Hospitals are well-honed institutions, smoothly functioning machines custom designed to cure your ass. But they're also workplaces, with all the usual ass-grabbery, office pranks, and bored waiting-for-the-shift-to-end wackiness found in any work environment. Although medical professionals are fairly good at keeping their shenanigans in check and barely ever graft boar tusks into their patients' mouths for shits and giggles, this still means that you can get royally shafted because of simple office routines.
We're talking about the shift change, that all-too-frequent moment when a doctor "hands off" her shift -- and patients --to the next one. According to one study, a whopping 25 percent of these handoffs result in an error in the patient's care.
No time for this bullshit when you've got Kanye tickets.
What's Going on Here?
Imagine a busy meeting. The first item on the agenda gets a lot of time and attention, but by the sixth one, everyone is tired and wants to get out of there, so they just sort of lazily leaf through the rest of the list. Well, in a hospital, the items are patients. At shift change, doctors prep the next guy using a list of the patients they're looking after. The further down the list they go, the less attention a patient is going to get.
"OK, so the chart says you're here for a pregnancy test ... oh."
What's more, there's absolutely no way of telling how they will place you on the list. Many hospitals don't bother organizing according to the severity of the patient's condition (that is, by how much explaining it requires), but just slap 'em on the spreadsheet according to their bed number, room number, or just the alphabetical order of their name. This means Mr. Adams, cruising the ER for Vicodin, has a decent chance of ending up with more attention than Mr. Zerkowitz and his never-before-seen Tanzanian supervirus.
And if that seems kind of random, just wait until you get the bill ...
Let's say you go through the American health care system with all the luck in the world. You survived falling into the Australian animal enclosure at the zoo. Emergency medical care managed to remove nearly all of the spiders and persuade the dingo to detach its jaws from your leg. You even avoided picking up any flesh-eating viruses at the hospital. Now all that's left is the bill. You know it'll be on the hefty side -- hospital bills always are, and you don't actually have the best insurance. Still, you're not worried. The only things the doctors in the ER did was scan you a few times and patch you up. How much could it cost?
Two weeks later, you get the bill in the mail for $56,000.
Wait, don't hang yourself before you rule out exotic dancing.
What's Going on Here?
Bullshit pricing, that's what.
Hospital overcharging of uninsured and underinsured patients is so common that an entire middleman industry -- medical billing advocacy -- has grown around haggling with the hospitals and correcting all the wacky extra charges added to people's bills. Notable examples of extra charges have included billing patients for the blankets on their beds and charging a separate fee for closing up an incision after surgery. This is a bit like the cable guy coming to connect your Internet and then charging you an extra $300 fee to leave your house.
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We apologize in advance for when they read this and actually start doing it.
And if they can't come up with enough extra fees, they'll just inflate the actual ones. Hospitals have been caught charging people a 10,000 percent markup for ER-administered Tylenol, and over $1,200 for a blood test that actually costs about $39. It's not that these shenanigans are even difficult to track down: Medicare ensures that the hospitals are paid a specially calculated per-patient fee that covers the average price of a procedure, which tends to be several times lower than what they actually attempt to charge. The Medicare-determined reimbursement for the average "So you walked in through the ER door" fee, already an absurd $300, can turn into freaking $1,200 in the unforgiving innards of the hospital's billing machine.
So, why the hell are hospitals being so sneaky? As it turns out, they're not. When asked, hospitals are unreasonably honest about the whole business and freely admit that they overcharge. They're literally just throwing fiscal crap at a wall and seeing what sticks. You can have 10 different patients who all get the same procedure, and they get charged 10 wildly different prices.
Some charge triple if they have alimony payments.
That's because the hospitals fully expect most of their clients (which are mostly insurance companies) to contest the bill to the point where they only pay a fraction of it. It's like the price at a used car lot -- they set it high because they expect you to haggle. The problem is that most uninsured people don't realize this, and hospitals aren't exactly rushing to tell them.
After all, these bills are often received by elderly or recuperating patients still confined to their beds, or by family members coping with a relative's cancer treatment. These people aren't very likely to go through a bill line by line, looking for the part where the ER charged them an $800 "not strangling you to death" fee. Then, a bunch of those patients will simply declare bankruptcy and never pay the bill at all, so the hospital has to make it up by trying to jack up the price on somebody else, like a game of hot potato where the loser is whoever doesn't have good lawyers. Hey, maybe it'll be you!
C. Coville's Twitter is here.
For more breakdowns in the system, check out The 5 Most Popular Safety Laws (That Don't Work) and 5 Popular Safety Measures That Don't Make You Any Safer.
If you're pressed for time and just looking for a quick fix, then check out 5 Ways We're Totally Ruining Kickstarter.
Related reading: Find out why getting a yearly physical makes you more likely to die young, #4 on the 5 Common Medical Procedures That Secretly Aren't Worth It. If you don't know the deadliest day to land in the hospital, its coming up, so read #8 in our 9 Most Statistically Terrifying Days on the Calendar. Of course, ambulances freaking explode all the time #5 of the 5 Terrifying Secrets About Riding in an Ambulance so you should just feel lucky to get there in one piece. And now to make room for all those new fears, we'll make a bunch of your stupidest fears disappear: you have a 96 percent chance of surviving a plane crash and are more likely to be killed by a cow than a shark.