(CBS) Most Americans know that if you get sick enough to go to a hospital, it's going to be expensive. But you may be surprised to learn that hospitals all over the country charge their highest prices, by far, to those who can afford it least — the 46 million Americans who don’t have health insurance.

Hospitals charge uninsured patients two, three, four or more times what an insurance company would pay for the same treatment. And, when the uninsured can’t pay, they often find themselves the target of collection agencies or in bankruptcy court.


It's people like Lisa and Scott Starbuck. The Knoxville, Tenn., couple was making about $50,000 a year, before taxes, in the computer-consulting business they run out of their home. A decade ago, they were downsized out of corporate jobs that provided health insurance. Lisa got insurance on her own, but Scott couldn't afford insurance after he was diagnosed with diabetes.

"Is it fair to say you were hoping against hope that the diabetes would get under control and there wouldn’t be any other illness?" Rather asked.

"We were just kind of gambling, I think, that that was gonna happen. But we didn’t have any choice," says Lisa Starbuck.

The couple lost their bet last year when Scott suffered chest pains and wound up in the emergency room at the University of Tennessee Medical Center — a non-profit teaching hospital.

Doctors diagnosed a mild heart attack. They inserted two stents to open up a blocked artery to his heart. It was a textbook case; there were no complications, and Scott was released after 72 hours.

A few weeks later, he got an itemized bill for more than $41,000.

"The biggest thing on there was the stents. The two stents were $19,000. And I’m not a medical professional, so I don’t know a lot, but I just didn’t see how that could be $19,000," says Lisa. "So I got on the Internet and looked up the list price, and it was $2,300."




Currently, the hospital is not allowed to "charge" any individual person more than the set price. However, they are free to accept less than the set price from anybody they wish.

They accept a fraction of the total bill from the insurance company but demand full payment from the individual without insurance.

Personally, this seems to beg for regulation. I see no issue with demanding and enforcing payment for services rendered. However, to force an individual to pay three or four times what the hospital would accept from the typical insurance carrier is just wrong.

Being in the finance biz I see first hand how bad the health billing system really is. A large percentage of what whould be a normally well off people get hammerd due to an accident or illness that cripples the family. I do believe that a majority of bankruptcies and foreclosures are health related as well.

But as Rush Limbaugh says, "The health system is the best in the world, people have to self insure like me". I'm sure he was not saying that back when he was selling potoato chips.

we dont even use the hospital that is less than a mile from our house because its always full of unisured people in the ER (if you can call it that) so we drive to another town where we know we wont have to wait 8 hours to be told to be told take these twice a day ( we wait 3 hours instead) o joy

You are absolutely right. Now take a look at the fellow in the article. If he has a decent job, he can't file for Chapter 7 bankruptcy to relieve him of the hospital debt. The new bankruptcy law generally prevents this.

So, the poor SOB is doubly screwed. Once due to a bill that is 3X what is "reasonable" and a second time because, eventually, he will be forced to pay it.

Unbelievable!!

Be careful I have a reputation to maintain.....and so do you so watch it.

I would never have know how bad the problem is until I became a banker and there are many people with screwed credit because HMO's don't pay as promised so the patient is left with the bill. I don't want to sacrifice our superior doctors and hospitals and have no idea what the answer is but status quo is not it.

If this flu thing hits, look out. The insured will not be insured because the customers that pay the bills because they are dead, sick or broke.

...........you have a reputation............since when...........

The law currently requires that the hospital charge all comers the same rate. They skirt the law by accepting less than the standard rate. Very similar to the "rack rate" in hotels. Nobody pays the rack rate. But, that's the rate on the door.

The hospital should be required to accept the same fee as they offer to their most preferred clients..........the insurance companies. That fee, BTW, is still way above what most clients will be able to pay. But, at least it's fair and reasonable. The client elected to go "naked". He lost. Provide him with a reasonable chance of getting out of the debt in his lifetime..............

Personally I think that the real devil is the insurance companies if you are self employed you better have a perfect bill of health or you are el screwbo.

I have been in medicine since the day I took my first breath of air. The hospitals aren't making the big money, the doctors aren't making the big proportions, and the nurses aren't either. The people making the money are the pharm and instrument manufactures. People can cite the R&D thing all day long but the fact of the matter is that despite all of the huge and often subsidized R&D risks have huge bottom line profits at the end of the year.

The doctors developing the surgerys are usually rewarded with some speaking engagements and their names in the text books the 15 minutes of fame while the instrument manufactures run away with the money. Arthroscopic knee surgery was developed by two doctors as time passed one of the doctors continued to teach and help patients while the other who was also a fine surgeon spent a bit more time selling the instruments. Although both are very well off guess which one is close to a billionaire.

The problem is literally going down peoples throats and in thier ass, not salaries and payrolls that knuckleheads would like to think.

Correct again.

The average doctor is basically an educated working man. They do make a decent living........most over $125K........but everyone forgets the opportunity cost to achieve this and the workload required to maintain it.

The specialists do quite a bit better with a lesser workload.

But, nobody beats the fellow selling the instrument/device/drug. They make out like bandits with a gross margin of greater than 90% on every single item they produce.

Imagine if you could get a 90% gross margin on a new house.

I know first hand of an uneducated Arthroscopic device salesperson that made more money than the guy who actually invented the surgery....that is no BS, 100% for real. Think about how many people benefited by the doc's efforts.

An illegal wetback with a broken arm will get the same treatment at the ER that a rich person, HMO subscriber or privately insured person will get. Only he doesn't have to pay, nor does it concern him that the rest will end up paying for him.

Actually, he does have to pay. The issue is collection of the money from an individual with no assets and without a proper job with a W2 income.

Such people are judgment proof.........and........may be in better shape than a fellow who is 50 years of age without insurance but with a proper job.

When it came time to pay my medical bills my HMO turned and would not pay. I fought all the way and still lost.

Everything was billed retroactively and then I was charged as a person with no medical insurance. Thousands in medical bills showed up in my mailbox. They had threatened collection from my paychecks, and bank accounts if I could not pay, which they could legally do in Utah.
I wrote letters to all the doctors and hospitals explaining my situation and all of them knocked an average of 30% off my bill(s). One hospital completely wrote off my bill (LDS Hospital in SLC Utah). Even with the deductions though I owed plenty.

I paid it all off a year or so back, but it was ugly. Even with insurance there is no guarantee those greedy HMOs will pay.

__________________
1994 C 280 117.5k, White (Good as new)
1997 Toyota Camry 149k Miles (Not so pretty anymore)

1990 190e 2.6 95k (Sold-Should not have)
1981 240d Stick ??? Miles...sold

Can you explain in more detail? I'm curious how and why they deny what would appear to be a legitimate claim.

Explain to me the part about how "he does have to pay" when it cannot be collected. I'm missing something.

You're simply confusing the requirement to pay a debt with the capability of collecting on a debt owed.

I'll grant you that the outcome might be similar.