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Politics : Politics for Pros- moderated -- Ignore unavailable to you. Want to Upgrade?

To: DMaA who wrote (304891)	5/13/2009 4:42:23 PM
From: KLP	2 Recommendations Respond to of 793964

To answer your question in a word: MONEY. They go by Medicare rules...and evidently for everyone no matter their age, not just medicare patients. What's in it for the hospital. One section of the bill I had was $8900 for a room charge!!! for a 2.5 day stay as an "outpatient with an observation admit" status...unknown to me at the time. There are many groupings like that. Exploring the "Pharmacy Other" bill, after I requested a detailed itemized bill for that section....I found: 1) Each pill was itemized and cost noted. The cost for each pill that I normally take was what ONE MONTH of an Rx for the same med costs.... 2) The combined total for each med by the EACH was between $3.85 and $11.59 ....these were billed as "self administered. The pill comes in individually wrapped, in a cup, put into the patients hand. Thus, it becomes 'self administered.' We know of course, we can not bring our own meds into the hospital. Of course it would have been MUCH cheaper for the patient, the hospital evidently, and any insurance that might have paid for some of these. In an Admit like I noted above, the insurances will NOT pay for these Rx. The patient has to.... If the patient is on "inpatient status admit" then the insurance WILL pay for them. 3) This went for shots too....Each of the 4 shots I had was $59.something. Turns out they were billed as "self administered" because I was on that type of admit. Of course, not only did I not ask for the shots, nor did I inject them into myself (don't even know how to do it) but that is a Medicare rule for this type of admit. The hospital makes money on each patient in this section with this type of admit... In my case, this section alone was just shy of $600..... Multiply that times the number of patients a day, times a year, etc times the number of hospitals.....Plus the care was not the same, the room wasn't cleaned as often, and all sorts of other things .... And note that I didn't even mention what went into the $8900++ charge for "room"....this part of the bill was billed by the HOUR. I guess the hospitals figure that the patient with at least some insurance can help pay the bill for someone who comes in without insurance. PLUS, as the article noted, Medicare wants a patient to be in the hospital for at least 3 days before they will even consider someone eligible for another nursing facility. Who stays more than a day or two after a major operation? Unless there is some major complication? Not many. These are the type of situations that should be noted and talked about in any medical changes to our system. The people who have been patients need to have some input before Congress. As do the Docs, and Medical Staff, and the various Insurances. We really do need to have an OPEN discussion all over the country about what we face now, and how any changes will effect the quality of health care we have now, and what will be the cost.