Conversations with Dr. K have revealed something I didn't quite get, but is probably obvious to medical professionals. It ain't the procedure, it's the bed. That's right, the bed.
If you stay overnight in a hospital, you'll probably pay at least $500. Plus another $500 if you got there in an ambulance. You might see the real doctor for about 20 minutes and he'll charge you $200 for the exam and write you a prescription for drugs that cost $100. But the doctor is not the expensive part. If you get an XRay, that's probably another $500 bucks...
But when I asked further I found out that there are beds, and there are beds. I broke it out into about 5 levels, the most expensive being an ICU. An ICU bed costs you about $3500 a night. That's where the money is. There are levels just below that, I think the term is something like a 'telemetry bed', where you're basically hooked up to all the monitors and staffs are required to check on you every 10 minutes or once an hour depending on the level of care. This is where the enormous bills come from. A kidney transplant operation only costs 4K, but if you're on a certain kind of dialysis...
So check this out:
OBJECTIVES: To determine the provider cost of administering intensive care unit (ICU) services, comparing 3 different staffing models for ICU coverage, and to compare the costs of using house staff vs nonphysician providers (NPPs).
METHODS: Data were collected on total staff composition and number of beds in ICUs from January 1, 2004, through December 31, 2004, at the 3 Mayo Clinic sites: Rochester, Minn; Jacksonville, Fla; and Scottsdale, Ariz. Institutional or national average staff salaries were used to determine total staffing costs per ICU bed per year at each site. Medicare medical education reimbursements were also taken into account.
RESULTS: Costs per ICU bed for physician staffing were $18,630 in Rochester, $37,515 in Jacksonville, and $38,010 in Scottsdale. When NPPs were substituted for house staff, the costs per bed were $72,466 in Rochester, $61,291 in Jacksonville, and $49,909 in Scottsdale. Incremental costs per ICU bed using NPPs were $53,836 in Rochester, $23,776 in Jacksonville, and $11,899 in Scottsdale.
CONCLUSION: Use of residents and fellows in ICU staffing at a major tertiary health center is more cost-efficient than use of NPPs. This finding could have implications for the cost of physician services in nonteaching community hospitals and the methods by which care is provided.
DME = Direct Medical Education; FTE = full-time equivalent; ICU = intensive care unit; IME = Indirect Medical Education; NP = nurse practitioner; NPP = nonphysician provider; PA = physician assistant
A journal (1) article published in 2002, estimated the total health care costs in this country to be just over 1 Trillion dollars a year. Dividing that by 300 Million people we come up with $3,333 per person, per year or $277 a month. 20% of health care costs are for ICU care, which typically make up 1% of the beds in an average hospital. Daily ICU costs range from $2,000 - $3,000 per day in the US. (1996 figure).