Monday, January 05, 2009

The Root of All Evil

On the contemplation of Billing.

I confess to not really understanding the complexities of Hospital Finance, either here or, specifically, in the US. (Or anywhere abroad, for that matter).

Scalpel, who is always worth readin', in case you're new here, has offered a couple of posts. Find them here and here.

By way of comparison, as I understand it in the UK, Emergency Departments here are paid flat fees for patients. 'Minors' (sprained ankle, cut finger) net us £35; 'Majors' (MI, bowel obstruction) £70 and stuff like major trauma £105.

Please note that I'm writing this from memory, so my figures may not be accurate, but I'm pretty sure there at least close. I am, as ever more than happy to be corected.

I'm also not sure where the funding for Radiology and Pathology comes into it, so that presumably ups the total tab to the state, but even so...

While I like the idea of going over to, e.g a 'means tested insurance' form of Healthcare provison in this country, the idea that we could fund it on the cash we pay in tax now may fall short if these figures were replicated.

You may well argue that £35 pounds for a cut finger isn't good value, but I'd say you'd be hard pushed to get much treatment in the US for $200 down.

Or maybe not.

As a last thought, we recently admitted a fella who had flown back from the US, with a diagnosis of acute appendicitis, because he couldn't afford the down payment on his treatment.


This seems crazy to me, and any of my bleoved colonial readers who can elaborate on the likely veracity of such a tale... comments welcome.


anji said...

Well, does he have travellers insurance? That's a start...

Canada will treat anyone (within reason)... if you're foreign, you still have to pay. But, it's not something that would have you sign the forclosure on your house.

In the US? For families to have babies in a hospital, it costs about $30 000 I heard... I'd pray in that case, to have it drop on te taxi floor or something, holy shit.

I know visiting in the states (with canadian insurance AND health insurance) that people get fucked all the time. My mom's cottage neighbour had an anurysm down there, and his wife had to stay in hospital for two weeks until stablised to move back to Canada where she passed away. The health insurance they purchased refused to cover it, saying she had a pre-existing condition of high-blood presure. The cost of life-support until she came back to canada, cost nearly $200 000. He's fighting (several years later) this still. His wife passed away... and he's left homeless.

Their selfish greedy capitalist bastards down there...

I think Canada cares a bit more... I sure the hell am happy to be a patient here...

scalpel said...

We cannot require payment up front. He could have gone to any emergency department in the country without a penny in his pocket (or even any form of identification) and we would have been required to "stabilize his emergency medical condition," which would require an urgent appendectomy.

He might have gotten a bill afterwards if the hospital were able to track down an address to send it, but he couldn't have been turned away for lack of funds.

DrShroom said...

I thought that might be the case; I was always slightly suspect about the case. For one thing, I couldn't see any airline allowing someone with a hot appy to fly...

Thanks for the input