That’s One Expensive Medication

After spending most of my career in healthcare, not much surprises me these days.  Well, that’s until this summer when my teenage daughter had a finger infection that was not reacting to traditional oral or topical medication.

She had a small infection on her finger that was being medicated with topical and oral medications without success. My wife was concerned and took her to our primary care provider. They recommended she go to the pediatrics’ emergency department at our local hospital.

After a few hours, it was determined that IV medication of a higher caliber was needed to protect against a potential infection of the bone. When you hear something like that, you quickly start to freak out as a parent. Off she went to the ED.

Several hours later, we were told she was staying the night. Under the circumstances, there was no choice other than an overnight stay in the hospital in order to get the medication by way of the IV. The next morning, after no sleep for my daughter (nurse’s checking in every couple hours) and myself (6’5” dad and a hospital couch doesn’t equal a Casper night’s sleep), we began the waiting process. Finally, at lunchtime, they determined the medication was working and she would be cleared to leave. Just before dinner, my daughter was discharged and has since fully recovered.

Several weeks passed and the mail came from our insurance company. The total charges for one night stay at the hospital and 2 bags of IV medication totaled an outrageous $5,200. Fortunately, we had insurance, that brought the total adjusted charge to $1,500. The adjustment was nearly a 72% discount.

As a healthcare professional,  I have heard about aspirin costing a hundred dollars and about other out-of-control pricing. I must say, experiencing this first-hand exposes the multilayered problem we have within our healthcare system.

The hospital charging $5,000 for a room for the night and two bags of IV is the first issue. The second and bigger issues are the discount off published pricing for the insurance carrier. It’s a complete furniture sale. Is this driven by the insurance companies need for discounts, the non-profits hospital ability to claim higher write off’s for free services or a combination of the two?

In the end, this is why transparency in healthcare is critically needed. This example shows how something minor can change a family’s financial stability rapidly without adequate insurance or no insurance at all.