An Example Of Why Health Care Costs Are So High

As many of you know, my wife is pregnant with our second child.  Both pregnancies have been very healthy for her, but there have been a couple of bumps along the way that have been checked out.

A few weeks ago, around her 30th week, she started having some persistent cramping in and below her stomach area.  She called the OB’s office and talked to the nurse.  After hearing that they had been going on for quite awhile, they advised that she should definitely get checked out.  They wanted her to get hooked up to a monitor to check the baby’s vitals as well as to measure whether my wife might be having contractions.

Normally, this is something that the OB office can handle.  In fact, with her first pregnancy she had a similar occurrence, and they had her come in to the office and get checked out.  Thankfully (as was the case this time), everything checked out OK, and the symptoms eventually went away after some additional rest.

The difference was that with the recommendation a few weeks ago to get checked out, they also told her that they couldn’t fit her in at the office.  Instead, they advised her to go to the hospital and get checked out at the labor & delivery unit.  There, they would perform the same tests.

We agreed to follow the advice, and went and got checked out.  As was the case with the first pregnancy, they did not see anything wrong.  She was having minor contractions, but they didn’t see anything too alarming and sent her home advising additional rest.

Better safe then sorry.

The difference, though, was the cost.  I knew we’d pay more having to go to the hospital.  But, the difference was staggering.

When my wife had to go to the office for her first pregnancy, they charged her a standard office visit.  When all was said and done, we paid a $15 co-pay and the insurance company covered about $50.

For the same thing happening this time, except at the hospital, they considered this an ’emergency room’ visit.  Our co-pay: $150.  The insurance kicked in another $500 or so.  That was after over $1,000 in ‘member savings’ due to negotiated rates between the insurance company and the hospital.

It’s staggering.

As far as who to ‘blame’, I’m not sure that you can.  You can’t really blame the OB office for not having any slots or staff or whatever it was that made them unable to see my wife.  You can’t blame the hospital as they have negotiated rates and all that with the insurance company for services.  You can’t blame us for going because it’s silly to even think about ignoring a potential problem.

All you can do is shake your head and know that health care costs are too high and the system that was built is somehow still out of control.  I keep hearing about how there is waste in the system that has to be eliminated in order for health care to be affordable and accessible to all.  If lawmakers truly want to tackle waste, perhaps looking at a few real world examples and starting from there might help.  I’ve got an example for them!

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2 thoughts on “An Example Of Why Health Care Costs Are So High

  1. Part of that hospital charge is making up for the uninsured. As we saw in the health insurance legislation, rates will rise. Health insurance is complex, but it can be better.

  2. I called around to get a quote on insurance for my fiance (to see if we could get him a single policy for cheaper than adding him to my account at work…)

    Nope…

    Health Insurance is so expensive now a-days that I wonder if it would be cheaper to not have it and just try and negotiate payment with a doctor directly.

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