Snake Bite Costs North Carolina Couple $89,000 Hospital Bill

[MillCreek]

http://www.huffingtonpost.com/2013/05/08/hospital-prices-cost-differences_n_3232678.html

Just like the article from Time on healthcare costs that I posted last year, the chargemaster explains all!

[cassandra and sara's daddy]

sure- based on volume -

 It is not legal to conspire to form a cartel to keep your prices up, or to inflict a bill of several orders of magnitude higher on one customer than another for the exact same order , without telling them up front what the cost will be- .  Joe, your hamburger is $3,000. Mike, your hamburger is $8.50. 

 boomhauers example above is a perfect example- well, we can't tell you a price till we figure out how bad we can screw you.

 

volume is not sole determiner  in my experience anyway

[Tallpine]

A few years ago a guy went into the local small town hospital with a rattlesnake bite, and he died.

He was only a mile away from the meat locker hospital when bitten, also.

[Pharmacology]

OK, add another $100 per stage for that.  It's certainly not something that takes entire days, or involves compounding other extremely rare or costly chemicals into the antivenom, right?  Another $300 total for the pharma prep, the nurse to pull it into a syringe, and the doctor to put it in the right vein.

Which are then logged as new IDC9 codes, and treated with new CPT4 codes.  Which have their own reimbursement rate for that treatment, separate from the initial antivenom treatment.  No need to charge EVERY snakebite patient with heart attack procedure codes, just because 1% of snakebite patients have heart attacks.

When the cost is not up for negotiation, you pad the profits where you can.

... Medicare?  I don't follow what you're getting at.

My point was that the husband saying "I can buy that online for $750!"  is bullshit.

[tokugawa]

OK, it sounds from your name like you are the guy in the know, prescription wise- so as far as you can identify what anti venin he received, what CAN it be bought for online, here- OR in other countries?
 You know what to look for, spend a few minutes and straighten us out.

[MillCreek]

http://www.americanownews.com/story/19907160/antivenom-meds

An interesting article.  I had no idea the CroFab manufacturing process was so complex.

[Pharmacology]

OK, it sounds from your name like you are the guy in the know, prescription wise- so as far as you can identify what anti venin he received, what CAN it be bought for online, here- OR in other countries?
 You know what to look for, spend a few minutes and straighten us out.

Well, here's the thing. There's only two  in the US; Antiveninâ„¢ and CroFab.  Wyeth pharmaceuticals stopped making Antiveninâ„¢ because even they couldn't afford to keep sticking horses.
Crofab  is the only one available. That's how I know what he received.
At one big hospital where  I worked,  it cost the hospital around 2K.  Another, crappier hospital paid much, much more for a vial.  It really does vary.

Let's say the husband buys it online.   He receives a powder in a glass vial.  He then has to,  somehow,  reconstitute that powder with 10mL sterile water. Then, after he's pulled that off he needs to dilute it into a 250mL bag of 0.9% w/v saline.  He now has just 4 hours to administer it to her IV (slow push for the 1st 10 minutes [50mL/hr max], then he can bump up el rate-o to 250mL/hr  if she doesn't go into anaphylaxis)  


Also, you can't forget to take CBC, along with clotting, bleeding, and coag times in order to make sure the stuff is actually working.

http://www.americanownews.com/story/19907160/antivenom-meds

An interesting article.  I had no idea the CroFab manufacturing process was so complex.

Yeah, it's actually really interesting how that technology hasn't been improved upon.

Kinda reminds me of the "scrapings"  used to make the first immunizations.

[MillCreek]

http://www.pbs.org/newshour/updates/americans-spend-much-pharmaceuticals/

Many reasons why the USA pays so much more for drugs than other parts of the world.

[Firethorn]

Yeah, it's actually really interesting how that technology hasn't been improved upon.

Kinda reminds me of the "scrapings"  used to make the first immunizations.

This leads to another question - is anti-venom still made the same ways outside the USA, and with similar costs?  Is there anybody working on a better method?

[Firethorn]

If not, then one needs to be passed ASAP.  You could package it with some anti-discrimination language about unmarked prices in retail, which would, after all, allow the staff to charge blacks more for the product, after all.  Healthcare providers could be doing the same thing.

Require all charges to be explained in full beforehand, or in the case of emergency treatment, as soon as the patient is stable and lucid, or the provider doesn't get to charge anything.  Given the amount of intake paperwork for an abscessed tooth, they could easily have included a price sheet with a signature line.

I believe that there are already laws in place in many areas about disclosing the price beforehand, which is why car repair places have to call you if they find something else while fixing your vehicle, or discover that the fix will be more extensive/complicated/expensive than anticipated.  It's just that medical care is exempted.

Fix the mess that is billing in healthcare, from providers to insurance, and I figure you'll cut a lot of cost.