Rant!

Its rant time.

On February 25th, the night before yet another exam (seems like every night is a night before an exam), after studying many hours that fateful thursday, I readied for bed. There were some dishes in the sink, Nehama, who already tucked herself in, told me not to worry about them, that she'll do them in the morning, and that I should just come to bed. The clock strikes 11:32 PM. Being the im/compulsive ADD child that I am, those dishes gnawed at me. So I decided I'll quickly wash them then go to sleep. After all, 11:30 isn't that late, and I wanted that coffee cup clean for my morning brew. So I am there washing the cheap ass ceramic mugs that Fayga left upon her departure from the apartment (a tale for another time), with my mind drifting through the vagaries of Pulmonology. I was scrubbing the inside of the cup, when it quickly broke into several pieces, giving me a nice slice through my right pinky (anteromedial aspect of the DIP of the 5th finger, to be precise and nerdy). Upon the sight of the gushing blood, and the numbness I felt on the pad, I began to feel concerned. I washed it out as best I could, viewing the supple tissue under the wound, and decided that, being a righty, this could make the test that I prepared so hard for, difficult. But, I resolved to not postpone the test, no matter what, because I value free weekends. So I went upstairs, woke Nehama telling her that I injured myself, and needed to go get stitched at the ER, and that she shouldn't worry. But she did worry, being the pleasant wife that she is, and she got out of bed. She said that I could just let it heal, but I told her that I wanted it stitched because it'll take forever to heal by secondary intention, and on top of that the lack of sensation is vexing. I told her that I didn't want to bleed all over my scantron in the morning, and on top of that we had white sheets on the bed. So she wrapped my finger up, and joined me in the car, though insisted that I drive, claiming that she has poor night vision. Amazing. So we go the hospital, they triage me, I sit there for 20 minutes watching Seinfeld reruns, and then they call me back, stitch me up, send me on my merry way.

Here is the annoying part. My insurance, which is through Nehama's work, provides for a $75 copay for ER visits, plus 20% of the ER physican costs. So let's break that down: $75 to walk in the door. then 20% of whatever the physician costs. Why you have to pay $75 copay is so F-ing beyond me. Ok, so then I get a bill from the ER physicians' practice...for $641.68. Ok, let's break down the costs, using costs attained from google searches of the materials used:

1 pack of 3-0 nylon sutures: $7.99
1% Lidocaine HCl: $1.41,
1 5 mL syringe: $21. (Note, this is the cost for 100 syringes, but I'll round up to prove a point)
1 25 gauge needle: $0.20
2 betadine swabs: $13.07 (Note, this is for 100 swabs. they only used 2 on me)
1 sterile field: $0.50.
1 roll of gauze: $4.70
1 piece of tape: $0.50 (rounded way up)
1 Suture kit: $23.24 (their's was likely way cheaper)
Total so far: $72.61.
This is a VERY liberal estimate of the costs, which I obtained through picking the first item I found online. I know that hospitals, which buy in bulk from medical suppliers, probably pay less than half this price. But, leaving that aside, that leaves  $569.07 in other costs. So what else am I paying for? The lights and power of the building. supplies to run it. Considering I entered the hospital at 12 AM, and left around 2 AM, nearly all of which was spent waiting in a non-monitored state with no supervision by personnel whatsoever, that puts me at $4.74/minute spent in the ER. That's amazing. However, if you consider that I was only in contact with the physician for around 30 minutes, that puts the total costs per minute with the ER physician at approximately $18.69/minute. That's good money right there. I know you're thinking, hey ben, what about the 3 minutes that the nurse spent wrapping your finger at the end. So I know I am being unfair to them, but this is just to prove a point.
The medical system is completely fucked. As a medical student, I know how much it costs to get our education, and I think I am developing an understanding of how much operating costs are at an institution. I do not think that the true cost of running 4 sutures, which took no time at all, is reflected in the $640 bill I received. These costs are frighteningly inflated. The reason being that insurance companies are such shitty reimbursers, yet they literally manage their clients' care. So they decide what gets paid for (meaning what procedures/visits get done) and what doesn't. In reimbursing less and less, and in people sacrificing their involvement in their own care, costs for all procedures have been driven way too high. there is no reason that this hsould cost this much. I got a bill from the insurance company for $367. They applied my deductible to the ER visit. This was a mistake. However, had I not called and demanded that they read me, word for word, my plan details, they never would have accepted that. They have "resubmitted" the claim. THe fact is, the republican plan of arguing over costs with health providers is dumb. When my finger was bleeding, I wasn't about to storm out of the ER, demanding a cheaper rate.  I would have fucking accepted whatever was offered. On the other hand, having no connection with the costs is also silly. Luckily, I'm a cheap ass jew and demand an explanation for every single cost applied to me, so I was able to get this corrected. Now I only have to pay 20% of this ridiculously inflated cost. I cannot wait until the government expands control of healthcare even more, so that these insurance companies will be put out of business. Imagine if I was actually unhealthy. I, all people in the US in fact, are literally 1 serious health problem away from bankruptcy. This is the second time that I have been billed incorrectly by the insurance company SINCE JANUARY! Both times the mistakes would have resulted in me paying more, and them paying less. "Mistakes." These are the biggest shiesters on earth, and they've got their hands around the balls of our healthcare. DOWN WITH HEALTH INSURANCE COMPANIES!