(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.

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.

You in the Ferry business or something? Not sure but that is what I thought. Anyways, if I want a ticket, it is say $5. however, if I am going to charter your boat for say 100 people, you might give me a ticket at $4. HMOs send customers to the institute. Joe Blow might never walk in to that place again. Who should get a better rate? Should I sell you product at the prefered price if you are buying a small quantity?

Further to that. If I have to make $100 and I have 10 clients, I make a $10 a client profit. However, if I have 10 clients, 5 of whom don't pay, I guess I will now have to make a $20 profit per client. We do have a lot of people who tap the ER because they have to see the patients and it costs much, much more to see a patient in an ER as opposed to a clinic. So, who makes up the difference? The paying client be it insurance or private pay. Since the insurance is bigger and can demand better rates, well, it falls down to the single private pay.

Since when should hospitals, doctors, etc, etc be running at a loss? It is a business, just like a computer business, export business, etc, etc. It exists to make money, plain and simple. If it doesn't, it should close up. You have the right to life, liberty and the PERSUIT of happiness. Go persue your happiness. It should not be a right. It should be a privillage. I have seen socialized medicine. When I went back there, I stockpiled all my drugs so that I can self medicate with advice from my wife.

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99 E300 Turbodiesel
91 Vette with 383 motor
05 Polaris Sportsman 800 EFI
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04 Tailgator 21 ft Toy Hauler
11 Harley Davidson 883 SuperLow

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.

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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.

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

Is this Dan Rather speaking? What's his source for this comment? Are we to believe whatever Dubious Dan says? With his track record, I would be skeptical that he even talked with anyone about facts on this. This has the stench of sensationalism hanging over it.

Dan retired last year..............

I say again, is this Rather?

............well.........if it is Rather.........then we can't believe anything in the article........correct?

Tell the truth now, you didn't even read and understand the article before you stampeded to paste it ,did you?