I'm involved in a minor financial battle with a hospital where I stayed overnight back in July. Being what's called technically an "observation" admission, my Medicare covered everything but "self administrable" medications. Why the distinction is anybody's guess. These are meds you normally take at home, but in the hospital they're provided for you and you're never given the option to bring them from home, and I don't even know if hospital policy allows it.
In any case, while I was in the hospital a nice lady from the business office came by and briefly mentioned the charge along with other details. I was feeling fine and everything was hunky-dory.
Three months later I got my bill for $200 for the one day supply of my meds. I take a few, and one expensive one, but nothing even close to that price. So I wrote back that I thought the charge was unreasonable and requested an adjustment. I recently got back an itemized bill listing the individual meds and the charges and sure enough they were all anywhere from 5 to more than 20 times their out of pocket cost from the pharmacy, that is, not the discounted cost that the hospital would pay. I won't go into the details, but for example 1 baby aspirin for $5.50.
So it brings up the whole subject of medical prices which is a great mystery, since no one pays for anything directly. We get letters from Medicare monthly in 20 different languages explaining the unexplainable, what the charges are, what Medicare approves, and what we may be responsible for, which is of course the only thing we're interested in. But that leaves out the secondary coverage which adds to the mystery.
At least now I have the actual charges detailed, after the fact of course which is a bizarre aspect of the whole transaction. I mean how many restaurants do you go into without prices listed on the menu and you find out when the bill comes. If you're in the rare one with no prices, you shouldn't be unless you are a multi-millionaire or a Washington politician.
So I wrote them back, thanked them for their service, which was good by the way, but still contended that the $5.50 baby aspirin, etc. was pretty absurd and I still want an adjustment. After all, I could just as well have brought in my pills from home and taken them with no problem.
Hospitals are a particularly byzantine component of the high cost of medical care. The ins and outs of the finances of these "non-profit" institutions is a great mystery, even for someone who worked in them for many years. It's true that they must write off a lot of services that they're obliged to do because they get federal financing. So they shift the cost to other payers, and that's where things get really complicated. But the bottom line is that they're a big player in the medical care cost picture. These "non-profit" institutions pay their CEO's big salaries, are presently in the process of buying up doctor practices wholesale, and are a bright spot in our somewhat shoddy infrastructure picture in that they seem to have the dough to build shiny new high tech buildings all over the place.
If you think handing over medical payments to the government would solve the problem, think again. One big reason for the present comfortable status of such mega health care institutions is that they're hand in glove with the federal government.
So it's going to be interesting to see how my little battle works out. The service was done, the hospital was out of town, so I could just blow it off, but I like to pay my bills. I just don't like getting caught up in this shell game. Emily says I should just pay the bill, but I'm too stubborn for that. Medical consumers should fight back, but it's hard to do when everything is a secret until you get the bill.
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