The Reality Of Costs Of An Operation In A Hospital

Last week, at a poker table, I was one seat away from an older gentleman who I’ve played poker with in the past. At some point the topic got around to healthcare, and this gentleman complained that he’d had an aneurysm, spend only one night in the hospital, and the bill came to aorund $39,000. I told him he was lucky on many fronts, and that a bill that low was actually pretty lucky.

I find that there are misconceptions about healthcare and the fees that, in some cases, aren’t in line with reality, and in other cases I can fully comprehend. A comparison of his procedure in the central New York area as opposed to being in the metropolitan New York area is at least 4 to 1, possibly more. But that’s not really the point.

In the past, having an aneurysm would have been a multiple day stay in the hospital; based on today’s rates, you’re possibly talking $40,000 right there just to lay in a hospital bed. In the past, he wouldn’t have had some of the equipment we have today, which means an operation of the sort he had to have would have been more dangerous, with less chance of success. In the past, he wouldn’t have been given the types of medications we have today, which would have meant the possibility of more complications and less chance of success.

Let’s talk about having an operation to begin with. Before anything begins, one has to do pre-admission testing, which will end up on the same bill as your operation; that’s law. Next, the room has to be cleaned, which means sterilized, and there are specific procedures that must be adhered to. You don’t just pull out the Spic and Span to do the job; it’s quite thorough. Next, there are fixed costs that aren’t allowed to show up on your hospital bill; sheets, gowns, gloves, needles, syringes, poles, bags, swabs, etc. That stuff adds up, but there’s more. Equipment can’t be charged for, only procedures, so many dollars are built into trying to recoup the cost of purchasing and maintaining hospital equipment. And of course we have lights, recording equipment, documentation equipment, computers, and, top of the list, all the people who have to be in the room, such as nurses, whose services can’t be separately charged.

Next we have supplies that will “possibly” be used in a patient. Each doctor has their favorites on items they choose, and in some cases the prices can vary drastically. Take pacemakers; the price of pacemakers can run from a couple thousand up to close to $100,000, depending on maker, type, etc. But you can’t go into an operation with only one. If the item that’s put into a body turns out to be defective, the hospital eats the cost of the item; yeah, sometimes you can return items, but not always. There are some items where the hospital can legally bill you for their usage, even if they really weren’t able to use it, such as screws during a knee operation, but not every supply item, especially big ticket items, are allowed to follow that same rule.

And , after the operation, you get wheeled into a waiting area, where hospitals capture the cost but will never get reimbursed for the time. Therefore, whether you take thirty minutes or two hours to come out of anesthesia, and this is if there aren’t any complications, the hospital will not ever be paid. Yet, nurses must monitor you with all sorts of equipment, and of course the time.

Finally, at least a month after you’ve been discharged and your bill has been paid (if the hospital is lucky to get paid in a month by your insurance company), if the hospital gets paid at least 40% for what was charged for your operation, it’s lucky. Sometimes the payment rate is only 10% of what the hospitals costs were; the overall total of the operation, in most cases, is meaningless. Those are negotiated rates, and hospitals are getting killed most of the time.

That’s just something else to think about. Now, if you happen to not have insurance, which means you’re a self pay patient, well, you might have a complaint; but nationwide hospitals are changing the rules for you also, thanks to a recent legal ruling in Oregon; so, life is about to get better for you also. But give your hospitals some space; they’re doing what they need to do, for the most part, in order to survive.