Maybe this will flush Eki out- $143K Hospital Bill Shocks Snake Bite Victem

**Mr Alca-Tazizzle** · 11th Jun 12, 21:40

SAN DIEGO -- A UC San Diego exchange student who is facing a $143,989 hospital bill for treatment after he was bitten by a rattlesnake spoke with 10News on Tuesday.
"My jaw was dropping down," said Dag-Are Trydal, as he described his reaction to the medical bill for treatment after he was bitten by a rattlesnake.

Trydal's bill made headlines in Norway, where his insurance provider was quoted as saying the charges from Scripps La Jolla Hospital were the highest they had ever seen.
Trydal, an exchange student studying cybernetics at UCSD, was walking to his car on April 26 when he felt a sharp pain in his foot.
"I stepped two steps back just immediately and I was seeing that a snake was sitting right between my flip flops," he told 10News reporter Allison Ash. "I was really scared, because I don't know much about the snakes here and how dangerous they are,"

It is a good Idea to have snake awareness in San Diego. In Sping They just come out into the open and sun to raise their blood temperature. If you step right on one their is a fair chance youwill be bitten.

When a passerby told him Scripps Hospital was right across the street, he decided to walk there.
"As I was walking over, my heart started thumping and I could feel a tingling in my body and a metallic taste in my mouth," he said.
Trydal was admitted to the hospital and given four doses of antivenom over a 24-hour period. He was thrilled that the treatment worked and he could get back to his studies, until he heard from his insurance companyThat was when Trydal learned what his visit to the hospital cost: $143,989. He was shocked.
"I thought maybe $10,000," he said, noting that if he'd had the same treatment back home in Norway "it would have been free."

Y'awl boys have many venomous snakes in Norway?

Trydal agreed to let the hospital release a copy of the bill to 10News. In it there are two separate charges for antivenin croatalidfab. The first charge is for $102,440 and the second is for $25,610. That is a total of $128,050.
"This is way too much, at least for a person that doesn't have good insurance," he said.
Trydal admitted he was glad he bought an insurance policy to cover him during his six months in the United States. When asked what would happen if he had not, Trydal responded, "That would be very, very bad. I try not to think about that."
A spokesperson for Scripps told 10News the antivenom is expensive and issued this statement:

"First and most importantly, we are grateful for Mr. Trydal’s recovery. We have reviewed our billing practices in this case and find all charges to be accurate and appropriate.
The largest portion of the charges was for antivenom, a very costly life-saving drug manufactured from snake venom. The patient required 10 units of the antivenom and a night in the Intensive Care Unit, which provides around-the-clock direct nursing supervision...........

.

Although Trydal said he believes the healthcare system in the US is "wrong, he declined to be too critical, saying his treatment at Scripps La Jolla was "excellent."

Yes UCSD is cutting edge. At least he has that going for him.

$143K Hospital Bill Shocks Snake Bite Victim - San Diego News Story - KGTV San Diego
Health care is exspensive in California.

Thoughts?

**Alexamateo** · 12th Jun 12, 03:14

First, I am glad to read he had insurance. Second, it is typical of hospitals to charge like this, but they never expect to collect it. It is just the way the insurance game is played.

My wife had a baby last year, and this was typical of one of the bills:

Charge $16,353.10..............Insurance payments $4629.25.................Insurance Adjustments $10,566.54.................Due from Patient $1157.31

So the actual charge was 35% of the bill, and my out-of-pocket was 7% of the bill (20% of actual charge).

It has been my experience that the top-line charge has nothing to do with the actual charge. It was similar to when I used to install underground irrigation systems. I asked for a catalog of the different pipe fittings. My jaw dropped at the prices when I started to look at it. The salesman laughed and said "Oh,you have an 83% discount, and truthfully, everybody gets at least 75%." It was done in that case to confuse the issue and , make it so no one knew what everybody else was paying.

Medicine and Health Care are unfortunately doing the same thing. I am sure no one ever expects to collect $144,000 from this incident, it's a shock thing to make you end up saying "Oh,it ended up being only $45,000."

The only thing I would say to the boy from Norway is that in Norway, he may not have had to pay anything out-of-pocket, but it was most assuredly not be free.

My opinion of all this? I think it stinks, and the health care industry better get it's act together and not continue to shake down its patients, or the government will do it for them.

**Mr Alca-Tazizzle** · 12th Jun 12, 05:23

When I was in my early 40's I started training for a half marathon. I got to the point where I was running 9 miles at an accelerated pace. I'd always had an intermittent problem with chronic Bronchitis. After finishing on of these runs as I was cooling down I had a feeling in my esophagus sort of like post nasal drip in your throat. The next morning I was coughing up green "oysters". After a couple days I started feeling weak so I went to the urgent care at Grossmont Hospital. They informed me that I had Bi-lateral Pneumonia, and I'd be hanging out there for about a week so they could get me on the "big guns" (intravenous anti-biotics). I was in the hospital for 6 days. My tab was just under 30 large. My insurance took care of it, and I paid my $500.oo catastrophic hospitalization deductable. I know my insurance settled for less than 10 grand. That was about 15 years ago. Today that stay would be around 100 G I'm guessing. The system is skewed. You can get a name brand medication depending upon what it is for say $100.oo, the generic is probably $8.oo pharmaceutical companies play a big role in the bottom line. If they were the ones that did the research and devlopement I can almost understand it before it went generic. But their continues to be a big desparity after. WTF is up with that?

**Big Ben** · 12th Jun 12, 08:26

What would have happened if he had no insurance?

**Malbec** · 12th Jun 12, 09:08

Originally Posted by Dr Giacomo Rappaccini

Yes UCSD is cutting edge. At least he has that going for him.

$143K Hospital Bill Shocks Snake Bite Victim - San Diego News Story - KGTV San Diego
Health care is exspensive in California.

Thoughts?

If you're going to have a licenced drug that sees very little use then the per unit cost will be very very high. That drug wouldn't have been much cheaper than any other drug to develop and the R/D costs would have to be recouped somehow.

If you're also going to have a healthcare system that bills patients for the cost of their individual treatment then bills like this, while shocking, should be expected.

In Britain there are plans to send patients virtual invoices after their treatment to give them an idea how much it cost to treat them (these wouldn't have to be paid). I think thats a pretty good idea as most people don't know how much such things cost.

**Mr Alca-Tazizzle** · 12th Jun 12, 11:44

Originally Posted by Big Ben

What would have happened if he had no insurance?

Charities would kick in. When you are giving them information like the name of your insurance carrier they also ask what religion you be representin’, it is best to say you are Catholic. Catholic Family Charities kick in big dough. They would also send it to a collection agency for whatever balance is left. In the vast majority of those cases they realize they can’t squeeze blood out of a turnip, so you take a big hit on your credit rating. That is part of the reason health care insurance is so high here. But when you go to the emergency room in California they can't, and won't refuse to treat you. That is why most of the rest of the country say we are socialist's.
Tough sh!t.
If you don't have net assets in excess of $1,999.oo and you can prove it CMS County Medical Services will negociate the rest in San Diego.
If you are military or a veteran of it they have their own facilities, and you don't pay squat. That is another reason health care in the country in general is high

**Mr Alca-Tazizzle** · 12th Jun 12, 12:08

Originally Posted by Malbec

If you're going to have a licenced drug that sees very little use then the per unit cost will be very very high. That drug wouldn't have been much cheaper than any other drug to develop and the R/D costs would have to be recouped somehow.

If you're also going to have a healthcare system that bills patients for the cost of their individual treatment then bills like this, while shocking, should be expected.

In Britain there are plans to send patients virtual invoices after their treatment to give them an idea how much it cost to treat them (these wouldn't have to be paid). I think thats a pretty good idea as most people don't know how much such things cost.

That's your problem

**Dave B** · 12th Jun 12, 12:19

Originally Posted by Alexamateo

First, I am glad to read he had insurance. Second, it is typical of hospitals to charge like this, but they never expect to collect it. It is just the way the insurance game is played.
My wife had a baby last year, and this was typical of one of the bills:

Charge $16,353.10..............Insurance payments $4629.25.................Insurance Adjustments $10,566.54.................Due from Patient $1157.31

So the actual charge was 35% of the bill, and my out-of-pocket was 7% of the bill (20% of actual charge).

Wow. We had our baby in February and the hospital bill was a big fat zero at the point of delivery (no pun intended). I thought that's what tax was for.

**Malbec** · 12th Jun 12, 12:19

Originally Posted by Dr Giacomo Rappaccini

That was about 15 years ago. Today that stay would be around 100 G I'm guessing. The system is skewed. You can get a name brand medication depending upon what it is for say $100.oo, the generic is probably $8.oo pharmaceutical companies play a big role in the bottom line. If they were the ones that did the research and devlopement I can almost understand it before it went generic. But their continues to be a big desparity after. WTF is up with that?

Chances are that the antibiotics you had 15 years ago were out of patent too since first and secondline antibiotics haven't changed much in a long time, even IV. Its only multidrug resistant infections that get newer drugs under patent.

Most drug companies do reduce their prices considerably once generic rivals come onto the market, otherwise they'd lose market share. However they do then offer a slightly different version of the patented drug, again under patent to retain profitability. For instance if antibiotic X should be taken 4 times a day then you might find that the drug company offers a long lasting one-a-day version just before the patent on the old drug expires. The new one-a-day version however will be under patent and will therefore be quite expensive compared to the now generic four-a-day predecessor.

If your hospital was giving you a generic but charging for an inflated branded price then of course that would be fraud. But then again you guys across the pond get ripped off left right and centre by the pharm companies so it wouldn't surprise me if there was something else going on.

BTW as the pharm companies see their future profitability worsening every year I'd expect more desperation from them in years to come.

**odykas** · 12th Jun 12, 12:27

SAN DIEGO -- A UC San Diego exchange student who is facing a $143,989 hospital bill for treatment after he was bitten by a rattlesnake spoke with 10News on Tuesday.

That it just outrageous.
What would the expected bill be like, in case a serious operation was necessary?
$1M for appendix removal operation?

**Mr Alca-Tazizzle** · 12th Jun 12, 12:44

Originally Posted by Malbec

Chances are that the antibiotics you had 15 years ago were out of patent too since first and secondline antibiotics haven't changed much in a long time, even IV. Its only multidrug resistant infections that get newer drugs under patent.

Most drug companies do reduce their prices considerably once generic rivals come onto the market, otherwise they'd lose market share. However they do then offer a slightly different version of the patented drug, again under patent to retain profitability. For instance if antibiotic X should be taken 4 times a day then you might find that the drug company offers a long lasting one-a-day version just before the patent on the old drug expires. The new one-a-day version however will be under patent and will therefore be quite expensive compared to the now generic four-a-day predecessor.

If your hospital was giving you a generic but charging for an inflated branded price then of course that would be fraud. But then again you guys across the pond get ripped off left right and centre by the pharm companies so it wouldn't surprise me if there was something else going on.

BTW as the pharm companies see their future profitability worsening every year I'd expect more desperation from them in years to come.

Oh yes I also had a Bronchoscopy

**Mr Alca-Tazizzle** · 12th Jun 12, 13:16

Originally Posted by malbec

Chances are that the antibiotics you had 15 years ago were out of patent too since first and secondline antibiotics haven't changed much in a long time, even IV. Its only multidrug resistant infections that get newer drugs under patent.

Most drug companies do reduce their prices considerably once generic rivals come onto the market, otherwise they'd lose market share. However they do then offer a slightly different version of the patented drug, again under patent to retain profitability. For instance if antibiotic X should be taken 4 times a day then you might find that the drug company offers a long lasting one-a-day version just before the patent on the old drug expires. The new one-a-day version however will be under patent and will therefore be quite expensive compared to the now generic four-a-day predecessor.

If your hospital was giving you a generic but charging for an inflated branded price then of course that would be fraud. But then again you guys across the pond get ripped off left right and centre by the pharm companies so it wouldn't surprise me if there was something else going on.

BTW as the pharm companies see their future profitability worsening every year I'd expect more desperation from them in years to come.

Originally Posted by Dr Giacomo Rappaccini

Oh yes I also had a Bronchoscopy

Oh yes I also had a Bronchoscopy and no they were not giving me generics. I also was awaken by a Filipino nurse slapping the sh!t out of me in the middle of the night. She ejaculated: "why you blood pressure 85/45" to which I retorted "maybe because I'm sleeping"? The most obtuse charge on my bill was one tablet of Elavil "Amatryptaline" a multi use tricyclic that my osteopath had put me on to relax a lower back issue. It cost more than the liquid cocaine (a 7% solution) they used as a local they poured down one nostril when they snaked the camera down my nose with a tiny alligator snipper on it to see, and remove crystallized cucus

to loosen and extract from my lungs. That was about 15 minutes of gagging and dropping as low as 90% oxygen saturation which in a controlled environment is not too dangerous but typically you absorb over 99+% with normal lung function. I'm not exactly sure how that is calculated.

**Malbec** · 12th Jun 12, 14:41

Originally Posted by Dr Giacomo Rappaccini

Oh yes I also had a Bronchoscopy and no they were not giving me generics. I also was awaken by a Filipino nurse slapping the sh!t out of me in the middle of the night. She ejaculated: "why you blood pressure 85/45" to which I retorted "maybe because I'm sleeping"? The most obtuse charge on my bill was one tablet of Elavil "Amatryptaline" a multi use tricyclic that my osteopath had put me on to relax a lower back issue. It cost more than the liquid cocaine (a 7% solution) they used as a local they poured down one nostril when they snaked the camera down my nose with a tiny alligator snipper on it to see, and remove crystallized cucus

to loosen and extract from my lungs. That was about 15 minutes of gagging and dropping as low as 90% oxygen saturation which in a controlled environment is not too dangerous but typically you absorb over 99+% with normal lung function. I'm not exactly sure how that is calculated.

How do you know they weren't giving you generics? The drug name (not the marketing name but the pharmaceutical name) on the side of the bottle or bag would be the same for a generic and patented drug.

I'm not surprised the nurse woke you up. A diastolic blood pressure that low (whilst maybe being utterly normal for you) would require further investigation to make sure you weren't going into shock and since you describe yourself as having a significant infection at that time septic shock would have been a concern. She would have been negligent had she not woken you up and investigated further.

I don't understand why the charge for amitryptiline is obtuse. If it was an ongoing prescription that you were on prior to admission they'd carry on giving it to you unless it interfered with your treatment. Was there a reason for them not to have?

I'm surprised they used cocaine because for procedures such as a bronchoscopy it has been superceded by bupivacaine and other local anaesthetics, even 15 years ago. Pharmaceutical cocaine and morphine are much MUCH less costly than their street equivalents and are actually pretty cheap. Both are 'historical' drugs with no R/D costs to recoup and the actual cost of growing and refining the drugs is not expensive if given legal cover, the pharm companies don't have to worry about confiscated shipments, buying off officials and all the other paraphenalia that comes with illegal drug supply.

**Rudy Tamasz** · 12th Jun 12, 15:39

Originally Posted by Alexamateo

My opinion of all this? I think it stinks, and the health care industry better get it's act together and not continue to shake down its patients, or the government will do it for them.

Just tell 'em so and make sure they listen.

**Mr Alca-Tazizzle** · 12th Jun 12, 15:53

@maybec. My bill said Elavil on it that is how I know. My referance to generics was about just going to the pharmacy for medicine in general, it had nothing to do with that trip. A hospital is not going to give you an itemized bill that said Elavil and give you the generic, plus it said Elavil on the tablet. Is that enough evidence for you? I got 5 Elavil while at the hospital and it came to 25 dollars and something. It was a long time ago. The Cocaine was $20 and something. I don't go to the pharmacy and pay that kind of money for that med. It was only 10 milligrams and I think my script was for 20 and that was less than 5 bucks generic at the pharmacy. So you can quit with your obsessive conspiracy theory

**schmenke** · 12th Jun 12, 16:26

Originally Posted by Dave B

Wow. We had our baby in February and the hospital bill was a big fat zero at the point of delivery (no pun intended). ....

The only out-of-pocket hospital costs we incurred during the birth of each of our kids was the daily parking fee. And I moaned about that

**Malbec** · 12th Jun 12, 16:35

Originally Posted by Dr Giacomo Rappaccini

@maybec. My bill said Elavil on it that is how I know. My referance to generics was about just going to the pharmacy for medicine in general, it had nothing to do with that trip. A hospital is not going to give you an itemized bill that said Elavil and give you the generic, plus it said Elavil on the tablet. Is that enough evidence for you? I got 5 Elavil while at the hospital and it came to 25 dollars and something. It was a long time ago. The Cocaine was $20 and something. I don't go to the pharmacy and pay that kind of money for that med. It was only 10 milligrams and I think my script was for 20 and that was less than 5 bucks generic at the pharmacy. So you can quit with your obsessive conspiracy theory

Sorry but I don't buy into conspiracies. I'm trying to clarify what you're talking about because it sounds as if you didn't understand how/why certain things were done to you. From your post it seemed as if you were claiming that your IV antibiotics were/weren't generic.

Elavil is merely a brand name for amitryptiline. Amitryptiline is the pharmaceutical name, you can buy this from several different manufacturers who will all stamp a different name on the tablet of which elavil is one. This isn't obtuse but I agree that the difference between the pharmaceutical name and the marketing name is confusing.

Just to clarify elavil IS a generic medication as the patent on amitryptiline ran out some time in pre-history.

**Malbec** · 12th Jun 12, 16:36

Originally Posted by schmenke

The only out-of-pocket hospital costs we incurred during the birth of each of our kids was the daily parking fee. And I moaned about that

Ditto. I've always wondered if people in the US and elsewhere where they pay for delivery are put off having kids because of it.

**Mr Alca-Tazizzle** · 12th Jun 12, 17:02

Originally Posted by Malbec

Sorry but I don't buy into conspiracies. I'm trying to clarify what you're talking about because it sounds as if you didn't understand how/why certain things were done to you. From your post it seemed as if you were claiming that your IV antibiotics were/weren't generic.

Elavil is merely a brand name for amitryptiline. Amitryptiline is the pharmaceutical name, you can buy this from several different manufacturers who will all stamp a different name on the tablet of which elavil is one. This isn't obtuse but I agree that the difference between the pharmaceutical name and the marketing name is confusing.

Just to clarify elavil IS a generic medication as the patent on amitryptiline ran out some time in pre-history.

No Sh!t, I'm only 58 years old I know my way around pharmaceuticals You just can't tell when I'm being facetious, with the fake cowboy/ redneck expressions. I will say this though, at the time I told a friend that they gave me cocaine for a local and he told me no way. I showed him my itemized bill and he ate crow. I played sports at a highly competitive level until the second time I tore the same hamstring after 6 months of rehab. I could have gone to a top shelf sports medicine facility, as I had a tear so big you could almost put a tennis ball inside it. However that is elective surgery and unless you are professional making big buck you live with it, and try not to exacerbate it, and all the peripheral effect it has like making my lower back more susceptible to acute episodes That was when I was 44 over the course of time it has regenerated to a small divit, with no doubt a healthy portion of scar tissue.
BTW I have a bottle of amatriptyline sitting in front of me right now. You know what it says here in the "home of the brave"

Amitrptyline sub for Elavil
ssssssssssssssaaaaaanap for the win

**Malbec** · 12th Jun 12, 17:14

Originally Posted by Dr Giacomo Rappaccini

No Sh!t, I'm only 58 years old I know my way around pharmaceuticals You just can't tell when I'm being facetious, with the fake cowboy/ redneck expressions. I will say this though, at the time I told a friend that they gave me cocaine for a local and he told me no way. I showed him my itemized bill and he ate crow. I played sports at a highly competitive level until the second time I tore the same hamstring after 6 months of rehab. I could have gone to a top shelf sports medicine facility, as I had a tear so big you could almost put a tennis ball inside it. However that is elective surgery and unless you are professional making big buck you live with it, and try not to exacerbate it, and all the peripheral effect it has like making my lower back more susceptible to acute episodes

I'm not posting here to insult you but what you're saying doesn't make sense.

You said yourself you were prescribed Elavil and that you weren't palmed off with a generic drug:

Originally Posted by Dr Giacomo Rappaccini

A hospital is not going to give you an itemized bill that said Elavil and give you the generic, plus it said Elavil on the tablet. Is that enough evidence for you?

Elavil IS a generic drug. The patent on amitryptiline ran out in the mid-70s.

I suspect the root problem here is that there are crossed wires. For me, a generic drug is any drug that is not still under patent. Most bread and butter drugs ARE generic.

Elavil may be marketed by Merck, the company that developed the drug back in the '50s but the medication would be produced VERY cheaply by ACME corp somewhere in India/China with the same supplier producing the drug for several different companies, ie once you get beyond the title on the packet it is a generic.