Reddit User Posts $55,000 Hospital Bill for Appendectomy

[davidn3600]

When a 20-year-old man got over the pain of having his burst appendix removed in October, he got hit with a hospital bill he wasn't expecting.

The bill from Sutter General Hospital in Sacramento, Calif., said the total charges were $55,029.31 but that the patient owed only $11,119.23 because his insurance had covered the rest.

Shocked, the patient took to Reddit to post the bill and vent his frustrations.

"I never truly understood how much health care in the U.S. costs until I got appendicitis in October," he wrote on the social media site. "I'm a 20-year-old guy. Thought other people should see this to get a real idea of how much an unpreventable illness costs in the U.S."

The recovery room alone cost $7,501.00, which the man said was surprising because he spent only two hours in there. The surgery cost $16,277.

"I think you can see how outrageous some of these costs are," he wrote.

http://gma.yahoo.com/reddit-user-posts-55-000-hospital-bill-appendectomy-123853510.html

[catrose]

1. in 2000ish this happened to a friend

only the bill was $10, 000 then & she had no insurance. She became a stripper to pay it off (and her several degrees), but that's not an option for everyone.

[warrior1]

2. As a military dependent in 1968 when I had my appendix out

Only cost my dad seven dollars for the time I spent staying at the hospital. The man who took my appendix out I found out later was the son-in-law of George Romney. Never did find out what his name was.

[LiberalArkie]

3. When I was born in 1948

The bill was $55.00 for 3 days of baby care and 2 days of mom.

[penultimate]

10. Adjusted for inflation, that's about $532 today.

[Sanity Claws]

4. If the appendix had burst, then the surgery was more than an appendectomy

In some respects, comparing the cost of cleaning up a burst appendix to the cost of appendectomy is like comparing oranges and grapefruit. They're not the same and the former is far more complicated.

Nevertheless, it is outrageous that a person is billed so much for this kind of surgery. Who could afford? How many hospitals would decline performing this emergency procedure because the person could not pay the bill?

[penultimate]

12. Can hospitals deny such a treatment? That's life threatening, right?

I always thought that they have to treat life threatening conditions regardless of ability to pay. Although even I am correct, I bet they don't do anything other than stabilize and then throw on the street.

[Sgent]

24. Two things:

Yes they have to treat the patient -- but they can try to collect the money owed even if it means bankruptcy.

Hospitals without an ER, or who do not accept Medicare of Medicaid, do not have to treat emergencies if there is no ability to pay.

[Faryn Balyncd]

29. It appears that this was NOT a ruptured appendix but that ABC mis-reported:

The bill itself does not appear to mention a diagnosis, and does not list anything related to any extended stay, nor anything indicating an extended course of parenteral antibiotics, or anything which would suggest a ruptured appendix, peritonitis, or an appendiceal abscess.

The statement by the patient mentions "appendicitis" with no mention of peritonitis, ruptured appendicitis, appendiceal abscess, extended stay, antibiotics, etc.

No one appears to use the term "burst" until the ABC report, which appears to be an inaccurate description applied by a sloppy ABC writer, not supported by the bill or any source, and in fact inconsistent with the facts revealed by the bill.

While a ruptured appendix with peritonitis and appendiceal abscess would be expected to be a more expensive event, and while such an event might involve an extended stay with extended administration of intravenous antibiotics, it appears that this patient had a one day stay, went home after approximately 24 hours, and the charges for pharmacy and intravenous therapy are relatively small.

All of the above suggests a simple appendectomy, not ruptured appendicitis, peritonitis, abscess, or extended hospital stay or other services other than those normal for a simple appendectomy.

And it appears that ABC's use of the term "burst" was sophomoric journalism.

Sutter's bill in excess of 600% of the Healthcare Bluebook fair price for an appendectomy, and the payments already collected from the insurance company even before Sutter billed the patient for a co-pay (which by itself exceeded the Healthcare Bluebook fair price for hospital charges for an appendectomy) do seem to be sufficient to provide Sutter CEO Pat Fry's $5.2 million annual compensation for running his "not for profit" entity. (The San Francisco Business Times reported that "not for profit" Sutter had a profits "soar" in 2012 to $735 million with total revenues increasing to $9.56 billion.)

[woo me with science]

5. SICK. Compare to the experiences reported from other countries:

http://www.karenstan.net/2013/12/31/guy-posted-hospital-bill-online-youll-see-everyones-talking/
http://www.dailykos.com/story/2014/01/01/1266512/--Helping-me-to-not-die-is-part-of-our-social-contract-Isn-t-it-part-of-yours

A lot of citizens of other countries chimed in with their own experiences.

An Australian with appendicitis never even saw a bill.

Aussie here. Had appendicitis a few years ago. Went into hospital, stayed 3-4 nights after the operation and until my fever went down.
Never saw a bill. Even had a follow up appointment a month later to make sure everything was going ok.

We pay a few hundred dollars a year extra on our taxes as a levy for our Medicare system. Less if we have some kind of private insurance.

I don't have private insurance, what you Americans would call health insurance. I am simply a citizen of the country I pay taxes to. Helping me to not die is part of our social contract. Isn't it part of yours?

A Canadian’s mother had foot surgery and her only charge was $60…for cable.

A Malaysian paid the equivalent of $25 for an appendectomy.

Malaysian here... for my appendicitis a few years ago...my total bill was RM 87.50 (USD 25.24)

Two people, from different parts of the world. The patient in Malaysia is charged $25.00 and the other, living under 'the best healthcare system in the world,' gets a bill for $55,000 for the same emergency.

Here is what a fellow American, who also had an unforeseen medical emergency as a 20-year-old, had to say:

I had the unfortunate luck to have cancer when I was 20. I had no insurance due to taking a year off from college, so my parents didn't cover me any longer. By the end of 2009 I was looking at 150k of bills, praying Medicaid came through. They did and paid everything in full. Though cancer stuff doesn't stop when treatments are over. After 09 I still racked up 50k in bills from scans, visits, blood work etc. I was forced to declare bankruptcy at 24 due to it. I'm now at a disadvantage for the main years to buy a home, get a career, marry, and make my life. All because some cells decided to mutate.

I'm looking at 5 years cancer free in June. So I've got that going me, which is nice.

His cousin died because he had reached his “lifetime limit” for treatment. He was 27.

Another American reported $2000 for a night’s stay, a juice box and a pill.

[distantearlywarning]

6. This is typical

In 2010 I had a routine laprascopic surgery to remove an ovary and a benign cyst. I was in and out of the hospital within 6 hours, no complications of any kind. I spent about 1.5 hours in a recovery room, during which time a nurse spent a total of 15 minutes with me, mostly bringing me juice and a few crackers and making sure I could pee before I went home.

I was well insured. Total cost to my insurance company: nearly $40,000. That's not a typo. If you saw the bills we got, you would be amazed. Every single piddly thing was itemized on a separate line and cost a ridiculous amount of money, from $6 ibuprofin tablets to $3.50 gauze pads (each). The fees for the nurses (who I barely saw after the surgery - my husband spent 90% of the time with me, helping me get from bed to bathroom, etc), were over $10K. Even insured, we still had to pay about 3K out of pocket, which wasn't too bad at our income level, but could have been pretty catastrophic for someone making minimum wage.

It's a total racket and a scam. Somebody's making $$$ hand over fist off every American citizen via health care costs. THIS is why America pays more for health care than any other country while getting worse care.

[CANDO]

7. For anyone incurring any healthcare bills you can't afford...

set up and make a payment every month, an amount you "can" afford. 2 years ago I was passing kidney stones and went to the ER. Ended up owing over $500. I could've paid it entirely in one payment...but just for spite, I paid $25 a month until it was paid off. They can't drag you into bankruptcy as long as you pay something, any amount you can afford, on a monthly basis. If it could've dragged on for 40 years of $25 monthly payments, so be it. The bill was being paid.

[penultimate]

13. Depending on ones situation, that extra $25-$50/mo can be a killer

It's only thing if you're taking care of yourself and make $30k - $50k/yr. But someone making $20k/yr with a kid, that cash is hard to lose.

[progressoid]

15. And pray to whatever god you like that you never have to have medical care again.

$500? That's chump change for a most medical procedures.

The Average ER Trip Costs 40 Percent More Than What Most Americans Spend On Monthly Rent

http://thinkprogress.org/health/2013/03/01/1659021/average-er-trip/

[The Midway Rebel]

17. And do not miss payments.

Ever. They accumulate and they offer no grace period or late payment options. Miss three payments and they throw you to the credit hounds.

[Liberal Veteran]

8. It also brings the question of the self-pay penalty.

It happens in nearly every health care facility in the USA. If you have insurance, what you are ultimately going to be charged (regardless of whether you pay or the insurance pays) is substantially less than you would be charged for THE EXACT SAME SERVICE if you don't have insurance.

The end result is that people who can least afford it are penalized in a disgusting manner.

I have never heard a rational explanation as to why the exact services provided to two people based on who is paying should be so different. If the hospital is willing to accept 2000 dollars in reimbursement for services for Joe Insured, why won't they do the same for Jon Uninsured who they expect to reimburse the hospital for twice to ten times as much for the same thing?

[pnwmom]

11. There is no good ethical rationale. But it happens because insurers

negotiate in advance the payments they'll make with hospitals. Individuals can't do that.

That's why, at the very least, everyone should at least have a catastrophic policy.

[CANDO]

18. The exact opposite seems to occur here in PA.

I witnessed my wife negotiate a cheaper option for us paying cash directly to the hospital rather than us pay our deductible if the hospital billed our insurance. They go for the gusto when insurance revenue streams can be tapped. By the way, my wife has worked in the healthcare administration field for the better part of 30 years. She knows how these vultures operate and therefore knew to ask for a cash discount when the situation called for it. We had a 2500 deductible which had not had anything paid on it. If we let them bill insurance, we pay more toward the deductible than we would have paid negotiating a direct payment. Doing this early in the year may not be a good option, but often works out well if late in the year and there hasn't been any reduction of the deductible amount throughout the year.

[pnwmom]

9. And if he hadn't had insurance, he would have owed the whole $55K.

That's why at least having a catastrophic plan is so important. The hospitals are free to screw anyone without an insurer backing them up.

[LeftyMom]

14. That hospital has added two expansions larger than the original hospital in the last ten years.

Somebody's got to pay for all of that, don't they?

I hope he at least got a west facing room with a nice view of Sutter's Fort and not an east facing view of the freeway.

[Hassin Bin Sober]

19. No shit.

Every hospital I know of has grown and grown and grown in the last 30 years.

The hospital I was born in was no small hospital. Now it has a "campus" that would rival a mid sized university.

Northwestern down town is gobbling up city blocks.

The hospital my partner just had surgery in just built a new "tower". (I will admit it is really nice. This ain't the hospital your grandma died in)


Yet they are all hurting

[LeftyMom]

22. The hospital in the OP is where I was born.

It was at that time (1981) a one square block brick building about eight stories high. A slightly premature C-section and a week of recovery were $3500 and they took payments. Over the years they added offices in the surrounding buildings as they became available, but nothing major. Then a few years ago they added a Cancer Center on the next block that's as big as the original building. As soon as that was completed they started in on a Women's and Children's wing the next block over from that, and taller than either of the others. It's a year or more late and god only knows how far over budget. Meanwhile the area near the hospital hasn't added any people. I don't get it.

[Faryn Balyncd]

16. The bluebook fair price for these hospital services is $8141. Sutter General is racketeering.

https://www.healthcarebluebook.com/page_Results.aspx?id=69&dataset=MD&g=Appendectomy


(And the Bluebook price is a PROFITABLE price.)

The reality is that Sutter General is attempting to overcharge by 675.9%.

Sutter General is attempting to collect 136% of the $8141 Healthcare Bluebook fair price as a co-payment from the patient after they had already defrauded the insurance company by collecting a fee of 539% of the bluebook fair price, which is a profitable price.

The sleazebags running Sutter General are a disgrace to capitalism, a disgrace to America, a disgrace to the human race, and a disgrace to the animal kingdom.

Adam Smith, the philosophical father of capitalism, would VOMIT to see such predation described as the system he envisioned.

The decision makers at Sutter General should be shamed.

More specifically, the decision-makers at Sutter General deserve public humiliation, class action lawsuits, criminal indictments, and social ostracism.

[jmowreader]

25. That looks like it's for a routine appendectomy, not removal of a burst one

If your appendix bursts and your body didn't wall it off before it went (encapsulation is a "textbook" case as in "the only place your doctor saw this before is in a textbook"* and if it happens to you, you'll get to meet ALL the doctors in the hospital) they have to open you up and clean all the shit out of your abdominal cavity. They've also got to feed a couple gallons of IV antibiotics into you, and you get a couple of different ones.

A routine appendectomy takes longer to prep for than to do.

* When it happened to me, the surgeon on duty told me, "no one working here has ever seen this before." Fortunately, the medical texts tell you exactly how to deal with it.

[Faryn Balyncd]

26. The bill indeed appears to be for a simple appendectomy. "Burst" appears to be a misnomer by ABC.

The bill itself does not appear to mention a diagnosis, and does not list anything related to any extended stay, nor anything indicating an extended course of parenteral antibiotics.

The statement by the patient mentions "appendicitis" with no mention of peritonitis, ruptured appendicitis, appendiceal abscess, extended stay, antibiotics, etc.

No one appears to use the term "burst" until the ABC report, which appears to be an inaccurate description applied by the ABC writer, not supported by the bill or any source, and in fact inconsistent with the facts revealed by the bill.

Yes, a ruptured appendix with peritonitis and appendiceal abscess would be expected to be a more expensive event. Such an event might involve an extended stay with extended administration of intravenous antibiotics.

It appears that this patient had a one day stay, went home after approximately 24 hours, and the charges for pharmacy and intravenous therapy amount to less than 6% of the bill.

All of the above suggests a simple appendectomy, not ruptured appendicitis, peritonitis, abscess, or extended hospital stay or other services other than those normal for a simple appendectomy.

And it appears that ABC's use of the term "burst" was sophomoric journalism.

And it would appears that CEO Pat Fry's $5.2 million annual compensation might have something to do with the fact that Sutter appears to routinely charge in excess 600% more that Healthcare Bluebook prices.

[Faryn Balyncd]

20. Photo of sleazebag CEO of Sutter General (who paid himself $5.2 millin last year):

?v=1


http://www.sutterhealth.org/about/ourteam/#Patrick%20Fry

Two recent articles in Modern Healthcare providing an update on the compensation of CEOs of non-profit hospital systems raised new questions. A summary of their total compensation:

- Donald Faulk (now retired), Central Georgia Health System - $8 million
- George Halvorson, Kaiser Permanente - $7.9 million
- Jeffrey Romoff, UPMC - $6.1 million
- Pat Fry, Sutter Health - $5.2 million
- Gregory Beier (retired), Novant Health - $5.1 million
- Dr Steve Safyer, Montefiore Medical Center - $5 million
- David Bernd, Sentara - $4.6 million

http://hcrenewal.blogspot.com/2013/08/should-we-cry-for-non-profit-hospital.html

Sutter Health's net income soars to $735 million






The saddest part of this story is that this is pretty much business as usual.

The business practices and ethics of the industry STINK.

Their multi-million dollar annual compensation is built upon a predatory system of nontransparent, discriminatory pricing at best. (in those instances when detailed examination of billing does not document outright fraud.)

[Warren DeMontague]

21. Yeah

I stopped subscribing to Time, but their piece on health care and costs was a must-read.

http://content.time.com/time/magazine/article/0,9171,2136864,00.html

[KauaiK]

23. Hospitalized for bleeding ulcers = $84,000

$84,000 which includes a 20 minute air ambulance ride in the amount of $30,000. I have yet to receive a itemized bill from the ambulance company in Utah.

[question everything]

27. Young people: are you reading this?

Yes, you do need medical insurance, so go ahead and sign for ACA. Now!

[former9thward]

30. Absolutely not the lesson from the OP.

The guy still owes 11k even though he had insurance. In a similar ACA case with a 6-10k deductible a young person would owe around 20k. Whether you owe 11k or 20k most young people would file bankruptcy. The lesson of the OP is not insurance. Insurance is the reason we have ridiculous 65K bills for a routine operation.

[RockaFowler]

28. I have a similar story from 2012

I was in the hospital for 5 days for a Gall Bladder surgery
I had no idea that there was anything wrong with my gall bladder before I went to the ER with extreme pain

My Hospital bill was $190,000. I'm still trying to figure out why - almost 2 years later. The cost was cut way in half once my insurance company got involved. But if I didn't have insurance I would be getting a whopper of a bill from them even today.

Something has to be done about these outrageous costs. That is what is making it impossible without insurance!!