WRAL Investigates

The problem with high health care costs

Posted March 2, 2010

— Emeilia Cowens is enjoying life and living it to its fullest after a near brush with death last fall.

That's when the 37-year-old spent two months in a local hospital and nearly died while fighting the H1N1 flu virus.

"I feel absolutely fantastic," Cowens said.

Financially, though, she says she is in rough shape.

Her medical bills amounted to approximately $330,000, and even after insurance, her out-of-pocket expenses are still more than she can handle.

"(I have) stacks and stacks of bills. It's overwhelming," Cowens said. "It's hard to keep your head above water."

Dozens of bills have already been referred to collections agencies, she said.

"The real person caught in the middle is the working individual who's making a living and working as hard as they can but can't make ends meet," said Dr. Bill Atkinson, president and chief executive officer of WakeMed Health and Hospitals. "They're the classic underinsured."

Atkinson says the cost of health care is out of control.

"I think the cost of health care to the individual has really outstripped our ability to keep up with it," he said. "It is a crisis."

Atkinson says health care facilities also have to make up for the billions in health care costs they write off.

"Whatever the costs to provide health care in America is, it's simply divided up and put on the bill of whoever's paying," he said. "Many of the costs are out of our hands."

Some of the seemingly surprising amounts that patients see on their bills factor in the cost of doing business – a way for hospitals to pay salaries and to pay for services – Atkinson said.

"You'll notice on hospital bills that there is no charge for nurses or any other personnel," Atkinson said. "Everything it takes to run an organization 24 (hours), seven (days a week), 365 (days a year) is incorporated into those things you're charged for. Aspirin and other things sometimes carry the bulk of that cost."

A look at a recent itemized hospital bill, for example, lists two 500-miiligram tablets of niacin as costing $35 each.

At a membership warehouse club, such as Costco, a 150-count bottle of niacin sells for $13.89. The same bottle at a hospital would cost a patient approximately $2,625.

Atkinson, however, says it's not a fair comparison.

"I guess I'd say, go over to Costco and see if you can get a nurse, a doctor, a trauma center, a neonatologist 24/7/365," he said. "See what it takes to pay for a trauma surgeon to be here 24-7. They don't have that at Costco."

Cowens say doctors gave her a 1 percent chance of survival. Despite the hospital bills she now faces, she says she feels fortunate to have a clean bill of health.

She is now negotiating payment plans with creditors to help get her budget manageable again.

"For whatever reason, God spared me," she said. . So, I know I have a renewed sense of purpose, and he didn't bring me through that to have me depressed about those bills," she said.


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  • NCMacMan Mar 5, 2010

    This report only underscores the need for healtcare reform in this country.

  • mpheels Mar 3, 2010

    Am I the only one who's bothered by the admission in this article that line item charges are deliberately inflated to cover other expenses? I work on several grant funded projects, and have to report each pay period the percent of my time spent on each project so that each account will be charge for the appropriate part of my salary. We're allowed to re-budget a small percentage of expenses - i.e. money originally planned for a new computer can go into salary support if needed, but only up to 10% of the total budget in any given year. We absolutely can't "hide" personnel and operational costs in the live items for materials and supplies. With all the intricate and sophisticated computer systems available, there's no excuse for charging hundreds of times more than the costs of materials just to cover personnel. Hospitals need to charge the real cost of materials, reasonable fees for use of equipment and maintenance, and reasonable fees to personnel time spent on patient care.

  • spacecowgirl73 Mar 3, 2010

    Let's not forget people who are "lawsuit-happy"...thanks to these people who want to sue the hospital for non-life threatening issues, hospitals are forced to increase prices to cover for malpractice insurance and disposable items. Also, The Joint Commission regulations are driving costs up to the roof.

  • Bendal1 Mar 3, 2010

    Health care in this country is broken; even someone with the best insurance will go bankrupt if they have a serious injury or illness that requires long or expensive treatment. My own health insurance covers 80% of costs up to $250,000; after that I'm on my own.

    Well, that sounds good, you might think. Except, a routine surgery for, say, angioplasty, can run over $100,000. Open heart surgery, or kidney transplants, can cost over $300,000. Cancer treatments can run $10,000 or higher per month.

    There needs to be some kind of blanket coverage for these kinds of medical costs so that people won't go bankrupt just because they became ill. I know families that wait until their kids are really sick (temperature over 103, convulsions) before going to the ER because they can't afford routine doctor visits or preventive care. This is flat wrong when every other developed country has a national medical plan.

  • bill7 Mar 2, 2010

    Yuphello...? You've obviously never had any interactions with an insurance company. Hospitals and Doctors set prices, Insurance companies ALLOW a certain amount for each type of procedure. The inflated prices are because people with money and with insurance pay for the care that those people who don't have insurance or money can't pay.

    The government does not set prices...

    I have several friends who are doctors, they are clear, the insurance companies are the problem. They require tons of paperwork and drive efficiency out of the system. They also regularly fight procedures that they don't want to pay for.

  • Leftfinsright Mar 2, 2010

    Assuming 20 percent out of pocket, that would be 60 grand. I don't know many people who could swing that kind of bill. I am not for government healthcare, but I do agree that scenarios like this are nuts. Even the insured are apt to go under if they have a catastrophic illness.

  • suncat Mar 2, 2010

    The United States is the only western nation that forces it's citizens to pay such outrageous amounts for medical care. If you are very poor, you can use Medicaid and if you can afford a top-end insurance plan, you don't have much to worry about. But if you are one of the majority of working Americans who either cannot afford to buy insurance or only can afford a lower-end plan, you are in big trouble. This is rationed medical care based on who can and cannot afford it. Let's start acting like a modern nation and end this antiquated system of medical care!

  • yuphello Mar 2, 2010

    It's not like doctors or hospitals make the prices.

    The Gov't controls and has specified every single medical procedure and the price of it, the doctors have no choice bu to charge as much

    The gov't makes are medical system look bad when in fact the gov't is the ones that's making it so expensive.

    PEOPLE ask your doctors

    I had a surgery and some inserts into my bones which all costed me around $87,000 which my doctor told me if the gov't hadn't been controlling it they could have effectively done the same surgery and payed everything needed for the surgery, doctors etc, for no more then $7,000.

    THE GOV'T is the problem not the health care, is this not obvious???

  • aspenstreet1717 Mar 2, 2010

    Insurance companies have a federal anti- trust exemption! Outrageous.

  • bill7 Mar 2, 2010

    How about we end the stranglehold insurance companies have. Insurance companies should NOT be for profit institutions. Wall Street will drive them for more profits and the only way they can accomplish that is through increasing premiums and decreasing pay outs. Insurance companies should be required to spend 90% of their premiums on medical care, and 0% of their income lobbying congress. No more than 10% of the premiums they receive should go toward operating costs, and 0% should go to profits. Insurance companies should be regulated just like public utilities...