Catch 22, 23 and 24

As trips to the hospital go, this one was pretty good, but it revealed a disturbing problem with America’s health care system.

My wife’s condition is treatable. The hospital was hospitable — everyone was friendly and responsive. Doctors, nurses, assistants and orderlies were all professional, able and empathetic. Even the food was pretty good. All in all it was a good experience if you have to be in a hospital.

Now it’s time to leave. There was a catch. In Joseph Heller’s World War II novel "Catch 22," if you were insane, you would not have to fly dangerous missions, but there was a catch. If you applied for an insanity evaluation to avoid dangerous missions, it proved you were sane. Therefore you could never be grounded for insanity. This was Catch 22.

In the hospital, my wife could check out, but only if she had her medication. No pharmacy in Medford had the medication and could not get it for two days, so in essence my wife could not check out. We called this Catch 23.

The hospital provided the medication at Medicare’s expense while my wife was in the hospital. The hospital would sell us the medication on checkout, but the hospital’s price then would be $800 per day, $1,600 for the two-day supply until we could get the medication from a pharmacy. This was Catch 24.

The hospital would let her check out, but the hospital’s price for the medication was prohibitive, so she could not check out.

Finally we found that Walgreens in Grants Pass had the medication — one month’s supply with an online coupon was $175. My wife checked out of the hospital, and we drove to Grants Pass. The co-pay on her one month’s supply was $99. We saved more than $1,500 by making the trip and had a nice lunch beside the Rogue River, as well.

Why was the hospital’s price for the medication 133 times more than Walgreens' price? Medicare obviously did not pay that price. The hospital’s very nice pharmacist could not explain the price. Stephen Brill’s in-depth analysis of health care costs in the February 2013 issue of Time magazine and in his later best-selling book placed part of the blame for high health care costs on the fact that hospitals use an opaque “chargemaster,” an internal price list for goods and services that bears no relation to the hospitals’ costs for them.

Are hospitals still using this “chargemaster,” and if so, why? Can’t we do better than this?

— David Beale lives in Medford.

Share This Story