By Sabriya Rice, CNN Medical News producer
and Elizabeth Cohen, CNN Senior Medical Correspondent When Dr. Linda Galloway learned she needed surgery to save her vision,
she scheduled the procedure immediately with her ophthalmologist. What an eye-opener it was when the hospital bill arrived. She noticed
several high-priced items, including a charge of $863.20 for
disposable forceps. "Surgical instruments can be expensive but I think $863.20 is really
outside of the realm of realistic prices," she complains. Then Galloway, an obstetrician in Orlando, Florida went online and
found similar forceps for $1,155 for a box of six, or $192 each. "I was outraged. I tried to get an explanation as to why I was charged
that amount of money," she said. When she called the billing
department, the answer upset her even more. "They said when you signed consent for the procedure, you allowed us
to charge anything we wanted to and therefore, this is what it is,"
she recalls. Galloway says she was especially upset because with her insurance
plan, she has to pay 20 percent of her medical bill and if the
hospital is going address her as a consumer, then she wants them to
level the playing field. "I need to be in power to do things. If you're going to charge me
this amount of money, then I need to know exactly what instruments
you're going to use and what medications you're going to use. Because
I can then buy them outside and bring them to the hospital." Florida Hospital, the place where Linda had her surgery says their
charges are fair and compatible with other hospitals. "Like all other hospitals across the country, [Florida Hospital] bases
charges on a charge master that serves as a guide,” a spokeswoman
wrote in an e-mail. She says that an independent contractor compares
Florida Hospital’s charges with those of other hospitals and that the
results show “we are in the mid-range in that pricing structure." But is markup of more than four times the market rate really reasonable? According to the American Hospital Association, the prices increases
are necessary. “A hospital is a very expensive enterprise to keep open 24 hours a
day, 7 days a week, 365 days a year and ready for any medical need or
emergency. And that does lay out a basic level of cost that has to be
captured through the charge structures," says Rich Umbdenstock,
president of the AHA. Umbdenstock says that hospitals have to compensate for programs such
as Medicare and Medicaid that traditionally underpay, and that each
hospital has to set prices in a way that helps their bottom line. "The hospital has to be able to bring in more money than it spends or
else it won't be there for the next patient.” Editor's Note: Medical news is a popular but sensitive subject rooted
in science. We receive many comments on this blog each day; not all
are posted. Our hope is that much will be learned from the sharing of
useful information and personal experiences based on the medical and
health topics of the blog. We encourage you to focus your comments on
those medical and health topics and we appreciate your input. Thank
you for your participation.
and Elizabeth Cohen, CNN Senior Medical Correspondent When Dr. Linda Galloway learned she needed surgery to save her vision,
she scheduled the procedure immediately with her ophthalmologist. What an eye-opener it was when the hospital bill arrived. She noticed
several high-priced items, including a charge of $863.20 for
disposable forceps. "Surgical instruments can be expensive but I think $863.20 is really
outside of the realm of realistic prices," she complains. Then Galloway, an obstetrician in Orlando, Florida went online and
found similar forceps for $1,155 for a box of six, or $192 each. "I was outraged. I tried to get an explanation as to why I was charged
that amount of money," she said. When she called the billing
department, the answer upset her even more. "They said when you signed consent for the procedure, you allowed us
to charge anything we wanted to and therefore, this is what it is,"
she recalls. Galloway says she was especially upset because with her insurance
plan, she has to pay 20 percent of her medical bill and if the
hospital is going address her as a consumer, then she wants them to
level the playing field. "I need to be in power to do things. If you're going to charge me
this amount of money, then I need to know exactly what instruments
you're going to use and what medications you're going to use. Because
I can then buy them outside and bring them to the hospital." Florida Hospital, the place where Linda had her surgery says their
charges are fair and compatible with other hospitals. "Like all other hospitals across the country, [Florida Hospital] bases
charges on a charge master that serves as a guide,” a spokeswoman
wrote in an e-mail. She says that an independent contractor compares
Florida Hospital’s charges with those of other hospitals and that the
results show “we are in the mid-range in that pricing structure." But is markup of more than four times the market rate really reasonable? According to the American Hospital Association, the prices increases
are necessary. “A hospital is a very expensive enterprise to keep open 24 hours a
day, 7 days a week, 365 days a year and ready for any medical need or
emergency. And that does lay out a basic level of cost that has to be
captured through the charge structures," says Rich Umbdenstock,
president of the AHA. Umbdenstock says that hospitals have to compensate for programs such
as Medicare and Medicaid that traditionally underpay, and that each
hospital has to set prices in a way that helps their bottom line. "The hospital has to be able to bring in more money than it spends or
else it won't be there for the next patient.” Editor's Note: Medical news is a popular but sensitive subject rooted
in science. We receive many comments on this blog each day; not all
are posted. Our hope is that much will be learned from the sharing of
useful information and personal experiences based on the medical and
health topics of the blog. We encourage you to focus your comments on
those medical and health topics and we appreciate your input. Thank
you for your participation.
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