It was your basic, run-of-the-mill accident. Kim Haselhoff's 9-year-old son got nipped in the finger by one of the family dogs. It didn't seem too serious, but there was a bit of blood.
Unfortunately, the pediatrician's office had just closed, and the local urgent-care clinic hadn't yet opened. So Haselhoff did what most parents would do: She drove her son to a nearby emergency room — in this case, Encino Hospital Medical Center.
The boy's OK. He didn't even need stitches. But Haselhoff might need to be treated for shock after receiving the hospital's bill for $1,721.75 and learning that her insurance will cover only a small portion of the total.
"What's the point of having a hospital up the street if it's too expensive to use?" she told me. "Why do we pay $700 a month for insurance if it doesn't cover something like this?"
Haselhoff's experience was all too common. Medical costs are often inexplicably high and are almost always kept hidden from patients until the bill arrives. Health insurance, meanwhile, is frequently coverage in name only.
The federal government released data this week showing that hospitals nationwide charge wildly differing amounts for the same procedure.
For example, Cedars-Sinai Medical Center in Los Angeles charges Medicare an average of $110,123 for a relatively common artificial joint replacement, according to the data. Centinela Hospital Medical Center in Inglewood charges twice that amount.
On the other hand, Hoag Orthopedic Institute in Irvine bills Medicare $52,066 for the surgery, while Kaiser's Los Angeles Medical Center charges only $35,524.
Different medical facilities might have different cost structures based on their location and the people they treat. That's understandable.
What's not understandable is how one Southern California hospital can charge as much as seven times more than another for the same treatment, according to the Medicare data.
Even worse, the government's figures provide a revealing look at the lunacy of medical pricing, but they don't actually show how much specific treatments truly cost hospitals, nor do they reflect how much money might be paid by insurers.
Medicare and private insurers routinely pay less than what a hospital bills, and different insurers will cut different deals with healthcare providers.
The bottom line is that, even with this rare look at medical pricing nationwide, consumers are still in the dark about how much treatments actually cost. All we know for sure is that the prices we pay are typically way above the hospital's true expenses.
Is it any wonder that medical bills consistently rank among the leading causes of personal bankruptcy?
Haselhoff, 41, isn't going broke. Her husband works for a prominent financial company, and the family is comfortably middle class.
But that doesn't mean a crazy hospital bill doesn't sting.
"It really makes you think about what you should do when your kid gets hurt," Haselhoff said. "Do I take him to the hospital? Do I not take him? It's very stressful."
After the dog bite in February, she rushed her son to the ER and was informed that she'd face a $500 charge just for walking in the door. That's before a single act of healthcare had been committed.
A doctor entered the examining room and took a look at the child's finger. He said there was no need for stitches but he nevertheless ordered an X-ray.
Then a nurse cleaned out the cut with saline and put a bandage on it. Haselhoff's son was also given a Tylenol.
And that was it.
The bill arrived in March. The hospital charged $271.90 for the X-ray. It charged $266.50 for the saline used to clean the cut. It charged $348 for the bandage. It charged not $500 but $661 for "emergency services." And there was a $28 charge for "miscellaneous services," whatever those might be.
The only bargain: a $1 charge for the Tylenol, although 200 caplets of the generic equivalent can be purchased at Wal-Mart for just $4.
Haselhoff believed her family was well-insured through her husband's job. But each family member's coverage comes with a $1,200 deductible, meaning that's how much of the $1,700 bill she had to pay. Her insurer, Aetna, paid the remainder.
Of course, Haselhoff has no regrets about her decision to take her son to the hospital. But she wishes she'd have had a better idea in advance about how much she'd be charged for what was, by any reckoning, a modest dose of medicine.
She also wonders how the bill could have soared so high for treatment that, except for the X-ray, she basically could have done herself at home.
That $266.50 charge for 500 milliliters of saline? You can find that same amount online for about $40.
Edward Barrera, a spokesman for Encino Hospital, said he was unable to discuss Haselhoff's case because of privacy reasons. But he said a lot of factors go into medical pricing.
"Charges are based on both historical data and negotiated payments" by insurers, Barrera said. "Hospital charges also reflect the individual hospital's mission, the patient population it serves and the subsidies necessary to provide essential public services."
There's a lot that's wrong with our healthcare system. Bringing true costs into the sunlight would be an important step toward making the system fairer and more accessible.
If hospitals and insurers won't introduce more transparency to medical pricing, this is clearly an area where federal authorities can act in the public's best interest.