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I have spent a week in a hospital twice, once in the late 90s, once in the lates 00s. Different hospitals, different health plans. Here's the thing: in the 90
by jerrya 15y ago
I have spent a week in a hospital twice, once in the late 90s, once in the lates 00s. Different hospitals, different health plans.
Here's the thing: in the 90s experience, I received a complete itemized bill, organized by time and day, for everything that was done to me. I didn't have to pay, my insurance did, but I received copies of the bill. In the 00s, I received virtually nothing. Again, my insurance paid, and I was just given the very briefest of letters explaining that I was covered, and how to handle short term disability, and the like.
I found receiving the complete itemized bill truly enlightening. What I learned was:
+ exactly what was done to me in the hospital and when
(I was not in a position to understand when I was admitted)
+ exactly what was being charged
+ exactly how expensive everything was
+ some charges did seem erroneous, perhaps for treatments that did not take place
The sum of the bill was staggering. But it was truly a good thing to see the bill. It helped me understand exactly what had happened. It served as a reference for googling my illness and treatment. It helped me understand the costs.
It helped me appreciate the efforts by others to get me that coverage. And it let me return some of that by giving me a way to check for mistakes in the billing.
I hope everyone has the coverage they need when they need it.
I do think that part of every medical service should be a completely itemized bill. I think it's a useful reference for the patient, I think it's a simple way to inform everyone on the complexities and costs of healthcare, and it's a simple way to encourage informed use, and correct mistakes.
If everyone had these bills, there would be websites developed to explain, compare, manage them, and it would help eliminate many of the games that hospitals seem forced to play.
So it would also encourage better accounting and put better incentives in place to have that better accounting.
- klenwell 15y agoI agree. I've been active in helping my grandparents manage their affairs the last few years and I find it interesting how frictionless it is for them, under the Kaiser HMO, to get medical services, especially prescriptions. I find it a little too frictionless at times. They sometimes show me the paperwork Kaiser gives them, but I don't remember ever seeing an itemized bill. I'd find it insightful, as I think they would too, to see a list of expenses. I'd also like them, and everyone (especially seniors), to see how much of those costs the government bears. Although I don't get too deeply into the politics of it with them, my grandparents are part of that Fox News senior demographic that would probably happily repeal "Obamacare" while being kept blissfully unaware of the benefits they enjoy because of government assistance.
- CWuestefeld 15y agoI'd also like them, and everyone (especially seniors), to see how much of those costs the government bears. At the risk of being pedantic, this is one case where one needs to remember that the government never bears any costs of anything. To the point: I'd also like them, and everyone (especially seniors), to see how much of those costs their fellow taxpayers bear.
- kenjackson 15y agoJust curious, who is the government, if not your fellow taxpayers? I always assume the government are fellow taxpayers. A lot people seem to think government is some group of people they've never met that live in a far away land.
- sethg 15y agoIt’s possible that in the second case, your insurance company was paying the hospital according to the diagnosis, rather than covering each procedure as a separate line item, and therefore no itemized bill was necessary. http://en.wikipedia.org/wiki/Diagnosis-related_group http://en.wikipedia.org/wiki/Diagnosis-related_group
- jerrya 15y agoHmm, that's an interesting take on it. Thank you. That's not my impression of what happened, but it could fit what I observed, and the concept of diagnosis-related groups seems useful. "diagnosis-related groups" reminds me of how car repair is sometimes done. A made-up example: a tune-up on your model of car at the local mechanics is $350, regardless of how much time it takes or parts required. Still, at the end of the day, they give me an itemized bill detailing everything they did, and put in, including waste fees they might be paying. While some of that may be useful for marketing/upsell reasons, much of that keeps me better informed as to the state of my car. In my 00s experience in the hospital, there was literally none of that, except for one thing: they gave me a manufacturer's warranty card, which was weird beyond belief, but I guess nice to have. Other than that, no detailed list of what had just happened. If DRGs are the future for billing, I'm not sure they are the best future for doctor/patient/hospital communications.