confused.

    MINNITE: It was absolutely clear that there were some people who just did not understand that they could not vote. [NPR.org, 11/5/10]

    Brennan Center: The Penalty For Noncitizen Voting “Is So Severe” And The Benefits Are “So Minimal” That “It Makes Sense That Extremely Few Noncitizens Would Attempt To Vote.” According to the Brennan Center for Justice:

    We are not aware of any documented cases in which individual noncitizens have either intentionally registered to vote or voted while knowing that they were ineligible. Given that the penalty (not only criminal prosecution, but deportation) is so severe, and the payoff (one incremental vote) is so minimal for any individual voter, it makes sense that extremely few noncitizens would attempt to vote, knowing that doing so is illegal.

    Once again I google your argument California illegal alien viter fraud and come up with right wing sites. (and 2 on article one person nabbed in Nevada.

    You don’t have to open a bank account. etc. Voting is a fundamental right in this country.

    More specifically, restrictive proposals were more likely to be introduced in states with larger African-American and non-citizen populations and with higher minority turnout in the previous presidential election. These proposals were also more likely to be introduced in states where both minority and low-income turnout had increased in recent elections. A similar picture emerged for the actual passage of these proposals. States in which minority turnout had increased since the previous presidential election were more likely to pass restrictive legislation.


    1. leejcaroll – I do not know how widespread it is, but voter fraud regardless of its scale is always a problem. We do know that it as affect two races in the last couple of years. One, the courts agreed it was fraud and massive, but could not agree to overturn the election. The latest one has massive African-American voting in a Republican district in the primary to select the candidate for the general. One person has admitted he was paid to get out the black vote (registered Democrat) for the one Republican candidate. Most pundits think it was more than enough to sway the election.

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