If you're not from America, or you're young and healthy enough to have avoided doctors up to now, you may not have been exposed to the delights of this country's high medical costs. So here's a demonstration, in the form of a $243K bill for a three-night hospital stay:
Meh, just tighten up the eating-out budget a little bit.
Hospital bills topping one million dollars are on the rise, and even a minor injury can leave you with a bill that looks like the hospital replaced all of your internal organs with diamond-studded plutonium. But beyond the initial punch to the wallet, the awfulness of ridiculous medical bills extends to places you might not have thought. Such as ...
5Even Insured People Are Going Bankrupt
The majority of bankruptcies in America are now caused by medical bills. Clearly, these bankruptees were devil-may-care hooligans who chose not to protect themselves with health insurance. Oh, wait: Most of them did have insurance. Three-quarters of Americans whose medical bills contributed to their bankruptcies were insured when their health problems began. Their real problem was that these un-American slackers were dumb enough to not be able to afford a low-deductible plan, or clumsy enough to come down with something that their insurance didn't cover.
And when you look at the random bills that even insured people get hit with, it's not hard to see how this can happen. I have a friend who broke an ankle slipping on her frozen driveway during the seven-month ice storm people in New York call a "winter." She was insured with an 80/20 plan, but still received a bill for around $6,000. This month, I got a letter from my own insurance company arguing that a single blood test I got back in March wasn't "medically necessary" and warning me that I might have to cough up the full price. How much was the full price of that single blood test? Just 5,000 freakin' dollars. Luckily nothing came of it, because otherwise I would have had to dip pretty deep into my weekly writer's salary.
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It's so embarrassing when you're at the local writer's club and can't afford to tip the valet.
These incredibly high and apparently random medical costs get even more ridiculous when you consider that ...
4Stupid Frivolous Shit Actually Costs Us Less
These bills are high, but hey, maybe doctor stuff just costs a lot. Those long white coats and stethoscopes-around-the-neck don't pay for themselves! Except that while fixing a broken ankle apparently costs as much as a new car or two, the charge for laser eye surgery is usually only around $2,000 per eye. And this isn't a freak outlier: Nonessential procedures like cosmetic rhinoplasty often cost a lot less than surgeries that people actually need.
Why is essential medical care so much more expensive? Look at it like this: Say you're a plastic surgeon who performs extra-nipple implants. This procedure isn't considered medically necessary, and therefore is not covered by most insurance companies, meaning that your patients must pay you directly. If patients choose not to buy your extra nipples for $5,000 per nipple, you'll have to lower the price to $4,000, or else change your business model.
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"Nipple pills? Nipple serum? Aerosolized nipple spray?"
But when you add in the American system of mostly-employer-based health insurance, things get weird. The patient doesn't pay the doctor directly -- a lot of Americans don't even realize that this is an option. Instead, hospitals and medical practices bill the patient's insurance company. Because insurance companies are usually big and powerful enough to have bargaining power, there's a good chance that they will respond by farting on the bill and sending it back. Hospitals know this, and so over the years they've started making up their own extremely high prices and throwing them at insurance companies in the hope that they will pay something. These so-called "chargemaster" rates have grown so ludicrous over the years that they now include things like $37 Tylenol pills and $137 IV bags.
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"For $137, that IV bag damn well better contain at least one nipple."
Once again, these chargemaster rates are mostly completely made up and have nothing to do with what these things actually cost. They're simply part of the monetary dance-off that insurance companies and hospitals are doing with one another. In most cases, the insurance companies agree to pay a small amount of the stupidly high bill, the hospital accepts this reduced amount, and everyone is happy. Except for uninsured and underinsured people, that is, because they are also billed at the chargemaster prices.
There are a bunch of other factors at work, of course, but this is a big reason why a single petting-zoo mishap could end up costing you the price of a small car. But most hospitals will still tell us that everything is fine for Joe Injured American, because ...