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April 26th, 2010
08:00 AM ET

Shopping for cheap surgery

Editor's Note: Everybody loves a bargain, but is it really a good idea to shop for rock-bottom prices when it comes to medical care? With so much waste in our health care system and costs continuing to sky-rocket, some Americans are actually sniffing out cheap surgery deals overseas. Today in our original series "Prescription for Waste," senior medical correspondent Elizabeth Cohen introduces us to one of them. Tomorrow on American Morning, you'll meet a doctor who was billed $863 for a pair of disposable forceps when she needed surgery.

Sound off: Share your health care horror stories with us. Post your comments below.

soundoff (122 Responses)
  1. Marie

    Something to keep in mind with hospital bills is that hospitals and doctors do not get paid what they bill in most cases. In most cases if they bill $500 for an item or service, they have a contract with the insurance companies for a certain "covered" amount for that item or service and they receive the covered amount not the billed amount, which is far less than the billed amount. Perhaps this is a good reason why the prices are so inflated on the bills to begin with. It is only one example of inefficiencies in the medical services to insurance company relationship.

    April 28, 2010 at 7:26 am |
  2. Alecta

    Not having universal health care is obscene. How about the young mother who finds a lump in her breast? Uninsured and her family barely getting by, she doesn't mention it. She keeps quiet and doesn't go to the doctor (it's too expensive and Bobby needs new sneakers) because she doesn't want to know. If she knew it was cancer, she'd have to make decisions, face her family's insistence on treating the disease, even though the costs could be more than they'd make in their entire lives.
    So she smiles and hides the growing lump and takes a lot of painkiller. She smiles and gets by, then grits her teeth and does what she can, and by the time her husband drags her to the doctor or she collapses she's nearly dead.

    Her children grow up motherless because they couldn't afford insurance. Because more prosperous people were horrified at paying a few extra dollars each year in taxes so that everyone could have medical care.

    April 27, 2010 at 8:38 pm |
  3. Lance McKinzie

    In response to Kelly Barnard: Your experience with some charges from a single visit being in network and other charges out of network is quite familiar to me and I expect to many. It seems clear medical care is best acquired with the skills of a lawyer and an accountant in addition to a pretty good understanding and strict due diligence into the medical field. Now that I am coming to understand the rules I can play all those rolls. But that should not be necessary. It was not necessary when Kaiser was my provider...at least the lawyer and accountant part...and it would not be necessary with a proper health care system. It is not necessary in the successful regional systems we have operating today–eg., Kaiser in California and Mayo Clinic in Minnesota and elsewhere.

    April 27, 2010 at 1:26 pm |
  4. LizAustin

    It is time that the hospitals and medical professionals took in more patients to create the income they need, and not charge the few patients they get that are forced to come to them to save their life, with outrageous prices for services and products. The patients get snared into the hospitals and medical professionals because they risk their health and maybe their life if they don't give into the extortional grip of this group. Many don't realize how bad this is or have no choice and then they lose everything to save their life. There is no decency in this and the ones who are so lucky to have health insurance for the minute don't care about anyone else as they have no empathy for those in peril of their lives and are vulnerable to this kind of immoral behavior. This is why we need even more reform that we have received with the health bill that we got which just moved the robbery to the government which will eventually bankrupt it if this is allowed to continue this way.

    April 27, 2010 at 9:13 am |
  5. Paul S

    You missed making a very important point and that is that the hospitals are forced into making these outrageous mark-ups partially because they need to recover the cost of coverage they have to proved to uninsured people who are using the ER for normal medical needs.

    One of the strongest arguments for the recent Medical Health Care bill was that we have to pay for those indigent people using the ER one way or another.

    April 27, 2010 at 8:47 am |
  6. Pat

    I have had an experience with just the same billing issues. The charges that hospitals charge are the reason that health care is so high. For 3 days in the hospital I was charged $9,300. I had no special care and no health care insurance because of pre-existing conditions. We need to start questioning these charges and stop thinking that insurance companies or medicare will oversea this. They aren't if insurance is paying if the bill is under $100,000 they pay no questions. If medicare they cut the cost at least 60% and then pay. We as customers of these hospitals and doctors we need to start asking questions.

    April 27, 2010 at 7:49 am |
  7. mike sey

    A 400% mark-up on forceps? I get it now: How else will the hospital CEO make his $200,000 salary and his whacking great bonus !

    Rx – one tsp of socialism in the morning; one more at night!

    April 27, 2010 at 7:40 am |
  8. Sandra S

    For the person suggesting doctors go into their profession to treat patients and not to make money:

    I do not know of 1 person that went to college and went into debt with an average of $100K just because they enjoy doing their work. It is the American dream. Why must physicians be denied this dream?

    April 27, 2010 at 6:51 am |
  9. Sandra S

    For the uninsured man who travelled out of country for surgery: why don't you put that money on shopping for cheaper health insurance? That way when you have a medical emergency that you can't travel outside US to treat, your doctors here in US get paid. Uninsured patients drive up the cost of healthcare. There are people who cannot get health insurance due to pre-existing conditions, but the majority can't afford it. Physician charges are not what is driving premiums up. Physicians have negotiated fees that haven't changed much in the last 10yrs. Check the salary of CEO for Aetna! I don't know a doctor making that much doing surgery.

    April 27, 2010 at 6:42 am |
  10. Margot

    When I needed a root canal, my dentist wanted to charge me more than $2,000. I don't have dental insurance and couldn't afford it. Instead, I booked a trip to Costa Rica and had it done for $500 by two of the most polished, professional dentists and oral surgeons I have ever met. They were trained in Chicago and Switzlerland and their offices were beautiful. It was a really a great experience and certainly an eye opener. There are definately options out there!

    April 27, 2010 at 5:45 am |
  11. dart

    After dealing with a rare medical condition for the past 6 years, I want what France, Canada, UK, etc. has done with their healthcare system.
    My family in France have only good things to say about their healthcare and the thought of losing your home and life savings because of illness is something they never worry about., nor are things like seeing doctors, specialists or going to hospitals within a network for risk of nonpayment from health insurance companies.

    Today, my condition has left me in financial hardship and this is with health coverage. A doc's visit plus shot I have to take 3x's a year to manage illness cost $2500 per visit. Poke, poke and a 1/2 hour later $2500 ($2000 is the charge for the shot).
    Insurance pays 80% after yearly deductible is met, but it starts to add up when this is a long term (possibly for life) treatment.

    We need healthcare reform in this country and I would much rather put money into a govt. healthcare system than paying the high premiums to health insurance companies that see health / illness as a business and whose ceo's make millions.

    April 27, 2010 at 4:45 am |
  12. A MD

    Although @ A Nurse made some very valid points, like most healthcare professionals she seems to be not doing complete justice by simply pointing fingers at causes that does not include themselves.

    So, I decides to add some more. After-all there must be a reason why all the patients are complaining but the healthcare providers (insurance comps included) are not coming up with any solutions. Meaning there are some real flaws.

    While there are times when you suspect a serious problem like a stroke or a heart attack where you need to do extensive investigations. But many times there are clear cut clinical signs that can be used to rule out many conditions, thus avoiding unnecessary testing – this is called clinical judgement. But doctors both in private offices and in hospitals still do a lot of testing, because they are paid for performance (not better performance as in using good clinical judgement, but as in more extensive reviews and testing – what for?).

    When asked they use the excuse of practicing defensive medicine. Sorry folks for giving insider info away! A look at the following real examples explains a lot.

    1) a cardiologist while reviewing a patient for chest pain refers the patient to his gastroenterologist wife to rule out chest pain from acid reflux disease in the food pipe even before he has finished a complete cardiac evaluation!

    2) a patient with an insurance that does low reimbursements was put through anesthesia and surgery even without doing basic blood work-up such as checking for liver and kidney function at the Yale New Haven Hospital in CT ( I am not surprised at the price discrepancies for ACL repair quoted at Stanford by somebody above).

    Of course, all of us are in this for money. Yes, I said it. No one is going through med school with all that expense and hard work to become mother theresa – they would join the missionaries if they wanted to. I don't mean to say that there are no compassionate doctors, I know quite a few myself.

    But the point is ethics. The docs & hospitals that over do tests and over-bill, the insurance comp that are always looking to find excuses to not make a payment & raise premiums, the irresponsible patients that ask for extensive testing, the pharma comps that want to make profits at the expense of all the players.

    This to me is the exact opposite of communist & socialist Russia where no one worked because everyone would get paid even if they din't work. Here people are rigging the system to make as much profit as possible for themselves simply because the money is coming from a third payer – the ins comp and indirectly from the people.

    This irresponsibility is raising everybody's premiums and millions of people are falling off insurance or becoming under-insured every year.

    I do not think that the healthcare reform bill is going to prevent the disaster we are heading into. There simply were too many vested interests to let that happen and spoil their party.

    April 27, 2010 at 12:00 am |
  13. David T

    Many study to become doctors because of the money. There would be fewer suits if the doctors were there for the patient and not the money. When you got people hacking around inside you because they need a new Porsche things will go wrong. Add in insurance companies who want a slice of the pie and then you get even more waste.

    I'll be heading overseas for my sports injuries. End of story.

    April 26, 2010 at 6:03 pm |
  14. Ian

    It's not just for USA citizens, I have met an Australian who is going to Vietnam for dental work and British citizens who go to India for medical treatment because it's cheaper or at least available without being on a long waiting list.

    April 26, 2010 at 5:57 pm |
  15. Marine wife

    I was due right at the end of my husband's student insurance plan, so we paid a $1000 premium to extend the coverage one month, because his new job did not start for three more months. Our son was born during that month, and it was a natural delivery that took 3 hours, no drugs, no procedures, and the doctor ran in to catch the baby, hand him to the nurse, and leave. I did not see him again before I left the hospital less than 24 hours later. I did not eat the hospital food, did not turn on the TV, and did not use the phone, because those were all separate charges.

    A while later, I received bills from the hospital and the doctor totaling $9000. They said my insurance had rejected the claim. I called the insurance company and reminded them I had paid $1000 to extend our policy. I was told I would have had to have been HOSPITALIZED on the last day of my regular coverage for the extension to have been valid. I emphatically argued that this limitation was not in the documents I had reviewed, and they agreed–but they were in THEIR internal documents, so I was out of luck.

    I tried to work something out with the doctor and the hospital, but was told they HAD to charge cash-paying "customers" the fully inflated amount, or insurance companies would not work with them. So according to my itemized bill, I paid $12 for the green foam booties placed on my feet, $60 for the blanket draped over me in bed (I didn't get to keep it), and $3,000 for the 10 minutes of the obstetrician's time, during which he yelled at me for being too loud and keeping him from starting someone's c-section on time.

    It took us three years of monthly installments to pay these bills. We tell our son he is the nicest car we ever didn't get to own.

    April 26, 2010 at 5:11 pm |
  16. Mark from Dallas

    If my wife and I semi retired and did not buy health insurance we could not afford the surgery either We would also not be able to pay the the kids college, our mortgage, ...etc. It sounds like he chose to be in the situation. Maybe he should re-think his current employment position. If he is OK with what he did, so am I. I guess I am not sure the point of the story. Are you saying I should be subsiding his medical care because I have chosen to keep working?

    April 26, 2010 at 5:05 pm |
  17. A patient

    The fact remains that greed is what is costing us the most money. Granted, medical staff spend time and money to go to school to do their job, they are still doing it to help people first right?? WRONG! It's always about the money. If they really were so modest to just help people, they would only take what they need, but they don't. What they need is a huge house, expensive cares, and all the trimmings. It's always been about the money. Everything is always about the money. I am trained in a specialized service (not medical), providing my services to a construction company. When I have the chance I help people out personally, for free.
    If anybody in the medical field tells you they just want to help people, I'm pretty sure they are full of it and unless you make just as much as they do or more, you probably would get shunned in their social circle. What does that say?
    Everything is always about being better than someone else, by all means – money. Period.

    April 26, 2010 at 5:03 pm |
  18. Kevin

    This story oversimplifies the issue of cost.

    1. He could have found a cheaper price in the US. There are places that offer a cash pay discount but he didn't look very hard.
    2. The reason the prices are so inflated here is that insurance companies negotiate to pay a fraction of the "retail price". If the retail price is 30k, then insuance probably pays 10k.
    3. Prices are also inflated because of malparactice (tort refrom would help that), pharma (we pay higher drug costs then almost any other country for the same drugs due to the drug lobby), and the cost that hospitals and doctors have to take care of indigent patients that come in through the ER without insurance (this would be improved with mandated universal insurance).
    4. Access to specialized care and cutting edge care is top-notch here in the US. This is expensive. When they rate healthcare and say the US is not that great, they are talking about primary care docs getting people to quit smoking, eat less, lower their blood pressre, etc. If you are talking about access to the newest and best treatment for a particular disease, there is no where better than here!

    Healthcare is very complex and not a simple issue of being a ripoff.

    April 26, 2010 at 4:46 pm |
  19. cindy williams

    I have no health care insurance and I need a colonoscophy, I am a 52 year old woman living in alabama, any suggestion.

    April 26, 2010 at 4:45 pm |
  20. Duckman

    My wife had the same surgery done twice at different 2 hospitals in Mass. Both are rank in the top 50 in the country and the bills were $14K and $18K.. So this guy's quote for over $30K was out of line..
    I think this is an Obamacare story, which was planted to say thank god we're spending a trillion dollars so this guy can have nasal surgery for nothing....

    April 26, 2010 at 4:44 pm |
  21. drtom1957

    It not just surgery. I needed the medicine Xeloda and for one weeks worth I had a deductuble of $150.00. I purchased the pills outright from a company in France and they even came in the same bottle that my pharmacist stocked here in the U.S. Same medicine from the same company for less than 1/4 the price. I get almost all my medicines from Europe now. All of the name brands not generics.

    April 26, 2010 at 4:43 pm |
  22. Delmar

    I am 39 years old and have been living with a slow-onset of MS. The disease is taking its time and I am very grateful for that. In its wake, I have been left disfigured as the right side of my face involuntarily seizes for hours at a time, leaving me looking like the joker. During these episodes I am blind in my right eye and lose equilibrium. I have been to many neurolgists and surgeons, and none of them want to correct the problem along the R7 nerve. I work in IT and have been laid off, displaced, and outsourced many times. Each time I find new employment, I start over with the healh coverage deductables and the doctors want to start fresh each time I change coverage. I have had hosipitals refuse current MRI's that were less than three months old, stating I had to use their facilities or look elsewhere for care. At the average cost of these MRI's being $2000-$3000 each, the specialists billing at $200 a visit, and all the testing, spinal taps, etc....I am left with nothing but frustration Now, let me be very clear....I am not disabled and contribute as a 9-5 corporate professional. I make $60k a year and cannot maintain a mortgage and health care at the same time. The surgery I need is well over $30,000 out of pocket and requires access to the base of my brain stem. I am bankrupt after 10 years searching for a solution and no closer to getting the surgery I need. I will always be the guy in the back of the room with the twisted face. There is nothing like scaring kids at the supermarket.

    I have a good friend who also has a debilitating disease that is not covered by health care. He has been HIV positive for 3 years and has to rely on experimental programs to get any kind of drug assistance. One pill costs $53 a day, a pill needed to survive. The company who creates this drug donates millions of the same pill a month in charitable donations to develping countries. It is a noble effort, but give a poor guy a chance in making it from one month to the next. He is denied coverage due to pre-existing condtions again and again. He chooses to keep working, but may need to take disability to get some sort of medical relief.

    I am working as a temporary contractor without benefits since my office relocated overseas and took my coverage with them. I find some comfort in knowing I DO NOT have any health insurance. In the US, health care is like a credit card. It is great to have and a fun to look at. God fobid you ever try to use it. As soon as you do, you dive into financial ruin. Thanks for letting me vent.

    April 26, 2010 at 4:34 pm |
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