Is it really that expensive?

[ESRD Survivor]

I have been receiving statements for what my insurance is paying for one month of dialysis, it ranges from 73k to 98k per month.  Seriously? Thats a million dollars a year.  I hope a transplant comes my way soon.

[Desert Dancer]

I have been receiving statements for what my insurance is paying for one month of dialysis, it ranges from 73k to 98k per month.  Seriously? Thats a million dollars a year.  I hope a transplant comes my way soon.

Hell no, it isn't that expensive. Put it this way: something like 60% of DaVita's patients are Medicare-only, yet they made millions in profit last year and they only get (now) $250 per treatment, per patient. Yet Fresenius tried to charge me $92,000 for one month; that's $7,666 per treatment, or $1,916 per hour.

It's simple greed. Gotta love that 'free market'.

[cattlekid]

My Fresenius center gets $2300 per week for my treatments (approx. $750 per treatment for those playing at home).

I went to a non-profit center while on vacation and they only billed $450 for my treatment.  I got better care in the non-profit center to boot.

Us private insurance patients really take it in the shorts.  I have to remind my center about how much they get from me per week when they get uppity.  I am blessed to have many choices of centers locally so they aren't the only game in town.  I plan on being out the door to a DaVita at home clinic within the next few months as soon as my fistula matures.  My current clinic is gonna cry, but so be it.   

[scooter26]

It won't be any different at Davita, it may actually be worse.

[lmunchkin]

Yes, Dialysis whether In-Center or at home with NxStage or Pd, it is all so very expensive!  What are you gonna do?  Thank God for insurance cause I certainly don't make that kind a money!

lmunchkin

 

[Riki]

When I go to New York, I pay $400 per treatment.  My credit card takes a thumping when I travel to the US.  I've heard of other centers that were charging travelers upwards of $2000 per treatment, which is absolutely ridiculous.

[daveosaurus]

My first bill from Davita was $15,000 for most of August! Who makes that kind of money? Not me. Medicaid is supposed to pay 80%. But how do I even come up with the other 20%? I Don't have any other insurance. 

[cattlekid]

Oh, I know it probably won't be any better cost-wise but at least if I go to NxStage, I'll be out of the center where the staff treats me like a three-year-old child instead of a paying customer.

It won't be any different at Davita, it may actually be worse.

[*kana*]

My insurance is charged about 32k a month for my PD supplies and service.  I think that is a lot for sugar water, an on call nurse I never talk to and a machine! 
I have Medicare and private insurance and the 20% of my 20% is written off by Fresenius so I pay nothing....thank God! 

[lmunchkin]

It is so sad that "everything" comes down to money! Iam so thankful that ESRD does have a life-support to fall back on, some other diseases don't!  But everything is expensive! 

Just a year ago, I spent $100.00 for about 8-9 bags of groceries. Now that same $100 is about 5-6 bags!  I just do not know what or how people are getting by.  My church has helped us tremendously and I am so very greatful, but if they had not, who could I have turned to?

Guess everyone in US is going through hard times whether illness or not.  It could be alot worse, so I can't complain!  But D. is rediculously HIGH PRICED and I just have no answers as to why?

lmunch

 

[daveosaurus]

I hear ya. It's almost too expensive to stay alive anymore. I'm not saying the alternative would be better but I'm not running from it nearly as hard as I used to. I'm really getting tired of fighting after nearly 16 years of diabetes, 4+ years of a leg amputation, failing eyesight, high BP, and now the worst, ESRD and dialysis. All this after being a cyclist in my younger days and knowing what it's like to be really healthy. It's hard to deal with having your body fail and having to give up activities you used to enjoy and be good at. In many ways it seems like the best part of my life, at 55, is over. Worrying about finances doesn't help, that's for sure. It's just ... one ... more ... thing that will eventually make the end welcome. But until then there's nothing to do but struggle on.

[HILINE]

My first bill from Davita was $15,000 for most of August! Who makes that kind of money? Not me. Medicaid is supposed to pay 80%. But how do I even come up with the other 20%? I Don't have any other insurance. 

that's not profit

[daveosaurus]

My first bill from Davita was $15,000 for most of August! Who makes that kind of money? Not me. Medicaid is supposed to pay 80%. But how do I even come up with the other 20%? I Don't have any other insurance. 

that's not profit

What do you mean? If Davita weren't making a profit they wouldn't be in business. Of course they are making a profit.

[poncho]

Heres a tip. You can negotiate price. i refuse to pay over 400 per treatment. Both Fresenius and Davita will do it. They have negotiated prices with Medicare and Insurance companie so why not with you.  Just be aware of drug prices and doctors consultations they add on

I live in France and get reimbursed a fixed sum when I Dialyse in the States. Fresenius quoted me a price of 700 a session.  I told them that was too high and I would find someplace cheaper. they asked me how much I could pay and I told them I got reimbursed 400per treatment and they agreed to it.

btw the bills they give me are like 1200 a session. I don't know what is going on, but I suspect it's some kind of scam or dodge. maybe if they say treatment costs 1200 but they take only 400, they get a tax write-off or something.

[jeannea]

It can be illegal for them to charge different amounts to different people. If they say that it costs $1000 to dialyze me with insurance but only $500 to dialyze you without insurance, that can be considered insurance fraud. That's why your bill is higher. They must be putting on the books that you never pay up. But even then it seems to be really close to being illegal.

[fearless]

I hear ya. It's almost too expensive to stay alive anymore. I'm not saying the alternative would be better but I'm not running from it nearly as hard as I used to. I'm really getting tired of fighting after nearly 16 years of diabetes, 4+ years of a leg amputation, failing eyesight, high BP, and now the worst, ESRD and dialysis. All this after being a cyclist in my younger days and knowing what it's like to be really healthy. It's hard to deal with having your body fail and having to give up activities you used to enjoy and be good at. In many ways it seems like the best part of my life, at 55, is over. Worrying about finances doesn't help, that's for sure. It's just ... one ... more ... thing that will eventually make the end welcome. But until then there's nothing to do but struggle on.

I want you to know that I understand that sort of despair.  Sometimes the only thing that enables me to keep going is feeling/knowing that there are others who feel and know it too.
Misery loves company.  And sometimes company is the only thing that allows misery to keep living instead of giving up.

[fearless]

I also want to say: I think dialysis-for-profit is criminal. 
God help you if you're poor and sick in the USA today.  In the case of dialysis, it's better than it was some years ago, but it's being eroded.  And if you're NOT on dialysis but you're really really sick?  Well, there's not much contingency for that at all.

Oh, and no: it's not that expensive!

[poncho]

Yes some of it is illegal, that's why some of these places have paid hundreds of millions in fines. But until they start throwing sime CEOs in jail, they'll keep doing it.

[rocker]

I try to explain to people - healthcare "prices" in the US are entirely fictional.  When hospitals/doctors are charging five and ten and twenty times more than Canada for similar procedures, it doesn't take much in the way of brains to know that this is not what the thing "costs".  Fictional.

And no, if what you saw was a bill, your insurance doesn't pay anywhere close to what the clinic bills.  Your insurance company may completely pay off that bill for five or six thousand dollars.  Your insurance company has the clout to negotiate favorable prices for their "bulk purchases".  Fictional.

Once saw a bill for a cath placement surgery.  About three hours total in the hospital, over $22,000.  I remarked on the ludicrous amount to someone associated with the hospital.  She gave me a funny look and said "Yeah, but if you were paying cash, that amount would immediately be discounted by 40%."  Fictional.

Why?  I use this analogy.  Say you make a new widget, that a lot of people want.  It costs you ten dollars to make that widget, and you can make about a hundred a week.  What would you charge for your widget to pay for your time?

Got a number in mind?  Good.  Now consider that anywhere from 20-50% of your customers will never pay you.  Now what do you charge?

We have "non-profit" hospitals around here that net hundreds of millions of dollars a year.  How do they do that?  Because they can "write off" their ludicrously inflated unpaid bills as "charity care".

What incentive does anyone have to keep these fictional prices from going up and up and up?

As for "fraud" - well, to have a fraud conviction, someone has to be interested in enforcing the law.  Who is going to do that?  You think your local sheriff is interested in being known as the guy who put the head of the hospital in prison?

There are no checks and balances in this system.  And it's the people who cannot pay who get screwed the worst.