Comments on: My Very First Emergency Room Visit

By: Rachel

Rachel — Wed, 01 Oct 2008 21:44:31 +0000

Extortion is right! We brought my two-year old daughter to the ER because she had swallowed some of my Grandmother’s pills (thanks grandma!) We waited for an hour in the waiting room, they checked her vitals and brought us into another room.

After around 1/2 hour waiting there, they drew her blood. Around three hours later, they told us all was ok- that we had passed the window of harm anyway (if she had swallowed the specific medication that we were concerned about, she would have had violent seizures and probably would have died before even the blood draw) and discharged us.
We probably won’t qualify to have the bill paid for by Medicaid because the hospital sent us the bill three months late, which is past the Medicaid’s window of opportunity. BTW, the bill came to over $1000… for a blood draw and checking vitals! This may not sound like much to some, but we can’t afford that…

At one time, we were offered health insurance by my husband’s employer. It would have come to $700/month for our family of four who has no pre-existing medical conditions. That’s $8400 per year- which is way beyond what we’d pay even including the ER visits if we paid for everything out of pocket. And this health insurance was offered by a hospital. I simply don’t understand how so many Americans can justify writing such a large monthly check to such a criminal industry.

By: tresho

tresho — Wed, 23 Apr 2008 13:52:31 +0000

“my bill was approximately $10,000 for the ER and $1,000 for the doctors time…I think we’re talking even more than a plumber makes right now”
No, you just wrote that your doctor’s bill was 9% of your total bill. Even if your doctor charged you NOTHING, your bill still would have been $10,000.
This would be like my plumber charging me $50 for his time and $450 for the copper fitting he installed — actually, with the price of copper skyrocketing, this may yet happen!
Fortunately I’m able to doctor myself & do a bit of my own (real) plumbing. Cleaned out my clogged kitchen drain yesterday using an old plumber’s snake I had laying around & other tools I have accumulated over decades, cost was $0, a lot of sweat at the time & sore muscles this morning. My last kidney stone I didn’t take to the ER, treated it with a lot (I mean a LOT) of fluids and generic naproxyn and acetaminophen from Wal Mart, cost about $6 for the meds, can’t give an estimate for the cost of the water, though. I don’t advise aspirin for kidney stones, because aspirin promotes bleeding in many people, stones usually cause some bleeding in the urinary tract, surgery is rarely necessary to remove the stones, and you really don’t want to have a bleeding problem after surgery. My last stone passed 3 weeks later with little difficulty. As always, your mileage may vary.

By: Don M.

Don M. — Wed, 23 Apr 2008 01:43:13 +0000

All right, I was in the ER for 90 minutes, IV, morphine, CAT scan and (generously!) 10 minutes of doctor’s time – my bill was approximately $10,000 for the ER and $1,000 for the doctors time – $11,000 in 90 minutes – also left with nothing more than an asprin and the stone still inside me – we’re now talking $122 a minute (mostly waiting time) or something like $1,000 a minute of actually talking to someone!

I think we’re talking even more than a plumber makes right now – God what a screwed up Health Care system this country has!!

By: tresho

tresho — Fri, 29 Feb 2008 23:32:36 +0000

I had my plumber fix a leak in my house, he charged me $50 for 1 minute’s work. I complained that I made less than that, and that I was a doctor. He replied, “Yeah, I made less than that when I was a doctor, too.”

By: Pinouk

Pinouk — Fri, 29 Feb 2008 21:13:10 +0000

OK, I just got hopefully the last bill for my visit to ER with a kidney stone. 4 hours at ER, IV, morphine, CAT scan and 10 minutes of doctor’s time comes to $8,500. That is $35 a minute! And the best thing is that they sent me home with the stone still inside! There is something wrong with medical billing in this country.

By: Chris S.

Chris S. — Tue, 19 Feb 2008 22:32:06 +0000

I had the pleasure of having a kidney stone last year that actually required three surgeries (I believe at least one of these was unnecessary). The total cost was $34,000.

Good news: I have insurance.
Bad news: the kidney stone ER visit occurred on New Years Eve, meaning that I missed NYE with my fiancee and had to max out my out-of-pocket for two years (2006 for the ER visit, 2007 for the surgeries). In total, I paid $3,500. Not fun for a 23-year-old (at the time).

And worst of all, I have another kidney stone that I have to take care of this year (I should have done it last year when my out-of-pocket was maxed out but I kept getting too busy).

By: Blue Cross agent

Blue Cross agent — Tue, 20 Nov 2007 21:51:07 +0000

Sorry to hear about your hospital visit. Hopefully your health insurance can coverage you and that you feel better.

By: parrotnut

parrotnut — Tue, 20 Nov 2007 03:42:07 +0000

I was there for a few hours, not admitted. Two bags of I.V. fluids 2 shots of pain meds. Told it will pass and given a `script for viocodin.

By: Jonathan

Jonathan — Tue, 20 Nov 2007 02:44:10 +0000

Ouch!

By: parrotnut

parrotnut — Tue, 20 Nov 2007 02:00:46 +0000

I just got my bill from the hospital for
for a 3.9 mm kidney stone. It`s $11,084.00. That doesn`t necessarily include other costs. Still have the damn stone 5 weeks later-too!

By: Murano

Murano — Sat, 23 Jun 2007 05:57:33 +0000

Average day in hospital: $7,157 That’s extortionate!!!!! How can any organisation justify that amount.

By: tresho

tresho — Fri, 15 Jun 2007 04:54:53 +0000

The worst kidney stone attack I ever had struck me while I was the ER doctor on duty, the only one in the county. It was interesting how reluctant the rest of the hospital’s medical staff was to take my place when there was no other alternative. My opinion of physicians in general really went down after that experience, and I am one of them.
I got IV morphine for that, it helped slightly. The thing that helped the most was getting off my feet, being relieved of caring for others, & self-hypnosis. This was before drugs like Toradol were used for kidney stone pain, in my opinion, those drugs (i.e., NSAID’s) work much better than morphine on nearly all my patients. My last episode of kidney stone was last summer, and started a few hours after I completed a day’s hike in hot dry desert conditions with not quite enough water ingested. When the pain started, I started drinking a pint of water every 30 minutes & drove across town to a store that was still open & bought Aleve. 200 mg of that & 1000 mg of Tylenol gave me a lot of pain relief. Within 18 hours I was much better, within 24 I was painfree. I passed the stone painlessly 3 weeks later. I did not seek medical attention, although I have done that several times before. I would not have recognized the stone had I not passed others. The stone was very small, more like a little dirt particle, & seemed negligible. I was visiting my sister 1600 miles from home & put off returning home until I was sure I had passed the stone. It is really no fun to have a kidney stone while you are traveling!
—- Many patients pass stones without knowing it, usually quite a while after the pain is gone. It is important to get one of your stones analyzed for chemical composition. Usually the best prevention is to maintain adequate hydration at all times. For average sized men in otherwise good health, this means about a gallon of water a day, plus many extra trips to the bathroom. Other kinds of stone patients would have different hydration requirements. Generally the only way you can be sure you are getting enough water is to take a little more than enough, hence the need for extra bathroom visits. I know this can be a hassle, but it’s nothing compared to a kidney stone. People tend to train themselves to become dehydrated so they can decrease their frequency of urination, it seems a consequence of an over-regimented society.
—- People’s ability to sense when they’re dehydrated is vastly overrated. My personal/professional opinion is that most people are dehydrated to some extent most of the time, so that if they have one episode of diarrhea or vomiting they almost faint. That’s one reason so many ER patients get IV’s in them.
—- I start every day drinking a pint of room-temperature water, all at once, and end every day drinking a cup of the same. The rest of the day I try to ingest the remainder of my gallon. One way to insure you take enough water is to fill your own personal gallon jug of water every morning, and make sure you have emptied it by the time you go to bed. It’s silly to count cups of water when you need to count quarts & gallons. I use room-temperature water because it is painful to drink that much ice water quickly, and I want to get the chore of so much water drinking out of the way. If your water tastes bad at room temperature, get a better kind of water. Most city tap water is quite foul at room temperature from all the chlorine they use. Pure water at room temperature should taste good all by itself. I buy reverse-osmosis (RO) purified water from machines that dispense it by the gallon, they’re available at most large grocery stores. Pure water will keep indefinitely in clean containers. I buy my RO water 7 gallons at a time in a large jug I bought at WM, and refill it faithfully once a week. No one else drinks from my jug.
Kidney stones run in my family. When I researched my family history I found a gggrandfather who died in 1873 of “gravel,” as kidney stones were called at the time. Most likely it was not a single kidney stone that killed him. He either had kidney failure as a result of multiple obstructions, or severe kidney infection from a stone blocking a ureter. The vast majority of kidney stone patients just suffer from intermittent painful episodes, and most pass their stones themselves. Nowadays stones can be removed, when necessary, more easily and with more safety than ever before.
I agree with Mike Lee on calling your doctor before going to the ER, in general. But you need to think ahead of time about what conditions mean “Call 911, NOW” Sometimes the ER is the best “first resort.” When I was in practice, two situations bothered me a lot. One was people with conditions that weren’t at all severe, often conditions that would go away even if nothing were done, who would “rush” to the ER and endanger lives in doing so. The other was people with life threatening conditions who would put off, delay, procrastinate visiting the ER until they were on death’s door, and sometimes well past it. I think every able bodied person should have already taken a course in First Aid & CPR, but that’s just my opinion.
I have already read the case of the woman who died in the ER of the waiting room that Teresa referred to. The media reporting was totally inadequate. As best I could tell by reading between the lines, that particular hospital had already been sanctioned by the federal government for previous EMTALA violations.
Just be aware that now that you’ve had one stone, you are more likely to have another, they tend to hit out of the blue. I have had enough of them in my lifetime for me to know they tend to hurt when I’ve been working up a sweat doing something active, and at the same time fall behind on my fluids.

By: Mike Lee

Mike Lee — Fri, 15 Jun 2007 01:21:29 +0000

The reason why it’s $5000 is because all the tests are done on the premises, and immediately (versus waiting a week for the test results from your doctor). You’re essentially paying for rush service.

Also, even though patients feel like they are being over charged, they don’t realize that ER docs actually go through a differential diagnoses of what you might have, and have to make a calculated decision from one’s test results, exam, and history of whether one has a life threatening illness. If we are wrong, one could potentially be discharged and die at home. It’s that extra level of complexity of thought process that most people don’t consider, and that’s what you’re paying for. Why do you think ER physician’s malpractice premium is around 100k versus an internist/family doctor’s premium of 10-15k? We see the sicker patients and take bigger risks.

Finally, the $5000 is not what the ER doctor is charging you, it’s the cost of each test, cost of each consultant doctor that sees you in the emergency room, cost of each CT scan, cost for the radiologist to read your CT scan. You’re paying several different doctors to interpret complex tests, sometimes in the middle of the night. If you hired 5 lawyers to research a case for you overnight, you’d probably be facing even higher charges, but probably wouldn’t see it as being overcharged…so why is paying for a doctor(s)’ services considered a ripoff to so many people?

By: Teresa

Teresa — Thu, 14 Jun 2007 13:36:21 +0000

Yes, I have always praticed going to the ER as a last resort. Because, I know that it is cost more than a regular Doctor’s visit. But come on, 5000, without any major test and with no admittance. The reason they kept him all night was because it was Memorial Day weekend and they were short of staff.

By: Mike Lee

Mike Lee — Thu, 14 Jun 2007 05:23:00 +0000

As an ER doc, here’s my advice to everyone:

Always call your regular doctor first before rushing to the Emergency room. Many times, they may be able to help you over the phone, and slide you into their appointment schedule for the next day to see you. If they feel the symptoms you describe is an emergency, they will tell you to go to the emergency room. The added bonus is that they usually call ahead of time to the ER you are going to to give us a heads up which will help expedite your service/admission if you need it. Secondly, he will give us additional information from your file that you may not have.

It it can wait, then wait and see your regular doctor in the morning instead (eg cough, cold, congestion, fever, sinus infection, etc) It’s called an emergency room for a reason. ER docs HATE seeing primary care types of complaints because it’s something that a primary care doctor takes care of. You waste the ER’s resources (room, doctor/nurses time) when they can be seeing someone with a real emergency. Also, it will always be more expensive to go to an emergency room, than to your own doctor first.

But of course, if you have an emergency, we always welcome your visit, and in fact look forward to it because it’s what we’re trained to do and what we enjoy doing.

In any case, feel better Jon!

By: windy

windy — Thu, 14 Jun 2007 04:55:22 +0000

Teresa-

hmmm… everyone in the United States, no matter if they have insurance or not, or no matter if they are a citizen, has the right to a medical screening exam on arrival to the Emergency Department, per the Emergency Medical Treatment and Active Labor Act (EMTALA).

If your story is true, you should probably vote for health care reform, as our system is definitely broken.

By: Teresa

Teresa — Thu, 14 Jun 2007 03:08:58 +0000

I took my husband to the ER last week. We received our bill. It was for 5,000. They charged him 1,600 for just walking in, then charge him 500. for a CBC and 1,800 for a ABD Acute W/Chest. He had no other major test. My husband is between insurances because he left his old job. He is currently looking seeking insurance. He came in sick at his stomach. I guess we should be thankful that they seen him. The woman in the news today could not be seen by anyone, not even the janitor. Her husband even call 911 to get help to take her to another hospital. She died because she could not get any help. I wonder if she had insurance or not, if this was the reason? America will help people in other countries before we will help our own. They will even bring people in from other countries to give them free health services.

By: Q at $1 Million to My Name

Q at $1 Million to My Name — Mon, 11 Jun 2007 20:57:57 +0000

Dang man, hope you’re doing better!

By: Kim

Kim — Mon, 11 Jun 2007 18:13:50 +0000

i actually just found out i had kidney stones last month for the first time as well. but guess what? i was travelling abroad when it happened! it was a scary experience because i was in a 3rd world country (peru!) but all in all, the experience was ok and the whole process only cost me 100-200 dollars (compared to if I had the same experience in the US it would have been thousands) interesting isn’t it? i ended up not even bothering contacting my insurance since the amount was so small. so lesson learned, if you have a medical emergency and no insurance, go to a 3rd world country. ha ha. jk.

By: ProfessorB

ProfessorB — Mon, 11 Jun 2007 10:35:06 +0000

I?ve not had any emergency room visits but I definitely learned a lesson from EAF?s comments

By: jbo

jbo — Sun, 10 Jun 2007 07:40:51 +0000

Just to let you know I have Aenta’s high deductible plan and you cannot just simply compare what they would have charge a person without insurance. They still get discounts because there’s still in-network plans.

I was really sick and went to the doctors office and had to be put on an IV, they pumped me with shots and I thought the bill was going to be outrageous since I have am using the HSA plan. Come to find out the bill would have cost a person without insurance something like 300 dollars, but since Aetna has a plan with them it only cost me 113 dollars, which came out of my HSA account. I got two prescriptions and both I went with generic at walmart and both combined didn’t cost me more than 10 dollars.

Basically my employer contributes 125 dollars a month into my HSA and one month of contribution paid for this one time of being sick. When I had 3 people looking over my body, hooking me up to an IV, putting shots in my butt. I truly thought I was going to get a big bill and I guess if I had no insurance I would have, but using Aetna’s in-network plan really saved me a lot of money.

I haven’t contributed a penny to my HSA account myself and I’m already up to 3,000 dollars. It’s earning around 4.25%. I can’t say enough good things about the HSA plan for those young that don’t get sick often.

By: Ira

Ira — Sat, 09 Jun 2007 15:00:09 +0000

Jay:

You absolutely used your insurance with your broken clavicle. While still under your deductible, you benefited from the contracted rate that your insurance company negotiated with the hospital/physician. It probably saved you 50%!

By: Ajay

Ajay — Sat, 09 Jun 2007 09:17:04 +0000

Hello Jonathan

Sorry for your troubles mate. However, It’d be great to see a follow up that helps people of various age groups better prepare for a situation like this. Especially us unemployed / self-employed blokes.

HSA + High-Deductable plans are a joke in my case, even though I’m in my early 20′s. I guess its time to research some cost effective alternatives. Hope everything works out well for you. Cheers.

By: Ryan

Ryan — Sat, 09 Jun 2007 03:56:32 +0000

I found a “young adult” plan from blue cross blue shield. Take a peek:

http://www.bcbsm.com/pdf/young.....d_baag.pdf

You still don’t want to get sick, since $2500 might be a lot in one’s early twenties.

By: Jay

Jay — Sat, 09 Jun 2007 02:14:08 +0000

When i was getting my MBA i had a high deductible student plan for my wife and I. Broke my clavicle in snowboarding accident and the doctor bills came to $980 total (with a clavicle you just basically put it in a sling and wait for it to heal – i didn’t even use a painkiller besides ibuprofin). My deductible was $1000, so i never did use that insurance, but i wouldn’t want to be caught without it.

I’m covered by BlueCross/BlueShield from my wife’s job now, with a great dental and vision plan, but will have to choose from the Federal Gov’t plans (i work for the Dept of Commerce) when my wife quits her job and starts law school in a few months. Considering Kaiser Permanente because it has the cheapest rates but you have to go to their facilities. The gov’t pays 75% of the premium, so $150 for both of us for a month for the standard plan (the same as the premium but higher deductibles across the board). Anyone have any experience with Kaiser?