Getting an Itemized Hospital Bill Is Basically Impossible | Hacker News Reader

Getting an Itemized Hospital Bill Is Basically Impossible

thedailybeast.com

48 pointscdme9 comments

One of our kids was born in a car on the way to the hospital. But when we got the bill there was a fee for fetal heart monitor. They actually took that line item off when we pointed it out.

That is because it is largely a work of fiction. The vast majority of a hospital's costs are fixed, not variable, so when they have to divide it up into individual "items", the amounts allocated are to each "item" or "service" are fairly creatively arranged.

Think about it - most of the stuff has to be there "in reserve" so to speak, with a fair amount of surplus to cater for surges of different kinds of sickness, so there is very little ability to match demand and supply. The actually variable stuff (e.g. drugs, saline, other consumables) is a fairly small part of the overall operating cost.

I don’t disagree about the hospital bill being a work of fiction but hospitals are hardly the first business to have high up front capital investments and inventory requirements. Veterinarians, multi-modal shipping, leisure resorts, airlines, etc don’t seem to have a problem getting mostly fair and itemized billing.

The problem with medicine is that the incentives are misaligned all over the place, not that their business model is somehow too hard to do.

Those other lines of business you mention are able to do some degree of negotiation with their customers around what level of service they provide which mitigates a large chunk of the problem.

I'm not saying you're wrong - most hospitals in my country (not the USA), do in fact manage to produce itemised bills, but as someone who has worked close to (but not in) hospital billing, I'm just saying that I have some degree of sympathy for the hospitals.

I would rather watch paint dry than deal with a hospital billing department. I guess you can include insurance companies in there also.

USA healthcare feels as scammy as car dealerships but you can’t really make a choice unless you are willing to die.

I feel like people completely miss the meditative/"Zennness" of drying paint

Compare to veterinarians, where you get an itemized bill when you leave and the credit card terminal to pay, even for emergency vet care. If it’s possible to do it for animals, then it’s possible to do it for humans too.

That website has some pretty heavy ungodly JavaScript or scroll hijacking, so I can't really read it (I'm on mobile).

However, isn't there a law that forces hospitals (at least in the US) to provide itemized bills?

yes, the article says that often times the hospitals just outright violate that law.

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