I recently had major surgery and needed to stay two nights in hospital. The good news was the success of the surgery. The bad news was the hospital bill.
Like all doctors in the Santa Monica hospital I went to, my oncologist is an independent contractor. This means that the hospital is charging me for the operating room and equipment, for the nurses who prepped me, for the medication I received, etc. My oncologist is charging me for operating on me, the anesthesiologist for keeping me under and alive. (It is actually more complicated than that, but this is the situation in broad strokes.)
The doctors’ bills were more or less what I expected for a complicated four-hour procedure. I expected the hospital bill to be on the high side – the robotic da Vinci surgical system costs a lot of money and they need to amortize it. But when I saw the hospital bill, a prime example for the insanity of U.S. health care system costs, it almost undid all the good work my doctor had put in. The total charged was, wait for it, … $99,303.50. This is not a mistake! And the lack of rounding the 50 cents is adding insult to injury.
Now that is some patient after-care. I am happy to be alive and that the surgery seems to have been successful. My doctor tells me to take it easy and to take a couple of weeks to recover. And then in the middle of it I get a bill for more or less 100 grand. So much for recuperation.
Over the years I have learned that medical bills can be disproportionately high (although this one takes the cake) and that what counts is the amount my insurance company has negotiated with their in-network providers. As it turned out after a long “review” time, the hospital had negotiated an amount of $35,307.00, quite different from the original billing amount. Health care providers call that difference “write-off”, so why do they “write in” these fantasy amounts in the first place? In the end, since I had satisfied my (considerable) deductible as well as my co-insurance by paying for my doctor and numerous pathology lab reports, I did not have to pay anything towards the hospital’s bill. Phew!
But why is this happening? Why this shock-and-awe billing practice? Frankly, I have no idea. I have heard the opinion that health care prices are inflated so that providers can negotiate a better in-network amount next time around. Maybe the total billing, irrespective of the actual amount recovered from patients and their insurance, is used in some metric that makes the provider look good, or attracts donors. Who knows. Even though I’m aware that insurance and provider will in all likelihood come to some understanding, it is still nerve-wrecking to have bills of that magnitude hang over my head.