Negotiate with the patient? We don’t generally do such things.
My first stint in the hospital lasted from June 29 through July 2. Four days, three nights and a bill of $54,275.82, steep but given the constant monitoring, transfusions, endless blood tests and inflated costs associated with care in this country, it makes sense. My insurer has a negotiated contract with the hospital I was treated at, they pay a pre-determined amount for each day I was in. Their total bill came to $8,538.00. Thanks to negotiations, the insurance company saved themselves almost $46,000. Pretty good.
In order for a bone marrow search to be formally’ started through the same facility it costs $6,000. According to the hospital, my insurer feels that the search is not a necessary medical cost and informed me they don’t cover it. I called to Empire Blue Cross Blue Shield to make sure this wasn’t all a prank, and according to Steve, a representative there, it actually was not. Steve also found it odd that a Bone Marrow Transplant is covered, but the search to find a match—a definite requirement for successful transplant—is not.
As a recent college graduate, and current sick person I didn’t have $6,000 lying around. I offered up an idea. Negotiate a more feasible price with the hospital—-thought being if an insurance company can negotiate a lower rate, shouldn’t the patient be extended a similar privilege? I’m certainly not the only person in the world who may need a bone marrow transplant, and I’m certainly not the only person who doesn’t have $6,000 lying around. Ask around a leukemia clinic, you’ll see.
But negotiating a price or even payment plan is a no go in this case. We don’t generally do such things, one person in billing told me. Instead they offer applications to other organizations “who can help you out..” or ideas on ways to fund raise, all to make sure you reach that $6,000 to “formalize” the search. I spoke with someone much more familiar with all this than me, and they explained it like this: Insurance companies have a lot of leverage to work with—they can negotiate lower rates because they have large number of patients to offer. Sort of like when you go into BJs or Cosco and buy in bulk. Wholesale economics, I get it. But for some reason comparing a business model that deals in over-sized jugs of mayonnaise, albeit with a drastically reduced per unit price and one that deals in human lives makes me feel nauseous.






September 22nd, 2009 at 4:28 pm
My mom works in a hematology center, and tells me stories of insurance companies and doctors screwing people over all the time. It’s completely ridiculous. Keep the blog going man, for all those who know nothing about our health care system, and probably should
September 22nd, 2009 at 4:56 pm
“Four days, three nights and a bill of $54,275.82″
Wow
September 23rd, 2009 at 11:10 am
Wish this was shocking but it is almost routine. It is absurd. All the shout outs about “Killing Granny” etc. What about this B.S. happening daily to sick and deserving people of all ages (Even like yourself insured) Come on people ! It is great Matt that you are addressing this in a productive way. Good Job.
September 24th, 2009 at 2:53 pm
Just 3 months ago, I was smug and complacent.
“Healthcare reform..why??..individual responsibility to have Health Insurance..problem??..what problem???”
…and then life happened..and I learned just how arrogant and ignorant I was..talk about your wake up call:
If you think there is no need for Healthcare Reform,perhaps you have never experienced a close encounter with a life-threatening illness.
September 27th, 2009 at 10:29 pm
Matt,
That’s crazy about the $6,000 to look for a BMT match. I think you may live in the wrong state. The’ve already completed two searches looking for a match for Gage and I havent received a formal bill yet. I also have Blue Cross Blue Shield Texas.
Gages mom, Denise
October 5th, 2009 at 3:43 pm
[...] of the healthcare system Oct.05, 2009 in healthcare Last week we addressed the patient’s lack of a seat at the healthcare negotiations table. Clarification: the patient isn’t even in the conference room. They are out pacing in the [...]
October 27th, 2009 at 1:07 pm
[...] My letter of appeal Oct.27, 2009 in Personal, healthcare As I’ve mentioned in the past, my insurance company will not cover the search for a bone marrow donor. [...]