$20,000?!

October 9th, 2009 · Comments

It’s the total medical expenses of a 5-hour emergency room stay my family recently experienced.

When I was single, I rarely visited doctors. I had no idea how much it costs to see a doctor.

Now, I’m married with two little ones, I pay much closer attention to medical bills.

Recently, we had to call 911 to take my son to the emergency room because he was extremely sluggish. It turned out that he had low blood sugar level because he didn’t eat well the night before and he was in a growth stage that his body simply needed a lot of frequent energy intake.

Here was the sequence of events.

We called 911. He was taken to the nearest hospital’s ER room.
The ER physician gave him several tests, and determined that he had low blood sugar level.
He was given IV. Within minutes, he was fully recovered.
The ER physician sent us to another ER room in Children’s hospital because she wanted to make sure there wasn’t any other problems.
We stayed in the first hospital’s ER room for three hours. We stayed at the Children’s hospital’s ER room for 2 hours, and were then discharged.

Two ER rooms, two attending physicians, one brain CT scan ($1000), one 15-mile ambulance ride from the first hospital to Children’s hospital, 2 hours of IV — the total medical expenses is a little bit over $20,000.

My PPO medical insurance covered 90% of the expenses. I still ended up paying $2,000.

Why am I sharing this story with you? Because I want to provide you specific data points about this country’s health care cost.

If I’m unemployed without health insurance, I will need come up with $20,000 to pay for 5-hour of stay at ER.

Some people advocate "consumer driven" health care — the idea is patient should compare shop and push for lower price. But, when my kid was sick, I wanted to provide the most timely and best quality care. "Price" was the last thing I was worrying about.

Health Care is not a product like LCD TV that I can compare shop at multiple stores and buy with the lowest price. Quality is more important than price in a lot of medical situations.

I did call the hospitals to give me detailed explanation of the expense items. But, the problem is that I don’t know if it’s cheap or expensive. They told me that a brain CT scan costs $1,000. But, how did I know if it’s a good price or not? There is little transparency in the medical industry in term of cost.

I’m sick of hearing politicians talking about "consumer driven health care" — the information transparency is not there. Medical Care is inherently not well suited for comparison shopping based on price.

If I’m unemployed and still want insurance, I can continue with CORBA for 18 months (or maybe a little bit longer due to government’s recent policy change.) But, I will need to pay at least $1,200 per month to cover the family.

If I’m self-employed, it’s very hard (or virtually impossible) for me to get insurance like the one I have today at a reasonable cost. Why? Because if you have any "preexisting condition", your premium will shoot up to the sky.

Public option, co-op, private option – whatever. I think the minimum requirements for health insurance is:

regardless of any existing condition, anyone should be able to purchase health insurance at a reasonable price
for anyone who is unemployed, he or she should still be able to access health insurance at a reasonable price
for anyone who is self-employed, he or she should still be able to access health insurance at a reasonable price

Obvious, it shouldn’t cost $20,000 for a 5-hour stay in emergency room. It’s ridiculous!

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Tags: Health

Viewing 7 Comments

Andrew 10/13/2009 06:59 PM 1 point
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While on COBRA, it is sad that people are afraid to go to the doctor for a regular checkup. Knowing you will be changing to another plan within 18 months, there is a strong dis-incentive to have anything diagnosed. Diagnosis can create the dreaded pre-existing condition that will either disqualify you for a new plan, or will force you to pay a lot extra.

Paying over $1000 per month for insurance you are afraid to use is a definite problem with the current system.

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ctelesco 10/10/2009 08:42 AM 1 point
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Your description of your child's health issue is vague so I am responding to what I read. Sounds to me like you overreacted. Who calls 911 simply because their child is "extremely sluggish" - this does not sound like an emergency to me. As the mother of two teenaged children I can tell you I called 911 ONCE - when my two year old daughter stopped breathing. People needlessly using the ER and ambulances simply because they have been blessed with good health insurance drives up the costs for everyone. My husband is self employed so we know first hand the pain of paying for our own medical insurance. Rather than worrying about "shopping around", how about excercising some common sense?

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GeekMBA360 10/12/2009 12:04 PM 1 point
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Hi, Cathy,

Thanks for the comment!

Sorry that I should be a little bit more specific about the description. Basically, the kid wasn't waking up in the morning. He would open his eyes for a few seconds, but then went back to sleep. It had never happened before.

Did we over react? I think it's hard to say. When we got to the hospital, his blood sugar level was dangerously low. From what I was told, it was the right decision to get him to ER within the shortest time possible.

After the incident, we did learn from the doctor that we could have tried to give the kid "water with honey". But, without knowing the cause, we had to take him in to get treated by professionals.

I think nobody wants to go to call 911 and/or go to ERs. It's not a pleasant experience.

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TedHoward 10/09/2009 08:27 AM 1 point
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Most of my friends in SF are ER residents. There are so very many comments I could make.
You say that there's no consumer transparency into prices. Do the doctors know the costs of different procedures and tests? The ones I know don't. It's also all 'sliding scale' because each medical plan authorizes a different level of payment. The medical providers often have to contact your insurance just to find out what to charge for a service.
If they diagnosed low blood sugar, why was there a CT and a trip to another emergency room? Doctors typically don't consider cost. They are tasked with providing the best possible care by exploring all possibilities, not balancing the costs and benefits of treatment options. So, your child had a CT, blood panels and more, followed by a transfer to Children's because non-pediatric ER's don't know much about kids and the first ER staff might have missed something. Part of this thoroughness is lawsuit avoidance but a large part is an academic curiosity and a desire to be meticulous.
It's like the Innovator's Dilemma in that everyone's actions make sense individually but taken as a whole it is clearly messed up. Unfortunately, the negative consequences of this snafu are mostly felt by the consumers of healthcare such as your family.

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GeekMBA360 10/12/2009 12:12 PM 1 point
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Thanks, Ted. "lawsuit avoidance + academic curiosity + desire to be meticulous" -- right on! These are the three key contributing factors to the cost. I don't have a solution. Maybe a "fully integrated" hospital like "Kaiser" in CA will help drive down the cost since all departments and doctors work closely in one campus? Not sure.

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Eric 10/09/2009 05:42 AM 1 point
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that's a sad story, sorry to hear about it.

the ct scan is particularly outrageous. the only way to justify giving a kid that much radiation when his blood sugar was low, is legal protection for the doctors. It's plain immoral. see http://www.bio-medicine.org/medicine-news/Expos...

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http://www.internetinc.com/

GeekMBA360 10/12/2009 12:08 PM 1 point
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Thanks for your comment, Eric. I was suspicious of the CT scan, and your link only validated my concern. :-)
The sad part is that he could have avoided the CT scan all along -- when we got to the hospital, the first thing the doctor wanted to do was to take his blood, which included checking his blood sugar level. However, the nurses who were assigned to us were not experienced in drawing kid's blood. They were panicking, was calling for "re-enforcement" from other nurses, poked him several times, finally got the blood, and then spilled the bottle. The doctor got frustrated, so she wanted to go to get a CT scan first since it would take than 1 minute. It's a mess. :-)

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