Thread by @dopamine_jawn

“Why do medical procedures cost so much?”

Dissecting a Medical Bill: A Thread

This is a bill my brother received for a 3-day ambulatory EEG, required to diagnose the cause of his new onset grand mal seizures.

21 leads are glued to the head to monitor brain activity continuously. The pt leaves wearing the device, returns at 72 hrs for removal.

First, let’s look at the exorbitant cost posed by the hospital for a procedure that takes probably 4 hrs of their time - $34,486.

You’re probably wondering what justifies the cost. Let’s start by acknowledging that it took over 20yrs of inflating costs to get here.

Q: How did the costs get inflated?
A: Your insurance company.

See the line “Insurance Adjustments”? This number reflects how your insurance company negotiated the set price by the institution.

Yes, your insurer can simply say “we are not paying that much” and refute the cost, and this basically a universal practice nowadays.

This practice dates at least as far back as the 90s. First time I saw an example of this was with my same bro’s tonsillectomy surgery in ‘99

My dad showed the bill to me and championed our ins. carrier at the time bc they only paid 35k for 100k surgery. We paid $100 out of pocket.

For years, hospitals were losing $ on procedures because insurers would not pay anywhere close to the full cost.

So they started raising prices above what it *actually* costs in order to collect an amount closer to their desired fee from ins. companies.

This, in turn, allowed fees to slowly rise, while insurers wisened up and began paying out even less by passing on more cost to the patient.

Today, my brother owes $3,529.69 for an outpt procedure that cost 1/3 of his tonsillectomy for which we paid only $100 in 1999.

My brother is employed by a big corp. and has decent insurance. He already met his deductible. He now has medical debt + $150/mo premium.

The only way to stop the vicious cycle of price gouging btwn insurers & providers is to eliminate private ins. & regulate the cost of care.

The only way we can do this is through a single payer health system. Enter: #MedicareForAll

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