Medical bills that can even shock a doc

About six months ago, I took one of my children to the emergency room for the first time as a parent. I shared my experience in a previous column, when I described being on the other side of healthcare, helplessly watching my lethargic and dehydrated nineyear old worsen while waiting at the emergency room at Mary Bridge Children’s Hospital to be seen by a doctor for his eventual appendectomy.

Like every other parent who has been in my situation, the cost to help my son was the farthest thing from my mind that evening. However, after receiving a bill with $77,917.90 in charges two days before Christmas, I wanted to re-visit the subject of our 12hour hospital stay to illustrate how runaway costs are destroying our healthcare system.

Thankfully, I do not have to pay the entire balance. (The grand total ended up topping $81,000.) Our family has Tricare insurance. My portion came to a little more than $2,000.

What I did not share in the previous column was that the first person to enter our room in the emergency department after a three-hour wait was the billing specialist. She wheeled her computer stand into the room with the ease of someone who had done it hundreds of times before. She explained that my copay was $138, and asked whether I would like to pay by cash, check or credit card.

My youngest son is the most pragmatic of all four of my children. He is driven and serious, sometimes more serious than I would like. As I reached into my purse and retrieved my wallet, he sighed and said, “Well, $138 is definitely worth paying to save my life, right?” The biller’s jaw dropped. I think she was in shock. I smiled at reassured him that his life was worth far more. I happily handed over my credit card, knowing he would get the care he needed that night.

After the biller left the room, my son asked if that would pay for his operation or if I would have to pay more money later. I assured him there would be many more bills coming in the future. We talked about the physicians who would help save his life that night, including the emergency room physician, the pediatric surgeon, the anesthesiologist who would put him to sleep and wake him up, and the pathologist, who would look at the appendix under the microscope to confirm the infection.

We talked about how important it was to pay the doctors who had trained for years to develop the expertise necessary to save children’s lives. We talked about how working as a doctor in our community paid for the roof over our heads, the clothes on our backs, the food we eat, and other things, like occasional family vacations.

But nothing could have prepared me for the astounding charges on the hospital bill. Our time in the emergency room involved a 10- to 15-minute visit with the physician, a blood draw, intravenous hydration with normal saline, and an abdominal ultrasound. The total of these services: $28,930.90.

The operation took about an hour, and my son spent two more in recovery before being moved to a hospital room for a few hours until we were discharged later that morning. The charges for his appendectomy and recovery: $52,695.00.

But here is the part that I never quite understood before receiving this bill. The hospital charges make up more than 97% of the cost. The pediatric surgeon trained for 15 years to do his job, yet was only paid $949.03 for saving my son’s life, less than 1% of the total. The pediatric anesthesiologist trained for 14 years to keep children safe while asleep for surgical or other medical procedures. For their expertise, they were paid $230.67, less than 0.5% of the bill.

And because it was a holiday weekend, I did not have any outpatient options to have my son evaluated. If I had, he would have seen his primary care physician, who trained for 11 years to do their job. To diagnose appendicitis in their office, order lab tests, interpret them, and order an abdominal ultrasound,