Hospital Billing Varies Wildly, Government Data Shows By BARRY MEIER, JO CRAVEN McGINTY and JULIE CRESWELL http://www.nytimes.com/2013/05/08/business/hospital-billing-varies-wildly-us-data-shows.html A hospital in Livingston, N.J., charged $70,712 on average to implant a pacemaker, while a hospital in nearby Rahway, N.J., charged $101,945. In Saint Augustine, Fla., one hospital typically billed nearly $40,000 to remove a gallbladder using minimally invasive surgery, while one in Orange Park, Fla., charged $91,000. In one hospital in Dallas, the average bill for treating simple pneumonia was $14,610, while another there charged over $38,000. Data being released for the first time by the government on Wednesday shows that hospitals charge Medicare wildly differing amounts — sometimes 10 to 20 times what Medicare typically reimburses — for the same procedure, raising questions about how hospitals determine prices and why they differ so widely. The data for 3,300 hospitals, released by the federal Center for Medicare and Medicaid Services, shows wide variations not only regionally but among hospitals in the same area or city. < - > The for-profit healthcare model sucks about $400 billion a year <http://www.pnhp.org/facts/single-payer-resources> out of our healthcare dollars to pay for administrative costs thatlargely disappear in a public system where administrative costs run dramatically lower.
Bitter Pill: Why Medical Bills Are Killing Us
Corrections Appended: February 26 and March 12, 2013
1. Routine Care, Unforgettable Bills
When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s father had been treated there 10 years earlier, and she and her family credited the doctors and nurses at MD Anderson with extending his life by at least eight years.
Time mag prints longest story ever by a single writer: “Bitter Pill,” by Steven Brill, on U.S. healthcare.
It was written by Steven Brill, a journalist, lawyer, and entrepreneur and the founder of Court TV, American Lawyer , and Brill’s Content. Brill’s most recent book was Class Warfare: Inside the Fight to Fix America’s Schools (2011).
Brill has a unique way of digging into stories of labyrinthine complexity, establishing the key dysfunctional elements, and exposing and explaining them in clear and straightforward prose that makes the reader feel smarter for having read him. He doesn’t always persuade everyone. When Class Warfare was published, Michael Winerip of The New York Times wrote a withering review, noting that Brill “knows that every story needs a villain or an evil force.” In Class Warfare, the villains were “bad teachers coddled by unions,” Yet, Winerip wrote, he didn’t give teachers their say. “Of the three million who work in traditional public schools, three are interviewed by Mr. Brill on the record; their insights take up six of the book’s 437 pages,” he wrote.
Applying that measure to Bitter Pill, I think Brill comes out better. The villains here are not those you might expect–the insurance companies. Here it is the hospitals and their highly paid executives. In this telling, insurance companies are victims too, often as powerless in their dealings with hospitals as are the individual patients whose stories Brill tells. If that sounds incredible, it will sound less so once you’ve begun to power your way through Brill’s story.
Brill’s mighty edifice is built on line-by-line examination of seven bills, showing the charges assessed against patients and insurers that are many, many multiples of what the services or products actually cost. He begins with an example that we’ve heard about, although usually in reference to aspirin. The first bill he examines includes this line: 1 ACETAMINOPHE TABS 325 MG. The charge, for a generic version of Tylenol, was $1.50. “You can buy 100 of them on Amazon for $1.49 even without a hospital’s purchasing power,”