Medical City is Dallas' Most Expensive Hospital

Categories: Healthcare

medicalcitydallas2.jpg
Medical City
It's always been nearly impossible to compare prices between hospitals. For one, most people who find themselves in an emergency room don't have the leisure to shop around. Even if they do, where are they going to turn? Healthcare providers don't typically put their prices on billboards. The opacity of pricing is one of the many, many reasons the health-care market is broken and Medical City can charge D Editor Tim Rogers $7,600 for a cookie.

The Obama administration took a significant step toward making the market more rational. Last week, it released a humongous spreadsheet listing the "chargemaster" prices that every single hospital in the country bills Medicare for each of 100 common inpatient procedures.

As Steven Brill noted in Time, Medicare basically ignores this number, then uses expense data provided by the hospital to decide how much it pays. For instance, Medical City bills the government $76,125 to treat a patient suffering from kidney failure with major complications. What Medicare actually pays is $12,836.

Private insurers, and especially the millions of Americans who lack health coverage, do not bargain from a position of such strength. Insurance companies negotiate discounts off the chargemaster price, but still invariably pay more than Medicare. The uninsured are lucky to escape from the ER with their shirt still on.

That's all well and good, but by now you're probably wondering where to go for that large and small bowel procedure that results in major complications -- the most expensive inpatient procedure listed in the government data.

bowelcostchart.jpg

And if you have kidney failure?

KidneyFailureChart.jpg

And what about a drug overdose?

DrugOverdoseChart.jpg

Notice a pattern? For pretty much every single procedure, Medical City tops the list. Baylor is a relative bargain.

Hospitals contend that no one really pays these charges. "Government programs like Medicare and Medicaid determine how much they reimburse hospitals," Medical City told The Dallas Morning News in a prepared statement. "Insurance plans negotiate their payments. Everyone else is eligible for our charity care program, or they receive Medical City's uninsured discounts, which are similar to the discounts a private insurance plan gets."

Then why bill people for such insanely inflated amounts? The short answer is because they can. The longer answer is that the system's broken. The newly released data won't fix it and probably won't do much to change people's behavior, but they do nudge hospitals in the general direction of a rational pricing system.

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12 comments
Sotiredofitall
Sotiredofitall topcommenter

1) Allow individuals to deduct their health insurance from their taxes (just like they essentially can if they receive them as a benefit)
2) Have employers get out of healthcare as a benefit and instead kick that money into the salaries of their employees
3) Allow people to buy health insurance from any provider across the country (also not currently allowed)
4) Allow insurance companies to offer plans that are primarily catastrophic in nature (also not currently allowed due to over-regulation)

The lack of transparency on medical transactions has turned the whole process into a game between the doctors, hospitals and insurance companies.  They're all in on the game and the patients are not.  

http://reason.com/blog/2013/05/14/a-small-business-owner-explains-the-hard#fold


garlandsucks
garlandsucks

why the bother this makes rich richer and fucks the poor...and after all isnt that what America's all about....One of my mom's doctor "friends" visited my daughter for 7 minutes in Childrens, looked at her and her chart, did nothing procedural....low and behold a $500 bill showed up about a month later.

ChrisDangerShow
ChrisDangerShow

Insanity, pure and idiotic insanity. Too bad we're not brave enough to push for universal coverage in this country, as well as actually having the balls to reign in hospitals with costs.

russell.allison1
russell.allison1

There is almost nothing in America more ripe for a class action law suit than the NCAA and division 1 college football programs...a very close second is every hospital in the United States.  That we tolerate a medical system that so divorces itself from all reason and logic is a mystery to me, but one day I do hope we say, "ENOUGH!". 

Long ago, the healthcare transaction was two parties-you and your doctor/hospital.  It was a simple and infinitely cheaper transaction.  We introduced a third party payer(Medicare, Medicaid, private insuraers) into that transaction and, voila-we have $30 tylenol. 

anon
anon

It's not surprising that they are most expensive. They are owned by HCA, which is one of the most aggressive companies in the country where hospitals are concerned. It charges the most (or at least attempts to) and has cut back on services and labor more than any of the other major for-profit hospital owners. Look, they're in it to make money but they need to own that they are the high cost, low service provider.

Also, someone should tell your intern who makes charts about choosing a Y-axis more appropriately. If you glanced at the last chart you'd think Medical City is 10-15x more expensive than Baylor when they are in fact not even double. I understand that smart people can read charts and figure it out, but you shouldn't assume anything about your reader base.

Just-Sharon
Just-Sharon

I thought the story was Tim Rogers was demanding a cookie and demanding they pay him $7.600 for the honor of serving him and threaten to sue them if they didn't hop to it in a short period of time. 

garlandsucks
garlandsucks

@ChrisDangerShow no we just require people to pay into an expensive and corrupt system that they cant fucking afford or give the government 2K, our government is now the equivalent of stick up robbers

anon
anon

@russell.allison1 While you're in the "long ago" machine, maybe you could talk about the kind of care you were receiving back in the 1950s, which is the last time that our country operated on an out-of-pocket system. Instead of life-saving treatments you had someone to hold your hand and make you feel better while you died. Sometimes, that's the best that can be done for a person but to pretend that the increased spending on healthcare hasn't yielded improvements is false. It simply hasn't yielded improvements commensurate with the increased costs. You may also want to check on which groups of people were systematically denied access to healthcare while you're in that 1950s utopia. Anyone who was poor, and definitely most minorities. 

CornyDoggy
CornyDoggy

@anon 

Yeah it looks like they chose the y-axis range based on making the bars to look symmetric compared to each other.  They should start at 0

russell.allison1
russell.allison1

@anon @russell.allison1 While still in the "long ago" machine I'll pass along an anecdote my father passed along-he was in med school in the 50's and operated a small clinic in the late 50's and early 60's, later going into psychiatry.  He frequently treated those who couldn't pay and took less from some than others-why?  Because that is what doctors used to do...long ago.  I do wish I had recorded him relating what the introduction of the third party payer did to healthcare, he could convincingly relate just exaclty how the third party is the  primary reason for increased costs from a first hand perspective. 

Now, fast forward to real time:  A spiral CT of the abdomen and pelvis with contrast-$8000 at a local hospital belonging to HCA.  After relating that I didn't have insurance the woman offered me a generous discount-to $5800.  Let's examine the costs associated with that-the nurse that will prep me for that makes between $24 and $32 an hour, the doctor that would oversee the procedure was probably billing at $135-$150, the tech running the machine lets say between $20 and $28/hr and finally, the clerical staff at between $12 and $16 an hour.  Assuming 2 hours for each thats somewhere in the neighborhood of $450.  Lets throw in a 450k machine thats used 20-40 (approximately )times a day...lets chalk up $300 for that.  I come up with labor and fixed costs of about $750.  Funny thing is that the independent imaging center 1 mile from HCA was willing to do the same test for $900. At the time I worked for HCA on a contract basis and had been employed by that same HCA facility for 10 years prior to my contract stint at another HCA facility-I quit later that week.  Improvements?  I don't think so.  Minorities are now joined by just about everybody else in not being able to afford care. 

ScottsMerkin
ScottsMerkin topcommenter

@russell.allison1 @anon I had some blood work last year, actually they were testing for one thing.  anyhow they billed my insurance for over $700 that came straight out of my HSA.  I called my insurance to protest the cost bc there was no discount for my insurance.  They told me there was nothing they could do bc of the way the clinic billed it.  fast forward a year, i got a notice that they had corrected the billing and refunded me $690 of the $750 they had charged my HSA.  Thats whats a joke, that the same test can cost one person $700 and another $60.  If i hadnt pressed the issue nothing would have happened

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