Monday, November 23, 2009

A Tale of Two Hospitals: How Sugar Water Helps Make Christmas Sad

This year we were planning to see my folks for Christmas. It won’t happen. The bills for our son’s medical issues are killing us. In the whole affair, we have experienced the devil and angel of health care. There have been posts here calling out the insurance companies, but it is time to hold the hospitals and clinics to the same fire. Our local hospital in Spokane has been a nightmare of over-charging, while the one in Seattle, Childrens Hospita,l has been a joy. One seems to be out for profit and the other cares for both my son and our family. As we reform health care, an important question is how can we get our hospitals to look more like the Mayo Clinic and Seattle’s Childrens Hospital and less like the pork-filled billing machines many of them are.

Understand our story: we have insurance, but our plan is now 80/20 with a maximum out of pocket, or so we were told. The reality, in practice, is very different and speaks to why our system is plagued by systemic problems. First, our 80/20 split is figured out before the insurance company is given their discount. Second, only a fraction of what we pay out counts toward our maximum. These are the problems of the insurance company. But they are not the only problems within the system.

It is time to call out the providers. The local hospital charged for two MRIs and two C-T scans, when only one of each was ordered, needed, and performed. They billed for two of each because they could claim a change of the angle for each scan and then code it as two different MRIs and two different C-T scans. Doubling the price for the love of money. Now, I say it was one of each in reality, because we had to purchase (after spending thousands of dollars) the MRI and C-T scan to take for the doctors in Seattle. I got only one disk for each, with only one reading, and the Doctors at the Childrens Hospital referred to one of each. One in reality and two for the wallet. In most businesses, such overcharging is considered fraud. In the medical world, this is business as usual. Health-care reform has to answer this problem.

Now, don’t think I am just mad to be mad. Having experienced great health care in Childrens Hospital, I know we can do health care better. The kindness and professionalism of Childrens has been a welcome change. They had us meet with a counselor to help with the financial piece. It also has been a fraction of the cost of the local hospital even factoring the travel and hotel expenses. The better care was cheaper.

The poignant example of how the local hospital over-charged us is a story of the most expensive sugar water. When we brought in our son for his MRI, they had to set an IV. The nurse made my son a pincushion as we, his parents, held him down. He looked at us with terror and confusion. Why were his parents holding him, while someone was torturing him? Eight tries later, the IV was finally set and my four-month-old panting from the experience. The nurse opened one thimble-sized container of sugar water to calm him. She dipped it in his pacifer twice and then threw the rest away. We were billed for two containers at almost $9.00 a pop. If we bought the sugar water by the gallon at that rate it would be $1,180. The pricey sugar water is part of the reason my family will not see my son on Christmas. The question I have is does this seem like justice to you?

1 comment:

Shannon said...

I followed your story on Sojourner's web site and felt compelled to wish you and your family the best. Praying for healing for all of you, sending good thoughts your way.

Sincerely, Shannon C.