Wednesday, December 15, 2010

Annals of insane medical service pricing

I recently had back surgery for a herniated disk. The procedure was pretty high-tech - insertion of a series of ever-larger tubes to create a roughly 1/2" hole, through which the surgeon could get in to my spinal area to clean up the bits of disk and disk gel that were pressing on my sciatic nerve. Time from walking in the front door of the surgery center to getting in the car to go home: under 7 hours. The results have been great - no pain at all for the first three weeks, then some minor nerve irritation as the steroids have worn off. The doc promises that this will go away, which it's already started to do.

As to the title of this post: the outpatient facility (Sam Ramon Surgery Center) is out-of-network. Lucky for me, I have great medical coverage through my employer. But being out of network means that we get billed at the full rate - not a contracted or negotiated rate. The "facility fee" for those 7 hours? Guess, then scroll down.

















$85,000.

I don't know what to say about this except that it's insane. It's obviously completely unrelated to the actual cost of providing the facility to do the procedure or to the skill of the people involved. (Note that the surgeon's fee was separate.) The usual explanation for insane hospital charges is that they have to cover unreimbursed ER and medicaid care. That doesn't apply to an outpatient clinic. They get paid for everything.

This is not the fault of any "greedy insurer". It's the greedy medical-industrial complex...

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