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.
