Tuesday, March 3, 2009

It costs how much????

$2600 for a 20 minute ride in the cha-ching bulance! That's the bill my brother received yesterday for his daughter's ride in the medical bus last week.
His daughter, Erica came down with the flu (roto virus) a pretty nasty virus, especially for a 2 year old. For those that haven't experienced it, it's not something you'd wish on most enemies. It affects little ones bad the first time they get it. Bronwyn was laid up for for one of the worst weeks we've ever dealt with when she got it. So after a long day where Erica wasn't able to keep anything down and they were worried about her hydration they took her into an Urgent care center.
After measuring her vitals, they determined that she was beginning to show signs of dehydration and that she had an elevated blood pressure. So they loaded her into the cha-ching bulance and drove her to the hospital for a 4 night stay. Their explanation was they admitted her due to the hydration issues and that they needed the cha-ching bulance due to her elevated heart rate. So based on this explanation and the type of vehicle, you might expect them to be blazing through traffic, lights and sirens blaring, right? After all, the care that could be provided was only available at the hospital on the other side of town. And getting there seemed to be of paramount concern. Unfortunately, this wasn't the case, it was a calm, peaceful ride with the parking lot speed bumps causing the most anxiety provoking situations.
So the bill shows up yesterday, $2,600. $600 for mileage and $2,000 for services. What gold laden fuel is this bus running on? What life saving techniques were done to her during this transportation that could possibly justify this type of bill/expense?
Let's go back to the justification on why they decided they needed to use an ambulance: Her heart rate was elevated. An understandable reason on the surface, but have you ever seen what a highly stressed, foreign place does to a 2 year old? Or how they react when see their parents worried? The sensitivity of a 2yr old to their environment is much higher then any adults. I'm not claiming that the elevated heart rate wasn't a serious concern, and it's easy to sit post-illness and play Monday morning quarterback. I just think there has to be a better way to handle these kinds of situations.
I recognize that medical care, isn't like talking to the mechanic. I know that telling me how much a procedure or test costs, does me no good in the long run. After all, the loved one comes first, but we all have limited financial means. There has to be a better way. I don't expect the urgent care staff to say, well Mr. X your child has an elevated heart rate and because of the dehydration we'd like to have her admitted to the hospital. By the way, do you want to take her there or would you like a $2,600 bus ride? Let's not forget, that if you don't take the bus ride, the insinuation is that you are criminally neglecting your child. So even if they offered the choice, wouldn't it just be medical blackmail? I'm not even sure where we begin to find a better way on this issue. After all medical professionals are working without the ability to pause and think a situation through, our care is left up to humans who are educated and experienced, but their abilities like all humans can vary greatly. Perhaps the best case scenario here is to try and find a family doctor that you get to understand how they operate and that fits your needs.
Since I can't come up with any suggestions to the other problem, let's look at the price tag issue, $2,600 for a bus ride. Please, someone, anyone, justify how the hell a bus ride costs $2600. I could fly first class to London, with one month planning for $2,200 round trip. While I don't expect them to provide medical procedures during that trip. I'm trying to find something that is comparable from the equipment and labor cost associated with it. Planes come close but there are too many variables. I know it's an apples to oranges comparison, but it has to start somewhere in trying to rationalize this cost. After all, driving 15 miles to the hospital costs me maybe $5 if you figure gas, and the wear on my car. Let's add in my driver's training, my salary per hour (times 3 for number of people), factor in down time, add some further value based on the higher price of the ambulance (and equipment) and I still don't know how you get to $2,600. If there costs are $2,600, how well are these hospitals running their businesses? Or is this a way to accrue revenue? This is going to bother me for a bit and I'm going to have to dig more to see if I can find more information on it. It doesn't pass the smell test though, (smell it and if it stinks it's probably rotten).
My instincts say this is just lousy administration, in trying to balancing the books they haven't measured the price with the service. It seems stupid and extremely short sighted and instead of trying to benefit their patients care and costs, they are too lazy to do anything about it. The hospitals will argue that they have to make up costs for people that don't pay and that the evil insurance companies that complicate their ability to do business. The insurance companies will say that hospitals prices are ridiculous and treatment should only cost x, which is what they'll pay.
I'm wise enough today to know that the issue is completely lost in the middle. It's been a discussion point for so long, the hope of solving it is absent from the conversation. It's more about pointing fingers and assigning blame. I hate that I see this in so many issues of our society. All I know is that a family concerned about their daughter's flu, wound up with a $2,600 bill yesterday for a bus ride.

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