[tolk460]

Article mentions the bulk of the bill was a "trauma activation". This is an alert from the EMS units to the hospital that they are bringing a patient with indications of trauma requiring additional medical resources to be diverted. The reaction and resources differ per trauma facility. SFGH is a level 1 center [1]. There are better news sources that describe the trauma system within the context of this story.

My opinion based on limited information within the article is that the field EMS suspected a closed head injury. The trauma "doctors at the hospital quickly determined that baby Jeong Whan was fine". If the baby had an MRI instead of a medical exam by a team of specialists, the headline would lose some weight.

The fee is to staff ED specialists 24/7. I believe the better question is: "should we charge for resources that were used but stood down after initial assessment by the trauma team?" From the perspective of the EMS field, there are protocols that describe tbe patient condition, mechanism of injury and other indicators which dictate a trauma activation.

[1] https://en.m.wikipedia.org/wiki/Trauma_center#Level_I

[mc32]

Sorry but $15 grand for “Activating trauma protocol” which was then rescinded is ridiculous and an absurd amount. It’s bald robbery.

[taneq]

Just how many specialists were they keeping available, and how much do those specialists cost? Let's say five different preeminent medical professionals were needed to respond to that emergency. Let's say that it used an hour each of their time. That's still $1000 an hour, which is exorbitant regardless of your credentials.

And that's the most charitable evaluation. They "quickly determined that the baby was fine." So what did the hospital do, charge out the entire cost of running the ER to one unlucky family since they were the only case who was brought in that hour?

[riquito]

> If the baby had an MRI instead of a medical exam by a team of specialists, the headline would lose some weight.

How so? In my country (Italy) for an MRI I would pay from 42 USD to 81 USD, depending on my income.

Not saying that's its real cost since we pay taxes to grant this to everyone, but from here to 18k...

[rasz]

Bad comparison. Italy has far inferior health system, barely able to provide 2x better infant mortality rate at 1/3 the cost when compared to US. /sarcasm

[semerda]

MRI avg price is $2,611 in the US. Google it. A hospital once charged my insurance US$12,000 for a CT Scan through emergency. A CT scan costs $1K (avg based on resolution) in the US. When I pointed out the stupidity of this to my insurance (with public twitter shaming) they quickly decided to cover my copay. Robbery or what?

[ericd]

Any ideas on how to fix the healthcare market? The feedback loops seem to be totally broken, in more than one place. I've long wondered how they could be restored, short of government action to try to make things drastically more efficient. Unfortunately, there seem to be strong incentives for officials not to do anything, given that that inefficiency means that healthcare is a major, growing, and well distributed employer.

Improved price transparency might help, and would be a relatively easy thing to improve, but with most patients not being responsible for paying their own costs, I'm not very optimistic about that route.

[semerda]

"but with most patients not being responsible for paying" -- right there lays the answer and the problem. I thought about this a lot while doing my 1st healthcare startup in silicon valley and connected with many startups "disrupting healthcare through price transparency". 5 years later... None succeeded.

If one could incentivize every patient to upload their bills to an open source service that would crunch the data and spit it out anonymously online showcasing hospitals & services rendered + insurers et al.. then I think we might be on our way to true price transparency and a potential disruption in US healthcare.

[ericd]

I spent some time thinking about ways to incentivize patients to upload bills, you'd only need a very small fraction to get a representative sample of how much different services cost at different hospitals. I haven't come up with anything very motivating, except maybe the desire to expose how ridiculous some of them are.

[hudibras]

That's the whole point of the article, thanks.