Sunday, July 12, 2009

Anatomy of a health care crisis

Medical emergency, photo by Yasser AlghofilyLessons from the Horsemiddle

by Mark Yannone

According to the Center for Science in the Public Interest, "Hazards in food cause an estimated 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year, most of which are never reported to public health officials. These illnesses cost American taxpayers approximately $6.9 billion annually in medical costs, hospitalizations, and lost work time according to the Economic Research Service (USDA)."

A large part of the estimated cost is the lost productivity due to premature death.

To illustrate, as of 2008 the total cost of getting sick from food-borne salmonellosis goes like this (per case):

If you do nothing and survive: $52
If you go to a doctor and survive: $536
If you go to a hospital and survive: $11,072
If you go to a hospital and die: $5,633,181

The productivity component of the cost varies with the treatment:

If you do nothing and survive: 100%
If you go to a doctor and survive: 32.4%
If you go to a hospital and survive: 4.2%
If you go to a hospital and die: 99.8%

So, the medical cost of getting sick looks like this (per case):

If you do nothing and survive: $0
If you go to a doctor and survive: $362
If you go to a hospital and survive: $10,602
If you go to a hospital and die: $9,609

Lessons:

Stay home.
Find a cheap doctor who will give you a cash discount.
If you go to a hospital, you'd better hope you die there; you'll save $1,000.

Sources:
Food hazard statistics
Salmonella statistics

3 comments:

Linda Bentley said...

Waking up Dead

That seems to be the only thing hospitals can't charge for up front: death. They can't even come up with a good-faith estimate beforehand.

In fact, when I was at Mayo several years ago, and they said they wanted to keep me overnight for observation, I asked them how much it would cost. They said they had no way of knowing since they wouldn't know what the doctor might order or what I might need.

I said, "let's make it simple and say I need nothing," and asked how much it would cost just for the room.

They told me not to worry about it because my insurance would take care of it and bill me.

I said, "I don't have insurance, so this is a really important question."

Then they said they would send someone up to enroll me in AHCCCS.

I told them I don't qualify for AHCCCS and need to know how much it will cost so I can make an intelligent decision.

The person had to go away for a really long time to get me an answer. When she came back she told me the room would cost $1,500.

I told her to get the IV out of my arm and I was out of here. If I decided I had a problem I'd just book a room in the fanciest hotel I could find nearby and take a taxi back. That all seemed like a bargain by comparison.

The emergency room bills were enough to choke a horse. A little over three years after I paid them, I received a check in the mail from Mayo for about $300 with zero explanation. Since that was the only time I was ever at Mayo, it had to be associated with that visit.

All I can figure is they overcharged me and were audited or they randomly decided to give me an after-the-fact uninsured discount.

So, dying is the best way to leave a hospital, at least from a financial standpoint, because when you wake up dead, no one takes Obama bucks there.

jdogg92056 said...

When I was a kid, my parents always encouraged me to read. As I had friends with older siblings, I always asked these older siblings about their reading habits. And so, I was introduced to Kafka at an age younger than I imagine most young people first discover him. I delighted in the totalitarian horror mixed with the theater of the absurd. I just never thought I'd see it in real life.

Mark Yannone said...

@jdogg92056

Sweet, isn't it? That's why so many people thought this was a real broadcast.