| Why
do hospital bills contain
charges such as these actual
examples as compared to drug
store or doctors office prices? |
One
needle $32 ($.06)
One
2
X
2
gauze
pad
$6.50
($.04)
One
electrolyte
blood
panel
$139
($11.29)
One
EKG
$178
($32.51)
One
vitamin
C
tablet
$5.77
($.05)
One
iron
pill
$5.60
($.15) |
| Why
does a hospital bill totaling
$82,585.31 for heart surgery
get discounted 56% to $36,168.66
and paid in full by Medicare
and a Medigap policy? |
Does
any of this remind you of
the $400 toilet seats bought
by the Pentagon?
That's
right.
It
is
all
due
to
government
control,
bureaucratic
rules,
lobbyists
and
political
manipulation
of
the
government
price
control
scheme
for
health
care. |
In
health care today, nobody
pays retail.
For
those
under
the
age
of
65,
insurance
companies
have
deeply
discounted
contract
rates
for
hospital
services.
If
you
go
to
a hospital
listed
with
your
plan,
the
plan
never
pays
$178
for
an
EKG
and
your
total
bill
is
deeply
discounted.
Your
share,
if
any,
is
discounted
as
well
but
the
$178
charge
is
there
because
of
Medicare
rules
(read
on). |
For
those over 65, Medicare has
a separate price control
scheme for hospital inpatient
vs. outpatient services.
In
1983,
all
inpatient
services
became
subject
to
a pay
by
diagnosis-price
fixing
scheme
called
DRGs.
One
price
only
per
diagnosis,
no
matter
how
long
you
stay
or
how
many
EKGs
you
get.
Medicare
never
sees
your
bill
and
could
care
less
what
a hospital
charges
for
these
services.
Your
Medigap
secondary
policy
only
pays
its
portion
of
the
DRG
Medicare
amount.
It
does
not
pay
anything
on
your
bill. |
Politicians
and government rules allow
hospitals to charge more
for Medicare outpatient services.
Through
some
good
lobbying,
the
hospitals
got
Medicare
to
grant
them
an
exception
to
prior
Medicare
policy.
Hospital
outpatient
departments
have
mushroomed
over
the
last
decade
to
profit
from
the
inflated
charges
that
Medicare
now
allows
them
to
collect.
Each
patient
service
can
be
charged
at
a high
rate
but
only
you
or
your
Medigap
supplement
pays
20%
of
the
inflated
hospital
charge.
Thus,
your
supplement
pays
20%
of
$178
or
$35.60
for
the
EKG.
Medicare
pays
80%
of
$32.51
or
$26.00.
This
totals
$61.60.
Your
doctor
only
can
collect
$32.51
from
both
Medicare
and
your
Medigap
supplement
and
cannot
collect
more
under
the
law. |
Because
of Medicare laws like these,
EKG charges, and all other
services as well, must be
charged at the same rate
for all patients.
It
is
illegal
to
charge
Medicare
more
than
the
least
expensive
charge
the
hospital
has
for
a service.
Thus,
every
insurance
company
and
every
patient
of
any
age
is
charged
the
same
$178
EKG
fee,
even
if
the
total
bill
is
discounted
because
of
an
insurance
company
contract
with
the
hospital. |
This
sounds like a crazy system
but it is devilishly clever:
the
government
and
Medicare
pull
the
strings
while
making
hospitals
look
bad.
Medicare
lets
hospitals
claim
inflated
payments
for
certain
outpatient
services
to
make
more
money
because
of
their
losses
under
the
government
payment
by
diagnosis
system
on
inpatient
services.
By
law
these
prices
must
be
listed
on
everybody's
bill
even
if
they
are
never
paid
that
way.
The
hospital
always
looks
like
it
is
trying
to
rip
you
off.
This
is
good
politics
making
the
government
look
like
the
answer
to
a problem
it
created
in
the
first
place. |
The
bottom line is: don't panic.
Your
insurance
carrier
or
Medicare
is
paying
wholesale,
not
retail.
The
bill
you
receive
is
the
result
of
government
rules,
lobbying
to
manipulate
these
rules
and
the
bill
is
not
reality.
Is
it
any
wonder
that
health
care
costs
are
rising
and
satisfaction
with
care
is
falling?
Think
how
different
it
would
be
if
each
of
us
was
the
hospital's
real
customer
instead
of
the
insurance
companies
or
our
government. |
|
