Over the last 5 years I’ve been involved in or a close enough family member has been involved in, close enough that I had to pay for it, no less 5 situations that involved hospitals and surgery.
Only two of these incidences involved overnight hospital stays and thankfully none of them involved any “Serious” work like critical units or such.
Of these 5 times I figured the “Hourly rate” I paid for each of these procedures etc ranged from as low as 100$ an hour to as high as 250-300$ or so an hour.
Considering that the local hourly rate for getting work done on my car at the dealership is around 100$ an hour, as is a plumber or an electrician, and an attorney costs around 125-150+$, depending on type of work and “Reputation”, locally per hour I’m wondering why people are screaming so much about “cost of care”?
Now don’t get me wrong I would like to see the cost come down too and see MANY ways to make that happen. However I also think people typically don’t look at health care in comparison to many other “Professions” and just expect it to be “Cheaper”.
Perhaps this is a little off of your topic, but from my perspective (hospital worker), here’s a pretty big indicator that the system is broken:
Biggest expense for a hospital is payroll and associated expenses - which makes sense, as health care is mostly about providing skilled services. Wages have been pretty much treading water with inflation, but the fastest growing expense here is health insurance for employees. And strange as it may seem, we’re having the same sort of issues as workers everywhere else as far as premiums and copays increasing, and coverage decreasing.
So anybody wants to know why health care is expensive? Mostly, it’s because health care is expensive.
That price seems quite low. Are you figuring the hours for the actual procedure, or are you including other stuff?
My wife had a procedure last week, performed by an RN. Cost $700… and took less than an hour including preparation and discussion. No fancy machines involved here either.
Are you talking out of pocket expense, or what was the original amount before insurance covered costs? I’m assuming you mean the later, but the cost rates you cite indicate the former.
Are you figuring the hours for the actual procedure, or are you including other stuff?
Figuring in “Other stuff” just as any business would. My procedure was around the same amount, only took 30-45 minutes. However it also included around an additional hour to hour and a half of the doctors time as well as another 1/2-1hour of “Secondary personel” time. The price also includes at least 3 lab sessions that will take I have no idea how much time.
Include paper work, billing etc etc and I can easily see 4-5 hours hours of “Labor” alone.
That’s 140-175$ an hour without taking out any “Material” which I’m guessing was probably less than a 100$.
Over the last 5 years I’ve been involved in or a close enough family member has been involved in, close enough that I had to pay for it, no less 5 situations that involved hospitals and surgery.
Only two of these incidences involved overnight hospital stays and thankfully none of them involved any “Serious” work like critical units or such.
Of these 5 times I figured the “Hourly rate” I paid for each of these procedures etc ranged from as low as 100$ an hour to as high as 250-300$ or so an hour.
Considering that the local hourly rate for getting work done on my car at the dealership is around 100$ an hour, as is a plumber or an electrician, and an attorney costs around 125-150+$, depending on type of work and “Reputation”, locally per hour I’m wondering why people are screaming so much about “cost of care”?
Now don’t get me wrong I would like to see the cost come down too and see MANY ways to make that happen. However I also think people typically don’t look at health care in comparison to many other “Professions” and just expect it to be “Cheaper”.
~Matt
I can fix my own car but I am not about to try brain surgery, yet… Imagine a glut of doctors, do you think there might actually be some competition for your buck? The medical industry is all about monopoly and money. I go back to the movie Sicko. Why $12K to attach one finger and $60K to attach another? Who set those prices? Is the same skill level involved for both fingers or are we talking 2 specialists and how much did the specialist(s) make? You find more people going abroad for surgery now because the skill level is the same but the $$$ is cheaper.
Figuring in “Other stuff” just as any business would.
The other things you cited, auto repair and lawyers are different. The auto repair only charges for the book time of the repair. Overhead and figuring out what is wrong and test driving, etc are not extra. The lawyer bills only for his time (I think), not the clerical overhead.
That price seems quite low. Are you figuring the hours for the actual procedure, or are you including other stuff?
My wife had a procedure last week, performed by an RN. Cost $700… and took less than an hour including preparation and discussion. No fancy machines involved here either.
What was it? If it was some out patient derm/plasitc’s or what not…duh.
The auto repair only charges for the book time of the repair.
Having spent a number of hours working in repair shops “Book time” includes everything. Anyone who can’t beat “Book time”, on most repeairs, shouldn’t be in the auto repair business. You are also charged for parts.
lawyers are different.
My experience with attorneys is that they charge for every second they spend with you or doing paperwork or anything…plus materials. I was charged for “Stamps” by and attorney once. Phone calls, court time etc etc all “By the hour”.
The lawyer bills only for his time (I think), not the clerical overhead.
They may charge “For their time” but they also charge enough to cover “Clerical”, you have to. If a doctor sees you for 30 minutes but generates 2 hours of paperwork, he has to get paid for it even if he’s not doing it. An attorney, car repair or any other profession has to do the same. It’s just that for a car repair bill there isn’t NEARLY the paperwork generated that is generated for a spleen repair bill.
Are you talking out of pocket expense, or what was the original amount before insurance covered costs? I’m assuming you mean the later, but the cost rates you cite indicate the former
I’m guessing emergency room? I would guess those expensive are much higher because you’re paying for ICU care for a headache. You still have to cover the cost of the equipment. In my trade it would be like running one small plate with holes in it on a 6 million multi spindle, roboticly loaded multi axis CNC. You can do it, but it’s going to be a whole lot more expensive than running manual mill because you have to pay for the machine.
Now don’t get me wrong I would like to see the cost come down too and see MANY ways to make that happen. However I also think people typically don’t look at health care in comparison to many other “Professions” and just expect it to be “Cheaper”.
In Canada, we never see the bill - that’s part of the problem with our system. People expect the healthcare system to always be there and cost “nothing”. Yet, if you know anything about the deliverables in health care and the fact that we are dealing with peoples health and lives, then you would think that people would value it highly - but because their are no bills we very rarely if ever see what things actually cost.
The only time we do as Canadians, is if we are in the unfortunate situation of having to go to a hospital in the U.S. and then we get this itemized bill, with charges for eveything from the ambulance ride to the hospital, to the linens on the bed, to the sutuers to stitch up the cut!! Then it hits home and I think that many are shocked!
Seriously in the last 5 years in my family alone we’ve had several procedures, one which would be considered “Emergency” and all seemed “Reasonably” cost by an hourly rate, especially considering the skill, expertise and risk involved. In most cases the hourly rate was comparable to an upper level attorney.
I’m certain that is not always the case and thus was wondering where the real cost is. I’m guessing it has a lot to do with more complex surgeries and even more insidious, drug costs. The antibiotics and 2 Valium I purchased for my last procedure costs nearly 12% the cost of the entire procedure. That ain’t right.
I also think most people rarely see a bill from a “Professional”. We go to the doctor expecting them to work for similar “Hourly” rate as we do, not realizing all the additional costs.
Lawyers, manufacturers etc charge large hourly amounts to cover these costs and the numbers are often “Shocking” to those not used to seeing them.
Again, not saying we don’t have a problem and that we can’t lower costs, I’m saying I’m not seeing a huge discrepancy between doctors, lawyers, dentist or even car mechanics.
From my experience, complexity adds into the cost. I had an ep study and cardiac ablation in Oct. The procedure took about 2 hours and I was in the hospital overnight (due to a bad reaction to the morphine). My total cost was close to $70,000 that broke down to something like $8,000 for the cardiologist and 2 nurses, $55,000 for the procedure, test, and equipment, $1400 for my one night stay in a double room on the cardiac unit, $600 for the recovery room, and $5000 for supplies and meds. My favorite is that the 2 tylenol that they gave me cause I had headache is actaully listed on the bill for $1.50. There was also some bills for post surgery bloodwork and whatnot that are not included here. So my hourly rate for my 24 hour stay is $2,916.00.
Now I have insurance so my out of pocket was $4,500.00 and the insurance actually only paid the hospital about 2/3 of the origianl bill due to those nifty cost agreements they have.
But I can’t complain about the cost. I mean they did map the electrical impulses of my heart, figure out which node was causing my SVT and then “remove” it so I no longer get heart rates about 290 bpm.
My 11 yr old son broke his thumb saving a penalty kick in a soccer game. It being late afternoon on Saturday, we went to urgent care for him to be seen & x-rayed. Doc there said she wasn’t sure if it was broken, said we’d have to wait for review by radiologist on Monday. Sure looked broken to me, so I took the x-ray to a radiologist friend who said, Yep, it’s broken. Urgent care bill – about $135 (I think).
Visit to orthopedist on Monday – Yep, it’s broken, let’s put cast on it. Bill for orthopedist = $175 consultation, $95 “Surgery”, $60 cast materials, + $40 for waterproof cast materials (can shower, swim, etc). Total bill there = $370.
Follow up visit to orthopedist to remove cast = Haven’t received that bill yet.
Total cost for a very minor fracture = $500 + the follow-up visit, so easily $600 to $700.
Meanwhile, when this happened, my daughter was in the hospital after having throat surgery – relatively minor procedure, but she needed to stay in hospital total of 4 days. Not sure of total bill on that, but the “unadjusted” total of all bills will be at least $35,000.
Hospitals adjust or write off parts of these amounts – if you have insurance – but the numbers can become mind-boggling pretty quickly.
Most practices dont bill for follow up care of this type. It is presumed and included in the original coding - sorta like warranty repairs being built into the purchase price of a car.
My busted up hand cost about $10k to make right. I was on the hook for about $2k of that.
The surgery and anesthisia were the biggest single ticket items, but the price didn’t seem out of the ordinary to me. I think the surgeon got around $2000, which seems reasonable considering what he did.
The therapy was the killer. $300 for a small custom hand brace – and I needed three of them over the course of treatment! A 10 minute ultrasound session was over $200. A small lump of play-doh stuff to strengthen with was billed out at $35, and a cheap plastic thing with rubberbands was nearly $100.
I am pleased with the results but I had the means to pay the deductibles and co-pays. I can see how someone could go broke really easily with no insurance.