US man with hospital bill of $153,000 from rattlesnake bite in American health care – Todd Fassler

July 21, 2015 9:32 am

 

The man has been left with a massive hospital bill following the snake bite.

Earlier this month a guy named Todd Fassler was bitten by a rattlesnake in San Diego, KGTV San Diego
reports. In itself this isn’t terribly unusual-the CDC estimates that
roughly 7,000 to 8,000 people a year get bit by a venomous snake in the
U.S. And somewhere between five and six people die from these bites each
year.
What raised eyebrows, though, was Fassler’s hospital
bill-all $153,000 (NZ$232,000) of it. KGTV reporter Dan Haggerty shared
it on Twitter. Take a look.

It’s not clear whether Fassler has insurance-and whether
these are dollar amounts that he will in fact have to pay out of pocket.
But the confusion over health care pricing is common for Americans who
receive bills and can’t be sure where the numbers come from. I reached
out to Fassler for comment but he wasn’t immediately available.
Here’s
what we do know based on that photo: The bulk of his hospital
bill-$83,000 (NZ$126,000) of it- is due to pharmacy charges.
Specifically, charges for the antivenin used to treat the bite. KGTV
reports that Fassler depleted the antivenin supplies at two local
hospitals during his five-day visit. Nobody expects antivenin to be
cheap. But $83,000?
There’s currently only one
commercially-available antivenin for treating venomous snakebites in the
U.S. – CroFab, manufactured by U.K.-based BTG plc. And with a stable
market of 7,000 to 8,000 snakebite victims per year and no competitors,
business is pretty good. BTG’s latest annual report shows CroFab sales
topped out at close to $63 million British pounds (NZ$149 million), or
$98 million dollars last fiscal year. The antivenin costs hospitals
roughly $2,300 (NZ$3,500) per vial, according to Bloomberg, with a
typical dose requiring four to six vials. In some cases multiple doses
are needed, according to CroFab’s promotional website.
BTG has
fought aggressively to keep competitors off the market. A competing
product, Anavip, just received FDA approval this year and likely won’t
be on the market until late 2018. This lack of competition is one reason
why snakebite treatments rack up such huge hospital bills – $55,000.
$89,000. $143,000. (NZ$83,000. NZ$135,000. NZ$217,000) In May of this
year, a snakebit Missouri man died after refusing to seek medical care,
saying he couldn’t afford the bill.
But the other reason why
hospitals charge so much is the byzantine negotiating process that
happens between hospitals and insurance companies to determine the final
payout amount. In the case of the $143,000 (NZ$217,000) snakebite in
2012, for instance, Scripps Hospital in San Diego explained that “it is
important to understand that these charges are not reflective of what
Scripps will be paid. At this time, the patient’s insurance company has
not yet paid the bill, and Scripps is in negotiations with the company
for the final amount.”
In many cases a hospital bill isn’t
actually a bill, but essentially an instrument in a complex negotiation
between insurers and caregivers, with bewildered patients stuck in the
middle. It’s difficult to know which charges are real and which ones
aren’t, and which bills to pay and which ones to ignore. It’s one reason
why medical debt is a huge factor in so many bankruptcies.
Hospital
bills that amount to legal fictions certainly don’t help consumers keep
themselves out of debt trouble. Todd Fassler’s bill is a perfect
example – he left the hospital on July 9, 2015. His bill said his
$153,000 (NZ$232,000) payment was due by July 27.

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