Price gouging the insured

May 19, 2008 at 12:43 am (Uncategorized)

The United States currently has about 47 million uninsured people.  Every year politicians, social groups, political commentators, ethical theorists, and medical student organizations try to come up with relief to the so-called “problem” by claiming that we need socialized medicine, higher taxes on the wealthy, a reduction in the amount of healthcare that is given, or any number of other scams that closely resemble Canada in price and England in quality. 

My own hospital caters to a large uninsured population.  Every day we provide numerous CT scans, x-rays, surgical procedures, intravenous immunoglobulin, radiation therapy, chemotherapy, and all manners of treatments that are given free of charge to our patients while inching us ever closer to bankruptcy.  Like most places, my hospital has taken to overcharging the insured to make up for the any losses incurred by caring for low-income people.  For example, merely walking in to the gyn emergency room immediately racks up a charge of $1000.  Once the ultrasound and blood tests are ordered, the bill quickly rises from there.  This charge is lobbied against everyone, regardless of their ability to pay.  We know full well that many of our patients—especially the ones seeking pregnancy tests—will never pay the bill.  Therefore, we are forced to charge exorbitant amounts to other people so that their insurance company will cover the difference.

Case in point: let’s consider my hospital’s trauma center.  After a car accident or gunshot, paramedics will quickly mobilize to bring the patient to a trauma center where a team of surgeons will run through the ABC’s of trauma, stabilize the patient, run him to the CT scanner, and take him to surgery if necessary. The cost for the initial evaluation is $29,000.  That price does not include surgery, hospital admission, or any critical care expenses.  Naturally, insurance companies realize what a scam this is and will only pay half of the price.  The patient is then left with a bill for $15,000—an impossible sum for most Americans.  The end result—even for an insured patient—is that the bill is left unpaid.  My hospital has become so fed up with not receiving reimbursements for its services that it immediately sends its bills to a collection agency without bothering to contact the patient for payment.  The hospital tries to explain its actions of double charging the insured by stating that it needs a method to cover the expenses of the poor.  I call this practice something else: price gouging.

In most states charging double for a good or service is illegal.  I would love to see an investigation into the practice of overcharging the insured.  Most consumers would be ashamed if they knew what healthcare really cost.