Leaked hospital records reveal huge, automated markups for healthcare

A former nurse at Scripps Memorial Hospital showed columnist David Lazarus screenshots of the facility’s electronic health record system. The screenshots show price hikes ranging from 575% to 675% being automatically generated by the hospital’s software.



https://www.latimes.com/business/story/2021-12-10/column-healthcare-billing-markups

Not very surprising. They have been doing this for decades.

575%-675%? I know they jack prices, but this is evidence of price gouging. It's one thing to mark an aspirin up to $8 but a procedure or pricey implant marked up 5-6 hundred percent? Wow.

And that's just at the hospital. All of the materials for said pricy procedure are already marked up quite a bit

I've posted about this before on here from time in medical device sales, specifically, spinal hardware. 500%-600% seems like an average markup. I've seen quite a bit higher. I don't think the hospital anticipates collecting anywhere near that when billing. If would invoice the hospital $1800 for a single pedicle screw, the hospital was billing substantially more. A single case, including allografts or autografts for a multi-level spinal fusion could certainly be in the $17k-$20k range and that just what we as the medical device company was invoicing the hospitals. For the most part, hospitals wised up and put caps on what could be invoiced if you wanted your products approved for use. In turn, I am sure that lowered what the hospitals was then billing the insurance providers.

None of this is surprising.

I thought about it a bit and was thinking this helps offset the FREE services to the uninsured they hand out too. Pass the bill to the next guy, so to speak. But it's still wrong.

Nothing surprising.

It is an ongoing game between hospitals and insurance companies. Hospitals want the money owed. Insurance keeps insisting that they will only pay percentages of things.
Well, if the insurance company is only going to pay 50% for a procedure, but all of the hospitals double their costs, then the hospitals still get the money they need. They also get to cover all of the losses from people that can't, or won't, pay. It also covers all of the massive malpractice insurance policies they have to carry... and then there's the corporate profit factor (not knocking it as it's not wrong, just noting it)

Totally wrong that things are marked up this much, but this is the game they have to play to exist in a world run by insurance companies and lawyers.

It's also not one bit surprising that hospitals would put a cap on what they would pay for things but fight like hell so that they aren't treated in the same fashion.

This should surprise no one who has ever been to the hospital, and looked at their EOB when it arrived from the insurance company.

Billed amount: $18,200.00
Insurance contractual write off: $17,500.
Balance: $700.
Deductible: $500
Insurance covers: $200.

It's like shopping at Kohls. There is the price, the price you actually pay, and 10 dollars for every 50 you spend, to get you to come back to spend some more.

I stopped shopping there years ago.

Ahhh the joys of "Capitalism", where things are worth whatever someone can get someone else to pay regardless of inherent value. Add to that a system where the currency doesn't actually have inherent value. Further, you don't actually have to have currency but can use "debt"/"credit." And to think people believe that children grow out of believing in make-believe. It's no wonder we've got such an infantilized population.

And the fact that it is a matter of life and death in this case seems to make generalized banter much less important. At least to most people.

I think it's more about keeping up with the insurance contracts... every insurance has a contract rate with the hospital on a percentage that they'll pay... so for a $100 charge, BCBS may pay $35.... so the hospitals jack up the prices to try and deal with it... but who gets screwed, are those that have to pay a cash rate and aren't keen enough to ask for a self pay discount (which is still more than the insurance companies will pay)

The fact that it is directly related to health, and people are willing to pay anything as an alternative to dying seemed to strengthen my point, I thought. It seems that preying on the unfortunate is the basis of our fairytale economy. It seems that the biggest thing this country is focused on producing is more money, irrespective of the actual value provided. Yay the US economy is "massive", instead of the rich having 100 yard superyachts, they can have 200 foot yachts and private spaceships, while the unfortunates get loaded with insurmountable debt.

edit: yes, I realize that 200 feet is less than 100 yards. Fortunately, I saw that and started laughing before going off on a longer rant. Figure I'll leave it for someone else's amusement.

At least you admitted it was a rant.

Point being there are very few human beings in history that wouldn't have paid any price to save their own life if they could. I don't think how high the price is makes any difference in that. I don't think how much money is printed changes that.

What it all boils down to is whether one thinks the health and saving the life of our own citizens is a human right or a business. We can see with this a perfect example of what happens when we leave it in the hands of business. They know people will pay any price to survive and live. And they have no problem demanding that price.

No doubt that hospital construction should be done for free, equipment and supplies should be free, not to mention the people working there should be paid minimum wage.

When you get down to it, people making money working at a hospital or in health care are horrible people, making money due to other people's misfortune.

Shameful.

Nice way to twist it. It has nothing to do with people working in the healthcare field or their pay. It has to do with corporate mark ups on everything from services to equipment and drugs. But you keep doing you in pretend land.

No one said anything about free. Equitable would be nice, though. Charging some rough approximation of what went into something instead of as much as you can get away with seems sadly to be too much to ask some people. Instead we've got inflated prices to keep up with someone else's inflated prices with only those that actually need the "products" getting shafted by a system that doesn't let them similarly arbitrarily raise their "price"/pay.

When you mention reasonable healthcare costs or human rights it's an automatic trigger for some people. Nobody wants the healthcare system to go broke. And while I like the concept of national healthcare I don't trust our government not to screw it up beyond repair.

Thank God I'm still alive.