It Is a Conspiracy

I try to avoid rants.   In general not one wants to listen to someone go on a bender, but I ask your patience on this one.

A month ago I ended up in the emergency room.   I accidentally whacked my thumb with an 8-inch chef’s knife  when making dinner with my husband.   The details aren’t important, but I ended with a deep cut that would not stop bleeding, no matter what we tried.   I was worried my husband was going to call 911 and we would add an ambulance call to what could be an expensive excursion, and so I agreed to go the ER and have it stitched up.

I spent less than an hour there from the time I got out my car in the parking lot until we were headed home.   It was  a slow night in the ER.   My cut was ultimately glued shut and I got a tetanus shot.

I recently got my Blue Cross/Blue Shield explanation of benefits for the event and was flabbergasted at the cost.     So the I called the hospital and asked for an itemized copy of my bill to explain how so much money was spent.

I get that there is a certain amount of overhead you are expected to pay for when you enter an ER.    You pay to have it there when you need it.   In all honestly the ER usage fee was big, but it did not send me in to orbit.   What sent me into orbit is that my tetanus shot was $367.50   Had I known this is what I was going to be charged I would have refused and gone to see my primary care provider or the Urgent Care clinic when it opened the next day.

I am lucky I have health insurance, but I pay dearly for it.    My health insurance premium cost each month is more than my house payment.   I am lucky I can afford both and don’t have to make the decision roof over my head or health insurance.   Everyone complains about the high cost of health care.   Some say  the insurance companies are the problem while others claim  the medical providers are the problem.   I don’t know which it is, but I felt I had an obligation to call our the hospital and ask they make and adjustment for the obscene charge for the tetanus shot.

I called the hospital and I got the song and dance about how there is overhead required to keep an ER available especially in rural areas. I agreed and told her I was not debating the ER charge, nor the wound repair kit charge of over $300 (even though all I used was two small packages of 4x4s, one bottle or sterile saline and a tube of wound super glue.)   I want the hospital to admit that a tetanus for $367.50 was excessive and to make an adjustment.   I got nowhere.

I next headed off the BC/BS.   I was going to report fraud.   I got the most amazing song and dance there I had ever heard of.   They proceeded to tell me they negotiated fees and agreed to honor them.   If they called the hospital out on a previously negotiated fee the hospital might drop out of network and then it would be nearly 80  miles for the thousands folks in my area to drive to the next in-network hospital.   The customer service person suggested I might ask the hospital to resubmit the charge for the vaccination as preventive services rather than medical treatment.   I would get better coverage on preventive care and my portion for this would be less.    I was moved to laughter and told her the last I checked a vaccination was preventative and they should not need a hospital to tell them that, and the problem was we were all being ripped off, not what my portion of the co-pay was.

This same insurance company had previously questioned my health care provider about the necessity of a migraine prescription.  It wasn’t some off label use nor over use.   They just did not like how much it costs and questioned if another less expensive option was available for my use.   It is easy to pick on a single health care provider or an insured who actually puts out the money that keeps them in business.   Heaven forbid that we question some hospital, like they are a sacred cow (cash cow).

Several days later I am no further along in this quest of trying to make someone give a rip about  exorbitant fees being charged and make an adjustment. Tonight I don’t see how I can fix this solution.   The hospital wants their money and they are not changing their mind.    BC/BS doesn’t seem to want to rock a boat that works for them.

Maybe all that is in it for me is a lesson, never ever go the local ER if it can be avoided.  It was a very deep cut and it would neither stop bleeding, nor stay closed.   I now wonder if I had given it another hour so or possibility  gotten creative at home if I could have avoided the visit.   I know the next time I will think several times and several times more before I walk into an ER again.    You are over a barrel and the local hospital knows it.   Urgent care here closes at 6pm.  There no other choices after hours in the area it is them or the highway literally.  Next time for me it might just be the highway.

For those of you who read to this point, thanks for your patience.   I hope that if you need to use your local ER you are a little more prepared than I was for how it all works.