An expensive ER bill

People know that visits to emergency rooms can be expensive, but KFF Health News detailed the interactions within one particular visit and the associated cost. The patient understandably felt that "Paying $3,100.24 for literally sitting in the ER entertaining my kids for an hour and a half feels kind of incredible." (The patient's insurance covered more than that amount, with the total billed amount as over $6,700). On the other hand, it is unclear what the visit should have been priced at.

A big part of the problem is that emergency rooms are... for emergencies, meaning that they must be staffed for what might happen, not what will happen. With salaries of medical professionals being as high as they are, it is understandable that ER visits would need to cover the unused capacity and would therefore cost more than what a member of the general public might expect. There is also the element of the hospital being compensated for specific knowledge rather than actual work (a matter of "knowing where to hit the hammer").

At the same time, it appears that the patient received very little "active care" from the hospital (the patient spoke to the doctor "for no more than five minutes"). Additionally, it appears that the patient might not have been charged more even if she required some more medical attention than simply being monitored, although it seems likely that in that case, the hospital would have found new billing codes to apply. With visits so unpredictably expensive, it is not difficult to imagine patients trying to avoid the emergency room, which is probably not in the public interest.

Perhaps an alternative billing structure would be for the insurance plans of nearby patients to pay a fixed monthly fee per patient to sustain the emergency room. Emergency rooms would then have more steady revenue, and patients could then be charged less for each visit. Patients with non-participating insurance plans would be charged substantially more. Practically, such an arrangement could introduce some complexities in terms of how insurers would determine which emergency rooms to support for their patients. While this arrangement is probably better for patients, it is unclear how insurers would regard such a proposal.