The real reason Hospital bills are so high in USA

https://youtu.be/CeDOQpfaUc8

  Adam Ruins everything

  Woman Patient: Of course I want as much medical care as possible .What could be the downside?

 Adam: Oh, there are a ton. For starters, how 'bout the fact that this place rips off folks like you every day.

  Woman Patient :  Whatever. I know the hospital is expensive, but it is worth it if I get the best treatment.

 Adam: No, it isn't. American health care is not the best in the world. (Susan Brink. NPR. 2017) But despite that, we spend more per person annually on health care than any other developed nation and a big part of the reason for that is that American hospitals overcharge patients massively.

(Music playing, cheering and applause)

This neck brace is worth $.20

But the hospital charged him... $.154

This I.V. bag cost less than a buck.

But she was charged $.137

These are real prices, folks.

 Woman Patient:  Hold up.

Wildly inflated health care costs?

This sounds like the work of politicians to me.Was it Obamacare? Trump Aid, McConnell Med?

What did you do?!

 Random white man: I'm not a politician. I'm just a boring white guy. Why does this keep happening?

 Adam:  Sorry, Rachel, but this time, it's not the politicians' fault.

The problem starts with something called the "Chargemaster."

The Chargemaster is a secret document full of insane prices,that hospitals use to charge us whatever they want.

Let's go on a trip through the history of medical billing.

 Woman Patient:  Well, I'd rather not.

(Adam) A hundred years ago, hospital pricing was pretty simple.

 Hospital administrator: We take the cost of providing care and add a little on top to make a profit. One amputation costs us five bucks. So we'll charge you..$6.50

But after the rise of insurance companies, hospital billing got complicated, in part because these gigantic corporations demanded gigantic discounts.

 Insurance representative: We send you thousands of patients every day. So, we want... half off all your prices.

 Hospital administrator: We can't afford that.

So, to please these powerful insurance companies, hospitals cooked up a plan.

 Hospital administrator: I've got it. We'll make up a really, high fake price, and then give you a discount off that.

 Insurance representative: Hey, as long as I get to tell my boss we got it cheaper.

(Laughter)

(Laughter)

(Adam) And in less than a century, health care prices went from reasonable to nonsensical.

Let's make one Tylenol $.37.00

Three stitches, $.2200.00

Ooh, here's a pitch.

What if we made rectal exams –$ 69. ??

Nah, that's too silly even for me.

♪♪

 Adam:  These crazily inflated prices are kept in the hospital's Chargemaster.

 Blows the dust on the cover

Woman Patient:   (coughs)

 Adam:  It's actually a computer file. But the book is more dramatic.

 Seven Dollars For a single alcohol swab? That's ridiculous.

 Adam:  And true.

  Woman Patient:  Well, I only pay my premium.

If they wanna rip off my insurance company with their fake prices, what do I care?

If you ever lose insurance, you'll care.

Because here's the really evil part.

If you don't have insurance,

you actually get charged these fake prices.

(studio audience cheering and applauding)

Let's see, heart X-rays.

That'll be $,.33000

I can't afford that.

No problem, we'll just garnish your wages.

Oh, bogus.

 Woman Patient:  Wait, they actually charge people without insurance

fake prices?

Yeah.

 Woman Patient:  That is terrible.

 Woman Patient:  Well, thankfully, I have insurance, so the Chargemaster doesn't affect me.Right

Unfortunately, it does.

Even if you're insured, you can get billed

Chargemaster prices if you go out-of-network.

And anything can be

out-of-network.

The hospital you go to, the equipment used to treat you.

Even the doctors you see.

Arrow specialist.

Out-of-network, I am very expensive.

Hospitals make a ton of money

overcharging

out-of-network patients.

It's a real cash cow and we all get milked.

(cow mooing)

Worse, every hospital has its own Chargemaster.

A treatment that costs , at one hospital

could cost a hundred grand down the road.

And you can't comparison shop

When you're dying.

 EMT Tech :Which hospital do you want?

Money Bags Medical or St. Vincent's Discount Sick House?

Money Bags it is.

Plus, since your insurance company faces inflated costs,

That can trickle down to you in the form of... higher premiums.

Oh, surprisingly painless.

Wait till you get the bill.

(cow mooing)

 Woman Patient:  How do they get away with this?

Simple, the health care industry spends more on lobbying than the oil and defense industries combined.

(cash register rings)

(men babbling)

Thanks, Doc. I'll take care of you real nice.

Say, does this cyst look normal?

Oh, God.

 Woman Patient:  So, how can I stop it? What do I do?

Honestly, nothing.

We need to go to the hospital,

so they have no incentive to change how they do business. And politicians have spent decades arguing

over how to pay the bill instead of asking why the bill is so high? Until they do, we're stuck with this system.

 Woman Patient:  God, what if I get fired and lose my insurance? I would be ruined! I feel so anxious.

(Woman over PA)

Rachel, the doctor will see you now. Down the hall and to your left.

 Woman Patient:  Well, then, if I'm gonna get ripped off, I might as well score some antibiotics.

I wanna be done with this cold and those miracle drugs are worth whatever they cost.

Even if it means the end of modern medicine?

  Woman Patient:  You are the worst person I have ever met, and I work in finance.

English  Adam Ruins Everything

In the United States, the chargemaster, also known as charge master, or charge description master (CDM), is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. In practice, it usually contains highly inflated prices at several times that of actual costs to the hospital.^[1][2][3] The chargemaster typically serves as the starting point for negotiations with patients and health insurance providers of what amount of money will actually be paid to the hospital. It is described as "the central mechanism of the revenue cycle" of a hospital.