User-pays hospital bills

Press, 23 September 1988, Page 12

User-pays hospital bills

By ALAN CONWAY

HOSPITAL Boards in New Zealand may be having difficulties balancing their budgets but, hopefully, they will not have to adopt the Draconian measures employed by the American Hosptial Cost Containment Boards. In the United States the end result has been that a number of patients have come close to postoperative cardiac arrest when they received their medical bills. A good example which came to public attention recently was that of an elderly lady in Florida who went for out-patient eye surgery. She was operated on for a cataract in one eye and spent half an hour in a recovery room where she was given a cup of coffee and a bill for $176. For that money she could have had a room in a five-star Hilton hotel.

After her half-hour stay in the recovery room, she was wheeled to a small dressing room where she dressed and made a phone call. For this she was charged $9O. Later she realized that she could have changed in the ladies’ room and used a public pay phone for 25 cents. This financial horror-story continued when she examined closely her full medical bill. Her pre-surgical tests were roughly what she had expected — chest X-rays $7B, an E.K.G. $69, and blood extraction and analysis for $l6B. While in surgery, however, she was given $lOl worth of I.V.s which included $37 for sterile water. (Some cynics are convinced that American hospitals give I.V.s to patients even if they are only having their toe-nails trimmed).

The cost for the use of the operating room was $753. In the theatre she was charged for each piece of cotton wool and tape used. (Two strips of tape across the finished eye patch cost $6). Other medical and surgical supplies came to $1873 plus $978 for unspecified “pharmaceutical material.” To add insult to injury she was charped $l2 for the surgeon’s gown. During surgery her blood pressure was taken four times. This “Monitored Anaesthesia Care” cost $6B. The surgeon’s fee together with that of the anaesthetist is expected to be about $3500 making a grand total of over $BOOO. In fairness, the lady can now see much better out of one eye even if what she sees in her medical bill is not to her liking.