One evening in May, while I was watching (and being put to sleep by) a Mets game, my girlfriend developed sharp, debilitating pains so severe that we had to take her to the emergency room. My girlfriend is prone to urinary tract infections, and we thought that’s what this was.
We arrived at Hoboken University Medical Center at 9:00 pm and waited behind three sets of people. The first had a headache and was given what I can only assume to be Ibuprofen and sent home. The next was told she had a stomach bug. She was out in ten minutes. The third, we later learned was addicted to pain killers and would in a rather uncreative and unconvincing manner, conjure new ailments every so often while subtly suggesting to the doctor what type of medication he thought would work best to treat him.
When we were finally seen by a doctor, she assured us that she would get to the root of the problem and a bombardment of tests were run. Some of these tests, I’m sure, were to make sure that it was, as we suggested, a urinary tract infection. It turned out that we were right and she was given strong antibiotics through an IV.
It was now close to midnight, I heard the Mets were losing 8-0, we had diagnosed the problem and I assumed after she was done with the IV they would prescribe some more antibiotics and we would be on our way, we were not.
The doctor recommended a CT scan and a few more IV treatments. They brought us to a room where we stayed until 4 am. Now, when I hear from a doctor that it’s time for a CT scan, I go along with it because I’m suddenly concerned there is a serious health problem at hand. I don’t think about cost. I should have.
Last week, my girlfriend received a bill for her seven-hour stay at the hospital. The total bill for the short stay was $16,448.40 – the cost of a 2012 Ford Fiesta. It was adjusted down to $12,724.21, 80 percent of which was picked up by Aetna (but only because she is 25 and still on her mother’s employer-sponsored coverage). My girlfriend owes the hospital $2,901.77. Her first monthly payment begins in August.
Before the provision in PPACA passed that allows grown children to stay on their parents plan until they are 26, she was on COBRA, where her mother paid $365 a month for 18 months before COBRA was exhausted. My girlfriend is finishing up two prerequisite courses before she plans on attending medical school and her employer does not offer coverage.
Now, it is obvious that the problem here is the extreme cost of the care itself. I’m sure that the hospital would say that the prices are meant to compensate for people with no insurance who use the ER as a primary care physician (the ER charges alone were $9,146.00). My girlfriend would have been one of those people, pushing the cost for everyone else up, was it not for PPACA.
The carriers are not to blame here. I am sure that Aetna was not happy to pay the $12,724. The problem is the cost. The CT scan charge alone was $3,814. What is it running on, liquid gold? I would love to see the itemized break-down of why it cost almost $10,000 just for my girlfriend to be prescribed some antibiotics. Had this happened at nine in the morning rather than nine at night it would have been handled by her primary care physician very easily, and for a fraction of the cost.
So, is there no solution to this outrageous pricing just as there is no solution to why the Mets are horrible? I don’t know which problem is more difficult to fix. What if the carriers took a page from Major League Baseball and entered into some type of collective bargaining with hospitals? I am not suggesting a strike similar to 1994 when droves of fans spent the summer watching minor league games. I am suggesting a cohesive and stern approach that lets hospitals know that these prices are unsustainable for the carriers and the patients. What about a medical loss ratio for hospitals that throttles the cost of medical care to a certain percentage over the cost to provide said care?
These are just ideas from an exhausted baseball fan in the middle of summer but these prices, they will continue to exhaust carriers and patients throughout the year and for years to come if a change does not take place.