Are Hospital ERs guilty of Price Gouging?

In an emergency, companies aren’t allowed to inflate their prices. It’s illegal.
For example, if a hurricane, tornado, or other natural disaster has devastated your area, your local hardware store cannot simply decide to charge you an astronomical fee for a power generator. Many companies have been fined for doing this.
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Then, just to be fair and for sake of argument, there's non-emergency price gouging:

While Christmas time price gouging is legal, even encouraged in some situations, other non-emergency situational price gouging is illegal. Sporting event ticket scalping is illegal and while it goes by another name, scalping tickets is nothing more than price gouging at its best. Someone wants to see a sporting event and someone else has tickets to spare. However, the bureaucracy of groups such as the NFL and NCAA do not want people getting into their own loss of profits so they have lobbied the government to make such swaps illegal. Ticket scalping seems like a harmless exchange. Especially when it comes to wants, rather than needs, I can not see objections to price gouging; it’s a win-win situation.

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So, given the fact that your body is your temple, when you need a doctor immediately, every cell in your body has gone into overdrive and a State of Emergency has been declared.

Let’s think about this for a moment because most of us have been in this situation before or will be at some point in their lives.

An accident has occurred and you have no other option than to go to the emergency room. It’s out of the question for you to make an appointment with your doctor and wait for him/her to see you. Even the recording at the doctor’s office instructs you to go to the hospital if it is an emergency.

If you’re not bleeding to death and don’t need an ambulance to pick you up, you’re stuck knowing that if you go to the emergency room rather than waiting to see a doctor, it’s going to hit you harder in the pocket book.

What should you know before going to the E.R.? The national average E.R. visit costs $383, while the national average doctor’s office visit is approximately $60. Unnecessary E.R. visits can delay care for those with true emergencies, and cost billions of dollars.

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Then, there’s the urgent care centers or “doc in a box” places where you can go if it’s the weekend or a holiday and your primary care physician isn’t available right away.

Here’s a breakdown on the price comparisons between these places and an ER visit:

Strep Throat
"Streptococcal pharyngitis" usually appears suddenly with severe sore throat pain. It can be particularly frightening for children, is highly contagious, and requires immediate treatment, but an urgent care center will charge just $111 for a visit and an ER $531.
Urinary Tract Infections
Experts recommend you see a doctor as soon as you experience urinary tract infection symptoms. Treatment at urgent care will run $110, as opposed to $665 for a visit to the ER
Earache
This common childhood ailment will run $110 at an urgent care center and $400 at an ER.
Upper Respiratory Infections
It's particularly important that those with asthma or emphysema deal with upper respiratory infections before they turn into pneumonia. Urgent care will charge $111, with the average ER bill coming to $486. If you're experiencing severe difficulties breathing, however, check with an urgent care center to ascertain if you should go directly to an ER for treatment.

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So, given that price gouging is illegal for companies to inflate their prices in the event of an emergency, why are hospitals immune from such laws and regulations?

Given that health care in the US is part of the “social war” going on right now, I thought this to be an interesting topic to discuss. Especially since it’s getting into the dreaded cold and flu season, are the American people being gouged by our hospitals when our body is in a State of Emergency?
From the prices listed and compared, it would seem so. I'd understand if the cost was $50 or $75 higher, but hundreds? It seems quite unethical to me and reform is in order.

Thoughts?

Edit to Add:
I understand that going to the ER for superficial injuries and illnesses delays help for those who need care immeidately, but nothing says that the ER could simply instruct them to go to the Urgent Care Center. Many are located right beside hospitals.

I think much of the cost is to cover what they pay the ER docs. They will get doctors from out of county, state to come in and pay them Big money to cover the ER for the weekend or a few days when their regular ones can't. Even at a medium size hospital, I've been told a doctor can make 10 - 30,000 for a weekend.

reply to post by DAVID64


You've made an interesting point. I was under the impression that the ER doctors were there as part of their residency. I know several doctors from India come here to get experience because it's part of their requirements to have worked in the US, but I didn't think they were getting paid more.

Edit to Add: The reason I started this thread is because I got a post card in the mail today advertising the hospital's ER.
It states:
"When you need emergency medical care, the last thing you need is a long wait to be seen. In our Emergency Department, our goal is to take you directly to a bed where you can be evaluated by the doctor.
In fact, we've become so efficient we're wondering what to do with that big, empty waiting room... !"

I'm just stunned that the ER even needs to advertise.

reply to post by Afterthought



Some doctors, as a part of their residency, do have to do a ER rotation. But a dr who already has their own practice or is an ER doc already, can moonlight at other hospitals to make extra money.

reply to post by DAVID64

to make extra money

From the price comparisons I listed, mission accomplished!

One of the things I was brought to awareness of at the ER was that they do not have the ability to turn away anyone, no matter how silly the case is.
Meaning you have someone with a case of the sniffles being set next to a person who's had a major leg injury.
Not only does this cause major hold ups, but also strains resources, time, and doctors.
I sprained my ankle hopping a fence a few years back, and my mum took me to the ER.

Now, I know how to care for sprains, I've received advanced first aid training.
And it was just a mild sprain, but my mom dragged me to the ER to be treated.
Waist of time, the nurse and I both agreed it was a mild sprain that'd be healed up within a week, and the bill was 200 bucks.

Due to lawsuts, they are no longer able to tell people to go back to see their GP, instead they have to treat them there in the ER.
This definitely drives up the costs to go to the emergency room.


I personally visit a 40 $ clinic up the road from me now if I need to see a doctor. Guy's from India and loves insulting the way the hospital system is set up here in the States.

reply to post by Afterthought



In a way, I can understand. You go to school for years and years, study your butt off, work 30 hour shifts with occasional naps if you're lucky and up to your elbows in blood and guts. Then you have to pay off a couple hundred thousand in student loans. I would want to be well paid for my effort too.

I recently went to a "doc in the box" that is associated to our local hospital, complaining of back pain. I peed in a cup so they could make sure I didn't have an infection or anything.

I was stunned when I got a statement from BCBS (our insurance company) seeing that the test was initially $4000 something. But BCBS was only charged somewhere between $200 and $300. All I could think was "thank goodness we have insurance or we would have been stuck with a $4000 bill."

There is definitely price gouging going on in this field.

reply to post by RuneSpider


Yes, there certainly is the instance when Mr. Sniffles Crybaby goes to the ER and can't be turned away, but he still shouldn't expect to be seen before Mr. Leg Fallingoff.

One thing I find peculiar is that my parents take their dog to an emergency vet for his typical appointments because they're open 24 hours and it's easier for my parents to go at odd times due to their work schedules.
Sure, they've sat in there for three hours before waiting until the emergency cases to be taken care of, but the prices are actually the same, and in some cases, lower than a regular vet's office.
If veternary clinics can do this, why not human hospitals?

The OP raises a good point and I think it deserves consideration. Urgent care facilities seem to have sprung up as a free market response to outrageous costs in ER visits. Often it is very difficult to get an appointment with a primary doctor the same day as is needed. Even more outrageous is that if you are sick at some companies it requires a doctors note to be excused from work. So I have to pay someone $60 to write me a note stating I am sick, after I just lost my wage for the day by being sick.

Even so, it should be entirely possible for an Emergency room to staff appropriately without gouging people in need. There is no reason the Emergency room cannot staff a few general doctors to see non emergency issues and charge accordingly. If the emergency room knows they cannot turn anyone away it does not mean they cannot route persons with needs that constitute non emergency issues to a doctor in the emergency room that is there specifically for that purpose. Perhaps, because many hospitals are for profit, a design such as this is actually counter to making money. Why change a business structure to adapt to the needs of the population, if you can justify charging higher prices by not changing it? It seems to me that this is an example of why all health care facilities should be ran as not-for-profit entities.

reply to post by angrymomma


Dang! That's one really expensive test!
Did they tell you the price ahead of time? You're lucky that the insurance company didn't kick it back. They're another one that has way too much power when it comes to what you pay and when they'll pay.
I mean, even at an auto garage, they have to tell you how much it will be up front. What a shock it must've been to see the bill!
If it was me (since I don't have insurance), I'd have been right back in the ER with a heart attack.

Don't forget the unnecessary tests that are sometimes ordered.

Last year I went to the ER b/c a medicine I was prescribed for migraines started making me lose my sight over the course of a couple of hours (I got better ). Instead of doing a simple pressure exam, that the on call eye doctor told him to first, (that consists of blowing a tiny puff of air into your eyes to check pressure) the first thing the doctor did was give me a spinal tap.

Let's not mention the fact that I am terrified of needles and the nurse had to keep reminding me to breath or I'd hyperventilate. But really, a spinal tap FIRST?

reply to post by Afterthought


Oh no, they never tell us the price of tests. We just pay the $35 copay and find out a couple weeks later that the insurance covered it (via statement). But we hear from Dr. offices within 2 days to find out if the bill can't be covered. THEN we find out what the price is.

reply to post by angrymomma


Sounds like you went to one of those Nazi experimentation hospitals!
Maybe hospitals have to fill a spinal tap quota like cops and speeding tickets?

Sorry to hear you had to go through such a painful test that was ultimately unnecessary. This kind of stuff should never be acceptable. Then, again, there's always Dr. House ....

reply to post by Afterthought


Usually the personal with a medical emergency gets seen first. But the simple glut of people causes the ER to back up. I've been waiting there for twelve hours when my friend was there due to repeatedly collapsing due to bad migraines.
I nearly had my appendix pop while waiting in a ER, due to the sheer number of folks and the relatively minor symptoms I was showing at the time.

Personally, I see the cost as partially a deterrent, a method to keep people out of ER who don't need to be there.

As a programmer for a claim payer I can say there is a terrible amount of fraud and waste. For example, when we receive claims, we need to run each one through:

1.) fraud detection
2.) repricing

In 1, the doctors add as many 'procedures' as they can to the 837, and we re-bundle/re-ject as many as we can. They have software to 'hide' additional codes in the 837, and we have software to detect these and reject them. It's an arms race.

In 2 the billed amount of the claim is reduced by up to 90% before we pay depending on the specifics of the provider network. The customer needs to pay 100%, but the insurance company pays a very small percentage of this.

It's the stupidest way to pay claims anyone could imagine. It is full of waste, fraud and inefficiency.

It's really sad what they do. I'm thankful we have insurance too. My son was really sick with strep last month. I had to take him to the ER. We were maybe there for 45 minutes total. I got the statement. $1800!!!! Plus $20 for the teaspoon of motrin they gave him.

reply to post by GalacticJoe


Thanks for dropping in to show the other side of the coin.
There should be some way that people can be seen more efficiently without having to declare bankruptcy after everything is said and done, or as another poster stated, dying on the floor because your symptoms don't appear as bad as the guy who's gushing blood. Internal chaos is hard to detect sometimes before it's too late.

Price is certainly a deterrant, but it's too bad that hospitals can't combine themselves with urgent care centers so help be more more cost effective and efficient.

I've had several trips to the ER and a hospital stay recently. What I noticed was that when I was in a room, everything in that room that was disposable and individually wrapped was charged to me whether it was used to treat me or not. As I was leaving, stickers with my name were put on every supply tray and drawer.

I think it's totally jacked up! It's straight up profiteering.

reply to post by kosmicjack


Ah, yes! The double dip.
Good point.

On another note, what if ERs charged soemthing akin to a "Non Emergency Fee"?
If you've been treated for something that could've waited, you have to pay an extra $100, while everyone who was there as their only option besides dying was charged at the going rate. It would be like a penalty fee, but seen more as the person who wanted valet service when they could've parked and walked.