The $1,300 finger and other lessons about the cost of health care

Sticker shock sent Carolyn Houghton on a mission after she received bills totaling $1,274.32 for three stitches in her right index finger at a local emergency department.

She had health insurance that ended up covering most of the bill, but she still wondered, Why so much? "I figured it should cost around $350, tops." Instead, she received a hospital bill for $775 and thought that was it, until another bill arrived, this one from the emergency room physician. It was $499. The doctor spent a half hour, tops, working on her finger, Houghton said. "I don’t care how many years he went to college and how high his malpractice insurance is, he’s not worth $1,000 an hour," she said.

Houghton may be among a minority of patients who question their bills and pursue items that just don’t look right. Health insurers encourage patients to study their bills and call the insurers with questions.

Here is Houghton’s story, along with tips from Mike Frith, director of business services at Saint Alphonsus Regional Medical Center, aimed at keeping medical bills that can accumulate in a few hours from tanking your budget for years.

Houghton, 54, was loading steel beams into her van to take to a Boise recycling center in June when she accidentally crushed her right index finger between two of the 70-pound beams. "It was bleeding, and I wasn’t sure how severe it was," she said. She got help patching the injured finger with a towel and some masking tape but decided to go to the emergency room at Saint Al’s, the nearest hospital. Her Blue Cross of Idaho health insurance paid for $400 in emergency care without any deductible or copay.

"I figured that would cover most if not all of it," she said. Later, Houghton learned that she also would have qualified for the $400 benefit if she had gone to a minor-emergency clinic, and the care would have been cheaper.

Still, her Blue Cross of Idaho health insurance paid a good bit of the bill, and her pleasant insistence that the hospital explain why she was charged so much in the first place resulted in the hospital knocking $200 off the bill, Houghton said.

Frith, of Saint Alphonsus, said that once in a while the hospital adjusts a bill downward after reviewing it, but he could not talk about the specifics of Houghton’s case because of patient confidentiality rules.

In the end, Houghton owed just $303 of her own money as her "out-of-pocket" share of the bill.
Houghton, who gathers recyclables for a living, figures her income is low enough to qualify for Medicaid, the public health-insurance plan for people with low incomes, but she won’t accept it.

Instead, she pays Blue Cross about $300 a month for a policy that has a $5,000 deductible and covers 100 percent of medical bills after that.

"I refuse to go through life with no health insurance," she said. "I don’t care how high it is, it’s not right to make somebody else pay for your health care."