The Cluttered Mind Uncluttered

Ph.D., Psychology, author, speaker, consultant

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Our 5-Hour, $10,000 Visit to the ER

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Back in August, while on vacation in Idaho, my wife began to experience some stomach pain., but didn’t think much of it. But, on our drive home around 9 pm as we neared Reno, the pain became intolerable. I called 911 and was directed to the emergency room of the Northern Nevada Hospital in Sparks.

As we entered the ER, I was first struck by how the stereotypes of an ER on a weekend night were confirmed. Literally all of the visitors were, based on appearances, old, poor, obese, under the influence, or all of the above (I say this as an observation, not a judgment). Once we got my wife checked in, despite being in considerable pain, she had to wait almost an hour to see a nurse. She was then admitted and waited in a room for another hour before a physician came in to examine her.

Once the doctor completed the exam, if you call it that because it lasted perhaps two minutes and there was no actual physical examination, my wife was told that she would have a series of tests done including a CT scan. She then waited another hour and a half for the tests to be started and another hour and a half before the physician gave her a diagnosis. Thankfully, the cause of my wife’s pain wasn’t serious and we were sent on our way at 2 am, 5 hours after we arrived (in the meantime, I stayed in our car in the parking lot with our two young daughters while they tried to sleep).

We have followed the health care debate over the few years and, as a result, know that ER visits are expensive, so we figured my wife’s visit would cost, oh, $2,000 or so. Well folks, we “misunderestimated” the cost by a factor of five. I just received the bill from our insurance company and the grand total was $10, 203 (or about $2,000 an hour). I called the hospital and received an itemized statement. Most of what was done was incomprehensible to me (I’m not that kind of doc!): CMP Pane ($510), Level 4 ($715), but an Internet search helped explain things a bit.

But, not surprisingly, the “bill killer” was an abdominal CT scan which ran a tidy $7525! I did a little research on line and found that a typical range for this type of CT scan runs the gamut from a national minimum of $1600 in Jonesboro, Arkansas to a national average of $2175 to a national maximum of $8,200 in Ketchikan, Alaska. I can understand why a CT scan would cost so much in rural Alaska, but can someone tell me why one in Sparks, Nevada would cost $7525?

Well, I called and asked the billing department at the Northern Nevada Hospital that very same question and was told that the bill was so high because the hospital doesn’t specialize in CT scans. Huh? You’re a hospital, you have a CT scan machine, you have technicians to administer the scan, you have radiologists to read the results, and I assume you do a lot of CT scans. How does that not make you a specialist? How does that justify charging three to five times the normal rate for CT scans and almost as much as one in a remote part of Alaska?

Now let me digress and put this experience in the perspective of health-care costs and health insurance in America today. I work for myself, so I buy health insurance for our family. Though we would love to have a so-called Cadillac plan in which everything is cover from the get-go, the premiums for a self-employed family makes your head spin. We chose a lower-premium, high-deductible plan with a Health Savings Account that costs us around $7,000 a year in premiums (our premium has more than doubled in recent years), that’s about half of what most families pay for coverage. At the beginning of each year, I deposit the allowed amount of pre-tax dollars (around $6,000) in our HSA and use that money to pay for medical expenses that arise up to our $9,000 deductible limit. This coverage has worked well for us because we are all healthy and, most years, don’t even come close to maxing out the deductible.

We are certainly grateful that there was a hospital nearby in the event that my wife’s pain was serious. And the care she received appeared to be perfectly adequate (though the bedside manners of the hospital staff needed some work). And, thankfully, due to some minor surgery my wife had earlier this year plus the usual medical expenses any family incurs, we won’t have to pay the $10,000 ER bill (at least not directly because we all pay for medical care with increased premiums).

On the drive home after leaving the hospital, my wife and I reflected on the experience and felt fortunate that, whatever the cost, we have the resources available for such emergencies. But, when we received the ER bill, we had a decidedly different reaction. We were appalled that there are many families in America for whom such a visit to the ER would drive them to bankruptcy, homelessness, and destitution.

It’s easy, when you have a degree of financial security, to have a real disconnect from the financial challenges that so many Americans face today. It’s also easy, in the partitioned society that America has become, to simply lose touch with the lives and experiences of those different from our own. Yet, our ER experience brought those challenges into sharp relief for me and the impression wasn’t pleasant.

It showed me the plain callousness of a country so supposedly principled that doesn’t provide such a basic right as health care for all of its citizens. I realized the absurdity of how much health care costs in America when other countries provide universal care at much less cost with far better outcomes.

It demonstrated to me the tragedy of so many good people who, out of no fault of their own, are suffering for a lack of such a fundamental right. And, as the father of two girls, it pains me to think of the millions of children who don’t have their most basic needs to live a healthy life  met: proper nutrition, a safe home, a decent education, and, yes, health care.

This wantonly neglectful treatment of so many Americans is an outrage and it is mystifying to me that it isn’t expressed by more people, particularly by our elected officials (actually, I’m not surprised by our elected officials’ indifference). How can this inaction be justified in any moral world?

And I came to these conclusions by simply visiting an ER in Sparks, Nevada, late on a Saturday night.

Categories: Politics
Dr. Jim Taylor

7 Responses

  1. Wendy says:

    My mother spent years in and out of the hopital. one week stays costed her and insurance well over 25k without even a surgery involved. Just scans and ekg’s, bed, saline treatment and the drugs. She had COPD and heart failure. Although medicare mostly paid she had deductibles and we always questioned the bill no matter what she had to pay that deductible but she was pissed the insurance medicare would pay a bill at 25k for a week in the hopsital when she didn’t get 25k worth of services. Scans do not cost that much especially not in inner city hospitals where they do specialize in it. It is disgusting what we pay but in the end we are actually paying for those who dont and cant pay. For the state plans that take a year to make the payment. My insurance plan isn’t the best but i pay not to much out of pocket but regardless i pay what i have to i still do not want my insurance company over charged just gives them more reasons to raise my rates next year.

  2. Moe says:

    I think this is typical of what “insured” Americans experience. It’s outrageous and I share your feelings about why more citizens aren’t more outraged by the discrepancies & staggering high cost of healthcare. I requested and itemized bill after hip replacement surgery & was shocked @what they charged: $810 for ‘self administered’ drugs. When I questioned what that meant they replied that when the nurse brought me my meds in a cup to take, that’s considered ‘self administering’! WHAT! Are you kidding me?! Also, $40 PER PILL -minimum. It disgusts me. .

  3. lck says:

    I’m surprised that you’re surprised, health care is outrageously expensive and ER care is the most expensive.

  4. mmmbbbggg says:

    We had a similar experience – my husband was in the ER for 3 hours for an irregular heartbeat. He didn’t even have any CT scans or MRI’s, and the bill hospital bill alone was $4,668.40. Since that doesn’t include the labs or the doctor bill, essentially he was rented the bed for $1,500 an hour.
    We don’t have insurance. After several years of paying in excess of $7,000 a year in premiums – and NEVER NEEDING SERVICES – I lost my insurance before I lost my job in 2011. One phone call to the hospital billing department and they reduced the bill to $400 if I could pay the bill in 10 days. And the real b*tch about it is if I was still insured I would be liable for the $2,500 deductible. The $1,432.00 doctor bill was also reduced by 90%, once they had proof that the hospital discounted theirs.

  5. Christopher says:

    Most of the time, if you don’t have insurance, the ER is free or basically free (the hospital asks you what you “can pay” and writes off the rest), especially if you’re illegal. A lot of ER goers have medicaid. That’s why most of the people there are obese, or poor, too obese and poor to work, or they drink so much they can’t hold or find a job etc. They had headache and wanted aspirin, they had a cough or a runny nose, they show up to the ER. Why not, they’re not paying for it. This is why it’s so expensive for you, the hospital charges the people who can pay more to cover the costs of the people who’s lives are too screwed up to pay. Unfortunately this has led to an explosion in healthcare costs and illegal immigrants! The affordable care act will put this situation on steroids as now illegals are the only NOT required to have insurance/taxed if they don’t. Derp. What a great life that’ll be. The best part is, if cops ever stop you for documents, you can give them the finger.

  6. donna says:

    Another reason the bill was so high is cost sharing. Most of the people in the ER waiting room probably had no insurance. So to pay for their healthcare the hospital adds a little more onto yours! Most likely you will see another increase in your insurance rates soon because in order to pay for the Obama care mandates your insurance company needs to raise your rates. Under Obama care your HSA is going to mostly like go away. How about those pre-existing conditions…sure the insurance company has to take you but Obama care doesn’t regulate what they will charge you.

  7. db says:

    The health care in America is barbaric (spelling?) to say the least. America has lost it’s standards and values. The government knows what we need, however, that is like talking to an empty chair! We are doomed!