Man With Health Insurance Charged $109k After Heart Attack

Even with Health insurance nobody is safe it seems.

This month, the series takes a look at Drew Calver, who was hospitalized last year in Austin, Texas, for a heart attack. His treatment included four stents in his arteries.

Calver has health insurance through a teaching job, which covered about $55,000 of the bill. But a month after his treatment, Calver received a bill for nearly $109,000.

He and his wife Erin were confused and frustrated by the medical bills at a time when Calver needed to be concentrating on his health.

Fortunately somebody had a deeper look into this hospitals billing and low and behold, BS:

Dr. Elizabeth Rosenthal, editor-in-chief of Kaiser Health News, explains that the prices hospitals charge are "kind of arbitrary."

"They can be anything. They pull them out of thin air," she told "CBS This Morning." "I have to say I looked at this bill and the prices for every line-item were just exorbitant. $200 for a blood test. $20,000 for one single stent. We looked into that and those stents probably cost $1,000, so there's mark-up on everything."

It's important to keep in mind that Calver had insurance, too, Rosenthal points out. However, because the hospital where he was treated was out-of-network, he was subject to what's referred to as "surprise billing" in which normal insurance protections don't apply.

Source

Another issue cited.... this situation in American medicine in which the hospital and insurer disagree on a price and the patient gets left holding the bag for the difference. That's ol' fashioned freemarket haggling for ya I guess? Secular talk did a fantastic video on this (well not fantastic, but great exposure):



But hey... heyyy..... at least health insurers can sell across statelines now right? Thanks to the administration? America's health system in action once again.

thanks Obama

originally posted by: notsure1
thanks Obama

More like damn you Obama.

a reply to: Southern Guardian

Republicans keep bringing this up, Democrats don't want to hear it. Hospitals charge whatever they feel like charging and you won't know until after the procedure.

It's like going to a restaurant and every restaurant refuses to give prices and they vary day to day and customer to customer.

Just an FYI St. David's Medical Centre, the hospital in question base in Austin TX falls under a Healthcare is a subsidiary of HCA Healthcare, Inc., a for-profit corporate behemoth owning and operating hospitals and healthcare facilities across the country.

a reply to: OccamsRazor04

Republicans keep bringing this up, Democrats don't want to hear it. Hospitals charge whatever they feel like charging and you won't know until after the procedure.

And what have Republicans proposed? Share with us here.

I believe it, and dont even think the hospital was at wrong, the health system is...

I had dental surgery a few months back, I also have health insurance BCBS, now I pay 1600 about every month for that, and I still had to pay 1100 bucks for 4 teeth to be surgically removed... Since they were below the gumline.

Looks like the next place needing disruption, is the medical industries ledgers...

The system is increasingly evolving into a " keep them busy " mentality, busy or barely making it.

a reply to: Southern Guardian

This is what happens when you mandate insurance. Suddenly the hospitals get to hike up prices on anything and everything because they know it's a blank check handed to them by insurance companies.

Essentially it was the income tax 2.0 which is why there was so much backlash.

a reply to: JinMI

So you're saying it wasn't bad before the mandate? 2010, need I remind you.

I would have to say it's fortunate he has health insurance. There was a time in the past he may not have been able to get the insurance period due to the heart condition. Transparency in hospital procedure and billing procedure should be demanded by the masses.

My wife and I had a child back in 2010 and our insurance that we had for two years canceled our policy citing that the pregnancy was a preexisting condition and we wound up stuck with the bill. I requested a line item bill so i could see what I was paying for. Low and behold there is a line item called "Spontaneous Charge" for the tune of 7000 dollars. I called and asked what was a spontaneous charge and they said its just that a spontaneous charge. I asked them if the could spontaneously take it off my bill and they simply said yes.

Requesting the bill and following up with a phone call save me 7000 dollars of a 12000 dollar bill. That shouldn't have been legal for them to do that because most would set up a payment plan and never question.

There are a few simple steps that could move healthcare reform in the right direction.

Just mandate that anyone or any institution offering medical care will need to publish a price menu. Have them list out all procedures and hourly rates in the open. They can also list all of the charges for materials used.

This pricing information has to exist in their systems or they wouldn't be able to bill anyone. They just need to publish it.

With the simple light of transparency and openness, corruption and price gouging would find it much harder to gain a foothold.

a reply to: Southern Guardian

What are you reminding me of? This happened last year according to the source.

So you're saying

This is essentially attempting to put words in my mouth. Let's stick to the conversation eh?

Interestingly enough there are some surgery centers in Oklahoma that refuse any govt insurance because if they accept it they cannot tell you the price before the procedure and they have limits on negotiation because of some idiotic laws.

By refusing any govt insurance they are able to give you and accurate quote, negotiate for the best possible price so all parties are happy.

Of course I am not sure they could help in this case, but there are so many lobbyist caused bad laws that show both parties in congress are complicit in the fleecing of the american people its always sadly amusing seeing partisans try and lay blame.

a reply to: JinMI

This is essentially attempting to put words in my mouth

How can I put words in your mouth when they're coming out of your mouth? And I quote:

This is what happens when you mandate insurance. Suddenly the hospitals get to hike up prices on anything and everything

Obamacare mandates insurance. Before Obamacare there was no mandate. The mandate came into place 2010. Your blame is solely on the mandate which implies this wasn't an issue before hand.

Stand by what you say.

a reply to: Southern Guardian

i get some of the stuff is expensive. i am not against healthcare professionals making a good salary. i am not against the hospitals making a profit.

its bull# when they charge you $12 for a single tylenol.

they wont let you bring your own and i get that too. they need to make sure you are getting what they say.

but they do not need to tax people like that.

a reply to: Southern Guardian
en.wikipedia.org...


Have a look at the history section.

a reply to: TinySickTears

The larger problem is the monopoly created by the insurance industry and hospitals referred to as "healthcare."

In essence, it's private corporations subsidized by our government 'for your safety.'

a reply to: JinMI

i dont comment on that cause i dont really understand it

i do know that can get a 50 count bottle for 5 bucks so when they charge you 12 bucks for one something is wrong.

12 bucks and it dont even have any codeine in it

a reply to: Southern Guardian

This guy had insurance but it only paid $55,000 out of the total of $164,00. That is almost as bad as the pricing itself. I wonder how much they payed over the last couple of years for that coverage, which turned out to be pretty much useless (for the majority of people that don't have $100,00 just lying around).

It looks like just another bill that will be cleared through bankruptcy. But that probably doesn't even have a feedback loop to the hospital as their profits are so great, they can just write it off from their tax load.

Hmmm, even a better reason to just take a firm grasp of self responsibility and take care of yourself.

a reply to: JinMI

This is how you get Elysium, the Have / Have Not Society.

It's HEALTHCARE and it's unafforadable without paying a company 1 or 2 grand a month, to allow you to then pay STILL whenever you have to goto the doc, and get meds, an any other service, then Dental isnt even covered there...

It's a scam, I can't stop that South Park music from the Cash For Gold episode when I think of this...

Just like how the states don't fix the deer over population problem, don't put fences up, or stop the deer from being hit by cars, yet your insurance rate goes up when you hit one... Wait.. what?!?! SCAM!

We're all just money batteries