Emergency Room Charges Turned Her Stomach

Henderson, NVA Nevada woman who made her way to the emergency room of the Siena Campus of St. Rose Dominican Hospital in Henderson for suspected food poisoning was appalled with emergency room charges exceeding $10,000. According to the Las Vegas Review-Journal (3/12/12), a CT scan procedure represented the lion's share of that emergency room cost.

Suzanne Newton told the newspaper that in her view hospitals overcharge patients with health insurance, to make up for the money hospitals lose on patients with no insurance or little ability to pay emergency room fees.

Newton made her way to the hospital in November after spending the better part of a night vomiting. She suspected food poisoning following consumption of salad dressing at a buffet that to Newton "tasted funny" at the time, the Review-Journal reports.

While having no quarrel with the care she received at the emergency facility, Newton nonetheless questioned the need for a CT scan of her abdomen, which the 66-year-old initially refused as unnecessary. She was also fearful for radiation. However, when her symptoms persisted and the doctor again recommended the CT scan, Newton agreed.

She told the Review-Journal that she felt like throwing up all over again when she was subsequently sent a notification of the cost of the procedure as paid by her insurance company: $9,333 for the CT scan alone. The total emergency room bill, which covered nursing care, consultation with a doctor and medication, was shown as $10,208.49.

Newton's insurance paid most of the freight on her emergency room bill less her deductable. Still, she felt the cost for the CT scan was excessive and sought a second opinion from Steinberg Diagnostic Medical Imaging Centers. She was told the cost for the procedure at the hospital came in at between five, and nine times higher than what a similar procedure would have cost elsewhere.

A spokesperson for the hospital suggested that comparing CT procedures is impractical because of underlying cost drivers, a statement said. However, according to a spokesperson for the Los Angeles Center for Health Policy Research at the University of California, Newton's irritation at her er bill is not without merit.

Dylan Roby suggested that hospitals engage in cost shifting, inflating the costs of procedures to the well insured in an attempt to make up for losses incurred treating other patients. That's why some emergency room bills are so high.

Roby also suggested that in his view, had Newton not had insurance, she never would have been recommended for a CT scan. Instead, "the doctor would have engaged in watchful waiting," that would have resulted in fewer er charges.

"I'm not the type who says my insurance took care of it and I only had to pay $777 out of my own pocket," Newton said in comments to the Review-Journal. "This is why insurance costs keep going up. Hospitals overcharge people with insurance to compensate for those with little or none."

Thus, the assumption that hospital overcharging is a continuing issue.