Why Are American Hospitals Charging Up to $800 for a $1 Bag of Salt Water?

[solarhydrocan]

Why Are American Hospitals Charging Up to $800 for a $1 Bag of Salt Water?
Melissa Melton The Daily Sheeple February 3rd, 2014 Reader Views: 6,436

Horror stories abound about hospitals charging people ridiculous sums of money in America for something as cheap and plentiful as an aspirin. This is nothing new, and it’s something that’s sadly just an accepted fact.

Just last month, this guy posted a bill for his appendectomy on Reddit and it went viral. Why?

I never truly understood how much healthcare in the US costs until I got Appendicitis in October. I'm a 20 year old guy. Thought other people should see this to get a real idea of how much an unpreventable illness costs in the US.
http://www.reddit.com/r/pics/comments/1tugnm/i_never_truly_understood_how_much_healthcare_in/
10762 comments

Because he was charged a stomach-turning $55,000 for the relatively simple procedure — an amount that would’ve likely induced appendicitis if the guy hadn’t already had his appendix taken out.

Overpriced, much? Did that surgery come with foie gras and caviar afterward?...

...I decided to do a little research to see if this was actually true. After all, approximately 70% of the surface of this planet is covered in water — 97% of which is of the salt variety. Are hospitals really charging Americans up to $800 for one of the most abundant resources on the planet and something that ultimately costs a whole buck to make?

Yes. As a matter of fact, it turns out they are.

MORE: http://www.thedailysheeple.com/why-are-american-hospitals-charging-up-to-800-for-a-1-bag-of-saltwater_022014

[Fumesucker]

1. .Because.They.Can.

[Alkene]

3. +1 n/t

[solarhydrocan]

5. And because the people allow it nt

[RC]

55. The next time someone calls me a "truther", I'm using that.

Damn mindless sheep.

[solarhydrocan]

76. Future historians will wonder how those that sought truth

were allowed by society to be mocked and scorned.

It's the definition of Orwellian.

I'm a "Truther" and damned proud of it. And the truth always wins in the end.
Might take 10, 50 or 100 years but the Truth will out.

[RC]

88. Especially when some things as so obviously, not the way we are told to believe.

[yuiyoshida]

8. beat me too it...

+100. EDITED to note, when they LEGALIZE POT...what DO YOU think a bag will go for? I bet it will be more expensive than a carton of Cigarettes.

[nikto]

19. Not if you grow your own

[FreakinDJ]

25. So they can "Pay Out Dividens" to the Wealthy Elite Stock Holders

of the "Subsidiary Corporations"

Its all a scam

[bemildred]

34. +1. nt

[Egalitarian Thug]

2. Is there something ambiguous about the term "for-profit health care"?

Does the concept of profiting, massively, from suffering and extorting people when they are at their most vulnerable, confuse people?

This is the system that our glorious leader insisted be the centerpiece of "his" health care "reform". What a refreshing change.

[solarhydrocan]

4. Well, Thug, there is profit and then there is *PROFIT*

this kind of ripoff and abuse should make Gordon Gekko blush

[Egalitarian Thug]

7. There are several areas in which profit seeking is completely inappropriate,

and health care is right at the top of that list. There is no debate on this because there are only two positions, either it is right to steal from the weak when they are at their most vulnerable, or it is as inhuman as one can get.

Choose.

[dionysus]

60. i think health care, education, and energy should not be based on profit...

most other things, knock yourself out, but those are too important to gouge people on.

[Egalitarian Thug]

68. And add justice. The lawyers might squeal, but this is one of those fundamental pillars

upon which any social group depends.

[TomClash]

6. It's all "in the bag."

Don't you see?

[Hoyt]

9. Fortunately, that's "list" price, and very few people (or their insurer) pay anywhere near that.

One advantage of having insurance (or Medicare) is that they essentially only allow a few dollars for something like that.

The irony is, if you are uninsured or have cruddy insurance the hospital or some ruthless bill collector might go after you for entire charge. Of course, few folks can pay it.

It's a pretty crummy way to treat people.

[ScreamingMeemie]

33. Fortunately, if you don't have insurance, very few hospitals will treat a "stomachache"

through the ER, and you will die of a ruptured appendix... saving everyone, yourself included. (<just in case)

[Hoyt]

36. Actually, they can't turn you away for an acute condition like that.

Now if you have cancer, they will stabilize you, send you on your way, so that you have to keep going back until you can get on Medicaid. A good hospital might help you get on Medicaid.

[ScreamingMeemie]

37. I will tell my neighbor that they didn't turn her away.

(Yep, she was turned away without treatment--told it was the flu). She ended up going to a county hospital 40 miles away. Yes, it happens. People die because they are turned away and told it's just a stomachache.

[Hoyt]

43. Glad she managed to get hospital care.

[ScreamingMeemie]

46. I am saddened that, while she managed-finally-to get care, if it wasn't for her husband forcing

her to go to the distance, she'd be dead right now. And that so many people still believe you can walk into any hospital and be treated for a life-threatening event. That shouldn't be happening in this country. Ever.

[Hoyt]

49. I agree it shouldn't happen, and she might well have recourse against the first hospital.

[ScreamingMeemie]

71. She would if she had the time and the cash. We shouldn't have to be threatening recourse.

Let's be real.

[Hoyt]

72. She doesn't need any cash. She can report an EMTALA violation to the regional office

of the Centers for Medicare and Medicaid Services. She doesn't have to be a Medicare beneficiary. EMTALA is a federal law that prohibits any hospital that receives Medicare funding - virtually all - from "dumping" a patient even if they have no health insurance in life threatening situations.

[siligut]

87. But she only had the "flu"

The first hospital didn't turn away a person with appendicitis, they sent away a person with the "flu", an appropriate action.

You can be sure an ER doc knows whether or not a person in insured when it comes time for a diagnosis.

[Hoyt]

91. An "mistaken" diagnosis ruse like that would be easy to prove.

[siligut]

92. How? By what was charted?

By what the patient says? How do you prove appendicitis when the ER doc didn't assess or chart a response to McBurney's point or do labs?

I have seen a myocardial infarction "misdiagnosed" even when CPK-MB and ST segments were elevated.

[Hoyt]

94. I'd look at the chart at the second hospital, and I think investigators would too.

[siligut]

95. "Her condition worsened during the 40 mile drive"

I am both glad and saddened by what I hope is just idealism.

[Hoyt]

96. I am saddened by your cynicism. They might well claim that, but who is going to believe it?

I don't think an investigator would, but we are just speculating.

Fact is, there is a law against patient dumping. Does it happen sometimes? Sure.

Fortunately, in this case the lady is OK, although I'm sure is was quite painful and frightening. Maybe, she can get insurance under Obamacare now, and not have to face this is the future. Or maybe in the future, she should go directly to the county hospital, where she is more likely to get needed treatment without any games.

[Sgent]

73. If the doctor thought it was the flu

then her problem is with the doctor. In most cases doctor's aren't even allowed to know the billing status (self-pay, insurance, etc.) until after the patient is seen. Its illegal for a hospital to discharge an unstable patient who comes into the ED.

[SamKnause]

10. Capitalism

To be more specific CORRUPT Capitalism !!!!

[Rider3]

11. Exactly

You nailed it. Capitalism.

[Adrahil]

85. Yes, the market is broken in this case.

Health is not and cannot be a free market. People will do whatever their doctor tells them to do because they don't want to die, and they don't have the expertise to assess whether or not the doc or hospital is bullshitting them.

The market is broken.

[SamKnause]

86. The system is rigged.

Corruption, fraud, greed, and malfeasance rules in the US.

[Faryn Balyncd]

12. Because we've allowed the crooks to take over.

[spike91nz]

13. insurance companies place inflationary pressure upon prices and produce a spiral

of cost increases to realize the costs, within the ~thirty percent or so that they will pay. This drives the costs of service up to where people can only afford the services if they have insurance and so they come to monopolize the market and set prices and conditions. Anyone who has been in private practice and had a privatized managed health service move into the area will know the developments that occur as the market adjusts to the insurance company's conditions. The costs of elements of service not covered by the insurance company's policy are shifted to inflation of costs of articles and procedures covered. The entire privatized insurance scheme is designed for inflationary cycles that raises costs beyond what would otherwise be sustainable by the market, much like credit schemes do with the price of goods. It also produces an impulse toward collusion and the compromise of integrity by professionals into a systemic corruption, wherein a $1 bag of salt water comes to cost $800. Insurance companies are evidence of the inherent corruption produced in for-profit capitalist schemes addressing critical societal needs.

[Ratty]

32. Absolutely exactly!

Outrageous hospital costs are designed to make us completely reliable on insurance companies. Which country has the next highest cost of saline and how much is it? Is it a country with nationalized health care?

[jsr]

41. Bingo.

[Fumesucker]

44. Hence the mandate for private insurance with no public option n/t

[hunter]

70. The more money flowing through the system...

... the more can be skimmed off by various "middlemen" along the way.

The U.S.A. so-called system of "health care" supports a lot of middlemen who provide no actual health care and have little or no incentive to control "costs" because controlling costs in a reasonable manner would mean putting themselves out of work and make their Wall Street shareholders sad.

[seveneyes]

14. Because our government lets them overcharge

And we elected the crew that could fix it but they won't. It's criminal and should be better controlled.

[WinkyDink]

15. The same reason restaurants charge more for meals than the price of the food: The employee costs;

the equipment costs; the rent; the laundering; electricity; etc.

Not saying this profit-margin isn't outrageous; J/S.

[B Calm]

16. How long will it take republicans to blame this on Obama Care?

[KG]

17. and now, we all have to buy into the scam.

woohoo!

[Freddie]

18. "Cost shifting"

Has been going on in our healthcare "system" for many decades. It's like buying a new car; there's the price on the sticker and the price you actually pay. Medicare, Medicaid and your insurance company pay a negotiated price far below the sticker price. Only the poor sap without insurance pays the full price. Or (more likely) pays nothing and the hospital writes off the full price amount as an accounting trick. And uses these numbers to justify an increase in negotiated insurance payments in the next round, so your premium goes up. Rinse and repeat.
One large criticism of the ACA is the high deductibles/out of pocket. But because you have insurance, at least you are paying the negotiated price, and not "full" price, in your out-of-pocket costs.

[liberal N proud]

20. That is why they call it Saline Solution

Fancy name gets premium price.

[nxylas]

21. Because Murka!

What are you, a Muslim or something?

[PeaceNikki]

22. May or may not be related, but there's a saline shortage right now.

Which is as terrifying as the price.

http://www.chicagotribune.com/health/sns-wp-washpost-bc-saline28-20140128,0,7947147.story

A shortage of intravenous saline is causing hospitals and dialysis centers to scramble to manage their supplies of the commonly used solution.

Health-care providers are asking doctors and staff members to use smaller IV bags and find alternatives, if possible, officials and executives said. Officials have not heard of any facilities running out of saline, "but we know that hospitals are still reporting that they may only have a few days' supply," said Valerie Jensen, associate director of the drug shortages program at the Food and Drug Administration.

Since mid-January, the FDA has received notices from "dozens of hospitals" each week about low supplies of IV saline, she said Tuesday. High demand has been prompted in part by an increase in flu cases in recent weeks. Many flu patients who are dehydrated need intravenous saline.

Frustration about the shortage led one hospital in the North to consider asking the government to release saline from its emergency stockpiles, said Bona Benjamin, a senior executive at the American Society of Health-System Pharmacists. She cited privacy concerns in declining to identify the hospital.

[solarhydrocan]

26. I might be able to help

I've got a pressure cooker and some Morton sea salt

[PeaceNikki]

28. It's not a joke.

[solarhydrocan]

75. I don't think there is anything funny about the US medical industry

How could there be a "shortage" of sterile salt water?

In medicine, saline (also saline solution) is a general phrase referring to a sterile solution of sodium chloride (NaCl, more commonly known as salt) in water, but is only sterile when it is to be placed parenterally (such as intravenously); otherwise, a saline solution is a salt water solution. The sterile solution is typically used for intravenous infusion, rinsing contact lenses, nasal irrigation, and often used to clean a new piercing.
http://en.wikipedia.org/wiki/Saline_solution

Literally all it is is salt and sterile water.

Maybe re-purpose a drone factory for a few weeks to alleviate the "shortage".

I suspect the "shortage" is to boost prices.

[Laelth]

23. k&r for exposure. n/t

-Laelth

[Diclotican]

24. solarhydrocan

solarhydrocan

Then thank every good in the universe - that I live in a country with universal healt care.. Last time I was in a hospital, because one of the kidneys was acting up again (3 time in a years time), in fact I got acute sick, at the hospital - they tend to take notice when you puke in the clinic for some reason (I was there for a check-up) And I got many of the salt saline bags, before the kidney was working as it should again....

I would be broke - or dead with a system like the US, so universal Health Care is something that I at least would defend nail and tail..

And yes - We do pay more taxes in my country than in the US - but we got it back again - in form of universal healt care at least...

Diclotican

[solarhydrocan]

27. "Uniquely American" is what the present clusterF is called

[fasttense]

29. Hey, paying for overpriced medical crap happened to me at the VA just this week

After spending the best part of my life in the military and getting injured to do it, I went to the VA to get some of that promised "free" health care. They charged me $24 for a $2 bottle of vitamins. Making disabled Vets Pay 12 times the value for a prescription is how Congress decided to pay down the deficit.

Yeah, now we Vets can come to the rescue of our country once again.

[blueamy66]

38. I finally got my friend to let me see his list of scripts and the cost of them at the VA

CVS, Walgreen's and Giant Eagle beat the VA prices for each one of them.

It's a shame.....

[Aerows]

64. That's a travesty, fasttense

I can't believe they do that to you after serving our country and getting injured. I'm thinking the first people that need to be reduced to minimum wage and forced to pay those kinds of prices should be the assholes in Congress and the other politicians that set this crap up.

[notadmblnd]

30. I remember 20 years ago when I had my son. The nurse gave me hell

because I took my own tylenol and didn't ask them for theirs.

[malaise]

31. Because people are willing to pay anything when it comes

to life and death.
As long as healthcare is a business and not a human right, this highway robbery will continue. Maybe someone will ask their dear pope how he feels about catholic hospitals exploiting sick people when he arrives in the US because all the hospitals exploit the sick.

[mucifer]

35. It's one thing Obamacare should be dealing with but it's not.

I am a hospice nurse and we do IV hydration at home. No way we could afford $800 per day for a bag of fluid. I'm curious about what we pay to get it in the patient's home. Medicare and medicaid don't reimburse us much.

[MisterP]

69. why deal with a problem when the people who would otherwise be complaining are starstruck enough

to give you a pass on literally anything?

[Sgent]

74. It does (kinda)

it doesn't mandate hospital pricing -- but it does put people on insurance / medicaid, etc. Those health plans negotiate pricing with the hospital, and they probably pay no more than $10-$20 for that bag of saline.

[tridim]

39. It's the Apple profit model.

[jsr]

40. Because it's an American hospital

[dembotoz]

42. not made with west virginia tap water

[jeff47]

47. They are tackling it.

The $800 price is the "list" price. Insurance companies have negotiated far lower prices.

The ACA forcing people into insurance plans means they are paying the "insurance" price, not the "list" price.

(Yes, single-payer would be better. We'll get there by introducing single-payer or public options in the "blue" states. The lack of dead bodies in those states will destroy the FUD, and those programs will expand to cover the entire country)

[jeff47]

52. Depends on the insurance and the hospital.

My wife had a kid last year, and we got to see the itemized bill that included "list" and "insurance" prices. Following the pattern in that bill, I'd expect the "insurance price" of that $800 to be about $20-40. Still way over production cost, but probably reasonable when you add in transportation, storage and reasonable profit for every handler along the way.

And saying that it's the insurance companies to blame pisses me off even more!

It's not the insurance companies fault. The insurance companies have negotiated more reasonable prices. That's how the ACA attempts to solve this problem - by making the insurance companies solve it.

But again, the ACA is only step 1 in the reform process. In 2018, single-payer will roll out in VT. We need to be lobbying other blue states to follow suit, or at least add public options to their exchanges. With no need to profit, the public options should be cheaper, and thus get more customers than the private insurance companies. Thus driving the private insurance companies out of those markets.

[jeff47]

58. It's insurance. Of course it's about future accidents.

Healthy people get insurance because they won't always be healthy. Of course that's about future health problems and accidents. That insurance can take the literal form of insurance in the US. Or it is insurance in the form of a single-payer healthcare system.

I was hit by a car when I was 18 and my leg was fractured. I got a cast and a few doctor visits after the fact (this was 30 years ago)

My kids are now 4 months, and 2 years old. Each of them cost about $50k to be born (we paid the out-of-pocket max under our insurance).

My birth cost under $1000.

Difference? A hell of a lot more technology and care was brought to bear, ensuring that there were no complications. You compare the tests, drugs and procedures from today to when I was born, and it's stone-age vs. information-age. My parents didn't know if I was going to be twins or not (I wasn't, just a big baby). I had pictures of both children's faces before they were born, as well as a massive number of tests performed before their birth.

That difference costs a lot of money. We could go back to $1000 births, but I don't think people will like going back to the infant and mother mortality rates from that era.

[jeff47]

61. Nope.

I am surprised to read such pro-insurance company posts.

Probably means you should read them again. I entered this thread explaining how we will destroy the health insurance industry.

No, I don't live assuming I will get sick enough to be hospitalized.

It will happen. We don't live forever. Even those in your Ecuadorian example will eventually require medical care, or will die quickly from lack of it.

[jeff47]

67. Nope.

Just to stop your speculation, I'm a software developer.

Your statements are all I have, because all I can do is read what you wrote. I can't see any body language or other ways in which you are trying to emphasize or de-emphasize what you are "saying".

[steve2470]

48. "because of people that don't pay"

That's the explanation I have read from the hospitals when asked to explain these highway robbery prices. They claim that because some people don't pay, they have to overcharge everyone else.

Don't shoot the messenger, please, I'm only repeating the hospitals' propaganda. Yes, some people do not pay or pay only part of their bill, but yes it's BS. It's the new car model: ask for way too much, negotiate down to something halfway reasonable.

[unblock]

51. no one pays retail price

this is true in many industries, but true to a comical extreme in health care.

the main goal is to make sure you're charging more than any insurance policy will cover so that you qualify for their maximum. beyond that it's funny money because the insurance company will just ignore the excess. you lose money if you charge too little and you lose nothing if you charge too much. so you charge too much.

and if you don't have insurance, then again, it's all negotiation, and again, there's essentially no downside to charging too much. you can always waive or write off the extra, but you lose out if you undercharge. some rich people will pay the ridiculous retail price without batting an eye, others will groan but pay it anyway because they don't have the time or resources to fight it. for those that fight it, you can further divide your customers based on how much they can cough up. in each case, you extract the maximum money from your patients, which is the entire goal of the modern american health care industry.


the upside of lowering prices is to lure in more customers attracted to cheaper prices. that doesn't happen much in health care, and particularly not when it comes to saline bags.

[upaloopa]

53. Because most reimbursements don't cover costs.

Who pays for the uninsured? Those who buy $800 bags of water.
All the more reason to adopt single payer.
The single payer sets reimbursement rates.

[Bennyboy]

56. the FREE MARKET! No gov't controls.

Ding a ling. put a quart of water in a fancy ass bag, describe it as product and voila, instant stock dividends.

[Fortinbras Armstrong]

57. Here is an actual figure from an actual hospital bill.

In December, I got a piece of glass embedded in my foot, and had to go to the emergency room. I received a copy of the bill, and the charge for the tetanus shot I was given was $160.74. According to http://www.ask.com/question/how-much-does-a-tetanus-shot-cost a tetanus shot costs between $20 and $40.

[Sunlei]

62. $6.49 from my Vet supply. 'Someone' makes huge profits.

http://www.kvsupply.com/plasma-lyte-a-1000-ml-solution

[Sunlei]

65. just to correct price, the plain saline is $4.99

[Aerows]

63. during my fun with the raccoon bite

and going to the ER ... I never ONCE saw a doctor. I saw only Nurse Practitioners. I shit you not. You don't see a doctor anymore at the hospital.

I can't complain that I didn't get excellent care, but still, I wasn't seeing MD's. I haven't seen the cost for what happened yet. Thankfully I have insurance, but for those that don't, it would probably be vomit-inducing.

[Recursion]

77. Because banks have locks (nt)

[jmowreader]

78. I know why

It might cost the drug company a dollar to make a litre of saline, but they charge the hospital multiples of that...sometimes two or three times what a bag of saline costs to make. Count facility costs like inventory management, the nurse to hook you to that bag, rental on the infusion pump, a certain amount of profit, interest on the mortgage they took out to build the floor your room is on, and so on into the cost of the product. Then there's indigent care expenses - the "it's that high because of people who don't pay" is crude and unfeeling, but it's also the truth: someone's got to pay for everything a hospital does, and if the patient can't then the rest of us get to. (This is the best part of Obamacare: by reducing the number of indigent cases, the rest of us will pay less for our healthcare.)

The important one is: health insurers never pay full list for anything. If a hospital went to an insurance company and told them "after adding in all the extrinsic factors, a one-litre bag of saline will cost you $80," the insurance company will attempt to negotiate them down to $8. Since they know right up front the insurance company is going to beat them out of 90 percent of any price they ask, they just take whatever price they really need to get, multiply by ten and "meekly" agree to accept "only" what the insurance company asks. Contracting is ALWAYS a game of bullshit; medical contracting is no different.

[davidpdx]

79. I had to go to the hospital when I was in the US

I had pneumonia and ended up in the hospital for 5 days. The cost? Over $30,000. The emergency room visit alone was $400.

Here in South Korea we have universal health care. I went to the emergency room at the hospital for an allergic reaction (on a holiday nonetheless) and with x-rays and a four hour visit only walked out the door owing $91. Granted that was a hell of a lot less serious, but even had it been the same it would have been no where near the amount in the US.

[dipsydoodle]

80. In the UK the cost would've been exactly nil.

Granted we do in fact pay for it in taxes but it sure makes life easy.

[davidpdx]

81. Yeah, but I can't complain about the Korea system though

It is so much better than what I had my whole life. I believe we are taxed at about 6% for insurance.

[dipsydoodle]

82. Sounds a good deal.

In very simple terms the UK aggregate tax is c. 25% of gross earnings above c. £7000 split between employers and employees.

[davidpdx]

83. Is that per year?

So about $5,700. I guess that is good if you never have to pay a bill. When I was making really good money a few years ago it probably ran about $2,000 a year. I've been a student for a few years so we pay about $70 a month each for individual coverage. When I start my new job next month it will probably go way up.

[dipsydoodle]

84. I figure it to be $7800 pa average

but then that covers the entire population including those either not employed or not eligible to pay i.e. children and those past state retirement age.

[UncleMuscles]

89. At least you get something for your taxes

I would be willing to pay more in taxes if it actually went to providing useful services to the PEOPLE instead of the wealthy and the MIC.

[Romulox]

90. Because payment is now mandatory, and the US gov't is the collection agent. nt

[Lunacee_2013]

93. Going over medical bills of any kind is nerve wracking.

I was charged $2,000 a few years ago for an ambulance ride. I live 4 blocks away from where that hospital use to be. 4 blocks for $2,000 is $500 per block. All they did was pick me up, put me on a stretcher, take my blood pressure, and drive. They didn't even put in an I.V. since we were so close to the hospital.

Our medical costs are insane. People don't need health insurance, they need health care. Insurance is one of the things that just gets in the way. When will we cut out the middle man and just give people the care they need?

Now that I think about it, the same hospital also charged me $18 for a bottle of Gatorade, which they gave me because they said I was dehydrated. Instead, what was really wrong with me was cancer. CANCER. I had to go to a different hospital to get that fixed. Ever since our local hospital changed hands and moved to a new building, they've gone downhill. And they done that because the new big bosses are to cheap to hire more nurses and aides. I've seen E.R. nurses work 18+ hour shifts because they were short-staffed. Its just crazy.

[Initech]

97. Profit. Greed. Profit. Greed. Repeat.