Why are emergency room visits so expensive?


#1

When I first found out I was pregnant, it was a late Friday afternoon and my primary asked me to go to the ER for a blood test confirmation and ultrasound, due to spotting and cramping in previous days.

So, they took some blood and gave me an ultrasound.

The bill was $2500. I’ve been to the ER for numerous things and know that it’s usally around 2-2500 for simple things.

Insurance covers all but $300, but why is it so expensive in the first place?

I’ve had blood drawn several times since then for the pregnancy and two more ultrasounds, and I’m only 13.5 weeks. Yet my doctors bills aren’t 2500…

What’s the deal?


#2

First of all, it is a hospital. Hospitals are notoriously expensive, e.g. ten dollars for an aspirin.

Secondly, many uninsured go to emergency departments. Some hospitals are dedicated to not turning the under- or uninsured away. In effect, you end up paying for them.


#3

Oh, my gosh. I wish I knew. I had to go to the ER last year around this time. I have colitis, but they didn’t know it then. They gave me some painkillers and did a CT scan. Then they did another one because they did the first one wrong. Our insurance is fantastic and we only ended up paying $100 out of the $3,000 bill, but when I saw that total on the bill I was still like, holy smokes. :eek:


#4

Ouch! that is $$$$$$$$

Yikes - am I glad I live in Canada. We have medical covered. Then our work insurance covers drugs, dentist, glasses, …


#5

[quote=Princess_Abby]When I first found out I was pregnant, it was a late Friday afternoon and my primary asked me to go to the ER for a blood test confirmation and ultrasound, due to spotting and cramping in previous days.

So, they took some blood and gave me an ultrasound.

The bill was $2500. I’ve been to the ER for numerous things and know that it’s usally around 2-2500 for simple things.

Insurance covers all but $300, but why is it so expensive in the first place?

I’ve had blood drawn several times since then for the pregnancy and two more ultrasounds, and I’m only 13.5 weeks. Yet my doctors bills aren’t 2500…

What’s the deal?
[/quote]

**Abby hope this finds you both in good health. I am a little confused why the DR sent you to the ER and I pray it is not because of problems.
This said the ER is always the most expensive way to be treated for any situation. As another poster stated they recoup money not collected from under/uninsured.
In fact here in the lower 50 the DR’s and hospitals are required to charge everyone the exact same price and there federal reimbursement is based on this.
So to get $10 back from the feds they have to charge $100 for the same service to everyone else. DR’s and hospitals had at one time sliding fees. This practice is now illegal. Many DR’s are no longer accepting patients with federal coverage because of these rules. Mine is one of them as well as some of the childrens DR’s in the area.
**


#6

It’s the ugly side of capitalistic health care.

True Emergency service is not price sensitive. Who is going to shop arund when they need emergency care? Nobody.

In short, they charge an arm and a leg because they CAN!


#7

I am going to go right to the core…and forget about being politically correct.
The previous posters are right on. You are not paying directly to a doctor for his/her services. Back in your parents or grandparents days people would pay the doctors directly and the amount paid was very reasonable. Then along came the sharks…I’m sorry…I mean the lawyers and the “victims”. They decided that they could make a lot of money for themselves and the so-called victims by suing until the doctors were forced to join a payment plan that would involve lots and lots of clerical workers and the big honcho called the hospital administrator. The administrator doesn’t have to know a thing about medicine but he/she is the one making the big bucks and deciding how the doctors should run their “businesses”. Then, the government also likes to force the hospitals to accept “all” patients whether they can pay or not. This may sound like a holy Christian thing to do but it also means that insurance companies must charge a lot more to pay for all the additional paper work. More often than not, the doctors are left holding the bag. they are “timed” each time they see a patient and are penalized if they spend too much time with them. The sad truth is that the children of doctors are not going into the medical profession the way family members used to in the past. The “smart” students are being told that medicine is no longer worth all the hard work, expensive schooling, and time required to become physicians. Doctors are being sued at such a high rate for “mistakes” (but usually for conditions that they could not control) that they are forced to quit before they have a nervous break down. After physicians pay for their malpractice insurance they barely have enough to pay back for their schooling and put a roof over their heads. In the San Francisco Bay area doctors can not afford to buy a house and are not willing to move from other parts of the USA where they might at least be able to buy a house. I could go on and on but I have to get back to my work.


#8

[quote=KathleenElsie]**Abby hope this finds you both in good health. I am a little confused why the DR sent you to the ER and I pray it is not because of problems.
This said the ER is always the most expensive way to be treated for any situation. As another poster stated they recoup money not collected from under/uninsured.
In fact here in the lower 50 the DR’s and hospitals are required to charge everyone the exact same price and there federal reimbursement is based on this.
So to get $10 back from the feds they have to charge $100 for the same service to everyone else. DR’s and hospitals had at one time sliding fees. This practice is now illegal. Many DR’s are no longer accepting patients with federal coverage because of these rules. Mine is one of them as well as some of the childrens DR’s in the area.
**
[/quote]

Hi KE!

Yes, everything seems fine now and that was weeks ago.

I took the pregnancy test around 3:30 or 4pm on a Friday afternoon. My mother, who is very good friends with my primary doctor, told me to call her immediately because I mentioned to her that I had experienced cramping and spotting over the last several weeks. She was worried I might have an ectopic pregnancy or the baby might be in some danger. So, she sent me to the ER for confirmation and to check on the little one. :slight_smile: I don’t think most primary doctors have ultrasound equipment… and we had just moved here and I didn’t have an OB yet. She didn’t want me to wait the entire weekend before being seen by either her or an OB she reccommended. I ended up needing a perinatologist anyway.


#9

The uninsured pay the whopping rates, IF they can. The insured have their negotiated prices that the insurance company pays. Part of the problem is that hospitals have to have everything, even though the hospital 20 minutes away also has everything. All those machines are expensive. Also, paying for the people who don’t pay is expensive, and my local hospitals have signs in the lobby saying the hospitals are required by law to offer emergency, pregnancy, etc. care no matter who you are (say, an illegal alien).

Princess_Abbey,

You might want to locate an outpatient version of your hospital. Many hospitals have an outpatient building on the other side of town from the hospital. Then you can get your blood drawn for a reasonable price. Yes, they are walk-in. Sometimes they are called, uh, urgent care centers. They probably would not have an ultra-sound, though. They will divert you to the real emergency room if it is warranted.


#10

I feel the pinch when it comes to hearing the American story of health care. If only the US had a sister system to what Canada provides. Canada delivers equal health care to every citizen, no matter what their social status or income level. And we never get a bill. It is all paid for with tax dollars, 100% government funded.

Of course, things like cosmetic surgery are not covered, but if a woman who wants a breast reduction can prove it will alleviate back pain, then that is covered, too.

To take an in- town ambulance ride in BC only costs the patient $53. The rest is covered under medical.

Even though I often complain about our government’s immorality, (same sex marriage) there is still much to be thankful for, living in Canada.


#11

just a side note for you and all other pregnant moms

when you have your baby request a line item bill afterwards and double check everything. they often charge you for items you didn’t get


#12

If the USA is going to have socialized medicine then it is only fair to have socialized lawyers. It is the lawyers who are making it difficult for the doctors. I will be catching a cold in purgatory when the lawyers start to get a taste of the medicine they are giving the doctors. As long as lawyers have control of Congress they will never let America treat them the way they are treating the doctors.
Once we have socialized medicine and law services then I think it is only fair to have socialized housing just like they had in Russia. Yes, I have my tongue in my cheek. Socializing America is a scarey thought!


#13

[quote=paramedicgirl]I feel the pinch when it comes to hearing the American story of health care. If only the US had a sister system to what Canada provides. Canada delivers equal health care to every citizen, no matter what their social status or income level. And we never get a bill. It is all paid for with tax dollars, 100% government funded.

Of course, things like cosmetic surgery are not covered, but if a woman who wants a breast reduction can prove it will alleviate back pain, then that is covered, too.

To take an in- town ambulance ride in BC only costs the patient $53. The rest is covered under medical.

Even though I often complain about our government’s immorality, (same sex marriage) there is still much to be thankful for, living in Canada.
[/quote]

I have had an experience with Canadian health care and darn near died. If I had not been medically savvy (hospital adm) I surely would have. And as for it being FREE—PULEEASE! Yes, the government pay, but YOU are the government and the taxes there are awful. Further, I had good insurance while we lived there (in the States, of course) and they paid my bill anyway. Doesn’t make much sense to me.


#14

[quote=manualman]It’s the ugly side of capitalistic health care.

True Emergency service is not price sensitive. Who is going to shop arund when they need emergency care? Nobody.

In short, they charge an arm and a leg because they CAN!
[/quote]

They also charge an arm and a leg to pay for the many people who get treated there without insurance or any way to pay. Many of them come in for colds, etc. That is not what an ER is for.


#15

there are two reasons I can think of off hand. One is the fact that doctors get sued constantly, and sometimes that is necessary (the lawsuit) sometimes it isn’t…I work for Radiologists…and I have seen some really silly lawsuits. For instance a hairline fracture, hardly anything you can do for it, but the pt. goes in the e.r. for x-rays…it is missed (it happens…it is incredible how many films a doc. sees during a busy night) Pt. is sent home…still having pain so he goes to an orthopedic doc…who takes out the x-ray and looks at it with a magnifying glass…finds the fracture…reports to the patient…Boom…lawsuit.

This raises the cost of the insurance that doctors pay to help with the cost of paying off the lawsuit…and I was told that here in KY. a Rad. will pay $60,000 a year for insurance. It’s probably more in other states. Try to convince a doctor he should eat the cost…it ain’t happening.

As far as the hospital I work for…it is a not for profit organization…they cant make a profit or they loose this statis…which is apparently really important for tax purposes…because every year if the hospital makes any profit we (the workers) get profit sharing checks. Not for profit also cannot turn anyone away, and so You…the insured…are paying for the uninsured.


#16

[quote=mary bobo]I have had an experience with Canadian health care and darn near died. If I had not been medically savvy (hospital adm) I surely would have. And as for it being FREE—PULEEASE! Yes, the government pay, but YOU are the government and the taxes there are awful. Further, I had good insurance while we lived there (in the States, of course) and they paid my bill anyway. Doesn’t make much sense to me.
[/quote]

Health care is free, though Canadians pay a stipend to the medical system. For our family, we pay $800 a year, based on our income. For a college student, they pay around $80 a year. Compare that to what US citizens pay for medical procedures. And yes, we pay taxes, but so does everyone. It is a good use of tax dollars, don’t you agree?

It’s true Canada has higher taxes than the US, but we have also consistently been rated the best country in the world in which to live. Also our wages are comparatively higher and that offsets the taxes.

As for your experience with the hospital you went to, that can and does happen anywhere in the world. Yours was an unfortunate experience, absolutely, but the same thing happens every day in your own country.


#17

[quote=onetruechurch]I am going to go right to the core…and forget about being politically correct.
The previous posters are right on. You are not paying directly to a doctor for his/her services. Back in your parents or grandparents days people would pay the doctors directly and the amount paid was very reasonable. Then along came the sharks…I’m sorry…I mean the lawyers and the “victims”. They decided that they could make a lot of money for themselves and the so-called victims by suing until the doctors were forced to join a payment plan that would involve lots and lots of clerical workers and the big honcho called the hospital administrator. The administrator doesn’t have to know a thing about medicine but he/she is the one making the big bucks and deciding how the doctors should run their “businesses”. Then, the government also likes to force the hospitals to accept “all” patients whether they can pay or not. This may sound like a holy Christian thing to do but it also means that insurance companies must charge a lot more to pay for all the additional paper work. More often than not, the doctors are left holding the bag. they are “timed” each time they see a patient and are penalized if they spend too much time with them. The sad truth is that the children of doctors are not going into the medical profession the way family members used to in the past. The “smart” students are being told that medicine is no longer worth all the hard work, expensive schooling, and time required to become physicians. Doctors are being sued at such a high rate for “mistakes” (but usually for conditions that they could not control) that they are forced to quit before they have a nervous break down. After physicians pay for their malpractice insurance they barely have enough to pay back for their schooling and put a roof over their heads. In the San Francisco Bay area doctors can not afford to buy a house and are not willing to move from other parts of the USA where they might at least be able to buy a house. I could go on and on but I have to get back to my work.
[/quote]

DRs are saddled with way tooooo much debt and the returns for those that take care for the general population is low. In some cases the union garbage men make more then the DRs in an HMO or PPC. (don’t yell at me the garbage men/women earn every penny)

Law suits and the insurance to pay for the claims even those that have no valid basis is a major reason for the price of health care. This is why “tort” laws and the amounts given to “punish” the bad DRs backfires on us all. We all pay for this in the long and short run.


#18

[quote=onetruechurch]If the USA is going to have socialized medicine then it is only fair to have socialized lawyers. It is the lawyers who are making it difficult for the doctors. I will be catching a cold in purgatory when the lawyers start to get a taste of the medicine they are giving the doctors. As long as lawyers have control of Congress they will never let America treat them the way they are treating the doctors.
Once we have socialized medicine and law services then I think it is only fair to have socialized housing just like they had in Russia. Yes, I have my tongue in my cheek. Socializing America is a scarey thought!
[/quote]

He he he…my brother who lives (and saps off the gov’t) in Germany always says such things…having survived Britain’s healthcare system for 3 yrs, I would much rather pay good money for good healthcare – just my experience – not everyone’s I’m sure, and I mean no disrespect, but I was horrified by the hospitals there – stacks and stacks of old papers and files, the braun ear thermometer was a “newfangled gadget” the nurses didn’t know how to work (I offered to lend her mine…lol) – it went on and on…


#19

[quote=paramedicgirl]Health care is free, though Canadians pay a stipend to the medical system. For our family, we pay $800 a year, based on our income. For a college student, they pay around $80 a year. Compare that to what US citizens pay for medical procedures. And yes, we pay taxes, but so does everyone. It is a good use of tax dollars, don’t you agree?
[/quote]

I pay less than that for my insurance…I am lucky. The REAL reason that Canadians get universal health coverage is because they don’t have to support a superpower army…Remember…if Canada were to be attacked…America will protect her. If we stopped policing the world…we might be able to afford universal health coverage, but that’s a different thread

[quote=Paramedicgirl]It’s true Canada has higher taxes than the US, but we have also consistently been rated the best country in the world in which to live. Also our wages are comparatively higher and that offsets the taxes.
[/quote]

Hmmmm…don’t really know what to say here. I have never seen these statistics. I always heard Norway or Sweden were rated top. Personally…Australia seems pretty nice to me…but I don’t go for the cold climates…

[quote=Paramedicgirl]As for your experience with the hospital you went to, that can and does happen anywhere in the world. Yours was an unfortunate experience, absolutely, but the same thing happens every day in your own country.
[/quote]

True. It could happen anywhere…But I like the fact that I can doctor shop…without any restrictions…go all the way across country to the best if I like. As I understand it you do not have that freedom.


#20

My health plan distinquishes between emergency care and urgent care. Some people use an emergency room for things that aren’t emergencies.

**. What do you consider emergency care?
**A. An emergency is the sudden an unexpected onset of conditions that a prudent layperson, who possesses average knowledge of health and medicine, could reasonably expect the absence of medical attention to result in serious jeopardy to the Member’s health. Such emergencies include, but are not limited to, heart attack, stroke, severe shortness of breath, or significant blood loss.

Q. What do you consider urgent care?
A. Urgent care is care you need sooner than a routine doctor’s visit. Urgent care is not emergency care. Examples of urgent care include: broken bones, sprains, minor cuts, minor burns, drug reactions and non-severe bleeding.


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