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Oranges w/ Cheese hates what Christmas has become
November 13, 2009 4:35 PM
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It's probably the 5 minutes in the emergency room + any sort of bodily fluid disposal they may have done plus corpse management? If they did an autopsy..

Hospital costs are ridiculous. My boyfriend recently spent 2 days in a cardiac ward for a very very low pulserate which ended up being inconclusive (they sent him home with nothing gained except that he shouldn't have been conscious, dunno why you still are). He didn't have insurance, so they did him the AMAZING favor of taking $2000 off his bill. How nice.

The bill ended up being ~$19,000. So he basically just bought a car without actually getting a car.

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7 replies
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thisistobehelpful
November 13, 2009 4:35 PM
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@Oranges w/ Cheese wants it to be winter already: SHOWING UP at the emergency room is $1000 assuming you didn't take an ambulance to the tune of $5-10,000.

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spazztastic
November 13, 2009 4:35 PM
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@Oranges w/ Cheese wants it to be winter already: As a crime victim, any autopsy done would be done by state pathologists, not the hospital.

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qwerty001984
November 13, 2009 4:35 PM
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@Oranges w/ Cheese wants it to be winter already:
I would not pay that. I would change my social security number so they can't ding my credit. $20,000 when they did not do anything is theft.

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logic meme
November 13, 2009 4:35 PM
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@qwerty001984:
\"I would not pay that. I would change my social security number so they can't ding my credit. $20,000 when they did not do anything is theft.\"

While I sympathize with the OP, it's not true that the \"didn't do anything\" at the hospital simply because a diagnosis couldn't be reached. They likely put him on telemetry monitoring during his stay, and ran multiple tests to evaluate a cause of his condition. Do you think the cardiologists, nurses, techs, machinery, room, etc all come at no cost?

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h3llc4t, breaker of office dress codes
November 13, 2009 4:35 PM
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@Oranges w/ Cheese wants it to be winter already: That poor guy! How scary for him, and what a terrible experience. Is he doing okay now?

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lannister80
November 13, 2009 4:35 PM
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@floraposte: On a related note, \"Repo! The Genetic Opera\" is one of the worst movies I've ever seen. Ugh.

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CumaeanSibyl
November 13, 2009 4:35 PM
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@lannister80: I gave up on it about five minutes in. Xanadu was more entertaining.

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Con Seannery
November 13, 2009 4:35 PM
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@lannister80: I can't tell if it was alright or terrible, honestly.

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h3llc4t, breaker of office dress codes
November 13, 2009 4:35 PM
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@lannister80: That movie broke my heart. It seemed right up my alley and it even had Ogre, which would have garnered major brownie points if it wasn't so absolutely awful.

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Pibbs
November 13, 2009 4:35 PM
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@h3llc4t, breaker of office dress codes: I just watched it on Monday night for the first time. I left my couch wondering if I had wasted the last hour and a half of my life, or if it was a pretty decent movie.

It's Friday and I'm still not sure.

But hey, I did get to see Poe's boobs.

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GitEmSteveDave_RockinLabCoat
November 13, 2009 4:35 PM
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Perhaps they considered the cooler in the morgue a \"room\", and were charging him for a bed? I don't know, honestly. I mean, I guess you could say it was for tests, medical equipment usage, but honestly how many tests can you perform/do/send someone for in the five minutes from bursting through the doors until they pronounce you?

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pecan 3.14159265
November 13, 2009 4:35 PM
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@GitEmSteveDave_RockinLabCoat: There's more to the story than these two articles have because it has to do with the nature of his care. If he had to be medevac-ed to the hospital, that costs a ton of money. If he needed a lot of blood, that's a lot of money. It's not like he came in and five minutes later, all he had were some bandages and an IV before they determined his injuries were too severe. Trauma units are prepared for the very worst injuries and that requires a lot of people, a lot of equipment.

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PunditGuy
November 13, 2009 4:35 PM
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@pecan 3.14159265: Maybe it depends on the hospital system, but in all my (admittedly, thankfully, limited) dealings with such things the transportation is a completely different bill from a completely different entity.

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gStein_*|bringing starpipe back|*
November 13, 2009 4:35 PM
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@PunditGuy: yes, i worked at MetLife for a few summers, and i got to see a lot of the bills from different parts of car wrecks - there was usually a bill from the tow and auto storage, one from the body shop, one from the ambulance company, and one from the hospital. (we'd often see a bill from the power company to replace damaged power poles, as well)

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padams89
November 13, 2009 4:35 PM
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@gStein_has joined the star bandwagon: In some circumstances the transportation (especially if by air) is included in the ED bill because the ED or hospital system also owns the aviation service. Additionally, as someone who works in a Level 1 Trauma Center. You would be very surprised how much is done in five minutes. From the moment the patient enters the room they get full body x-rays which are read immediately by a radiologist, a full body exam by physicians and surgeons from multiple specialties among numerous other things.

Things in a trauma bay happen in this order:
Airway: the airway is secured and the patient is ventilated if unable to do so on his/her own. This may include intubation, surgical cricothyrotomy, chest tubes, chest decompression and many other highly skilled and precise procedures that are fatal if done improperly.
Breathing: Respiratory therapists are present to get the patient on a ventilator, bi-pap, c-pap or other appropriate breathing machine if needed.
Circulation: There are cariothoracic surgeons as well as the full crash team ready to resuscitate the patient using things as simple as a defibrillator or as complex as in room surgical interventions that include repairing the chambers of the heart.

YES, all of this can easily happen in the first five minutes. In fact, it is extremely rare for the ABC's to take more than 1 minute total especially because there are typically 10-15 people in the trauma bay, each with a specific and highly skilled purpose.

While all of this is going on the aforementioned x-rays are being taken (everyone is wearing lead and the table has films in it so all they have to do is move the overhead system and clear the x-ray field for a few seconds.

These things are just the tip of the iceberg of what is done in five minutes in a trauma bay. Although the bill is expensive, keep in mind that all these people are ready to do this for YOU 24/7/365 and although there is not a patient every shift the staff still needs to get paid.

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ohenry
November 13, 2009 4:35 PM
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@padams89: That actually is a very interesting, informative post. I give you a non-official off-brand gold star :)

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logic meme
November 13, 2009 4:35 PM
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@padams89: Yep good post. People don't realize how expensive it is to provide level 1 trauma care, and your bill could easily be much more than this if you went on to receive surgery, ICU stay, etc. While it sounds insane that 5 minutes would cost $29k, a level 1 necessitates a protocol that occurs quickly and involves multiple teams and tech that you have outlined well. (I'm a 4th year med student)

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gerrycomo
November 13, 2009 4:35 PM
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@logic meme: How long before you make the big cashola and gain the respect of all your peers from being a doctor?

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humphrmi
November 13, 2009 4:35 PM
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The letter was inappropriate, an administrator of UC Davis already admitted their mistake and apologized.

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3 replies
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fantomesq
November 13, 2009 4:35 PM
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@humphrmi: Yep. The bill was supposed to go to the insurance agency... this 'issue' has already been remedied and is only being played up for its press value.

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Schmeeky
November 13, 2009 4:35 PM
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@fantomesq: I think there are some legals issues at play here as well. If the patient had insurance and the hospital or medical provider has that information on file then they can't send the bill to the family or whoever would be responsible for any expenses. At least in Georgia (which is one of the more regulated states insurance-wise) the provider can get yanked out of an insurer's network for pulling stunts like that.

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treimel
November 13, 2009 4:35 PM
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@fantomesq:


But it didn't go to the insurer, hence the issue--scare quotes not needed. Moreover, they didn't directly apologize to the family-a pr flak gave a general statement. I'm glad this is being publicized.

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The Porkchop Express
November 13, 2009 4:35 PM
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@treimel: Sending the bill to the family is fine, they can send it to insurance and/or contact hospital and re-give insurance info. It sucks but they can do that.


The letter advising that the son was no longer welcome on the other hand....horrible. not only should that letter not be sent, but they should have the records to know that he would no longer need to go there at all.

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treimel
November 13, 2009 4:35 PM
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@The Porkchop Express:


No, it's not fine--you're confusing \"not unlawful\" with okay to do. Moreover, it is entirely unclear that the family has any responsibility in this matter whatsoever--the proper person is the executor/administator of the estate, and that may or may not be a member of his immediate family. Additionally, the hospital itself admits that it should have sent the bill directly to the insurer-rtfa.

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The Porkchop Express
November 13, 2009 4:35 PM
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@treimel: They admit it now. Sometimes the insurance info isn't there.


Of course you're right about the estate being responsible (if no insurance) but how are they to find the estate (again if no insurance or insurance info).

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treimel
November 13, 2009 4:35 PM
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@The Porkchop Express:


First, there is exactly zero evidence that the insurance info was missing. (By the way-if they had such a handy excuse, don't you think they would've used it? I do.)
Second, it simply isn't the parents' problem to help the hospital find the executor for the hospital. This really is very simple--the hospital sent a letter they had no right to send and caused gratuitous suffering. There's a reason they apologized--they were dead wrong.

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YardanCabaret
November 13, 2009 4:35 PM
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How much do those doctors and nurses make that 5 minutes of their time cost $29,000? That's nearly $6,000 a minute.

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8 replies
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yume_ryuu
November 13, 2009 4:35 PM
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@YardanCabaret:
I don't even think Howard Stern makes that kind of money per minute.

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coren
November 13, 2009 4:35 PM
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@YardanCabaret: Keep in mind that those staff aren't constantly dealing with such heavy trauma cases though. It's not as though on a regular night they'll get say, 30 or 40 patients (meaning that hospital saw triple or more that in need of that kind of care in that time frame) which is what they might need to keep up that rate of pay - but they need to be paid regardless. I'd imagine 10 severe traumas like this might be more the norm for one shift, if that. Plus that might be the non insurance rate - I bet an insurer has negotiated lower rates. Then there's the indigent folks (which they somehow claimed he was - which is pretty bizarre in and of itself) who won't ever pay, or if they do won't pay close to their whole debt. It adds up. It's still insane, but there are at least mitigating factors.

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coren
November 13, 2009 4:35 PM
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@YardanCabaret: To follow my earlier comment, check out this article: [www.nwfdailynews.com]

They're going to get about 5 percent of what they billed. 5 percent here would be about 1500 bucks, or 300 bucks a minute. Call half of that over head, split it about 10 to 12 ways (they've got at least that many people waiting) and it gets much closer to the reality of what the doctor's get paid.

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Rachacha
November 13, 2009 4:35 PM
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@YardanCabaret: Although not on the same scale my employer would charge $300/hr for my time while I made only $30/hr. The additional fees paid for overhead, test equipment, insurance, building rent and utilities and administrative costs (whocp paid for the salaries of HR and accounting staff). In a hospital they have a large amount of redundant equipment and facilities \"just in case\". 29k for 5 minutes seems excessive, but that cost most certainly covers morgue time and the paperwork to officially declare you dead.

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Techguy1138
November 13, 2009 4:35 PM
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@YardanCabaret: The amount of skill and training it takes to be an emergency room trauma surgeon is immense. Likely the unit was entirely specialized, and prepped and waiting for him. It likely takes an hour to do all of the proper wrap on on something that serious.

The cost wasn't for what they did but for the simple fact that there were there to take him.

It's a sad day when you realize that dying on the scene will save your parents a big bill.

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Kuchen
November 13, 2009 4:35 PM
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@YardanCabaret: Most of that cost probably is NOT the staff, but the procedures, equipment, medication/blood products. A trauma team can actually do a lot in 5 minutes.

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Dethzilla
November 13, 2009 4:35 PM
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@Kuchen: I imagine 5 Trauma patients in that condition who can actually afford to pay that bill will cover the cost of the equipment.


This is the type of article the Pro Health Care Plan can latch on to and get the bill pushed through.


Of course the article forgot to mention that most Colleges include Insurance in tuition of the school... unless he opted out... which was dumb.

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friday3
November 18, 2009 4:52 PM
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@Dethzilla: I would ask that you provide your reference that MOST colleges provide insurance. In fact, it is just the opposite. They allow you to PURCHASE student insurance through a buying pool, but it is not part of any tuition

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coren
November 13, 2009 4:35 PM
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@Dethzilla: Mine certainly doesn't - is that private schools, state schools, both, or does it vary?

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nova3930
November 13, 2009 4:35 PM
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@Dethzilla: Yeah but its like any other business that requires large capital expenditures. You have to keep enough $$$ on hand to pay for upgrades and replacements as they become available.


What makes it worse is that you slap \"3 letter gov't agency approved\" (FAA,FDA, etc) on anyting, and the cost goes up 5-10X due to certification compliance costs.


We wanted everything to be heavily tested and safe to minimize risk because of people selling snake oil 100 years ago and now we're shocked that those requirements have driven up cost....

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ARP
November 13, 2009 4:35 PM
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@nova3930: Most medical provider also grossly overcharge for two main reasons:


1) To offset those who can't ever pay
2) To offset payments from insurers who often only agree to pay a fraction of the costs.


So, people without insurance are getting the short end of the stick because, they're being forced to pay the full amount.


This also means that providers keep raising prices to offset 1 and 2. It's a never-ending cycle.


So, when you complain that you don't want to pay other's costs, too late, you already are.

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nova3930
November 13, 2009 4:35 PM
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@ARP:


Sorry but my wife is a Dr. and #2 is BS. No Dr. with a desire to eat will accept less than what care costs from a private insurer. At that rate, they're better off closing the practice and sitting at home.


The assertion that insurance pays less than what care costs is absolute nonsense if you think about it. If the majority of your business is covered by insurance, and there are really only one or two insurance companies per state, then logically if insurance is paying less than cost, you're going to go out of business. Its the old business fallacy of \"we lose money on every sale but we'll make it up in volume.\"


Incidentally the only two \"insurers\" that pay less than what care costs are Medicaid and Medicare and the only reason they get away with that is the reimbursements are set by law.


Thats also a big reason its becoming increasingly difficult for those on Medicaid and Medicare to actually find a Dr to treat them and end up going to state/federally funded residency programs that are required to treat them as a consequence of accepting that funding. They can't get rates to cover care, they just stop accepting them where they can.


You're explanation also is quite contradictory when coupled with the fact that insurance premiums are going up. If insurance is paying less than cost, then non-payers should have no effect on cost. The answer lies in the fact that its not a contributor, its people use more and more expensive healthcare combined with the fact that we as Americans see health insurance as prepayment for health care services, which it should not be.


For people making cash payments the fee schedules are typically set up such that one of three things happens.


1. You pay up front. If you do you can generally haggle with the Dr. and get a fee close to what the insurance pays. The insurance company gets those rates because they have a guaranteed contractual payment arrangement in place.
2. You don't pay at all and get sent to collections or whatever.
3. You pay in installments and pay a lot more than 1 in order to cover 2. No different than any other \"financing\" arrangement, especially one thats completely incapable of being secured.

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ARP
November 13, 2009 4:35 PM
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@nova3930: Sorry, I meant cost in terms of list price, not cost of providing services. So, providers need to make up for that low margin, by charging very high margin on others.

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XTC46
November 13, 2009 4:35 PM
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@ARP: And you are correct in your statement. My accounting professor was an accountant for a group of hospitals here and explained exaclty that as an example. They know that x% of paitieints will not pay...ever. Everyone elses fees get bumped up to cover that loss.

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sb01
November 13, 2009 4:35 PM
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@YardanCabaret:

clearly, I am in the wrong line of work....

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pecan 3.14159265
November 13, 2009 4:35 PM
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\"I can't believe that in any country besides the U.S., any civilized country, that the parents of a murdered boy would receive this bill for $29,000 and such an insulting letter,\" Gerald Hawkins, the victim's father, told ABC 10 in Sacramento, CA.


I get that he's very upset, and it's totally understandable how upset he is because he's grieving over such a horrific tragedy....but it was a clerical mistake. The second article linked called it an error in the automation process for billing. This happens to be extremely unfortunate, but there's no indication that the people in the billing department was aware that this poor person had died. Clearly, it was a misexchange of information. It's not like there were people in the billing department sorting through files of deceased people, saying \"whose family can we make miserable today?\"


Again, I totally understand how upset he is. But it's not like someone was out to get him or did it deliberately. It was a very, very unfortunate mistake in the billing department. Mortifying for the person who authorized for it to be sent, I'm sure.

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RvLeshrac
November 13, 2009 4:35 PM
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@pecan 3.14159265:


Excepting that in most other countries, the letter would never have been sent. They would have been covered by the NHS and would have had no contact with the billing department of the hospital.


So, yes, he was correct: As a citizen of any civilised country, you're never directly billed for emergency health care.

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lannister80
November 13, 2009 4:35 PM
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@pecan 3.14159265: So it's OK to make mistakes if they're \"clerical\"? It's called quality control.

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friday3
November 18, 2009 4:52 PM
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@lannister80: I suppose you have never made an error in your profession or in anything in your life either? Sh*t happens, deal with it. If the father had called or written the hospital and said, my son died, he had insurance what is this. END OF STORY. Maybe he should vent his anger at the person who MURDERED his son, not those who tried to save him and are trying to get paid for it.

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jimv2000
November 13, 2009 4:35 PM
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@lannister80: Quality control only goes so far. If no one in the billing department knew he was dead, then no amount of QA in the billing department would have helped.

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SlappySquirrel
November 13, 2009 4:35 PM
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@jimv2000: One would think his only being billed for five minutes worth of care would be a big clue.

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RayonFog
November 13, 2009 4:35 PM
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@jimv2000:

I think that's kinda the point. You would think a modern hospital with a level 1 trauma center such as UC Davis would have a little check box or something in the patient's file that says \"deceased\", and perhaps another one that says \"insured\".

I agree with what W10002 said - the hospital needs to reach out beyond just a press release.

To me, the most ridiculous part of this is calling the dead patient indigent. Um, yeah, he didn't pay his bill cuz he's dead. Maybe if someone checked that little \"deceased\" box in his file, they'd know that.

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friday3
November 18, 2009 4:52 PM
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@RayonFog: Unfortunately your solution sometimes does not work in doing things the way the insurance companies, or the LAW permits.

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pecan 3.14159265
November 13, 2009 4:35 PM
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@lannister80: I didn't say it was okay that the mistake was made, but I think the man clearly feels as if the hospital did it on purpose, and that's not the case.

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W10002
November 13, 2009 4:35 PM
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@pecan 3.14159265: I thought it was a clerical error too. However, if you were in his position, your emotions would overwhelm you too.

Regardless of the situation, the hospital needs to reach out to the family [not through a PR press release] and personally apologize for the error. Otherwise, they have no excuse for the mistake.

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utensil42
November 13, 2009 4:35 PM
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@W10002: UCD's lawyers will never allow the hospital or University to directly apologize because it would leave them too vulnerable to a lawsuit. Trust.

/UCD graduate student and staff member, but not a \"representative\" of the University.

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MostlyHarmless
November 13, 2009 4:35 PM
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@pecan 3.14159265: Yeah, I thought it was probably a clerical error too. Could happen to anyone in any country.

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floraposte
November 13, 2009 4:35 PM
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@MostlyHarmless: I think it's the conjunction of the two things--the height of the bill and the mistake in sending it to the family--that's given the story its impact. The thing is, if the family didn't have insurance they would have gotten that bill not as a mistake, and it's pretty likely that some families have in fact received just such bills. So even if the suckage got mitigated for this family, this is still a reminder of broader suckage.

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ARP
November 13, 2009 4:35 PM
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@floraposte: Well if they did actually get this bill becuse he didn't have insurance, isn't it their own fault? I mean he should have taken better care of himself and the parents should have put aside $29k in case something like this happens. They need to exercise some personal responsibility.


/snark

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sleze69
November 13, 2009 4:35 PM
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While the letter was definitely inappropriate, the bill was still valid. Do people think that all hospital bills are forgiven if the patient dies?

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16 replies
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StarVapor
November 13, 2009 4:35 PM
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@sleze69:

The problem is that inappropriate responses have become the norm these days and are really more of a view of what those who send them are really like.

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Herbz
November 13, 2009 4:35 PM
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@sleze69:

Just one more reason for a single payer system, then we don't have to worry who pays for it.

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Real Cheese Flavor
November 13, 2009 4:35 PM
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@sleze69: Yeah, the bill doesn't bother me nearly as much as the \"Don't bother coming back unless you have insurance, kthx\" letter.

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BluePlastic
November 13, 2009 4:35 PM
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@Real Cheese Flavor: That's what bothers me. Sending the bill to the parents is bad enough, but to add the snotty letter saying don't come back without insurance...that's really crappy. I understand medical care doesn't come free, but surely they could at least have some kind of computer system that could flag bills for deceased patients to be reviewed for correctness before blindly sending them out. It's really callous for a hospital to send a \"don't come back\" letter to someone who died right there at that very hospital.

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jimv2000
November 13, 2009 4:35 PM
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@sleze69: Generally when you are dead you are released from your obligations to pay your bills. And your obligations to do anything else.

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dragonfire81
November 13, 2009 4:35 PM
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@jimv2000: That's why I thought too, though maybe it's different in the case of a hospital which would obviously have a higher incidence of people arriving for treatment and either not leaving or dying before a bill could be paid?

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supercereal
November 13, 2009 4:35 PM
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@jimv2000: You might be released from your debt obligations if you die, but your estate sure isn't. These things just don't magically go away...

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ARP
November 13, 2009 4:35 PM
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@supercereal: True, but his parents are not the estate. Now, if they had evidence that they were the representatives of the estate, fine. But its pretty obvious, they weren't that sophisticated about this.


So this was more than just a clerical error (asuming he was an adult). They were attempting the sleazy technique of billing people who don't have a legal responsibility for another person's debt.

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treimel
November 13, 2009 4:35 PM
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@sleze69:


Well, inasmuch as the deceased was insured,and so this bill should never have recbeen sent directly the bill was in no way, shape or form \"vaalid.\" Moreover, the parents =/= the estate necessarily. rtfa.

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kethryvis
November 13, 2009 4:35 PM
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@sleze69: The family was covered under insurance. So it's not like they are trying to get out of paying anything. It's just crazy that 1) the bill came to them instead of going straight to Kaiser, their insurer, 2) that their son was called indigent when he was not, 3) that their son is DEAD and therefore won't be seeking anymore treatment anyway, and the biggest one 4) IIRC he was basically pronounced DOA. Why did it cost so much for such a short period of treatment? I think we see part of what's wrong with our healthcare system, folks...

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u1itn0w2day
November 13, 2009 4:35 PM
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@kethryvis: That about sums it up .


Found this a while back [www.nwfdailynews.com] - this bill puts that 29K to shame but the family really got the short ended on this UC Davis bill .

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coren
November 13, 2009 4:35 PM
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@u1itn0w2day: That had [www.power4home.com] as an ad. How very appropriate for a consumerist comment.

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floraposte
November 13, 2009 4:35 PM
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@sleze69: Though whether anybody other than the estate is actually obligated to pay the bill will depend on the survivors' status and the state law.

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utensil42
November 13, 2009 4:35 PM
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@floraposte: Heh. Estate. Dude was a CSU Sac student. Like most other students, he doesn't have anything that could be considered an \"estate.\"

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Megalomania
November 13, 2009 4:35 PM
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@sleze69: If it had been a week long struggle to try and keep him alive, you might have a point. This however was 5 minutes where most likely nothing they did made any difference and never could have. It's completely beyond belief that anything they did could have cost them anywhere near to $29,000.

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friday3
November 18, 2009 4:52 PM
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@Megalomania: Ok, give us the number since you are the \"expert\" on this. People need to realize that a fireman, police officer and trauma room specialists are paid whether somebody uses their services or not. You still pay for the police and fire even if they never need to respond for 1 second.

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iammoses
November 13, 2009 4:35 PM
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@Megalomania:
I think the $29000 is believable. When that patient came into the emergency room the hospital committed all it's resources and abilities to try to save his life, the hospital didn't care about the odds of a patient surviving it just went into the situation 100% doing what it does. It is tragic that the patient only lived 5 minutes but I think it's unfair to to compare cost versus time of treatment in a hospital.

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Kuchen
November 13, 2009 4:35 PM
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@sleze69: Except it wasn't. It should have been sent to his insurer. And I don't think they parents thought the hospital bills would be forgiven at all, they just didn't expect (and rightly so) anything like this from the hospital.

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SagarikaLumos
November 13, 2009 4:35 PM
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Add to it that any insurance company who got this bill would pay a substantially reduced bill. If a private individual got a bill for $35,000, private insurance would probably pay $18,000 and the medical center would consider that full payment from the insurance company. The irony is that if you have more money, they're willing to settle for less of it. Even greater irony that a large percentage of the people who get the largest bills simply pay none of it at all.

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Hua Kul
November 13, 2009 4:35 PM
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Last year my wife spent 14 days in a hospital and the total bill was over $58,000. The insurance company paid them $8,800 and the hospital accepted it as payment in full. If we had not had insurance I would not have been able to negotiate the bill down to $8,800. Something doesn't seem right there.

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RvLeshrac
November 13, 2009 4:35 PM
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@Hua Kul:


I will grant that hospital administration and insurance companies are both made up of some of the sleaziest people you could imagine, but hospitals will typically reduce your bill based on your income. I had my bill cut in half when I went in for an emergency room visit (chest pains).


Of course, had they simply prescribed the antibiotics when I had told them to, it would have cleared up the searing pain in my chest 5 hours earlier, cost me $1500 less than they charged, not wasted a bed, and prevented whatever damage may have been done to my heart by the pericardytis during the six hours I waited in a hallway.


Adding insult to injury, the hospital bill cost more than the additional yearly income tax liability I would have suffered had I been living in Canada, and up there I would have been seen *immediately* instead of waiting hours to see a doctor. Did I mention the searing chest pains?

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ARP
November 13, 2009 4:35 PM
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@SagarikaLumos: Yes, which is why providers charge so, much. They don't get \"full\" payment from insurers, so they need to charge more to the people that can least afford it.

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SagarikaLumos
November 13, 2009 4:35 PM
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@ARP: No, they're getting full payment probably from the insurers, the ones that they get nothing at all from are what drives it up, the insurance companies (responsibly) refuse to directly subsidize treatment for the uninsured on the backs of their customers and shareholders.


The hospitals have to try. Every once in a while, someone, maybe the state, ends up paying the inflated bill and it evens out.

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Covertghost
November 13, 2009 4:35 PM
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@coren: That's nuts.


For a transplant it was only $300k.


For a separate visit where I was sedated with Dilautid for 3 days straight it was only ~$60k.


Methinks those hospitals are just ridiculous

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bunnymare
November 13, 2009 4:35 PM
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My daughter died of cancer in February (she was just under 10 months old), and I still get bills and EOBs from the insurance company, the hospice care provider, the diagnosing-but-refusing-to-treat hospital and others, almost every single day. Most of these people are dunning me for $5 here or $7 there, because they undercharged a copay (they will only get that $5 via a crumpled bill shoved up their ass, if I have anything to say about it). The worst part for me is that most of these letters are written/mailed TO my daughter, most frustratingly from the insurance company who knows the situation because her policy has been terminated based on her death. HATE!

The only place that's never sent me a bill is St. Jude Children's Research Hospital. They've only sent me nice notes, and encouragement.

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nstonep
November 13, 2009 4:35 PM
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@bunnymare: Simple solution...send the payment in pennies.

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holytrainwreck
November 13, 2009 4:35 PM
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@bunnymare: Perfect. Crumple up that $5 bill and shove it up their ass.

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repete7
November 13, 2009 4:35 PM
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@bunnymare: I'm so sorry for your loss.

When my nephew passed away the insurance company refused to pay the bill for his admission to the hospital because he lived less than 24 hours from the time he was admitted. After a year, my sister threatened to take it the local news station and then they settled up.

I don't believe that these are automation mistakes. I believe that hospitals and insurance companies have these \"errors\" built in their systems to try to take advantage of people when they are most vulnerable.

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SacraBos
November 13, 2009 4:35 PM
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@bunnymare: To be fair, St. Judes is subsidized entirely by donations and Danny Thomas's Foundation. The Shriners Hospitals (Scottish Rite, etc) are also the same and great places for kids. We donate there whenever we can.

Other places need to bill in order to pay staff/equip so that when you do need them - they are there. If they didn't get paid from somewhere, where would we be?

I'm very sorry for your loss, and I do think some of the billing practices make things difficult.

That's one practice I really hate from hospitals. You go in, and you get a bill from the hospital, the doctor, the lab, the pharmacy, something else - all looking for their little co-pays and such. Sorry, but when I go to the hospital, I shouldn't have to pay for it in such an a-la-carte fashion. The Hospital is the \"prime contractor\" and all bills should be coordinated through the hospital, not from each Tom, Dick and Harry individually.

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bunnymare
November 13, 2009 4:35 PM
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@SacraBos: Oh no, agreed. Medical providers should be paid, and setting aside the very unusual situation of St. Jude and similar charity-funded no-pay hospitals, they absolutely need to send bills.

On the one hand, they should be more sensitive when an unexpected, tragic death has occurred. On the other hand, automation is a part of life and we have to accept it, as frustrating as it is.

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The Porkchop Express
November 13, 2009 4:35 PM
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@bunnymare: @johnfrombrooklyn: I truly do feel for you both and wish that not only did you not experience the loss, but that it was handled better by the companies involved.

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MaxSmart32
November 13, 2009 4:35 PM
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@bunnymare: I'm very sorry for your loss.

That is the part that I don't understand...obviously it was NOT just meant for the insurance company, why on earth would UC Davis tell the insurance company that the insured was no longer welcome at their facility, and that he should go to a clinic? Something's not right about that.

@humphrmi: That's the very core of the problem. It's so impersonal. No one cares about the individual anymore.

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pecan 3.14159265
November 13, 2009 4:35 PM
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@MaxSmart32: The second link says it was a clerical error based on automation, which leads me to think that the billing office automatically churns out certain types of letters depending on what files are flagged for certain things, and this poor man's file was mistakenly plucked and the letter was generated even though it shouldn't have been.

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ColoradoShark
November 13, 2009 4:35 PM
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@bunnymare: That is very sad. On a positive note, I'll be increasing my donation to St. Jude's.

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bunnymare
November 13, 2009 4:35 PM
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@ColoradoShark: Hey, thanks all for the kind words! This post really got to my heart, so I appreciate your thoughtfulness.

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Julia789
November 13, 2009 4:35 PM
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@ColoradoShark: St. Jude's has a holiday catalog out, where you can shop for gifts and benefit the hospital at the same time. 100% of profits after expenses benefit them.


[shop.stjude.org]

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pecan 3.14159265
November 13, 2009 4:35 PM
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@Julia789: St. Jude's knows how to get into my wallet even further. I guess it's time to browse the catalog.

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RvLeshrac
November 13, 2009 4:35 PM
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@pecan 3.14159265:


www.childsplaycharity.org


Corporate/Legacy sponsors often pay for medical equipment and staff. While money is nice, consider donating crayons, books, games, toys, and other things that the big endowments don't cover. It sounds frivolous on the surface, but not when you hear about kids who have their entire childhood stolen from them by sterile white rooms.


There are *LOTS* of non-profit children's hospitals out there, and all of them do great work. They're frequently the only resource available to the parents of terminally ill children, as the for-profit hospitals that have the resources most often simply refuse to treat long-term patients who aren't filthy rich.

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johnfrombrooklyn
November 13, 2009 4:35 PM
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@ColoradoShark: My wife and I had a baby who died about three hours after she was born three years ago. We have consistently received mailings, phone calls,and \"promotions\" from the very same hospital encouraging us to come in for checkups. In addition this hospital sold our names to every marketer in the book. Because we gave the baby a name, we're blessed with constant mailings addressed to her.

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Techguy1138
November 13, 2009 4:35 PM
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@johnfrombrooklyn: If they refuse to stop this bring them to court to get them to stop.

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bunnymare
November 13, 2009 4:35 PM
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@johnfrombrooklyn: Oh, that is so very, very sad, I am so sorry that is happening. What a horrible thing for your hospital to have done.

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Oranges w/ Cheese hates what Christmas has become
November 13, 2009 4:35 PM
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@h3llc4t, breaker of office dress codes: As far as we can tell? He's fine. He's up in michigan right now and dealing with a completely different medical issue.

What sucks more is that the whole time he was scared to death because he used to have SVT (super ventricular tachycardia) - basically your heart goes so fast it can no longer pump your blood properly - when he was a child. They operated and fixed it. Apparently this was a side-effect from the operation.

If it continuously recurs he'll have to get a pacemaker later in life.

He's happy now. He's working for S2 Games and making the website for heroes of newerth. Its his dream job. Now he is just waiting for me to get up there.

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Adhominem
November 13, 2009 4:35 PM
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@Oranges w/ Cheese wants it to be winter already: WoW. I love your boyfriend. I play HoN all the time with my friends. Seriously, like ALL OF THE TIME.

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h3llc4t, breaker of office dress codes
November 13, 2009 4:35 PM
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@Oranges w/ Cheese wants it to be winter already: I hope he doesn't end up having to get a pacemaker. Good luck to him. (And that job sounds awesome, btw. I was a beta player for HoN, I can imagine it's a fun project to be working on.)

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Rectilinear Propagation
November 13, 2009 4:35 PM
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They admitted that the letter shouldn't have been sent but only because the patient died. Do they normally freak out at people who don't pay their bill within 10 days? Most hospitals and clinics I've been to don't even send a bill for months. How are they deciding that someone is indigent after only 10 days and it's the first time they've sent a bill?

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TheHans
November 13, 2009 4:35 PM
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@Rectilinear Propagation: Our local hospital automatically sent our account to Collections at the same time they mailed the bill for my husband's $282 ER visit (stitches needed in his hand). I received the bill one week after he was treated, wrote the check (he had no insurance at the time), and mailed it the next day. Collections called THAT EVENING. I actually got to use \"the check is in the mail\" and MEAN IT. Apparently, since there was no insurance/ER visit, it was standard practice for that hospital to send the bill to collections when it was mailed. 'Pissed' doesn't even begin to cover it.

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catastrophegirl chooses not to fly
November 13, 2009 4:35 PM
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@Rectilinear Propagation: true, i had a hospital stay in october 2007 and got a follow up bill for the portion the hospital wanted to bill me [incorrectly] on top of the insurance payment in december 2007. didn't hear a peep out of them in the meantime.

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Oranges w/ Cheese hates what Christmas has become
November 13, 2009 4:35 PM
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@Rectilinear Propagation: My boyfriend received a bill about a week after his 2 day stint in the hospital. For $19,000, demanding payment by the end of the month.

Because obviously, he has $19,000 just laying around somewhere.

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floraposte
November 13, 2009 4:35 PM
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@Oranges w/ Cheese wants it to be winter already: Was he admitted through the ER? I'm wondering if places don't bill ER stuff faster, because of the high cost and the absence of a regular-visit relationship.

If he wasn't admitted through the ER, then obviously my theory's blown right there.

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Rectilinear Propagation
November 13, 2009 4:35 PM
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@floraposte: Even when I've gone to the ER bills took forever. Perhaps it's a regional thing or a public vs private hospital thing.

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Loias calls you out if you can't RTFA
November 13, 2009 4:35 PM
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What a nice reminder of the many issues the U.S. has with health care. Five minutes should never cost that much, especially if the patient doesn't survive. At the very least they should a money back guarantee on that one!

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coren
November 13, 2009 4:35 PM
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@Loias: I understand the idea, but what if I come in with a rare genetic order that is untreatable, or trauma that would take two hours to fix but I expire in those first five minutes. Sometimes there's nothing you can do - but the hospital still did everything they could.

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iammoses
November 13, 2009 4:35 PM
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@Loias:
There is no guarantee in an emergency situation that you will live and the hospital does not tell you the odds and asks if you would like to try before it tries to save your life, the hospital will try to save your life with all it's abilities and resources when your brought into emergency room. Even though the patient didn't live, the hospital did commit 100% of it's abilities and resources for that effort however brief it may have been. The hospital should be paid for that effort so that the hospital can continue to function to try to save other lives.

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madanthony
November 13, 2009 4:35 PM
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@Loias:

Why? Unless the patient died from their negligence, which he didn't, it's not their fault that he died. They still performed the services. And if their is anyone who I would want paid a shitload of money it's a trauma team that's literally saving lives.

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Snaptastic
November 13, 2009 4:35 PM
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@madanthony: If they are being paid for their services, they should be responsible for some kind of result. Granted the kid may have died from being beaten to death, but I'm sure cutting holes in his throat, sticking in tubes and using electrically-charged paddles on his heart (and all that other stuff doctors do) didn't help too much in this case. Hell, I can kill off patients with the stuff there and I don't even have a medical degree!

I had a cavity filled and paid a good chunk of money for it (I was uninsured at the time). A month later, the filling fell out and I called the dentist--all the while expecting to end up paying another couple hundred dollars. I was pleasantly surprised when they did the filling (and a bit extra work to keep it from falling out) for free. Why? The doc felt that it was total crap to pay that much for his work (which he prided himself on), then to have nothing to show for it.

I know there is a world of difference between a dentist and an ER trauma team, but I think it is total crap to stick someone with a bill that costs more than their net worth--especially when they die.

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holytrainwreck
November 13, 2009 4:35 PM
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@madanthony: I call bullshit. In Canada you could get a greater standard of care for much less money and bullshit.

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coren
November 13, 2009 4:35 PM
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@holytrainwreck: Right, but that doesn't make anything he said bullshit - it's still not their fault, they did what they could, and they're definitely one of the more deserving things of money.

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Trai_Dep
November 13, 2009 4:35 PM
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Isn't barring a dead person from further hospital care the same as barring a married person any more sex?

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JulesNoctambule
November 13, 2009 4:35 PM
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@Trai_Dep: Looks I'll have to tell the spouse we've been doing it wrong all these years.

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jayde_drag0n
November 13, 2009 4:35 PM
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The only person responsible for accrued debt is the person who accrued it. You cannot go after parents or siblings or employers for someone else's debt, have you not been paying attention to this site? When a person dies the remaining debt is paid off of that persons estate, property and money leftover.. so if the kid does not have an estate, or money , or cars.. or anything the creditors and lenders take a loss, it does not come out of anyone else's pockets. Debt is NOT inheritable.

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ninram
November 13, 2009 4:35 PM
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@jayde_drag0n: As he was a student, it could also be that he was still a dependent on the parents 1040. The parents of a depentant child, minor or adult, are responsible (as I understand it).

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coren
November 13, 2009 4:35 PM
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@ninram: Dependent means you depended on them for financial support, not that they had an obligation to give it to you. The two aren't at all the same, trust me.

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treimel
November 13, 2009 4:35 PM
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@ninram:


Then change your understanding--being claimed as a dependent simply means that a taxpayer is able to claim that he or she paid for the majority of the support of a particular individual (generally a minor) in a preceding tax year, it has *zero* to do with debt accrual, ciontract formation, and the like.

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IamBort
November 13, 2009 4:35 PM
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If he had lived one hour, that would have cost over $350,000, or 8.4 million dollars a day, assuming those doctors had treated him. We are clearly all in the wrong business.
So much for payday loans being a scam, they are small potatoes.

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IamBort
November 13, 2009 4:35 PM
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People complain socialized medicine costs too much, i dare them to prove Canada pays this much for 5 minutes of care.

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pgh9fan1
November 13, 2009 4:35 PM
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Interesting that he could no longer seek services there because he's indigent. That's a particularly caring hospital. And people wonder why we need a national health insurance plan.

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Woodside Park Bob
November 13, 2009 4:35 PM
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Under the federal EMTALA act, it is illegal for hospitals to turn emergency patients and women in labor away without assessing and stabilizing them. They might tell someone who is indigent that he is unwelcome, but legally in an emergency they are required to provide care.

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coren
November 13, 2009 4:35 PM
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@Woodside Park Bob: While that may be true (and I am not saying that you're wrong) if I have been told that I, or my hypothetical child, is not able to go to a hospital, chances are I am not familiar with that piece of legislation and I will take them at their word. In an emergency I'd probably risk it anyway, but I'd have had no idea that they'd give me care anyway, but I'd be desperate.

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NickelMD
November 13, 2009 4:35 PM
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As a disclaimer I don't work at UCDMC, but I am an ER physician and I do transfer patients to Sacramento fairly often - many to UCDMC.

While UCDMC is by no means a perfect hospital, far and away more than other local facilities they will accept the uninsured ER patients who I want to transfer because I don't have the specialty services available at my hospital.

Does the hospital bill patients and tell them to go to the county health clinic if they are uninsured? Yes. Do the doctors and nurses there do what is right for patients regardless of ability to pay? Absolutely. And those two things are not mutually exclusive.

I have never once had a 'wallet biopsy' performed by UCD before they accepted a patient in transfer. The nurses and doctors at UCD do the right thing even if the bean counters send bills like this.

In a broken health care system, UCDMC is one of the pieces that is holding our frail safety net together. At least in the Sacramento area.

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lehrdude
November 13, 2009 4:35 PM
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I guess the hospital didn't have a money-back guarantee?

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iammoses
November 13, 2009 4:35 PM
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@lehrdude:
Life does not have a money back guarantee.

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StanTheManDean
November 13, 2009 4:35 PM
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These days a \"good\" trauma is going to rackup charges at the rate of ten's of thousands of bucks per minute, especially in the first 5-10 minutes of care.


And on average, better than 90% of those \"good\" traumas are not going to have a positive outcome (if you know what I mean)


30 years ago I was one of those \"good\" traumas. My first 6 hours of care was $150,000. Remember, that was 30 years ago... when medical care was cheap. Fortunately I had fairly decent insurance and only had to pay the $2500 deductable.


Why the big expense? Because the majority of the \"good\" traumas will have zippo insurance and those that do must pay for those that don't.

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coren
November 13, 2009 4:35 PM
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@StanTheManDean: Oddly enough, that deductible is about what the equivalent cost for the amount of time this poor kid got. Talk about inflation.

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Oranges w/ Cheese hates what Christmas has become
November 13, 2009 4:35 PM
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@StanTheManDean: And they say that the new medical program is socialism. Obviously we're already there.

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floraposte
November 13, 2009 4:35 PM
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@StanTheManDean: Congrats on being 30 years past that! And on getting into trouble near what would have been one of the few trauma centers of the time.

It's not just the uninsured thing--as you note, a lot of people don't make it to the bill-paying stage from such places, so the survivors have to pay for the unlucky as well.

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Oranges w/ Cheese hates what Christmas has become
November 13, 2009 4:35 PM
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@h3llc4t, breaker of office dress codes: Yeah, they posted a picture of the crew on their facebook account yesterday. Everyone is drooling over the girl -_-

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boobookitteh
November 13, 2009 4:35 PM
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It's hard to comment on the bill without an itemization. Level 1 trauma teams don't come cheap though - neurosurgeons, trauma surgeons, nurses, anesthesiologists - all have to be kept in house on call.


regardless, the letter telling him not to come back is a little cold, even without considering that he died. It's also problmatic that they would refer someone with a complicated medical situation to follow up with a different hospital. Thus fragmenting care - which leads to higher overall costs as tests are delayed or repeated with new providers.

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imsnowbear
November 13, 2009 4:35 PM
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@boobookitteh:
The outrage is not sending the bill. They provided the services, they're entitled to charge. Apparently they charge a lot, but that's a different topic. To me the problem is the gratuitous and wicked hearted letter telling the patient to GFY and die somewhere else next time.

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treimel
November 13, 2009 4:35 PM
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@imsnowbear:


the bill should have gone directly to the insurer--the hospital concedes that.

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coren
November 13, 2009 4:35 PM
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@treimel: In a press conference, face saving move - not in a direct apology to the greiving family. I'm not sure that's fixing the problem.

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Scuba Steve
November 13, 2009 4:35 PM
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@h3llc4t, breaker of office dress codes:


Ogre? From Revenge of the Nerds? He wasn't in that.

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squinko
November 13, 2009 4:35 PM
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@Scuba Steve: oHgR, the singer from Skinny Puppy and oHgR. She just used the wrong spelling.

I hated that movie so much, but Anthony Steward Head was great.

@Oranges w/ Cheese wants it to be winter already: Where is S2 Games at here?

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zjgz
November 13, 2009 4:35 PM
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@squinko: Awww. I love Ogre (Thats actually my avatar). I wanted to see that movie for the longest time because of him. I guess it's not worth watching though.

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h3llc4t, breaker of office dress codes
November 13, 2009 4:35 PM
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@squinko: Technically I think ohGr is the band consisting of Nivek and Mark Walk. Nivek is listed under the \"Ogre\" spelling in the Repo credits.

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[DFX] Deimos
November 13, 2009 4:35 PM
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In either case, the parents aren't responsible for debts incurred by their adult son. It just doesn't work that way.

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floraposte
November 13, 2009 4:35 PM
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@[DFX] Deimos: Somebody with actual legal knowledge in the state and the field will have to comment on the real viability of this, but I've found at least one claim that the 25-year-old's being claimed as a tax dependent qualified the hospital to bill his parents.

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sonneillon
November 13, 2009 4:35 PM
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@floraposte: I am not a lawyer but my aunt had something similar where they were going after her for her sons debt. She had her lawyer file some type of paperwork which divorced her from the \"inheritance.\" That essentially did the same for his debts.

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treimel
November 13, 2009 4:35 PM
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@floraposte:


I'd like to see a cite for that--I'm very, very dubious. I can only speak for Pennsylavnia--but here, no way, no how.

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floraposte
November 13, 2009 4:35 PM
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@treimel: When I say \"claim,\" I really mean \"claim,\" as in \"random individual on the internet says that's what's happening.\" Here's the one I just ran into (scroll down to SJK's comment): [www.avvo.com]

I wouldn't be surprised if the odd debt collector made a case for that as a reason even if it weren't legally viable, too.

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treimel
November 13, 2009 4:35 PM
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@floraposte:


Re: debt collectors; I entirely agree there--I feel pretty confident that they would make such a claim. I think the reason \"dependents\" comes up and causes confusion for people is that many families have insurance policies where kids are covered by virtue of their dependency. However, I'm confident that (insurance issues aside) a person's status as a dependent does not make his debts somehow tranferrable thereby.

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floraposte
November 13, 2009 4:35 PM
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@treimel: It certainly wouldn't make any sense to me, as we're talking very different areas of law--what next, people arguing they should be tried as juveniles because they're claimed as dependents? But I thought it was an interesting report nonetheless.

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AdvocatesDevil
November 13, 2009 4:35 PM
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If this was really an honest mistake, why would they have sent the INSURANCE COMPANY a letter saying \"you're not welcome back here\"? Obviously this is another example of a hospital hoping to squeeze some money out of the family, who didn't owe them anything. YES, the deceased received some sort of service, but no one except his insurance company is responsible for paying any bills. You cannot go after family, friends, associates, etc, for a debt after someone dies. This hospital is full of it.

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coren
November 13, 2009 4:35 PM
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@AdvocatesDevil: NICE catch, I missed that entirely.

Something is seriously wrong - there were two major screw ups here, one not billing the insurance company and the second of sending that letter to the family of the deceased.

Hm...why would they be sending that to his family since he wasn't living there?

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pecan 3.14159265
November 13, 2009 4:35 PM
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@AdvocatesDevil: It did not specify whether the bill and the letter was sent together. I think it was a separate automated process in which the son's name was mistakenly flagged for the letter.

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floraposte
November 13, 2009 4:35 PM
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@pecan 3.14159265: The original article says that they were in the same envelope.

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TheMonkeyKing
November 13, 2009 4:35 PM
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Stunning...I believe this to be a case of relying on technology too much and not enough in-person investigation. Yeah, I know, people cost and that would cut into the profits.

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savdavid
November 13, 2009 4:35 PM
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So the hospital thinks they weren't responsible for a \"clerical error\"? Whoever sent out that bill works for the hospital and the hospital alone is to blame. They would sure take the credit for a anything a worker did that was good PR. Shameless!

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madanthony
November 13, 2009 4:35 PM
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@savdavid:

I think there are different degrees of responsibility. Yes, they should have processes in place so dead people don't get dunning bills. But some people seem to be acting like the hospital explicitly made a point of sending a bill to a dead person, rather than accidentally sending a form letter.

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RvLeshrac
November 13, 2009 4:35 PM
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@madanthony:


No, I think people understand that this wasn't a \"willful\" screwup.


What's at issue is that they sent a letter to a deceased person. Someone who was declared dead at their hospital. The file that was used to create this bill would have been flagged to indicate that the person was deceased.


It was an accident, but it was an accident with far-reaching consequences. It inflicted immense psychological harm on the family of the deceased.


Additionally, the \"indigent\" letter is bordering on illegal, as a hospital cannot legally refuse emergency care to anyone at any time for any reason.

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Oranges w/ Cheese hates what Christmas has become
November 13, 2009 4:35 PM
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@squinko: They're in Portage somewhere.

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SadSam
November 13, 2009 4:35 PM
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This happens all the time, I just spent (for the sixth time) 1/2 hour on the phone with my insurance company and a doctor's office that keeps sending me bills and collection notices for $250 bill despite the fact that both the insurance company and the doctor's office have told me I'm not responsible for the bill (I paid my co-pay, the doctor's office failed to timely submit it to the insurance company therefore the insurance company won't pay it, etc.)


Despite the fact that I'm not responsible for this fee the doctor's office billing office said that the bills are generated automatically and that they have no way to turn them off. If an account shows a balance they bill it to the patient and send them to collections regardless of whether the patient actually owes the amount showing owed on the statement.

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DerangedRoleModel
November 13, 2009 4:35 PM
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So, is death a pre-existing condition?

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rrapynot
November 13, 2009 4:35 PM
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I work at a hospital that has an average of 60 beds filled each day. It costs us about $300 million per year to operate.

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greggen
November 13, 2009 4:35 PM
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@rrapynot: Hmm, that's 300Million divided by 21900 (60 beds times 365 days in a year) equals under 14K a day per bed, or actual cost $570 an hour. Quite the markup...

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tripnman
November 13, 2009 4:35 PM
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I thank the UC Davis Medical Center everyday when I wake up with my wife next to me. Three years ago she had to have emergency abdominal surgery and it wasn't until the bills started arriving that we realized how awful her insurance really was. Not only did we have to cough up a $3000 cover charge to get her in the door, the final bill for surgery and six days of recuperation was just shy of $300,000. Her insurance \"graciously\" covered all but $80,000. We pleaded our case to UC Davis and the surgical team ended up donating their time, lowering our bill for room and board to $20K. Next month we make the final payment on that.

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chazcarr
November 13, 2009 4:35 PM
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Well I've been to UCD Med, and must admit they are pricey even for a hospital. What makes it so is that there is a lot of researching going on with patients there. They need money to try and compete with mega-hospitals like Sloan or Anderson. Also, this tuff happens all of the time. Billing departments are a joke and always have been. I know of some cancer patients that have to call into the billing department at Yale every time they get a bill because of errors. Most people can't figure these bils out. Luckily I can. You'd be surprised how much you pay for that you never used. You'd also be surprised how often a hospital will at first pretend that you don't have an insurance card, they make more money that way.

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Trance1861
November 13, 2009 4:35 PM
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I am actually more upset with the tone of the letter than the fact they sent it to the parents of a deceased child (which, don't get me wrong, is horrible).


I understand in today's world, hospitals need money from individuals and insurance companies to stay open, but I think the tone of a collection letter for a hospital bill should be VERY different than the tone of a letter for, say, a department store.

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gover57
November 13, 2009 4:35 PM
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Are the parent's actually responsible for this bill? Can they tell the hospital to F*** off? glad i'm taxed like crazy up here in Canada and will never have to worry about any of this kind of crap. I'd be telling them to go after my kids estate to get thier money, and being a student, it's likely he has no assets in his estate, and they wont get anything.. You guys need to vote in that damn medical law that's all over the news down there. who cares what the stupid anit-new law hype is, its better than what your current situation is...

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MartaMyrrha
November 13, 2009 4:35 PM
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@gover57:


if the pt is not a minor, then nope, parents aren't liable

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mommiest
November 13, 2009 4:35 PM
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I'd like to see the actual amount they would bill the insurance company--bet it wouldn't be close to $29K.

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coren
November 13, 2009 4:35 PM
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@mommiest: My guess, something around 1400-2000.

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sumocat
November 13, 2009 4:35 PM
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Sounds like a sterling endorsement of a single-payer system.

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Bob Lu
November 13, 2009 4:35 PM
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I am confused. Judged by what Mr. Seamons said, it seem that the ER visit in question was unnecessary. Was the ER visit not directly related to the lethal beating?

If this is the case I'd say the hospital made some bad PR decision but is not actually in fault. Someone used the resources improperly, they should pay for it, even be panelized. It is sad that they were later murdered, but it doesn't change the fact that they used the the resources improperly.

In the other hand if the bill is for treating the lethal beating, what Mr Seamons said will be totally utterly BS, and the hospial should not just apology. They need be investigated, fined and someone have to lose their job.

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treimel
November 13, 2009 4:35 PM
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@Bob Lu:


What on earth do you think he was pronounced doa at the er for? Of course it was the fatal beating.

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Bob Lu
November 13, 2009 4:35 PM
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@treimel: Sorry if I missed anything but after I rolled back and read it again I still couldn't find the line saying that he was announced DOA at that ER visit. I didn't read all the comments and links, tho.

Anyway, if he died at the ER visit in question, UCD medical center is very, very wrong.

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treimel
November 13, 2009 4:35 PM
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@Bob Lu:
well, I went=off half-informed in my comment, too--strictly speaking, doa is when you're pronounced dead \"on arrival.\" In this case, they worked on the kid for about five minutes before pronouncing him dead in the er.

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t0ph
November 13, 2009 4:35 PM
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Everyone that looks your way in a hospital sends you a bill. It is crazy ridiculous.

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MartaMyrrha
November 13, 2009 4:35 PM
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Havent read the whole thing + articles yet...but I work at a trauma center and we easily go thru $20k, 30k, even $55k worth of blood products in an hour trying to save a life.


I would need to see the itemization of course and chart, but Ive seen plenty of $30,000 30 minutes stays worth of bills for a pt who expires.


As far as the \"insulting\" letters - the computer dropped them as any other patient accounting system would. \"The computer\" doesnt care if it is a $100 bill or $100,000 bill. I also would like to know if the hospital received insurance info timely when pt was there. If the pt can't talk, expires, then family arrives, the liklihood insurance was known and provided timely by family during the most distressing time of their life isn't high. The means it was set up as self pay and not set up to the insurance.


I got tired of very injured people coming in, often without ID, who lie, are uncooperative, or are too injured to speak blame the \"evil hospital\". We didn't set up these systems to annoy and hurt family; culturally hospitals are a business that have to \"Follow the rules\" if they want to get reimbursed - while saving lives most of the time - so the doors can be kept open for the next round of v. injured people.


The fact that only 40% of our patients have insurance cards with them doesnt help + the others who when asked what their insurance is say, \"I don't know.\"

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floraposte
November 13, 2009 4:35 PM
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@MartaMyrrha: To be fair, \"the computer\" also didn't write the template for the letter, input the fields for the recipient eligibility, or arrange for the letter to be sent. People were involved in this, and they screwed up.

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Oranges w/ Cheese hates what Christmas has become
November 13, 2009 4:35 PM
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@Adhominem: Heh, he only works on the website, but I'll pass on the thanks to the team.

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Quatre707
November 13, 2009 4:35 PM
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Suffer a potentially fatal injury and seek emergency medical treatment? Don't have insurance? Well, it doesn't matter whether you live or die, because your live is still over after you receive the bill.

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H3ion
November 13, 2009 4:35 PM
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The hospital in the original post may have been heartless and brainless, but a lot of the posts are contradictory. We DEMAND the very best of medical care. We demand Level 1 Trauma Centers which, by their very nature, cost a fortune to maintain. Face it. If you had a cardiac event you would want to be transported in an ambulance that had advanced life support capabilities and you would expect to be diagnosed in a cardiac ICU by a board certified cardiologist. If it turned out, ultimately, that you just had indigestion, you could thank God for your good fortune in not having had a heart attack, but would you then be justified in complaining about the bill because they couldn't find anything wrong?

And the billing is totally messed up anyway. The hospital may send a bill to the insurance carrier for $29,000 but their actual reimbursement may be less than $10,000 and they're not allowed to balance bill. We had that exact situation in a string of MRI clinics that I represented. Our charge was $950. Medicare would allow less than $300 and the private insurers would key their reimbursement to Medicare plus some percentage. People went berserk when they saw a $950 bill but the fact was that only people with no insurance paid that amount, and we would usually discount the bill in that circumstance. We weren't raking in money because our actual receipt per scan was around $350.

We can rightfully complain about medical costs when we don't demand the most expensive and most comprehensive medical care. Until then, the costs go with the territory.

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RvLeshrac
November 13, 2009 4:35 PM
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@H3ion:


The question of billing has less to do with the bill and more to do with the actual cost of care.


Hospitals routinely charge $2/ea for OTC aspirin tablets, $5+ for a pair of OTC latex gloves, and we're supposed to think that the bill we get is 'fair'?

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sevenwhitehorses
November 13, 2009 4:35 PM
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it is a sad commentary that they charge this much. is this not in part BECAUSE of the insurance companies? they agree to paying such high fees so the fees are charged. if they could only charge what an average person can pay it would be far less. also is how much can be claimed and gotten in court, once again, insurance companies can afford the outlandish fees awarded but in this case awarded by a jury who decided it was ok since it is, after all, just and insurance company who pays. it is us, who have to pay these high insurance fees that pay. most doctors i know would do the work for they love for less if not for the insurance fees. tort reform is needed.

for five minutes of their time they really think they deserve $30,000 dollars? they were there at work! they are paid to be available. heck even most mechanics will look at a car and tell you if them inspecting it would be worth the charge.

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Cycledoc
November 13, 2009 4:35 PM
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Whether it was an \"honest\" error or not is irrelevant. Where else in the industrialized world would this happen?

NOWHERE!

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henrygates
November 13, 2009 4:35 PM
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Am I the only one who thinks they should have sent the bill to the roommate?

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holytrainwreck
November 13, 2009 4:35 PM
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Health care like housing should be a human right and not depend on the size of one's pocketbook.

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JulesNoctambule
November 13, 2009 4:35 PM
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Once again, I'm reminded that I won't be able to afford living through any kind of trauma. Looks like I won't be able to afford dying from it, either.

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baristabrawl
November 13, 2009 4:35 PM
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You don't get a freebie because someone dies.

You also can't be so irresponsible as to send a letter to someone telling them their dead child is a deadbeat.

Seriously? The hospital system knows if someone is discharged as \"expired.\" It should be reprogrammed to NOT tell you that your dearly departed is broke. When honestly? They probably never got insurance information to begin with.

Now I'll go read the story in order to have an informed opinion.

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TheSurlyOne
November 13, 2009 4:35 PM
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Back in 1982, my 22-yr old cousin shot himself in the head intended to commit suicide. He survived for an hour or so, but died on the operating table about 15 minutes into surgery. The neurologist billed my aunt, a single parent who worked two jobs and had just lost her eldest child, in excess of $17,000!!! She had no health insurance coverage, so she spent the next SEVEN years paying off that CROOK! Within the first year, he placed a lien on her house AND her car, which he said would remain until he was paid in full!

The hospital and ambulance service never even sent her a bill. A few months before making her final payment to that S.O.B., karmic justice worked it's magic. At age 48, he died (while cheating on his wife...literally, in the act) from a subdural hematoma! My aunt paid the last few payments to his estate. Later that year, his widow returned every penny my aunt had ever paid AND she paid off the $20k balance on her mortgage to apologize!!!

Karma is a b!tch!

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jcargill
November 13, 2009 4:35 PM
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Only in America. No, really, only possible in America.

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el elarmist
November 13, 2009 4:35 PM
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I'm surprised the victim's father called the US a 'civilized country' given that our uncivilized manner of health insurance is what kills so many people every year. That is why he go tthe big bill in the first place - the hospital assumes insurance will pay, and charges whateve they want to make a profit. Who cares that insurance doesn't pay and the family is left with the bankrupting bill.

CIvilized countries have universal health care.

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Marko_Vulvic
November 13, 2009 4:36 PM
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@el elarmist:


Bingo. I'm never surprised when I see this type of news from the US. Which is sad.

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betsbetsbets
November 13, 2009 4:35 PM
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This story has been a hot topic with the on-line autism community as well-- the victim was mildly autistic. It's terrible to find that it just keeps going and going thanks to UCDavis's appalling treatment of this family. And I hope our fine congressmen and women will take note today.

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coren
November 13, 2009 4:35 PM
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Assuming the article is correct, the bill and the \"deadbeat\" notice were sent in the same envelope. So what, you might say. Bear with me.

There was the obvious screw up: he had insurance and his parents were still billed (which to my knowledge they have no obligation to pay unless they are his estate, but IANAL).

There was the obvious \"be a fucking person\" screw up in sending a dead kid's parents the notice about him being persona non grata at the facility.

But here's the thing: he didn't live with his parents. We know this because he had a roommate (who inflicted the beating that ended his life). Further, he wasn't a minor - he was 23 at the time of his death. So why was a bill sent to his parent's home? And while I agree it's possible that was still listed as his address rather than his address at the school, why was it also *addressed* to his parents? Every article I've read said it was received by or addressed to them - nothing about opening a letter that was addressed to their son or anything about it being for their son.

It takes more than a simple clerical fuck up to send a bill to someone that was an insurer's responsibility, and wouldn't be their responsibility even without insurance, nevermind the deadbeat notice. The only way that gets to the parents is if they know the kid is dead, and send it anyway.

And that's fucked up. Be a fucking person.

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Darkneuro
November 13, 2009 4:35 PM
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Doctors are like lawyers. 5 billable minutes turns into the minimum billable hour. And let's not forget the over-inflated cost of the facility itself. And of course, unless it's a non-profit hospital, they have 500% markup. They also sell $130 single-dose aspirin packets.
Deciphering itemized hospital bills is a lesson in outrage.

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Bog
November 13, 2009 4:35 PM
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It doesn't even look like that either the estate, the victim, the family, nor the insurance of the victim is legally responsible for the charges and costs.

All of that can be laid on the roommate who murdered the victim. When you illegally assault, harm, murder, etc. someone you are liable and responsible for all the resultant medical costs.

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allstarecho
November 13, 2009 4:35 PM
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Last I heard, any hospital that accepts federal funds can't deny you treatment. I can't imagine that the University of California - Davis Medical Center doesn't accept federal funds. That being said, how can they tell someone not to come back and to go to another hospital?

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NitrousO
November 13, 2009 4:35 PM
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Oh wow. Small world. I volunteer in the UCD MC Emergency Room and know people who knew both the deceased and his killer who was his roommate if I recall. She said that the one who snapped and killed him did so with a baseball bat which he borrowed from one of her friends. They also said the guy was a little batty to begin with as he would routinely bang on the walls.

The strange part is I have been in the resuscitation room where they would probably have taken him when they have had people in pretty serious condition come in and most of the time it looks like a bunch of people standing around trying to keep pressure on this or that while two people actually do something. How those few moments ever amount to that cost are always beyond me.

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uclajd
November 18, 2009 4:52 PM
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Another reason ERs are closing. Next time you are dying and it takes 30 minutes to get to an ER, decide if this \"free\" medical care entitlement mentality is a good thing.

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