Would it be wise for many hospitals to replace saline with balanced fluids for hospitalized patients? It appears so. Doing such a move might significantly reduce mortality and morbidity, according to Vanderbilt University Medical Center's Matthew W. Semler during a presentation at the annual meeting of the Society of Critical Care Medicine.
The study involved 28,000 patients at Vanderbilt University who were given either saline-based IV bags or balanced fluid variants. They found that for every 100 patients on balanced fluids, there was one fewer death or critical kidney damage. Yes, 1 percent doesn't seem a dramatic reduction — but when viewed at a grander scale, that could mean up to 70,000 fewer deaths and 100,000 fewer incidents of kidney problems annually in the United States.
(Score: 4, Interesting) by bzipitidoo on Thursday March 01 2018, @05:35AM (1 child)
Don't be too sure that the price of a bag of saline solution includes the labor. But even if it did, it's still outrageously high. It's often over $300. ERs also like to throw in this so called facility fee, which might be to cover labor, but no one can really say for sure. Medical pricing in the US is so messed up and corrupt that no one, not even the health insurers, can explain it.
3 years ago, I went to the ER 3 times, and received a bag of saline solution each visit, for $306 each. Then it got weird. Health insurance reduced the price of the 1st bag to $151, the 2nd bag to $64, and the 3rd bag to $27. WTF?! Shouldn't the same item cost the same each time? Took me a year to learn what I think is the correct reason. Wasted a lot of time arguing with health insurance call center flunkies. About half of them admitted they couldn't explain it. The others pulled explanations out of the air. One thought it was because ER service on the weekend is more expensive. Nope, the $151 was a Thursday, and the $64 was a Saturday. Another thought different drugs must have been added to the saline solution. Nope, nothing was added that way, and if any had been, they would have been separate line items, not bundled into the price of the saline solution. Still another tried to tell me the line items were meaningless and the real prices were set in a secret agreement between the health insurer and the ER that neither I nor he would be allowed to examine. Finally I learned that the prices of the line items are set by the level of ER care (1 through 5) they assign patients. At level 4, the bag is $151, and at level 3 it is $64. So how come the health insurer couldn't tell me that? I also learned from a medical billing advocate that at level 4, the bag is included in the facility fee, so that $151 was them trying to double bill me for that item. As if their rates aren't high enough, they just have to cheat too. Wow. It's obvious the excessive complexity serves to hide crap like that. Anyway, I decided the whole thing was academic, and I told them I did not agree with their pricing schemes, whatever the reasoning was, and refused to pay their prices. I paid them the Medicare rates of about $2 per bag.
By then, they'd long since turned it over to debt collectors. I wasted time trying to explain matters to the debt collectors before I figured out they don't give a crap, they only want the money. Finally told them I would not pay and to never call me again. In hindsight, I should have told them that much sooner. There's not much they can do about it, now that medical debt doesn't much count against your credit rating any more. They could try to sue, but that's very expensive and might backfire on them by exposing their racket, so they won't, not for a few thousand. I really think good citizens need to pressure the medical community much more, by refusing to pay their ridiculous rates, if we are ever to see serious reform in the cost of health care in the US.
Wouldn't surprise me if the price of this new IV liquid is set to at least double what they charge for the saline. Because it's new tech, you know.
(Score: 2) by VLM on Thursday March 01 2018, @09:34PM
I had a girlfriend who had the same experience with a broken arm over about $1000 oh probably a quarter century ago. With medical inflation since then that's probably around $20000 now for the same xray and cast. She claims to have said something like "Well, I don't have any money so you're not getting any money and the debt will fall off my credit report years before I ever get any money or need a loan anyway, so don't bother me anymore" and it worked.