LA's Good Samaritan Hospital marks up the price of a lorazepam pill by 14,000%

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Doesn’t surprise me at all. When I got my appendix out 20 years ago I paid $80 a pill for Tylenol 3 while I was in the hospital…

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While I don’t agree with it, it’s a symptom of America’s for-profit healthcare system It’s also part of a catch-22: the bills are high to cover for those that can’t/won’t pay, and those people can’t/won’t pay because the bills are high.


There are some visual problems with saying, “$.25 for pill” “$19.75 for nurse dispensing pill, checking it against patient records, meeting safety protocols, etc etc.” there is some fixed overhead for delivering a pill to a patient.


Another factor is that the price the hospital demands is not the price the insurance company pays. Especially Medicare patients pay negotiated rates for everything - the full price is just some weird kind of fiction. Also the poor don’t pay that - either Medicaid pays or the hospital writes it off.

It seems the only one who pays full price would be an well-off person with no insurance. Those people exist, but they’re exceedingly rare.


Would you make the same argument for the $20 mini-box of facial tissues I got charged for when my son was born?

Look, no. Just no.

That is just


Having a poor person in my life (SO’s mom), I can tell you with confidence that medicaid does not cover very much and the hospitals send bills for the difference between the government’s negotiated rate and the insane fake dollar amount they attach to their services. They send the unpaid bills to collections in 60 days.

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I did not know that was legal. It’s not, with Medicare. Is Mom anywhere near 65?

She is now, but she had a minor heart attack just before she turned 64 and then required stint before she turned 65. What a damned mess that was.

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It’s nice that they can clearly see the line item. Some Hospital Billing code is simply that - secret code.
You have to call and get an itemized bill (request one with descriptions).

It’s all a “Hot Potato” bargaining war between the Hospitals and Insurance companies with patients as the sucker in the middle who doesn’t know the rules of the game.

Weirdly enough, I’ve found you can get a feel for the system by asking your dentist how they charge.

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I tried to find the price of physical therapy, which my doctor prescribed. There was literally no way to find out the price before the service took place. No one could answer the question, they couldn’t even give me a range more specific than within a $300 range for a service which took about half an hour. I spoke with three people in person and one on the phone. They all seemed to be annoyed that I was taking up their time with my stupid questions. If I hadn’t been in such pain, I would have skipped it altogether.


I’ve had the exact same problem trying to find out prices for imaging and laboratory tests. I never got an answer. Some of the reasons given were…
You have to ask the insurance company. You have to ask the provider. You need to know the procedure code. We only give that information out to doctors.

Without the ability to know and compare prices there is no healthcare market.


I’m sorry, are you saying a hospital can deliver a 17 cent pill for 17 cents?

It’s worth noting that Samaritans were the Isis Terrorists of their day. All except that one single good Samaritan.

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Haven’t you heard the Good News? Fleecing customers contributes to the economy and creates jobs! So this truly is the work of a true Americam Good Samaritan.

The invisible hand has shitty bedside manner.


Down here in New Zealand Lorazepam is about NZ$0.04 per 1mg tablet. But we have a state enterprise called Pharmac that leverages the bargaining power of our whole population to buy all our pharmaceuticals for us and they keep drug prices way down.

You might think that with only 4.5 million people (but lots of cows and sheep) that we don’t have much bargaining power. But most everywhere else negotiates on a hospital by hospital basis … In the US, the drug companies get to charge whatever they want and the healthcare providers can’t negotiate at all.

Pharmaceutical companies hate Pharmac with a passion and want to get rid of it. Unfortunately our prime minister loves playing golf in Hawaii with his mate Obama even more than he likes tugging women’s hair, so we’re probably going to end up in the TPPA. And then we’ll have to pay through the nose for drugs too … :frowning:


No one has actually stated that. The actual argument is that 14,000% is an absolutely ridiculous mark-up.


It all made me feel like the entire healthcare industry is about making money for hospitals and insurance companies, and that the humans are just grist for the mill, to be ground up in service of the real goals.


US hospitals disguise their capital and O&M and credit risk and non-reimbursed readmission costs into bills of people who can pay via insurance. And since they can’t put a line item in the bill that says, “Pill, $0.25” “Capital and O&M Costs Associated with Pill, $11.27” the pill becomes $11.50 or whatever. It’s stupid. But that’s why it happens. Everything has some service fee built into it, whether it’s a band-aid or a stent.

Whatever one’s criticism of American health care v. European health care, the thing often held up as the great indictment of American health care is stuff like this, but it misses a critical point. A lot of European health care costs (capital, O&M, etc.) comes form an entirely different budget than patient bills so the “billed” item is often just a reflection of the marginal cost of the item. A radiation tech might well cost you less in Europe, but the reason the bill of a Cat-Scan is $100 in Germany and $10,000 here, or whatever, is the hospital isn’t trying to pay off the equipment lease on GE on the backs of the patient’s budget, some other budget’s taken care of it.

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