FEBRUARY 9, WEDNESDAY

MEMORIAL MISSION HOSPITAL, ANOTHER BIG BUSINESS

Several years ago Kathe fell in the Munich airport and hurt her shoulder. Finally, after hurting the shoulder again, the doctor said that she needed to have an operation. She did and was feeling fine. It was even outpatient surgery. But a couple of days later she didn’t feel well and was having trouble breathing and after some delay and an overnight mixup, her surgeon put her in Memorial Mission Hospital, the largest hospital in Western North Carolina, almost too late. On her way from the emergency room to her hospital room she suddenly had intense pain and couldn’t breath. It was an embolism in her lung and it was lucky we were in the hospital. The nurse knew just what to do and immediately gave her a shot which unclotted the clot in her lung and let her breathe again. She was in the hospital for observation for two days and then sent home with pills to prevent further clotting. She never had the problem again.

The whole thing must have been very expensive, thousands of dollars, but we weren’t worried because we were covered both by Medicare and AARP supplemental insurance. We had never gotten a bill from previous visits to the hospital, we didn’t get a bill this time, except for one thing.

It turns out Medicare wouldn’t pay for Kathe’s regular medicines which she normally took at home every day. We had an ample supply on hand but the hospital had a rule that all medicines given in the hospital had to be prescribed there and provided by the hospital. It was to protect the patient they said.

She was taking several medicines. We were charged $600 for a two day supply of four medicines, three of them cost $150 and the fourth, eyedrops prescribed by her eye doctor because she had glaucoma, cost $450. I agreed to pay the $150 but was unwilling to pay the $450 without a clear explanation for why it cost so much. She needed two drops each day. A bottle that would last a month cost less than $30. Why was she being charged $450 even if they used only four drops and threw the bottle away?

I made about six trips to find out, to the emergency room, the hospital pharmacy, the hospital billing office, and three trips to the main billing office in Biltmore Park out near the airport. Everyone I talked with was very nice, everyone listened carefully, everyone said I needed to see someone else. No one could explain the $450 bill. I even called the insurance company through which we got Part D Medicare drug insurance. The woman there was very pleasant but couldn’t explain it. So I kept going back. On the third trip to Biltmore Park, with the accountants who presumably knew why we were being charged $450 somewhere upstairs and out of sight, I was told by a very nice woman downstairs that my case would be reviewed one more time and then I would have to pay. The woman called that afternoon at 2 and said that if I didn’t pay our bill promptly I would be turned over to a collection agency. They had apparently lost patience. I didn’t know what to do. At 4 the woman called again and said that they had reviewed our case again and that we didn’t have to pay anything, not the $450, not the additional $150 that I was willing to pay, nothing. Case closed.

At first I was relieved. But the more I thought about it the more disturbed I got. First of all they had run me in circles for nothing. Secondly, anyone who didn’t run in circles would have paid $600 for less than $30 worth of medicine. Thirdly, the whole system suddenly seemed corrupt to me, not Memorial Mission, the whole health system. It was clear the accountants were trying to balance the books any way that they could and that the price that they were charging for the drugs had no relation to the cost of the drugs. I was in cloudcukooland. Suddenly the health care we were getting was excellent but the health care system itself was corrupt. I knew this already on a theoretical level but here was absolute proof. And it was clear to me that it wasn’t worth their while to keep fighting over $15 actual worth of medicine, if that. If I had come back six times I might just keep coming back asking questions and pressing for an answer, an answer they didn’t want to give me. I was a minor irritation but enough of one to simply get rid of me by charging nothing. A month later we learned that non profit Memorial Mission Hospital was being sold to HCA, a huge for profit company owning many large hospitals. I wondered if they were more interested in smoothing things over, my small case a part of the smoothing, than in having a small ruckus.

But it was only at this point that I got to the fourth reason for being irritated. I realized that I paid no attention to the rest of our hospital bill, to the thousands of dollars we were being charged. Uncle Sam through Medicare would pay anything the hospital wanted and I wouldn’t say a word. I was actually complicit in this corruption. As long as I was covered I was happy. But as a citizen I shouldn’t have been. I should have resisted my taxes being spent without making sure that the bills charged by the hospital were fair. I know that Medicare reviews bills, but I have a suspicion that built into the system is the heavy influence of the pharmaceutical industry and complicit politicians and that Medicare itself agreed to be gouged with feeble attempts to hold the line. I saw corruption and said nothing. I was complicit. And I was complicit even when they shut me up by saying I didn’t have to pay a cent. I shouldn’t have quit asking or pushing for an anwer. But I did. I was complicit and am left with a feeling of helplessness and guilt and betrayal for not doing what was right.

An article in the Asheville Citizen Times on Friday, February 11, describes how all the local hospitals, including Memorial Mission, are violating a law that them must be clear about how they charge or pay fines. So maybe things are changing and maybe not. Read the article here. https://www.citizen-times.com/story/news/2022/02/11/nc-hospitals-violating-federal-price-posting-rule/6738750001/.