美国国家公共电台 NPR Sticker Shock Jolts Oklahoma Patient: $15,076 For 4 Tiny Screws

 

DAVID GREENE, HOST:

If you've ever read an itemized medical bill, you might have noticed that small things can come with these ridiculously high prices. Every month, NPR with Kaiser Health News has been taking a close look at some of these bills, and I sat down with Kaiser Health News Editor-in-Chief Dr. Elisabeth Rosenthal.

Thanks for coming back.

ELISABETH ROSENTHAL: Oh, thanks for having me.

GREENE: All right, so we've been asking people to send us their medical bills, and you've been analyzing¹ them. It sounds like a lot of it's been eye-popping. What have you been finding?

ROSENTHAL: Yeah, our bar is pretty high. We started off with a $17,000 bill for a urine test.

GREENE: Oh, my God.

ROSENTHAL: Then we went to two scans, one that cost 200, one the cost 9,000 - same scan, same city, just weeks apart.

GREENE: Different prices.

ROSENTHAL: Different prices. So this month, we're moving onto a new outrage², and it's about four little screws that a woman in Oklahoma got during toe surgery that ended up costing $15,000.

GREENE: Fifteen thousand dollars for four screws - I mean, those must be some screws. Well, we're going to hear her story here. Sherry Young, 57 years old - she lives in Lawton, Okla. And we sent a reporter named Jackie Fortier with StateImpact Oklahoma to hear her story firsthand.

JACKIE FORTIER: Hi.

SHERRY YOUNG: Hi. Nice to meet you. I'm Sherry.

FORTIER: I'm Jackie. Thank you so much for having me.

All Sherry Young wanted was to live without pain. She's had osteoarthritis for years.

YOUNG: I have arthritis³ in multiple areas of my body. And I was having sharp, stabbing pains in two different parts of my shoulder, and then I was having pain walking on the bottom of my foot.

FORTIER: She and her doctors came up with a plan - have two surgeries on the same day, one on her foot and one on her shoulder, both at the University of Oklahoma Medical Center in Oklahoma City. Due to her arthritis, she'd had surgeries before but had never really scrutinized⁴ the bill.

YOUNG: The insurance company paid their part of it, and my - I paid my part. I didn't pay much attention to it.

FORTIER: She was in the hospital for three days, and the surgeries were a success. But a few days later, back home recuperating⁵, Young went to the mailbox.

YOUNG: Blue Cross sent me a letter saying that the surgery costs were denied because I had been put into the hospital. And the bill for all of it was about a $115,000.

FORTIER: Her insurance company had only approved an outpatient procedure, and so suddenly, Young found herself on the hook for the cost of the hospital stay and both the surgeries.

YOUNG: Well, I was shocked. I was still trying to recover from my surgery. I had my shoulder in a sling⁶, and my foot was in a boot. So I started thinking about what it would do to me if I had a $115,000 debt that I would have to deal with for years and years.

FORTIER: With a bill about five times her annual income and more than the cost of her house, the retired⁷ university librarian started asking questions

YOUNG: I asked for an itemized bill because then I was extremely interested in why all of that added up to $115,000.

FORTIER: When the itemized bill arrived, she was stunned⁸. One charge stood out - $15,000 for four tiny screws that were used to hold the bones of her foot together.

YOUNG: Unless the metal the screws are made of was mined on an asteroid⁹, I don't know why tiny pieces of equipment should cost over $3,000 each.

FORTIER: The screws weren't the only shock - a drill bit for $2,000 dollars; a saw blade for more than 600. She showed me the itemized bill.

YOUNG: And then here's some kind of a surgical¹⁰ blade or something for over $5,000.

FORTIER: Young contacted the hospital. She even called the manufacturer who made the screws, but she couldn't get straight answers as to why they cost so much, so she sent her bill in to us. For NPR News, I'm Jackie Fortier in Oklahoma.

GREENE: Fifteen thousand dollars for four screws - how does this happen?

ROSENTHAL: First of all, the basic answer is, there's no market for these little pieces of medical equipment - no real market. So...

GREENE: You can charge anything you want if...

ROSENTHAL: You can - I mean, there's no price at all, effectively. So basically, the manufacturer takes a screw that might not be that different than what you buy at Home Depot¹¹, they can mark it up to whatever they want, and then the hospital can mark it up however much they want. So what we discovered is that the manufacturers said they normally charged $300 to a thousand dollars for a screw. They wouldn't give us the exact estimate. So that means the hospital, in charging about $4,000 for a screw, is marking it up maybe a thousand percent.

GREENE: Even more, yeah.

ROSENTHAL: Even more. However, what we also did - we took the next step. We went back and said to someone who manufactures generic¹² orthopedic parts, what would it cost to make this? His estimate was about $30.

GREENE: What about these tools that she was paying for, like $4,000 for a drill, $600 for a saw. Can't those be reused? Does every patient have to pay for a new piece of equipment?

ROSENTHAL: Well, what's happened is, over time, we've moved towards more and more disposables, which makes sense with infection risks. But the problem is, there's no market for that, either. You can charge whatever you want for a saw blade or a drill bit.

GREENE: Did she get this resolved somehow or she - she didn't have to pay this, did she?

ROSENTHAL: Well, no, she didn't in the end, but it's not because she herself really got a resolution. I mean, I think the wonderful thing she did, which is so smart, is when she saw this massive charge - a hundred and thirteen or $15,000 - she said, I want to see an itemization. And that's when she noticed the screws were that much. So basically, she didn't get any answers herself. We went on our investigation¹³, and when a reporter called the hospital and the insurer and said, what gives? - they said, oh, it's just a mistake; she doesn't have to pay any of that.

GREENE: So is that the lesson here - we can't trust the hospital; we can't trust our insurance; we have to double-check everything and make sure we're not having to pay mass amounts of money we shouldn't be paying?

ROSENTHAL: Sadly, at this moment in time, I think yes, you always have to have your antenna¹⁴ up. You have to do what you would do in any other part of your life, which is ask for itemization. If there's something you see that looks outrageous¹⁵ to you, complain about it. Complain to your employer, your insurer, to the hospital. Oftentimes, these prices are set assuming that no one will ever see them.

GREENE: Elisabeth Rosenthal from Kaiser Health News, thanks a lot.

ROSENTHAL: Thank you.

(SOUNDBITE OF TEEN DAZE'S "SPIRIT")

GREENE: Now, here's another thing you can do - share your bills with us. Whether they're sky-high or just sort of interesting, NPR and Kaiser Health News would like to see them. You can go to NPR's Shots blog to upload your bill.

1 analyzing   

v.分析；分析( analyze的现在分词 )；分解；解释；对…进行心理分析n.分析

参考例句：

• Analyzing the date of some socialist countries presents even greater problem s. 分析某些社会主义国家的统计数据，暴露出的问题甚至更大。 来自辞典例句
• He undoubtedly was not far off the mark in analyzing its predictions. 当然，他对其预测所作的分析倒也八九不离十。 来自辞典例句

2 outrage   

n.暴行，侮辱，愤怒；vt.凌辱，激怒

参考例句：

• When he heard the news he reacted with a sense of outrage.他得悉此事时义愤填膺。
• We should never forget the outrage committed by the Japanese invaders.我们永远都不应该忘记日本侵略者犯下的暴行。

3 arthritis   

n.关节炎

参考例句：

• Rheumatoid arthritis has also been linked with the virus.风湿性关节炎也与这种病毒有关。
• He spent three months in the hospital with acute rheumatic arthritis.他患急性风湿性关节炎，在医院住了三个月。

4 scrutinized   

v.仔细检查，详审( scrutinize的过去式和过去分词 )

参考例句：

• The jeweler scrutinized the diamond for flaws. 宝石商人仔细察看钻石有无瑕庇 来自《现代英汉综合大词典》
• Together we scrutinized the twelve lemon cakes from the delicatessen shop. 我们一起把甜食店里买来的十二块柠檬蛋糕细细打量了一番。 来自英汉文学 - 盖茨比

5 recuperating   

v.恢复（健康、体力等），复原( recuperate的现在分词 )

参考例句：

• He's still recuperating from his operation. 他动了手术，还在恢复。
• He is recuperating from a serious back injury. 他背部受了重伤，目前正在康复中。 来自辞典例句

6 sling   

vt.扔；悬挂；n.挂带；吊索，吊兜；弹弓

参考例句：

• The boy discharged a stone from a sling.这个男孩用弹弓射石头。
• By using a hoist the movers were able to sling the piano to the third floor.搬运工人用吊车才把钢琴吊到3楼。

7 retired   

adj.隐退的，退休的，退役的

参考例句：

• The old man retired to the country for rest.这位老人下乡休息去了。
• Many retired people take up gardening as a hobby.许多退休的人都以从事园艺为嗜好。

8 stunned   

adj. 震惊的，惊讶的 动词stun的过去式和过去分词

参考例句：

• The fall stunned me for a moment. 那一下摔得我昏迷了片刻。
• The leaders of the Kopper Company were then stunned speechless. 科伯公司的领导们当时被惊得目瞪口呆。

9 asteroid   

n.小行星；海盘车(动物)

参考例句：

• Astronomers have yet to witness an asteroid impact with another planet.天文学家还没有目击过小行星撞击其它行星。
• It's very unlikely that an asteroid will crash into Earth but the danger exists.小行星撞地球的可能性很小，但这样的危险还是存在的。

10 surgical   

adj.外科的，外科医生的，手术上的

参考例句：

• He performs the surgical operations at the Red Cross Hospital.他在红十字会医院做外科手术。
• All surgical instruments must be sterilised before use.所有的外科手术器械在使用之前，必须消毒。

11 depot   

n.仓库，储藏处；公共汽车站；火车站

参考例句：

• The depot is only a few blocks from here.公共汽车站离这儿只有几个街区。
• They leased the building as a depot.他们租用这栋大楼作仓库。

12 generic   

adj.一般的，普通的，共有的

参考例句：

• I usually buy generic clothes instead of name brands.我通常买普通的衣服，不买名牌。
• The generic woman appears to have an extraordinary faculty for swallowing the individual.一般妇女在婚后似乎有特别突出的抑制个性的能力。

13 investigation   

n.调查，调查研究

参考例句：

• In an investigation,a new fact became known, which told against him.在调查中新发现了一件对他不利的事实。
• He drew the conclusion by building on his own investigation.他根据自己的调查研究作出结论。

14 antenna   

n.触角，触须；天线

参考例句：

• The workman fixed the antenna to the roof of the house.工人把天线固定在房顶上。
• In our village, there is an antenna on every roof for receiving TV signals.在我们村里，每家房顶上都有天线接收电视信号。

15 outrageous   

adj.无理的，令人不能容忍的

参考例句：

• Her outrageous behaviour at the party offended everyone.她在聚会上的无礼行为触怒了每一个人。
• Charges for local telephone calls are particularly outrageous.本地电话资费贵得出奇。