Wall Street Journal: As Medical Costs Soar, the Insured Face a Huge Tab ($1.2 M Bill after PADDING):

[Faryn Balyncd]

A remarkable front page expose, detailing the bill padding that has become common practice in U.S. healthcare:

Wall Street Journal: As Medical Costs Soar, the Insured Face Huge Tab

Jim Dawson Hit Cap After Hospital Padding;
The $1.2 Million Bill

By JOHN CARREYROU
November 29, 2007; Page A1


MERCED, Calif. -- One day in late July, Jim Dawson happily returned home. He had spent the previous five months in the hospital battling an infection that nearly killed him. The phone rang shortly after Mr. Dawson and his wife, Loretta, entered their house. . . . . . . . It was the hospital. California Pacific Medical Center was calling to remind the Dawsons that they owed it $1.2 million. . . . . . . . Mr. Dawson, 61 years old, had health insurance through his employer, but had maxed out his plan's $1.5 million lifetime cap halfway through his long hospital stay. In addition to the bill from CPMC, Mr. Dawson owed tens of thousands of dollars more to scores of doctors who were involved in his care. Mr. Dawson and his wife's combined assets totaled a fraction of their medical debt.

"I had never thought in a million years that anything like that could ever happen," says Mrs. Dawson.

As spending on health care has climbed to almost $2 trillion a year, or 16% of the U.S. economy, the number of Americans burdened with massive medical bills has soared as well. According to a 2005 survey by the Commonwealth Fund, an estimated 34% of adults aged 19 to 64 face problems with medical bills or have accrued medical debt. A majority of those people -- 62% -- had health insurance, the survey found. . . . . . . . . Million-dollar medical bills like Mr. Dawson's, while still unusual, are becoming more common as insurance policies once thought to provide catastrophic coverage prove inadequate when it comes to high-cost illnesses. . . . . . . . Part of the problem: Even as medical progress and new technologies raise health-care costs, health plans have been slow to raise their caps. Mr. Dawson's $1.5 million cap was relatively generous by today's standards. The Segal Company, an employee-benefits consulting firm, says the average health-plan cap among companies it advises is $1 million a person -- the same as it was in the 1970s, when the purchasing power of $1 million was the equivalent of nearly $6 million today.

Another issue is the widespread practice of bill padding by hospitals and other health providers. While hospitals say bill padding is their only defense against the aggressive cost-reduction efforts of insurers and government programs, the end result is that individuals can, with little warning, be left stuck with wildly inflated medical bills. . . . .

For instance, CPMC charged Mr. Dawson $791 for stockings designed to improve blood circulation. The same pair can be purchased on the Internet for as little as $12. . . . . .Allan Pont, CPMC's chief medical officer, acknowledges that the charges on Mr. Dawson's bill are "Disneyland numbers".................



. . . .(snip) . . . . . .



In her quest to know exactly what she was being billed for, Mrs. Dawson also asked the hospital for copies of all her husband's medical records. A copy service used by the hospital called to say the copies would cost $1,030. Mrs. Dawson was outraged. Further angering her, a letter from CPMC's foundation soliciting a donation came in the mail.


. . . .(snip) . . . . . . .



entire article (with a page from Mr. Dawson's hospital bill, a letter he received from legal services, & a donation solicitation from CPMC's foundation) at:
http://online.wsj.com/article/SB119610495315004214.html?mod=hps_us_inside_today

Jim Dawson survived a catastrophic illness only to face a $1.2 million medical bill.

MEDICAL LIABILITIES

• Million-Dollar Bills: As health-care spending soars, so has the number of Americans with huge health-care tabs.
• Funny Money: Many hospitals heavily pad their bills by marking up items and services.
• The Bottom Line: Hospitals say bill padding is their only defense against government and insurer cost cutting, but the practice can leave individuals with wildly inflated bills.

The present reality is that insurer-negotiated "discounts" - available only to insurance companies, now comprise not 10-15% of medical bills, but frequently 65-70% or more. Consequently, when an individual is left with bills exceeding their maximum payout, or with bills uncovered by insurance for any number of other reasons (pre-existing conditions, cancellation of policy, denial of coverage, no insurance), they are left paying a totally fictitious "full pay rate" that is often 300% or more greater than the insurance company rate (a rate at which, coincidentally, hospitals & medical providers prosper).

If an individual attempts to pay cash in advance, he an generally only negotiate a discount in the range of 20%, and still must pay a rate several times greater than insurance company-negotiated rates.

When an extraordinary example of this predatory pricing hits the newspapers, hospitals may quickly to adjust the bill.

Yet, with the exception of a single payer plan, all of the current health care plans depend on perpetuating the predatory insurance industry which has created this inherently discriminatory pricing.

[PM Martin]

1. Medicare for ALL, NOW!

The current system is corrupt. The insurers are corrupt, the providers are corrupt.

$700 for cloth? WTF?

[Faryn Balyncd]

2. Why is the so-called "liberal media" ignoring this issue, and pretending that the corporatist .....

health care plans currently being discussed address this corrupt system.

Why does it take the Wall Street Journal to look at this with open eyes?

[no_hypocrisy]

3. With "The System" as it exists right now, the only true way to save money

for medical costs is to succumb and die. Welcome to Charles Dickens Redux.

[daa]

4. Have to make a PROFIT somehow nt

[supernova]

5. Honesty in billing

That's another discussion that we will have to have when we get single payer.

We will all have to be honest about how much things cost, realistically. They hospital will have to be honest about how much procedures and supplies are, and not charge one person one rate and another patient adifferent rate because a their patient's ins co short sheets them.