“Would you like the $9,400 CT scan or the $450 CT scan?”

“Would you like the $9,400 CT scan or the $450 CT scan?”

     We’re not all careful. Some of us ride motorcycles on the highway,… recklessly. A nephew ended up at a Level I trauma center in Houston, Texas, in March of 2016 as a result. He was patched up and lived to ride another day. Ten months later, his dad gets the final itemized hospital bill. As doctors in the family, my wife and I opine on medical matters with some frequency. The dad texted us a picture of the bill. As you are sure to expect, the charges were for ridiculous amounts that no one really pays. Most people probably think that these matters just get handled somehow, somewhere, between insurance companies and hospitals, then the patient pays some reduced amount of that massive charge, bewildered but happy to walk away still financially solvent after the threat of a bankrupting and indecipherable hospital bill. For most people, that vague understanding (and narrow fiscal escape) seem to be enough to be able to put the experience behind them. For others, though, we want to understand what the *expletive* is going on?!

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