Blood from a Stone: Happiness and an $838 blood test

My dental hygienist recently noticed that my normally low blood pressure had spiked so she encouraged me to get a check up. I did. It was Flaubert who said that “in order to be happy one must be stupid, selfish, and in good health.” Was my last chance for happiness at risk?

A week later the doctor found nothing abnormal but ordered a battery of blood tests, just to be sure. The bill came this week: $838.20. Closer inspection revealed that, after an “insurance adjustment” for $593.33, I owed “only” $244.87.

I guess I should have been happy. But even that seemed rather high, so I called St. Luke’s to ask about it. Maybe they would have sympathy and lower the bill… or perhaps just accept the “adjustment” from Highmark as full payment.

The hospital official was adamant about my paying the whole thing despite my meek effort to negotiate a lower charge. They wanted full payment but they were willing to let me pay $20/month until it's paid off, with no finance charge. Which I concluded was pretty reasonable of them and was the best deal I was going to get.

But over $800 for blood tests still seemed outrageously high a charge so I went a stop further. I called Highmark, my insurance company, to ask what they thought about St. Luke’s charges. What I learned shocked me.

The official from Highmark explained to me that the insurance adjustment is never paid. St. Luke's only gets the $244.87 they charged me. There was no real $838 fee for analyzing my blood. So I asked Highmark what that $838.20 is doing on the bill. Why imply that is the charge when it really isn't? Highmark's answer: “That is what someone would be charged if they did not have insurance.”

What?!!! I responded. People without insurance are charged over three times more than people with insurance? That is, insured people are only charged about 30% of what uninsured people are charged. And uninsured people have to pay the full, inflated, amount. Yes, she assured me. “That's the way the system works.”

I guess, Flaubert to the contrary notwithstanding, I have little hope for happiness.