Brooklyn Man Charged 100K For Two-Day Hospital Stay

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The following is an article in today’s NY Daily News:

The patient is fine – it’s the hospital bill that’s sick.

Almost $10,000 for two nights in a semiprivate room. More than $16,500 for six hours on the operating table.

Total bill for back surgery in a Manhattan hospital: $109,000 – and that’s not counting doctors’ fees.

The good news for the Brooklyn man who needed the operation is that he has insurance, and forked over just a $300 co-pay to cover his hospital stay.

Critics charge the case pulls back the covers on hospital bills that have run amok, driving up health costs for everyone even as the feds try to expand insurance coverage.

“These prices don’t make any sense,” said the 56-year-old grandfather from Midwood, a city worker who had two disks replaced at St. Luke’s-Roosevelt Hospital in October.

“Even if I don’t have to pay it, the bottom line is we’re all paying it,” added the man, who was covered by Empire BlueCross BlueShield.

Eye-popping sums on hospitals’ price lists include everything from $1,178 for a stint in surgical recovery to $10 for a single pain pill.

Most insurance companies and hospitals negotiate steep discounts.

But critics say the system hurts anyone forced to pay out of pocket – the uninsured and insured patients who go out of network or have limited policies.

Officials from St. Luke’s-Roosevelt stood by the charges and said they are in line with competitors. Empire also stood by the claim, which health care experts said apparently was settled for about $71,000.

National health economist Graham Atkinson said inflated charges were sparked by now-closed Medicaid loopholes that encouraged high prices because hospitals were paid on a percentage basis.

Once they rose, the prices never returned to Earth and have climbed faster than inflation for decades, he said.

When adjusted for inflation, hospital costs in New York State are up 35% since 1992, Atkinson said.

“Hospital costs are spiraling out of control,” Atkinson said. “An awful lot of bankruptcies in this country are due to health care costs, and it’s mostly hospital costs. It is unconscionable.”

A spokesman for the Greater New York Hospital Association said that while members are committed to keeping prices low, “hospitals have long been caught in a fiscal vise” of soaring costs and shrinking reimbursements.

Joseph Stamm, president of the Manhattan-based auditing company MedReview, said paid claims over $100,000 for one- and two-day hospital stays are on the rise – though insurance companies are often reluctant to let him audit.

“There needs to be outside review,” Stamm said.

(http://www.nydailynews.com/)


17 COMMENTS

  1. If there was tort reform, then the hospitals would be able to make a profit because their insurance costs would be lower and the ordinary citizen costs would be lower.

    But, as long as Shelly Silver is allowed to get his way in Albany, that will never happen. And of all the chutzpah, Shelly Silver was honored by a yeshiva eventhough he is against vouchers for all families for all ages of children and for all incomes. How dare they!

  2. Not surprised. I was insurance-less for a while after having lost my job. My daughter was in the Emergency Room for a hours, we thought she might have had appendicitis. Turned out to be nothing serious. We explained that we had no insurance and they said that Medicaid would start a case. Never happened and still iosn’t. We keep getting bills in the amount of $7000 plus for the ER portion alone, not to mention about 15 or perhaps more doctors who “examined her” (never happened either, she was seen by 1 doctor). The bills keep coming. The system is broken. Hospitals are permitted to steal, maltreat, lie, cheat, etc…. and no-one can stop them. Now you know why our government is in the red…..

  3. If they would start especially here in New York de-regulating the insurance industry and the healthcare industry, privatize the hospitals, then the hospitals wouldn’t resort to these outrageous practices to make ends meet.

  4. Compare with the article earlier today http://www.theyeshivaworld.com/article.php?p=46542 in which the attacker of Rabbi Moskowitz was ordered to pay $9.5K restitution, it would seem that the far more serious medical attention was needed, and that the amount couldn’t possibly cover even just the medical costs.

    It would be helpful to see in this case exactly what the hospital received, from the insurance company, or government insurance policy.

    Patients without medical insurance should not have to pay _more_ than what the hospital and practicioners accept as payment in full from these sources that are better able to pay.

    The inversion that some patients without insurance are not expected to pay anything, the pricing system even worse.

    There is no real market, and therefore the “full list price” put on this bill has nothing to do with what is the established value.

  5. Your ad for socialized medicine is misplaced.

    One should ask how much “the real bill” is – that would be what the insurance company pays — which is probably a lot less than the “nominal” bill. The price you mentioned was the equivalent of the “list” price, but virtually customers (except for some of the uninsured) end up paying a radically lower “street” price (officially the line is the hospital has a deal with the insurance company).

  6. Posts 1-4 are all excellent posts.
    I agree we need tort reforma nd deregulation of the insurance and hospital industries.

    About tort reform, it needs to be done right.
    Most of the time when Tort reform is described in detail, it said that it should consist of limiting the amount of money anyone can sue for.

    That in my opinion, is wrong.
    If someone comes into the hospital for exploratory surgery on one leg and wakes up with the other leg removed, there is no amount of compensation that would be enough to cover it so
    I would in that case be in favor of a multimillion dollar settlement (tens of millions in fact)just for the fact that the person will now spend the rest of his/her life crippled and possibly be seriously impaired in doing/finding a job plus the fact that the hospital and doctors need to be punished for making such a serious mistake caused by obvious gross negligence.

    Tort reform needs to be something that allows legitimate law suits, while eliminating the frivolous ones.

    For example if the doctor in order to cover himself wants to do test after test to cover everything and the patient does not want to spend ofr all those tests, he should be able to sign a waiver that releases the doctor from doing those tests he feels are not so necessary.
    Once that waiver is signed, the doctor can never be sued even if the patient suffers some problem that would have been picked up by a test that
    the average person in his position would usually never need (such as a 20 year old being tested for Alzheimers or a 60 year old being tested for Measles).

    Or a patient that jumps out of the wheelchair on his way out of the hospital and injures him/herself cannot sue when they were told to stay in the chair till they get into the car to go home.

    We need tort reform. But it must allow legitimate lawsuits, while eliminating the frivolous lawsuits.

  7. hereorthere, the only way to rid the legitimate from the frivolous would be to first put limits on awards to limits on the portion of the lawyers take to mandating that loser pays. Then there would be limits on tort.

  8. I strongly disagree with any limits on how much someone can get from a legitimate lawsuit.

    That is overkill and simply a way that will hurt everyone, like using a shotgun, to kill a fly.

    Lawyers need a decently large compensation out of any settlement, in order to want to take on a case without upfront fees, that the average wronged party cannot afford.

    The wronged perty, needs (in some cases) a very large settlement to try and have some kind of life after some serious malpractice by some doctor who might mess up badly then happily go out on the golf course.

    Because after all, it’s not HIS leg that was wrongly removed.

    Someone like me for example has no savings because my income is far too low to put anything away.
    I barely survive by doing physical labor for relatively low pay.

    If G-d forbid my leg were wrongly removed by a doctor I’d be out of work permanently without a single dime in income.

    Now lets say I needed at least $30,000 per year just to live like I do now.
    Now you must double or triple that because with a missing leg I’d need a place several times the size just to get around in a wheelchair.

    So lets say a minimum of $60,000 just to live as I do now.

    If I live another 20 years that would ad up to $1,200,000 or 1.2 million and that does not include rising inflation or rising taxes whioch the government is NOW starting to tax retroactively going back many years and raising taxes on income already paid.

    If you include ‘that’ it rises to many millions.
    And none of this includes the long term care now needed or the loss of hope of me ever improving my financial situation.

    So any ‘limits’ on any award I get, would guarantee I’d become homeless and probably die of exposure or from Hepititus from eating out of garbage cans to survive on a daily basis.

  9. Yes hereorthere, but care is being now denied to people and there is rationing of healthcare going on now because the various municipal governments can’t afford to their respective Medicaid and Medicare budgets. Yes, the plaintiff would lose out but the majority of the population is losing out even worse if you DON’T limit jury awards.

    Halacha puts limits on awards that a Beis Din would let’s say find someone chayuv. Why not the secular courts? The answer is the American Justice Institute, one of the biggest donaters to the Democratic Party which is why a good Jewish boy from the Lower East Side by the name of Shelly Silver refuses to even allow a discussion of tort reform put on the agenda of the Assembly.

  10. #6, this is #3: I have tried for almost two years now to UNSUCCESSFULLY negotiate with the hospital, the collection agencies and everyone else (machers) involved. They INSIST on getting their “list price”. Your talk is empty. You should research the topic before you give wrong advice. FLATBUSHBUBBY, you with me on this one?

  11. But I think that the high costs in health care have nothing to do with the awards in the very few legitimate lawsuits and far more to do with the very many illigetimate lawsuits.

    Like the lawsuits from the girl who was brought free of charge for; I think it was spina bifida or a cleft pallat, something like that.

    And she dies on the operating table after the surgeons did everything possible to save her then the ungreatful family tried to sue the hospital for something like 20 million dollars.

    This case shoudl not get an award of any kind even a limited one.
    It should be thrown out and the lawyers fined for bringing a frivolous lawsuit in the first place.

    I do not know what Halacha says about limiting awards but I believe that would apply only in a situation where all the laws are according to halacha and America is not run by Halacha.

  12. America is not run on Halacha but the law can be changed and let’s not forget what many of our politicians and great statesmen have said about our culture and the Judeo-Christian heritage. What would define legitimate or not? So far only case law precedent has but I am saying start now by yes limiting the awards.

    In halacha we know there is such a thing as the “minority follow the majority”. That is, when need be when we judge, we rule in favor when it is applicable that if the majority are favored by such a din, then we rule in favor of the majority. In addition, in Mesechtas Nezikin, it delineates what the five types of damages that the defendant is liable under and how they are calculated.

    I am saying take an example in Halacha, find the conservative minded (Republican) politician and start now. The many can’t afford their insurance costs because the insurance companies have to cover their liabilities for the minority who are paid damages in a lawsuit.

  13. daboss, I too have had the same experience. But, again, is the hospital trying to make a profit or cover their costs? The insurance on a hospital is atrocious along with the insurance costs on all of the pharmaceuticals that they pay for and the insurance costs for their medical staff. Why don’t you investigate? I feel sorry for you but the reality here in New York is that the insurance industry is one of the worst overregulated industries and you are unfortunately paying the price.

    I would strongly suggest you look up the closest Republican elected official and sit down with him and ask him how could such a thing happen. What he tells you may be shocking.

  14. To #3/#12 Why not declare bankruptcy and let the hospital chase their tails for the money?
    Just remember an illegal alien gan get free health care no questions asked, but an American citizen can’t.
    You are right the system is corrupt and broken and now fools like Obama want to make it even worse with their Stalinist “government” plan.

  15. But Flatbush Bubby, why do you think that the very few legitiomate lawsuit awards, are the problem, and not the many multimillions paid out in the unjustified, ones?

    And even worse, are the multimmillions paid out to illegal aliens for their “free” healthcare.

    I think the blame the few legitimate lawsuits for the high cost of health care, is kind of like finding one Jew in jail and blaming Jews for all the crime in the world (which believe me the antisemites are doing quite strongly in the comments in at least two youtube videos, that I know of).

    The blame has to go where it belongs and it is not on the awards for the very few legitimate lawsuits.