Well my friends.. I was pleased/shocked/entertained to find that I received the following responses to this quiz, in ascending order:
- “over $100,000”
So who won???
I suppose I am relieved to say that, well below both the median and mean values offered by my most esteemed friends, my total billed costs were….
And with the fascinating guess of $47,157.58, my good friend Jimmy won this challenge! Jimmy how did you do it?? Did you hack into my health insurance online account?
But to all 11 of you, thanks for playing!
In all seriousness though, I should conclude from this exercise that at least in this example, healthcare costs are not as bad as we imagine them to be. Or possibly, unfortunately, my costs were relatively not as bad as those experienced by you or people you know who have been in similar situations. I hope that is not the case because this cost is staggering enough as it is. But it is interesting to see that 9 of 11 people guessed higher, with 7 of these 9 guesses significantly higher.
Whether you believe me or not, I had guessed about $30K before I saw the bills so the reality surprised me. Though I’m not too worried because I hit my (still pretty high) out of pocket maximum of $2,500 and am off the hook for any bills after that. So $30K or $48K or $350K is of no material difference to me.
Here is the source data to satisfy all your many curiosities. Maybe it is an over-share, but I do not see any other way for average people to acquire solid healthcare cost data.
The blue line is where I hit my 2014 deductible of $1,500, and the red line is where I hit the out of pocket max of $2,500. I also re-coded the column called “Visited” from mumbo-jumbo to something understandable, for your pleasure.
As I looked through these bills, many of them make sense. Before you get too hot and heavy about, for example, an ICU room costing $8,000/night, consider that no fewer than 4 medical professionals had to care for me nonstop. Not to mention the slew of food ladies, custodial people, and front desk clerks that seemed to be genuinely needed to keep things running. It all adds up – as you can see if you are used to costing up services as I do at work. If you were to bill out just the 4 full-time medical folks at a blended rate of $85/hr for the 4 days * 24 hrs/day, you would have the $32K bill. Of course the nurses and PAs were looking after 6 beds not just 1, but when you take into consideration all the other costs, I can’t really argue.
Clearly some medical services price-gouge (such as $2,600 for a 5-minute ambulance ride, lovely and expert though my ambulance ladies were). And some are just unnecessary (such as the $300 heart ultrasound, which the ICU admitted they only ordered because the ultrasound specialist was in on her day off, even though they estimated my risk of heart problems as low). But I couldn’t tell you what else all this should cost on the whole.
Given what strikes us all as a really high overall cost ($48K), combined with the very large amount covered by insurance ($32K, considering United has received only $18K for me in premiums since I joined), combined with the artificially “low” feeling of the subsidized max of $2,500, I am left with this existential question of “what should healthcare really cost?”
The hospital people assured me that I probably would have died of hypoxia or organ shut-down or a variety of other side-effects related to pneumonia had I not gotten in there. And I clearly do not have any other source of constant oxygen provided with a Bipap mask. So if you assume they are correct, I suppose the cost of their services should be commensurate with the value of my life. But that is way too high! I am worth more than $48K.
Alternatively, if you really billed just the straight cost of the employees’ wages, materials, and equipment usage (and I’ll throw in upkeep and calibration), with a modest profit margin, I assume it would be way lower. (Because as many of us know, many healthcare workers are not paid commensurate with their training and the criticality and severity of their working conditions.) Maybe the price would be so low that people could actually afford to pay for it by themselves without the interventions of insurance.
So I assume that the final cost is a blend of true cost and a bit of “we saved your life” jazz, clearly subsdized by the Health Insurance Industry. If the question is how much I think it is really worth to me, to have had access to life-saving technology that I needed (though without surgery or other procedures, to put it in perspective), I guess I would honestly answer with a number possibly higher than $2,500. I don’t mind that the cost was capped there – lower would be better, but I do not really see how.
Does anybody get anything else out of this? Is $2,500 too much to save your life? Is a $48K bill too high even though insurance paid for $32K of it and rejected $14K of the cost? Or is there a way to reduce all of these costs? Would we be better off without health insurance?