Monday, June 12, 2006

What's Wrong With This Picture or I'm Glad I am Canadian

Riley's only three years old and he's a million dollar baby. We also like to amuse ourselves by poring over the 50+ pages of itemized charges. For example, each night in the ICU cost $11,795. Now, I've never stayed in a hotel that cost $12,000 a night, but I guarantee it beats the pediatric cardiac intensive care unit for luxury hands down. At a minimum they definitely have a better wine list.
And here's $390 for a guidewire. Several $44.10 charges for carbon dioxide (carbon dioxide??!). Those crappy little oxygen sensors that wrap around his toe (and last a day, tops) cost $61 each. The VCR-sized chest tube drainage boxes (Pleurevacs) are $617 a pop.

Every charge is grossed up to include overhead and labor. One medication cost $27.88 a dose (Riley takes it three times a day). That $27.88 is meant to include the cost of the nurse administering it, but still. In the outside world a 100-day supply costs $15 (our copay is $5). That's a 557% markup.
And here's a real doozy:

$8.51 for a Chapstick??! Current price on Drugstore.com: $1.99. At 4 grams a stick, that's $2.13 a gram. That's a full-service tube of lip balm.
Of course, our HMO won't pay the full amount. Given that they're one of the biggest HMOs in America, they probably won't even pay half. But our experience makes us feel extremely grateful that we're amused by this bill rather than wondering if we should declare bankruptcy now or wait for the bank to foreclose on the house. The sad reality is that 15% of Americans would be in just such a bind. I'm also lucky that by law, group health plans can't deny my family coverage for pre-existing conditions. That means any employer that offers its employees health care must offer Riley health care. We'll never be able to get individual coverage - insurance companies would laugh in my face. It ties my son's health care irrevocably to the state of my employment.

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