Why you need health insurance: Man has appendix removed, gets shocking $55,000 hospital bill


20-year old Reddit user zcypher recently had to go to the hospital to get his inflamed appendix removed. After his appendectomy was complete, he left the hospital within 24 hours. Later on, he was given a bill that came up to a massive $55,029.31 USD. Luckily for the man, his insurance covered majority of the bill, but he still has to pay $11,119.53… which is no small sum but is significantly lower than what he would have owed if he did not have insurance.

He posted pictures of the bill to inform people about just how high some hospital bills can get.

“I never truly understood how much health care in the U.S. costs until I got appendicitis in October,” he wrote on Reddit. “I’m a 20-year-old guy. Thought other people should see this to get a real idea of how much an unpreventable illness costs in the U.S.”

“I think you can see how outrageous some of these costs are,” he said in reference to some of the higher prices on the bill. Among many of the other expenses, room and board cost him $4,878, and his time time spent in the recovery room, which according to zcypher was only 2 hours, cost $7,501.

It seems that zcypher may have gotten lucky with the $55,000 bill. According to a study,which was done at the University of California San Francisco and took information from 19,000 patients getting the same operation as the Reddit user, the cost could be as low as $1,529 and as high as $182,955.

[via ABC News, Imgur]

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  • Ashraf

    [@Mike S.] This is very true. Credit score will likely suffer.

  • This doesn’t even mention overbilling by hospitals and doctors. My Grandmother had an extensive hospital visit once. One of my parents stayed with her the whole time. The doctor stuck his head in the door 2 maybe 3 times the entire period but charged Medicare for daily visits. when the bill was passed on to my Dad he called up to take care of it and had that changed.

    When Medicare was first proposed in Congress, the AMA was 96% against the bill. After they altered the bill to allow the doctors to set the prices, that changed to 98% for it. Medical prices immediately started rising an average of 600% the rate of Cost of Living did each year.

    [@Netpilot] I didn’t expect universal health care to be passed within my lifetime, though I figured it was inevitable at the rate prices are going up. Obamacare is a disaster in the making but it is an attempt at universal health care.

    I would add one other thing to your health care reform suggestions though. Drug companies develop new drugs here in the US because we have subsidies and tax laws designed to encourage then to. They get amazing benefits for drug research and amazing tax reductions as well. Yet they also charge patients in the us more than any other country for those drugs citing the need for testing mandated by the FDA costing more. They will even go so far as to combine two drugs, that are about to become eligible for low cost generics, so they can continue to charge higher prices for them. Basically they want to have their cake and eat it too. That needs serious reform. At a minimum I think price limits should be set as no higher than the same drug costs anywhere else in the world and the practice of combining drugs to extend the monopoly should end.

  • Mike S.

    [@Ashraf] Unfortunately, unless the hospital excuses the debt, who knows what it might do–potentially destroying one’s life over the debt. My family never has had a hospital tell us to forget the post-insurance amount owed–to the contrary, they have fought over every charge for a tissue or aspirin.

  • Ashraf

    [@Mike S.] They remain on the hook, yes, but many people don’t pay and many hospitals don’t expect to be paid — it is factored into their pricing.

    [@Netpilot] Ditto.

  • Netpilot

    AFAIK, hospitals will waive a substantial portion of the patient’s responsibility with a call to the billing office (or the patient’s advocate office) and you ask really nicely.

  • Mike S.

    [@Ashraf] Unfortunately, the patient remains on the hook for any unpaid amount, as the consumer of the goods and services.

  • tony

    @n.n right on
    we really need a reform and ACA is no where near

  • Ashraf

    This is due to purposeful overbilling by hospitals (and/or doctors, if talking about a doctor’s office). Why? They bill as high as possible so as to secure the most payment from insurance companies; many don’t expect individuals to pay the remaining portion. If they do pay, good. If not, that was expected.

  • Netpilot

    [@n.n] I began by agreeing with you about medical reform as I started reading your comment, then it devolved into an off-topic rant.

    An appendectomy for appendicitis is neither preventable by education nor obfuscates cause by a treatment of symptoms.

    An ultimate method of reform could consist of three parts:

    First, a mandate should be established that a single entity be responsible for the entire billing of a medical procedure. The a-la-carte, dribbling of individual bills from a hospital’s different departments and doctors must stop, much as airlines must include ‘all taxes and fees’ in their ticket prices.

    Second, a body should be established to set measurable standards for identical procedures. This would be similar to auto mechanic’s Parts and Labor Estimating Guides, published by Chilton and Motor Manuals.

    Lastly, practitioners and establishments should be required to establish and publish their rates for a measurable unit, just as anyone who bills by the unit (mechanics, law and accounting firms, consultants, etc.) establish their own rates, influenced by experience, expertise, and market forces.

    I think these measures would go a long way to narrow the range of costs for similar procedures at different entities and would give consumers (patients) some leverage to ‘vote with their wallet’ while still providing a free market.

    Of course, I am realistic enough to understand that the politics involved would prevent this from happening in our lifetimes, if ever.

  • n.n

    This is not a reason for insurance. This is a reason for medical reform. The pricing model is distorted through manipulation, especially with government intervention. The progress of cost shifting and lack of accountability has produced comprehensive market distortions, ranging from medical care to education and throughout the economy. The consequence of continuing to treat symptoms, while obfuscating causes, will be a nationwide Detroit effect.