First, take a look at this:

This is the insurance statement from the web site for my one night of the hospital stay and the pre-op tests (based on the first date). This doesn’t include the bill for the operation, the anesthesia or the radiology which are other line items.

The discrepancy between the billed amount and the amount paid by the plan is beyond absurd. The “Network Discount” is 89%.

Obviously the hospital is making due with the $2904 that they are being paid by my insurance. What’s the $25K that they are charging then?

You can argue that that’s the bill I would get from them if I didn’t have insurance — but that’s fake too. All I would have to do it walk into the administration or billing department and ask for that myself. I’ve heard first-hand stories about people doing exactly that (not to mention the million web sites that tell you exactly how).

So who what the hell is the giant number then?

My guess is that this is how people go bankrupt.

The top line number would go to a collections agency who buys the debt at (my guess) the amount the hospital needs to keep running — i.e. the “Paid by Plan” number, though probably a bit less.

So here’s the rant I promised. Let’s start with a few simple facts that can’t really be disputed:

  • People get sick. People have accidents. People need medical care.
  • Doctors, by oath, will (should?) treat a patient that comes to them.
  • Doctors typically have a high debt load themselves from many years of medical school.
  • Doctors, like everyone else, need to put food on the table. They are a highly skilled profession and should be treated as such.
  • Nurses and the rest of the staff, like the doctors, have bills to pay and food to buy and everything else. They, like the doctors, need to be treated just as fairly. It’s a hard job.
  • Hospitals are an expensive thing to run with lots of specialized gear. That doesn’t come for free.
  • Some people have insurance.

Let’s start with that list.

If someone sick comes to the hospital, they’ll generally get treated. Especially if it’s a life-threatening issue — think gun-shot wound or a heart attack — you treat first and ask about the money later.

If they can’t pay their bill the hospital/doctor will eventually write off the loss and sell the debt to the collection agency and keep running.

Going to the other points though, everyone still needs to get paid. Who pays it? Well, my insurance, and your insurance, and so forth.

The doctors still need to get paid. The nurses still need to get paid. The machines and building don’t pay for themselves.

And let’s not even begin on the whole non-life-threatening cases — the issues that can be put off for now, until they wind up in the emergency room and cost more than anything else.

If it sounds like I’m arguing for universal insurance, you’re right in a way. The underlying thing I’m trying to get at is I’m ranting against the funny-money billing that the medical industry does. What good does it do anyone? I’m insulated by my insurance company so it doesn’t really, directly affect me. But it does since the premiums I pay keep going up.