$1300 Nose Bleed

I received the following E-mail this morning on another blog:

"Where is Wyoming on your list. It is a state in the USA. Our local
hospital, Wyoming Medical Center here in Casper Wyoming, is so greedy
about their charges and will not tell you what they charg before
you have your visit. Emergency care for a simple nose bleed wes $1,300.00
Why are they allowed to get away with this.
How do you make the greedy companies tell you what their charges are
BEFORE you agree to have care when it is not a life or death situation. If
I had been informed how much it was going to cost I would have refused the service.
HELP"

The sender did not leave an E-mail address to reply, so I thought I'd reply here.

First things first: $1300 for a "simple nosebleed" is outrageous.

Second things first: going to the emergency room for "a simple nose bleed" is outrageous.

What to do? Call the billing department, make them an offer. But bear in mind you elected to use highly specialised services of a very expensive health care facility.

I had a lot of nose bleeds as a kid. Spontaneous ones, they would just start happening. The remedy cost less than a cent and involved tearing one tissue into two, plugging my nostrils and tilting my head back. Occasionally, I would pinch the bridge of my nose (as instructed) but it didn't really seem to do anything.

When did it become acceptable to go to the ER for a nose bleed? This is half the problem, this is what drives costs up. I don't have nearly enough information to figure out how serious the author thought the situation was, maybe it was the first time it had ever happened and he or she thought their brains were going to fall out, but I'm going to go out on a limb and say no, it was a simple nose bleed.

I feel really bad for the author that they are now stuck with a ridiculous bill. I would absolutely call the hospital and offer them $500 and a payment plan. I agree wholeheartedly that pricing needs to be more upfront. In the absence of hospitals doing this, we're working as hard as we can to publicise as many prices as we can. You can browse pricing at OutOfPocket.com where you'll notice I have a similarly-priced ER visit, for which the insurance paid less than $500.

But I would also counsel that next time you have a nosebleed, tilt your head back lean your head forward (1970s Welsh national health advice aside, apparently the thing to do is lean *forward*, thanks Kenneth!). Visiting the ER for a nosebleed is like going to the car dealer for a flat tire. They'll do pretty much the same thing as the guy on the corner, but charge you ten times as much.

As long as this country refuses to have a public option, you are consuming health care in a free market economy, with all the trappings that come with that. The ER is not your local clinic. But as long as you treat it like one, they will be happy to bill you.‎