TCTI: Too Crazy Too Ignore
 Dave Ross

You better shop around

April 24, 2012 @ 8:47 am

Surgeons are very intelligent people. But there is one question that will stump them every time. "Hey Doc -- what will my operation cost?"

And the latest study shows that the reason they have no idea is that hospitals seem to be making it up as they go along. An example from a new UC San Francisco study of routine emergency appendectomies in California:

A woman goes to a hospital in rural Northern California, it was a small incision, appendix out, she was released the next day; the bill - $1,529. Another woman goes to a hospital near San Francisco -- and she also had cancer, but she was there just to have her appendix out -- same small incision, released after one day, HER bill -- $182,955.

Here's Dr. Renees Hsia who helped write the study:

"Hospitals can basically charge whatever they want because there is no guideline or reference. I study this and I'm a physician and I can't figure it out."

CBS's Dr John LaPook has figured it out:

"So you roll into an emergency room, you need your appendix out, how much does it cost? How much you got?"

But Dave you say -- hospitals compete. They advertise all the time -- "Get your surgery done here." Why isn't THAT working?

"Because a patient can't just get up and go down the block and go to another hospital," said LaPook.

Well he could -- if he didn't have a ruptured appendix!

And this doesn't just happen with appendectomies. Other studies show a hysterectomy, gall bladder removal, or a colonoscopy can vary by a factor of 20.

What other industry works like that?

"In the morning she tries to collect the money and says he must pay her $800."

Besides the escort industry in Cartagena?

More Dave Ross

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Comments (7)


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  • Chuck Gould wrote...
    As part of pre-op diagnostics,
    April 24, 2012 8:07 am
    they X-Ray your wallet.

    Health insurance companies root for higher and higher medical bills. They can always raise the premiums to cover their actual costs, but in most states their profits are limited to a percentage of the premiums they collect. (15% or so is common). The higher the cost of medical care, the higher the justifiable premiums to cover it, and the higher the ultimate profit.

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  • ron prevost wrote...
    Hospitals compete - but with insurance, not other hospitals
    April 24, 2012 8:35 am
    And even if they did compete with each other, doctors doing the surgery often work different hospitals, depending. ... A procedure might cost a hospital say $10,000, and if they think your insurance covers it, they may bill $10,000. Or, they may bill as little as what they think you can afford. OR, as hospitals take a lot of losses on emergency treatment (not the welfare cold, but the broken ribs, etc.), they might bill insurance SUBSTANTIALLY higher. And YOU get the surprise if it turns out the insurance DOESN'T pay. .....What this all does to insurance rates, well.......... .......................................................... Oh, and Dave, stop using my Escort Gate material. And don't quit your day job.
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  • mnpat wrote...
    Maybe my insurance is much different then yours
    April 24, 2012 9:14 am
    When the primary care physician or facilities, bills the insurance carrier I have....the insurance adjusts the bill based on what they WILL PAY.....I'm obligated for my share of course but not the amount the insurance company deems is a OVER CHARGE. Of course anything not deemed an emergency....I have always received accurate estimates of the procedure well beforehand. Some of this may take a little effort but that is the way it goes.....as per your example of the two people....I believe there is more to the story then a simple incision.
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  • messiah101 wrote...
    mnpat
    April 24, 2012 7:24 pm
    It must have been minor surgery if the patient was released the next day
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  • rational wrote...
    commonality
    April 24, 2012 9:03 pm
    The common item between the 2 cases...neither patient shopped for better prices because it's all covered by insurance, which the government meddles with. Look at lasik surgury...it's not covered by most insurance and the costs have actually gone down over the years because people shop for best deal (which doesn't always mean best price for the economically challenged) and they do so because the money is coming out of their pockets.

    The insurance issues could all be fixed but neither party is willing to do it.

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  • soo purletiv wrote...
    @ Bill Law
    April 24, 2012 9:32 pm
    Why would you have them cut THAT off? ;-)
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  • SeattleD wrote...
    Bill Law, I won't think you're less of a man because of your sex change
    April 25, 2012 6:40 pm
    because I didn't think you were much of a man before your sex change.
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