Comments on: Price of a hospital circumcision in the US: $23,000 http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html Brain candy for Happy Mutants Tue, 21 May 2013 12:47:00 +0000 hourly 1 http://wordpress.org/?v=3.4.1 By: modusoperandi00 http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201898 modusoperandi00 Tue, 30 Aug 2011 01:55:00 +0000 http://boingboing.net/?p=115589#comment-1201898 I got circumcised. A bunch of times. The doctors gave up. They were just making it angry. You wouldn't like it when it's angry. I got circumcised. A bunch of times. The doctors gave up. They were just making it angry. You wouldn’t like it when it’s angry.

]]> By: donovan acree http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201485 donovan acree Mon, 29 Aug 2011 18:21:00 +0000 http://boingboing.net/?p=115589#comment-1201485 It works like this. Hospitals need to ensure patients visit so they contract with insurance companies to send business their way. In return the insurance companies get a HUGE discount on services. The amount of discount or write off depends on the hospitals bargaining power. A lone hospital in a city can demand better compensation than one that must compete. For example, I've seen Cigna contracts that only pay $300 per day for inpatient services no matter how much work is done. Medicare and Medicaide usually only pay 20% or less to the hospital. The rest is adjustment. Our government has made it illegal to charge differently for cash, insurance, and medicare so the price structure has to stay the same. The hospital has to charge $1000 to get $200. This gives us grossly inflated prices. That $23,000 is so the hospital can actually bring in the $4,600 it will actually cost them to do the work. Remember, at a hospital you are paying for doctors, nurses, techs, admissions, and all of the related overhead. The problem here is how the feds have gamed the system with medicare and insurance. It works like this.
Hospitals need to ensure patients visit so they contract with insurance companies to send business their way. In return the insurance companies get a HUGE discount on services. The amount of discount or write off depends on the hospitals bargaining power. A lone hospital in a city can demand better compensation than one that must compete. For example, I’ve seen Cigna contracts that only pay $300 per day for inpatient services no matter how much work is done.
Medicare and Medicaide usually only pay 20% or less to the hospital. The rest is adjustment. Our government has made it illegal to charge differently for cash, insurance, and medicare so the price structure has to stay the same. The hospital has to charge $1000 to get $200. This gives us grossly inflated prices. That $23,000 is so the hospital can actually bring in the $4,600 it will actually cost them to do the work. Remember, at a hospital you are paying for doctors, nurses, techs, admissions, and all of the related overhead.
The problem here is how the feds have gamed the system with medicare and insurance.

]]> By: Hugh x http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201195 Hugh x Mon, 29 Aug 2011 07:26:00 +0000 http://boingboing.net/?p=115589#comment-1201195 Rather than accept a hyped-up conclusion as "compelling" yes, that's a reasonable thing to do. Rather than accept a hyped-up conclusion as “compelling” yes, that’s a reasonable thing to do.

]]> By: Hugh x http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201194 Hugh x Mon, 29 Aug 2011 07:25:00 +0000 http://boingboing.net/?p=115589#comment-1201194 You answered your own question. "Children are by legal definition unable to give consent" and circumcision is the removal, lacking medical need, of a normal, healthy, functional, irreplacable body part - that it would be illegal to remove it if were any other such part of a non-consenting human of any age, or the most nearly corresponding part of a girl baby. In brief, circumcision is anomalous. You answered your own question. “Children are by legal definition unable to give consent” and circumcision is the removal, lacking medical need, of a normal, healthy, functional, irreplacable body part – that it would be illegal to remove it if were any other such part of a non-consenting human of any age, or the most nearly corresponding part of a girl baby. In brief, circumcision is anomalous.

]]> By: Hugh x http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201173 Hugh x Mon, 29 Aug 2011 05:27:00 +0000 http://boingboing.net/?p=115589#comment-1201173 There are dozens of DIY devices for foreskin restoration, and tens or hundreds of thousands of men are doing it - which should tell you something about whether cutting if off is such a good idea. There are dozens of DIY devices for foreskin restoration, and tens or hundreds of thousands of men are doing it – which should tell you something about whether cutting if off is such a good idea.

]]> By: Hugh x http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201172 Hugh x Mon, 29 Aug 2011 05:25:00 +0000 http://boingboing.net/?p=115589#comment-1201172 As Russell Crowe said, if you can't spell it, don't do it. As Russell Crowe said, if you can’t spell it, don’t do it.

]]> By: Hugh x http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201171 Hugh x Mon, 29 Aug 2011 05:24:00 +0000 http://boingboing.net/?p=115589#comment-1201171 There are men who would pay $23,000 to get their foreskin back. Put the money in a trust for his education, and your son (the doctor) will thank you twice. There are men who would pay $23,000 to get their foreskin back. Put the money in a trust for his education, and your son (the doctor) will thank you twice.

]]> By: Tzctplus - http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201137 Tzctplus - Mon, 29 Aug 2011 01:46:00 +0000 http://boingboing.net/?p=115589#comment-1201137 So what you and others are saying is that circumcision has health benefits for males that can't be bothered to wear a condom? Golly, I am changing my mind about this pointless procedure. So what you and others are saying is that circumcision has health benefits for males that can’t be bothered to wear a condom? Golly, I am changing my mind about this pointless procedure.

]]> By: Tzctplus - http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201136 Tzctplus - Mon, 29 Aug 2011 01:40:00 +0000 http://boingboing.net/?p=115589#comment-1201136 You know what he means.... he didn't mean surgery that is necessary. You know what he means…. he didn’t mean surgery that is necessary.

]]> By: Tzctplus - http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201135 Tzctplus - Mon, 29 Aug 2011 01:37:00 +0000 http://boingboing.net/?p=115589#comment-1201135 Here in the UK I believe it would be all for free. Here in the UK I believe it would be all for free.

]]> By: DewiMorgan http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201095 DewiMorgan Sun, 28 Aug 2011 22:08:00 +0000 http://boingboing.net/?p=115589#comment-1201095 Erm... all you people are spelling it "tort reform". But cosmetic surgery on young boys... that's clearly "tot reform". Erm… all you people are spelling it “tort reform”.

But cosmetic surgery on young boys… that’s clearly “tot reform”.

]]> By: Beth Gibson http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1201015 Beth Gibson Sun, 28 Aug 2011 16:39:00 +0000 http://boingboing.net/?p=115589#comment-1201015 What's tort got to do with this all? I woulda thought it contract law What’s tort got to do with this all? I woulda thought it contract law

]]> By: bobk http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200884 bobk Sun, 28 Aug 2011 03:18:00 +0000 http://boingboing.net/?p=115589#comment-1200884 Aren't those targets already circumcised? Now, if you could get the Predators to sew it back on, you might have something there. Aren’t those targets already circumcised? Now, if you could get the Predators to sew it back on, you might have something there.

]]> By: gwailo_joe http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200835 gwailo_joe Sun, 28 Aug 2011 01:27:00 +0000 http://boingboing.net/?p=115589#comment-1200835 Why has no one discussed the real issue here?  If you DON'T circumsize your sons, they will almost certainly never become famous and world renowned porn stars. Cut dicks sell flicks!  Think of the poor childs' future!  In these troubled times you would limit his chances of making a living wage in his later years?  For Shame! (and of course THE COVENANT WITH Y#WEH for crying out loud)  heh heh... Why has no one discussed the real issue here?  If you DON’T circumsize your sons, they will almost certainly never become famous and world renowned porn stars.

Cut dicks sell flicks!  Think of the poor childs’ future!  In these troubled times you would limit his chances of making a living wage in his later years?  For Shame!

(and of course THE COVENANT WITH Y#WEH for crying out loud)  heh heh…

]]> By: Ianmac http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200708 Ianmac Sat, 27 Aug 2011 21:19:00 +0000 http://boingboing.net/?p=115589#comment-1200708 Perhaps the hospital was trying to discourage such child abuse, without having the guts to refuse outright. Perhaps the hospital was trying to discourage such child abuse, without having the guts to refuse outright.

]]> By: Kimberly McKinnis http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200619 Kimberly McKinnis Sat, 27 Aug 2011 19:23:00 +0000 http://boingboing.net/?p=115589#comment-1200619 Hospital visits are ridiculous. When I was in the ER for several dehydration and food poisoning, I received a bill full of charges for co-pays, down to the PILLOW on my bed. It was the most ridiculous bill i have ever seen and fighting it with my insurance company was a nitemare. Hospital visits are ridiculous. When I was in the ER for several dehydration and food poisoning, I received a bill full of charges for co-pays, down to the PILLOW on my bed. It was the most ridiculous bill i have ever seen and fighting it with my insurance company was a nitemare.

]]> By: Mario Gil http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200592 Mario Gil Sat, 27 Aug 2011 18:56:00 +0000 http://boingboing.net/?p=115589#comment-1200592 My wife got breast implants two years ago and she got billed $2,500. This year she underwent a small 30 mins surgery to extract a little mass from one breast and she got billed $29,800. The awkward part is that the plastic surgeon charged exactly what he quoted for the whole procedure, including followup visits. But despite we repeatedly asked for a quote on even a rough approximate before the mass extraction, it was practically impossible to get any amount from anyone at the hospital or at the doctor's office. Between the outrageously expensive things they billed there was a $850 disposable support bra! My wife got breast implants two years ago and she got billed $2,500. This year she underwent a small 30 mins surgery to extract a little mass from one breast and she got billed $29,800. The awkward part is that the plastic surgeon charged exactly what he quoted for the whole procedure, including followup visits. But despite we repeatedly asked for a quote on even a rough approximate before the mass extraction, it was practically impossible to get any amount from anyone at the hospital or at the doctor’s office. Between the outrageously expensive things they billed there was a $850 disposable support bra!

]]> By: Marktech http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200561 Marktech Sat, 27 Aug 2011 18:12:00 +0000 http://boingboing.net/?p=115589#comment-1200561 <blockquote>So what you're saying is that you doubt the accuracy of the claim, but do not have the time to investigate further, so you're just going to go with your hunch?</blockquote>If you substitute for "your hunch" the words "proper scientific scepticism", that's not far off; but don't forget, the onus is on the people making the claim to substantiate it.  It's their job, not mine, to provide robust supporting evidence for what they believe.  Otherwise there's no reason to believe it, is there?

So what you’re saying is that you doubt the accuracy of the claim, but
do not have the time to investigate further, so you’re just going to go
with your hunch?

If you substitute for “your hunch” the words “proper scientific scepticism”, that’s not far off; but don’t forget, the onus is on the people making the claim to substantiate it.  It’s their job, not mine, to provide robust supporting evidence for what they believe.  Otherwise there’s no reason to believe it, is there?

]]> By: Mister44 http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200489 Mister44 Sat, 27 Aug 2011 17:22:00 +0000 http://boingboing.net/?p=115589#comment-1200489 Why should *I*. I am hardly an expert. I think something like a "blue book value" would be prudent. Why should one person get $X for a missing hand, and another person $Y - the difference being who had the better lawyer. I see a lot of Drs for my issues. I have friends who are Drs, and then there are Drs the kiddo has seen. I have asked over a dozen of them what they thought would be the one thing to effect health costs the most. Everyone one of them said tort reform. My wife who is a layer and works  in health and retirement plan law has said tort reform. I am inclined to listen to these people. You can look at the states with the worst tort laws and see how they are losing Drs to other, friendly states. Not wanting to only rely on the fallacy of appealing to authority, they saw two big cost that tort reform would rein in. First was malpractice insurance. It is a jaw dropping number what a general practitioner has to pay for malpractice. For small, on Dr offices, this puts a huge strain on their business. These people are not performing surgery or anything like that, but they still pay a very large number in case they get sued for missing a disease that only Dr. House would be able to diagnose. The other thing was because of their fear of being sued, drs order a ton more tests than what would be prudent otherwise. Needless MRIs and other expensive tests rack up the insurance company costs, raising your premiums etc Why should *I*. I am hardly an expert. I think something like a “blue book value” would be prudent. Why should one person get $X for a missing hand, and another person $Y – the difference being who had the better lawyer.

I see a lot of Drs for my issues. I have friends who are Drs, and then there are Drs the kiddo has seen. I have asked over a dozen of them what they thought would be the one thing to effect health costs the most. Everyone one of them said tort reform. My wife who is a layer and works  in health and retirement plan law has said tort reform. I am inclined to listen to these people. You can look at the states with the worst tort laws and see how they are losing Drs to other, friendly states.

Not wanting to only rely on the fallacy of appealing to authority, they saw two big cost that tort reform would rein in. First was malpractice insurance. It is a jaw dropping number what a general practitioner has to pay for malpractice. For small, on Dr offices, this puts a huge strain on their business. These people are not performing surgery or anything like that, but they still pay a very large number in case they get sued for missing a disease that only Dr. House would be able to diagnose.

The other thing was because of their fear of being sued, drs order a ton more tests than what would be prudent otherwise. Needless MRIs and other expensive tests rack up the insurance company costs, raising your premiums etc

]]> By: jerwin http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200486 jerwin Sat, 27 Aug 2011 17:21:00 +0000 http://boingboing.net/?p=115589#comment-1200486 <i>The fee covers the cost of the use of the equipment, medical/surgical supplies, drugs, staff time and other supplies and expenses incurred during the procedure</i> But neither the physician nor the anesthesiologist are employed by the hospital; and they will charge for their time.  The fee covers the cost of the use of the equipment, medical/surgical supplies, drugs, staff time and other supplies and expenses incurred during the procedure

But neither the physician nor the anesthesiologist are employed by the hospital; and they will charge for their time. 

]]> By: elix http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200485 elix Sat, 27 Aug 2011 17:20:00 +0000 http://boingboing.net/?p=115589#comment-1200485 Glad that at least someone's being honest that the pricing scheme is entirely arbitrary. And, apparently, is designed to leech off the insurance system and any poor suckers who're unfortunate enough to get sick/injured when they don't have insurance. Refreshing. I don't know how the bean counters responsible for the billing can sleep at night. Glad that at least someone’s being honest that the pricing scheme is entirely arbitrary. And, apparently, is designed to leech off the insurance system and any poor suckers who’re unfortunate enough to get sick/injured when they don’t have insurance. Refreshing. I don’t know how the bean counters responsible for the billing can sleep at night.

]]> By: chumpmeat http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200471 chumpmeat Sat, 27 Aug 2011 17:10:00 +0000 http://boingboing.net/?p=115589#comment-1200471 Well that does it, I'm definitely not going to circumcise my hospital. Well that does it, I’m definitely not going to circumcise my hospital.

]]> By: jerwin http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200469 jerwin Sat, 27 Aug 2011 17:09:00 +0000 http://boingboing.net/?p=115589#comment-1200469 Technically, surgeries that are neither emergency surgeries (initiated immediately) nor urgent (initiated within 48 hours) are elective. Such surgeries may still be medically necessary, but the doctor and patient can still choose when the surgery is to occur.  Since so many of the plastic surgeon's repertoire is not covered by insurance, their fee structure appeals to consumers, rather than to insurance companies. Boston General's prices are designed around the insurance company's expectations, not the average consumer. Technically, surgeries that are neither emergency surgeries (initiated immediately) nor urgent (initiated within 48 hours) are elective. Such surgeries may still be medically necessary, but the doctor and patient can still choose when the surgery is to occur. 

Since so many of the plastic surgeon’s repertoire is not covered by insurance, their fee structure appeals to consumers, rather than to insurance companies. Boston General’s prices are designed around the insurance company’s expectations, not the average consumer.

]]> By: Mister44 http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200463 Mister44 Sat, 27 Aug 2011 17:05:00 +0000 http://boingboing.net/?p=115589#comment-1200463 I am thinking about this more than I probably should be ;o) But if a foreskin is something that is desirable for this operation, can/do people try to "regrow" it? That isn't the right word, but during WWII some Jews would do procedures that would give them a foreskin so they could try to pass as Christians. I don't recall the specifics, something like string and weight to pull on the skin to elongate it. Sort of like how people use those big disks in their ear lobes, or the tribal Africans with the large disks in their lip. I am thinking about this more than I probably should be ;o) But if a foreskin is something that is desirable for this operation, can/do people try to “regrow” it? That isn’t the right word, but during WWII some Jews would do procedures that would give them a foreskin so they could try to pass as Christians. I don’t recall the specifics, something like string and weight to pull on the skin to elongate it. Sort of like how people use those big disks in their ear lobes, or the tribal Africans with the large disks in their lip.

]]> By: Beth Morgan http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200391 Beth Morgan Sat, 27 Aug 2011 16:05:00 +0000 http://boingboing.net/?p=115589#comment-1200391 I work at a company that helps people understand and track their health care expenses (www.simplee.com), and this was an actual comment we got yesterday from a medical professional:  "The number that is stated as Total Health Care Costs is wrong. You are summing up all retail prices charged to insurance, and not what insurance actually paid. As any healthcare professional knows, the retail price charged is arbitrary and does not show anything about real costs. This is never a price that is paid unless you are uninsured."Uh... yeah, okay.  Glad to see someone on the inside of the system admitting how flawed it is, I guess. I work at a company that helps people understand and track their health care expenses (www.simplee.com), and this was an actual comment we got yesterday from a medical professional: 

“The number that is stated as Total Health Care Costs is wrong. You are summing up all retail prices charged to insurance, and not what insurance actually paid. As any healthcare professional knows, the retail price charged is arbitrary and does not show anything about real costs. This is never a price that is paid unless you are uninsured.”Uh… yeah, okay.  Glad to see someone on the inside of the system admitting how flawed it is, I guess.

]]> By: Joe Sixpack http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200344 Joe Sixpack Sat, 27 Aug 2011 14:48:00 +0000 http://boingboing.net/?p=115589#comment-1200344 There are limits to what parents can consent to on behalf of their children. For example parents of a 11-year-old girl cannot force her to have sex with a 55 year old man just by "consenting" on her behalf (and thank lawyers for that, because there exist cultures that would have a field day with that loophole). I'm not sure if the circumcision debate is any more intense in North America than it is in Western Europe. I'd venture that the debate has been more or less resolved in Western & Northern Europe, given their low rates of circumcision. Accusations of racism or religious intolerance also inevitable appear in any European debate due to their demographics of circumcision. As for other parts of the world, the practice is rare in China, and practiced in India only by the country's Muslim population. There are limits to what parents can consent to on behalf of their children. For example parents of a 11-year-old girl cannot force her to have sex with a 55 year old man just by “consenting” on her behalf (and thank lawyers for that, because there exist cultures that would have a field day with that loophole).

I’m not sure if the circumcision debate is any more intense in North America than it is in Western Europe. I’d venture that the debate has been more or less resolved in Western & Northern Europe, given their low rates of circumcision. Accusations of racism or religious intolerance also inevitable appear in any European debate due to their demographics of circumcision. As for other parts of the world, the practice is rare in China, and practiced in India only by the country’s Muslim population.

]]> By: t3kna2007 http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200343 t3kna2007 Sat, 27 Aug 2011 14:43:00 +0000 http://boingboing.net/?p=115589#comment-1200343 > Why is the cut/uncut debate in North America so intense? Because as is too often true, it reveals that North Americans have for the most part lost the facility/desire for moderate discourse? "The argument .. is to da det." /T'Pau > Why is the cut/uncut debate in North America so intense?

Because as is too often true, it reveals that North Americans have for the most part lost the facility/desire for moderate discourse?

“The argument .. is to da det.” /T’Pau

]]> By: fnarf http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200334 fnarf Sat, 27 Aug 2011 14:11:00 +0000 http://boingboing.net/?p=115589#comment-1200334 Better than nothing, but still piss-poor. Condescending, uncomprehending, and dim. Actually it is quite simple to solve, and yet impossible at the same time. Single-payer is your answer, but it will never happen. Not until health care is 75% of GDP, and not even then. Better than nothing, but still piss-poor. Condescending, uncomprehending, and dim.

Actually it is quite simple to solve, and yet impossible at the same time. Single-payer is your answer, but it will never happen. Not until health care is 75% of GDP, and not even then.

]]> By: Lobster http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200323 Lobster Sat, 27 Aug 2011 13:47:00 +0000 http://boingboing.net/?p=115589#comment-1200323  In America ('Murica) it costs $350 to spay or neuter a dog.  In America (‘Murica) it costs $350 to spay or neuter a dog.

]]> By: Lobster http://boingboing.net/2011/08/26/price-of-a-hospital-circumcision-in-the-us-23000.html#comment-1200322 Lobster Sat, 27 Aug 2011 13:45:00 +0000 http://boingboing.net/?p=115589#comment-1200322  I'm sure that most of them are just lazy illegal immigrants who could totally afford to pay but would rather buy tacos and sombreros and burros with their money.  Our society would be MUCH better if we refused to subsidize a little humanity and instead let those people die for their greed or failure to have money.  After all, they aren't like us, and they can't speak our language so it's not like any white people would even understand it when they beg for someone to please stop the pain. That's how the line goes these days, right?  I’m sure that most of them are just lazy illegal immigrants who could totally afford to pay but would rather buy tacos and sombreros and burros with their money.  Our society would be MUCH better if we refused to subsidize a little humanity and instead let those people die for their greed or failure to have money.  After all, they aren’t like us, and they can’t speak our language so it’s not like any white people would even understand it when they beg for someone to please stop the pain.

That’s how the line goes these days, right?

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