Thursday, July 30, 2015

How Government-Run Health Care Just Saved Us Over $50,000

Today is the 50th Anniversary of the Medicare Program
Alma Jean had a heart catheterization done at RMH Sentara in May, and learned she needed to have two stents put in due to an obstructed artery. This resulted in an overnight hospital stay and a total bill of $65,374.55 (just $10,000.00 less than we paid for our house 27 years ago).

According to our statement Medicare paid $12,374.07 of the bill and Everence, our supplemental health insurance, covered the rest of the allowable amount, another $1,297.46. The remainder was labeled a "Discount or Ineligible Amount", a grand total of $51,703.02, for which RMH Sentara was not reimbursed.

I'm neither a medical nor a financial expert, so I may not fully understand all of this, but it does raise the question of whether hospitals seriously overcharge for their services.

For example, of the 20 separate items in our statement, the two main procedures, "percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed" were listed at $20,629.00 each, or $41,258.00. Then there was a $2,344.30 charge for the injection of one 1mg of bivalirudin, among other 18 items. Yet the total amount Medicare and Everence paid for everything was just $12,227.26, representing a huge saving.

Makes me wonder whether a single payer government-run health care plan would really be such a bad thing. My oldest brother Sanford, who moved with his family to Costa Rica in 1965, doesn't think so. When he suffered a serious heart attack over a year ago,he had three options: 1) Do nothing medically, and trust God to heal him; 2) Pay for all of his care at a private hospital; 3) Utilize Costa Rica's "Social Security" program which provides  health care for all. Cases are prioritized in terms of urgency, but the care he received through this third option was adequate and he is doing well.

Sometimes a government can accomplish some good things, and Medicare appears to be an example of such a program. Maybe it's one all citizens should have access to, not just us fortunate older ones.
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