The High Cost of Health Care

By: Rick Montanez Email
By: Rick Montanez Email

Many people are surprised at the actual cost of getting care from a hospital. One southern Colorado woman tells 11 News she was shocked when she opened her bill after a short visit to the emergency room.

The charges from her bill were more than $5,000. And most of that cost was just for being in one of the ER rooms. Joan Silva isn't angry about the bill; like many she wants to know why the cost of health care is so high. She says she was charged nearly $100 for a test that you could take at home for a tenth of that cost. Silva ended up in the ER to treat her stomach flu. "It really surprised me that it could cost this much," she said.

Silva’s detailed bill shows a charge of more than $5,151 to her insurance company. More than $3,500 of that is just for the room. "I was shocked," she said after opening the bill.

To find out why bills like Silva’s are often thousands more than one might expect, 11 News talked with the President and C.E.O. of Penrose-St. Francis, Margaret Sabin. "The entire industry is dealing with the decreasing reimbursement because of decreasing coverage," said Sabin. “And that is sometimes challenging to the public because they may see higher and higher charges but we’re saying we’re getting less and less of the dollar reimbursement.”

Sabin has been running Penrose-St. Francis for a little more than a year. She said in the last few years about one in four or maybe even one in every three patients can't or don't pay their bills. When a bill is paid, in most cases, most of it is covered by insurance companies.

With the increase in people going underinsured or uninsured, Penrose Hospital is only seeing about 30 cents on the dollar. So just to meet operating costs hospitals like Penrose-St. Francis have to charge higher rates to everyone and many of those bills won't be paid.

Sabin worries even the 30 cent return on each dollar billed could drop more in the coming years. "As individuals can't afford health insurance and some small businesses drop health care coverage that could be a direction we're going in,” said Sabin.

If that happens, bills like Silva's will go even higher. But, Sabin said the opposite could happen with healthier lifestyles and with big changes out of Washington, D.C. "Health care reform, the passage of more bills that cover more Americans is the right thing to do," said Sabin.

Making health care more affordable is the goal for all Washington lawmakers, but as we’ve seen lately, lawmakers are deeply divided on how to make that happen. Sabin feels the reform should push forward, even if bugs will need to be worked out. She said some reform would be better than nothing.

The changes however, won't come soon enough for Silva. "It makes me feel bad for the people who don't have insurance and can't get a discount," she said.

11 News also contacted Memorial Health System, in an emailed statement, the hospital said “There are many factors that influence the cost of health care, including labor, supplies and equipment, pharmaceuticals, facilities, clinical practice patterns and community health status. For example, quality health care relies on highly-trained and specialized caregivers, many of whom are in short supply, which means labor costs are high. Patients expect and rely on access to leading-edge technology and facilities, and depend heavily on high-priced medical devices and pharmaceuticals. In addition, costs are driven by clinical practice patterns—clinical decisions made by physicians in the best interest of the patient’s care. And finally, the degree to which a community struggles with expensive-to-treat chronic diseases like diabetes, heart disease, cancer also influence use of the health care system and therefore costs.”

Several of the health care professionals 11 News talked with said it is a good idea to shop around and look for the best price and the best track record for your own medical care.


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