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Reddit User Posts $55,000 Hospital Bill for Appendectomy
ABC News
By SYDNEY LUPKIN | ABC News – Jan 1, 2014


When a 20-year-old man got over the pain of having his burst appendix removed in October, he got hit with a hospital bill he wasn't expecting.

The bill from Sutter General Hospital in Sacramento, Calif., said the total charges were $55,029.31 but that the patient owed only $11,119.23 because his insurance had covered the rest.

Shocked, the patient took to Reddit to post the bill and vent his frustrations.
"I never truly understood how much health care in the U.S. costs until I got appendicitis in October," he wrote on the social media site. "I'm a 20-year-old guy. Thought other people should see this to get a real idea of how much an unpreventable illness costs in the U.S."
The recovery room alone cost $7,501.00, which the man said was surprising because he spent only two hours in there. The surgery cost $16,277. "I think you can see how outrageous some of these costs are," he wrote.

But the bill was not so unusual, given recent studies that showed how the cost of medical procedures could vary from hospital to hospital, said Timothy McBride, a professor and health policy analyst at Washington University in St. Louis.

In April, University of California San Francisco researchers set out to find out how much an appendectomy cost among 19,000 patients in California. An appendectomy varied in price from $1,529 to $182,955, the researchers wrote in the study published in the journal Archives of Internal Medicine.

"For some reasons that are probably quite legitimate, they pad these prices to cover what economists might call fixed costs," McBride said. These include such items as uncompensated care and staff costs, he said. Hospital prices can therefore vary depending on whether the hospital is a teaching hospital, sees more patients with chronic disease or offers only basic care. As a result, patients shouldn't be afraid to ask questions, and -- if necessary -- ask for a price reduction, McBride said.
"It's kind of like an opening bid if you went into an auto store," McBride said of hospital billing. "Very few people now pay the sticker price."

Sutter General Hospital spokeswoman Nancy Turner said hospital billing is complicated, and that the hospital has people available to help patients navigate it. She said hospitals often serve many patients who don't pay at all or don't pay the actual cost of treatment because they are on Medicare or Medi-Cal, California's version of Medicaid.

"Sutter Health agrees that an improved billing structure is needed, where published charges are more closely aligned with actual costs," Turner said. "And a more straightforward pricing system is only possible when reimbursement from government-sponsored patients covers actual costs."

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Snakebite victim charged $89,000 for 18-hour hospital stay
Dylan Stableford, Yahoo News By Dylan Stableford, Yahoo News
January 27, 2014

A snakebite victim who was treated at a North Carolina hospital came away with more than just fang marks when he received an $89,227 bill for an 18-hour stay.

Eric Ferguson, 54, from Mooresville, N.C., was taking out the trash at his home last August when he was bitten on the foot by a snake. He drove himself to Lake Norman Regional Medical Center, where he was treated with anti-venom medicine.

According to his bill, the hospital charged $81,000 for a four-vial dose of the medication.

Shocked at the price tag, Ferguson told the Charlotte Observer he and his wife found the same vials online for retail prices as low as $750.

Ferguson, who is insured, said his care was "beyond phenomenal."

"It was just the sticker shock," he said.

Because the hospital has a contract with Ferguson's insurer, Blue Cross and Blue Shield, it reduced the total bill to $20,227. According to the Observer, the couple paid $5,400 out of pocket to cover their deductible and co-pay.

The hospital defended its prices, saying it has to charge prices higher than retail because of the various discounts it is required to give insurers.

"We are required to give Medicare one level of discount from list price, Medicaid another, and private insurers negotiate for still others," officials told the newspaper. "If we did not start with the list prices we have, we would not end up with enough revenue to remain in operation."

The hospital added: "Our costs for providing uncompensated care are partially covered by higher bills for other patients."

The Fergusons' case is, of course, not unique. A 2013 cover story by Steven Brill in Time magazine ("Why Medical Bills Are Killing Us") detailed the "outrageous pricing and egregious profits" destroying the U.S. health care system, noting that Americans were expected to spend an estimated $2.8 trillion on health care last year.