Why does healthcare cost so much?

[auditor0007]

This is just one example of our messed up system. Because I now find myself without health insurance, I have been forced to seek out the cheapest care possible. While I was covered by my insurance company, my treatments were being paid for through my insurance, but I still had to pay the deductible and then some.

I have hemochromatosis which is a genetic disorder that allows the body to absorb too much iron. The treatment necessary to remove the excess iron is simple blood draws or phlebotomies. They remove a pint or more of blood at a time and with that, about 200 milligrams of iron are removed. The body then produces new blood less the iron.

Now, when I was paying for this through my insurance, I was sent to the hospital's infusion center. They charged my insurance company around $600 per phlebotomy. The insurance company paid them a little over $375. To me, that is a lot of money to have them take a pint of blood out of me.

Anyway, now that I am paying cash, I found a very well referred hemotologoist who will have his own nurses perform the phlebotomies in his office. Cost: $75

This just makes me wonder; if I was being overcharged by 500% for something as simple as a phlebotomy, how much money is being wasted on everything else when it comes to healthcare? Why would an insurance company agree to pay $375 when the same procedure could be done for $75?

This is where I completely agree that basic services should be paid for out of pocket. Insurance companies have created a smorgasbord of services that they will pay for and because of this, nobody even knows how much it should cost for x or y service or procedure. But the money ends up in someone's hand at the end of the day, and for it, the consumer is receiving very little.

BTW, it took 100 phlebotomies in 18 months to remove all the excess iron from my body. My insurance company paid $37,500 for this, but it could have been done for as little as $7500.

 

[Luissa]

I worked for Albertson's and had a prescription plan but I had to get my prescription through the albertson's pharmacy where it would cost me 30 bucks. If I went to Walmart it would have cost me 4 bucks.

 

[Political Junky]

I worked for Albertson's and had a prescription plan but I had to get my prescription through the albertson's pharmacy where it would cost me 30 bucks. If I went to Walmart it would have cost me 4 bucks.

Medicare D forbids any bargaining for prescription drug prices bought in bulk. Hmmm, wonder if their giving $millions to our congressmen had anything to do with that?

 

[veritas]

This is just one example of our messed up system. Because I now find myself without health insurance, I have been forced to seek out the cheapest care possible. While I was covered by my insurance company, my treatments were being paid for through my insurance, but I still had to pay the deductible and then some.

I have hemochromatosis which is a genetic disorder that allows the body to absorb too much iron. The treatment necessary to remove the excess iron is simple blood draws or phlebotomies. They remove a pint or more of blood at a time and with that, about 200 milligrams of iron are removed. The body then produces new blood less the iron.

Now, when I was paying for this through my insurance, I was sent to the hospital's infusion center. They charged my insurance company around $600 per phlebotomy. The insurance company paid them a little over $375. To me, that is a lot of money to have them take a pint of blood out of me.

Anyway, now that I am paying cash, I found a very well referred hemotologoist who will have his own nurses perform the phlebotomies in his office. Cost: $75

This just makes me wonder; if I was being overcharged by 500% for something as simple as a phlebotomy, how much money is being wasted on everything else when it comes to healthcare? Why would an insurance company agree to pay $375 when the same procedure could be done for $75?

This is where I completely agree that basic services should be paid for out of pocket. Insurance companies have created a smorgasbord of services that they will pay for and because of this, nobody even knows how much it should cost for x or y service or procedure. But the money ends up in someone's hand at the end of the day, and for it, the consumer is receiving very little.

BTW, it took 100 phlebotomies in 18 months to remove all the excess iron from my body. My insurance company paid $37,500 for this, but it could have been done for as little as $7500.

Why couldn't you just donate blood and they could use it on anemic people? Not being snide, it seems you are paying for something that could be solved easily. Have you asked?

 

[auditor0007]

This is just one example of our messed up system. Because I now find myself without health insurance, I have been forced to seek out the cheapest care possible. While I was covered by my insurance company, my treatments were being paid for through my insurance, but I still had to pay the deductible and then some.

I have hemochromatosis which is a genetic disorder that allows the body to absorb too much iron. The treatment necessary to remove the excess iron is simple blood draws or phlebotomies. They remove a pint or more of blood at a time and with that, about 200 milligrams of iron are removed. The body then produces new blood less the iron.

Now, when I was paying for this through my insurance, I was sent to the hospital's infusion center. They charged my insurance company around $600 per phlebotomy. The insurance company paid them a little over $375. To me, that is a lot of money to have them take a pint of blood out of me.

Anyway, now that I am paying cash, I found a very well referred hemotologoist who will have his own nurses perform the phlebotomies in his office. Cost: $75

This just makes me wonder; if I was being overcharged by 500% for something as simple as a phlebotomy, how much money is being wasted on everything else when it comes to healthcare? Why would an insurance company agree to pay $375 when the same procedure could be done for $75?

This is where I completely agree that basic services should be paid for out of pocket. Insurance companies have created a smorgasbord of services that they will pay for and because of this, nobody even knows how much it should cost for x or y service or procedure. But the money ends up in someone's hand at the end of the day, and for it, the consumer is receiving very little.

BTW, it took 100 phlebotomies in 18 months to remove all the excess iron from my body. My insurance company paid $37,500 for this, but it could have been done for as little as $7500.

Why couldn't you just donate blood and they could use it on anemic people? Not being snide, it seems you are paying for something that could be solved easily. Have you asked?

The first reason is that very few blood banks will accept blood donations from anyone with hemochromatosis. There are a few blood banks that have received an exemption from the FDA, and they can accept the blood. The problem with the blood is that it has too much iron for some and can only be used for certain circumstances. Those who actually receive blood transfusions for anemia cannot receive this blood. That sounds odd because those needing transfusions for severe anemia need the iron to increase their hemoglobin. However, these same people begin to load iron over time. If they need regular transfusions, eventually they face the same problems as someone with hemochromatosis. Then their only option is to use chelating drugs to remove the iron. This is a very difficult way to remove iron as it requires being hooked up to a machine 12 hours per day for weeks at a time.

Besides this, there is a secondary reason someone such as myself would not wnat to donate blood through a blood bank. For 18 months, I was having a pint of blood removed every five days. Blood for donation must be taken with a 16 guage needle as smaller needles destroy whole red blood cells making the blood useless for transfusion. 16 gauge needles are very large and they scar the veins over time. Scarred veins are tougher to penetrate and eventually it becomes very difficult to get a good stick. So it is recommended that anyone needing to have so many phlebotomies over such a short period of time have them done with higher guage needles that are smaller. They have always used 19 guage needles on me, and even with that I had some scarring.

 

[veritas]

Thanks for the answer, auditor. Very informative. I am sorry you have to go through this.

 

[auditor0007]

Thanks for the answer, auditor. Very informative. I am sorry you have to go through this.

It really hasn't been so bad. The only really bad part is that all the excess iron caused me to develop cirrhosis of the liver. The iron is gone now and I keep it in check by having four or five phlebotomies per year. The cirrhosis shouldn't get any worse, although I do have a much higher risk of developing liver cancer at some point. Hopefully that won't happen though as long as i don't do anything to make it worse.

This has been really minor in comparison to what my late wife went through battling leukemia. Unfortunately, she lost that battle. As for me, I just wish I would have found out I had this at an earlier age, before I developed cirrhosis. At least now I know to have my kids tested so they can be treated early on if they also have this. With early detection and removing the iron before it becomes to excessive, there are no complications.

 

[veritas]

What do they do with your blood? Do they throw it out? Could it be used for research purposes?

 

[auditor0007]

What do they do with your blood? Do they throw it out? Could it be used for research purposes?

Yea, they toss it. Not literally. They have to dispose of it properly of course in case of contamination.