The Real Reason Why Health Care is So Expensive

In the early evening of the Fourth of July, my wife was cutting cilantro for a salad we were bringing to a friend’s party. Distracted by yelling children, she accidentally cut her left index finger with the knife. Yikes!

It was a fairly deep cut across a nail, bleeding profusely, and we all agreed she should have it checked out.

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Naturally, it being after 5:00 p.m., our regular family doctor’s office was closed tighter than a drum.

We decided that, rather than go to the Emergency Room – where it would cost us an arm and a leg – we would try to go to the “Urgent Care” clinic instead. As a result, we dropped out kids off at the party and drove the five miles to the “Urgent Care” clinic. But it, too, was closed tight with an office sign that proclaimed their office hours from 9:00 a.m. to 5:00 p.m.

At this point, we had no choice: So we drove over to our local community hospital emergency room… where, I must say, we received wonderful care.

First, the admitting staff did their efficient admission procedure on us. Then, a triage nurse of some kind examined my wife’s wound and agreed that, yes, it would be a good idea to have a doctor check it out.

Another nurse took us back into a cubicle where she was propped up on a hospital bed. Her blood pressure and temperature were taken… and some routine medical history questions were asked by a third nurse.

We sat there for about 45 minutes until a young lady doctor strolled in. She was a marvelous doctor, warm, personable, seemingly very competent. She and my wife chatted about their gardens, growing tomatoes and what-not. The doctor decreed that the cut didn’t need and couldn’t accommodate a stitch, with the nail and all. As a result, she briefly cleaned the wound with hydrogen peroxide and then applied some “dermabond,” a SuperGlue-like substance to seal the wound. She also recommended that my wife get a tetanus booster. Yet another nurse came in to wrap the cut finger in a bandage.

We were in the hospital for nearly two hours but the actual treatment took literally five minutes (clean the wound, applying “Dermabond”).

When it was all done, a “billing agent” appeared and demanded further identification for billing (social security number, name of employer, etc.)… which we provided.

Two weeks later, the bill arrived: The hospital billed Anthem Blue Cross $1,659.74. Blue Cross disallowed $906.75 of that, leaving us to pay (because of our high deductible) $753. That works out to about $150 per minute of actual treatment.

And that’s not counting the doctor. She’s an independent contractor and her costs are extra. Her bill was for $342 — $226 for “surgery” and $116 for “emergency service.” Anthem Blue Cross said we had to pay $235.92 and they disallowed $106.08.

Thus, the total cost for fixing a cut finger was $988.92.

This is why medicine is bankrupting America. This was just the cost of fixing a cut finger. Imagine the bloat and built-in waste of, say, a heart bypass operation.

We didn’t need six different nurses… a hospital bed… an admissions staff… a complete medical history… a billing agent… and all the other rigmarole of an emergency room to treat my wife’s cut finger. Any decently trained nurse could have done exactly what the doctor did.

The padding was obvious:  The hospital charged us $374 from “central supply” (that must have been the band-aid they put on my wife’s finger), $117 for “pharmacy injectables” (okay, I guess that sounds reasonable for a tetanus shot) and $1,168 for the emergency room itself.

Yet, doctors now routinely refer patients to emergency rooms because they no longer want to be bothered with such nuisances as cut fingers, especially on weekends. They are clueless about what the costs of such visits actually are. The very poor, naturally, don’t pay anything when they go… they are covered by Medicaid. But it is people like us, who have health insurance, who pay the $150 a minute for routine care.

What is needed is not so much Obama’s socialized medicine – turning the entire country into a gigantic HMO with six-month waiting lists, crowded hospitals and over-worked doctors and nurses – but simply intermediate facilities between a doctor’s office and a critical care emergency room.

Such clinics could provide levels of care from an ordinary nurse to a nurse practitioner to, in worst case situations, a full-fledged M.D. It would save ordinary people a ton of money… and might help solve the health care crisis.

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Robert J. Hutchinson is an author and essayist. His most recent book is Searching for Jesus: New Discoveries in the Quest for Jesus of Nazareth (Thomas Nelson, 2015).