I had a recent personal experience at the local community hospital emergency room after an attack of kidney stones. This was my first trip to an emergency room since I sprained an ankle shooting baskets in the early 1980s in New Jersey (I was visiting friends. I lived in NYC at the time).
The charges for my visit to the emergency room are below. The treatment I received I thought was excellent. I was in tremendous pain, was nauseous and could barely speak - all due as it turned out to a 2mm wide kidney stone. I had no idea what was wrong with me. While my brother drove me to the hospital (about a 20 minute drive), my sister-in-law looked up the symptoms in a medical book. She fairly quickly determined that the problem was a kidney stone. This is what the problem turned out to be.
I had to wait about 1/2 hour in the office area of the emergency room, first going through administrative chores, then waiting, before being checked by a nurse who then led me to a bed in the emergency room. Samples of my urine and blood were taken and tested. The nurse administered an intravenous solution in my arm to hydrate me. She also administered a pain-killer and an anti-nausea drug. I felt fine almost instantly after receiving the dosage. I then waited about 10 or 15 minutes to be wheeled into the CAT scanning room where I underwent 2 scans. This took about 10 minutes. Then back to the emergency room. Then a 1/2 wait for the various results to be checked. The emergency room physician gave me the results, then I waited another 15 minutes are so before discharge.
Total charges for the hour or so that I was waiting or being "treated" in the emergency area are $4,331. This is a truly astounding number. My copay was $100 at the time of the visit. I later paid $354 for a total of $454 for the visit. Aetna, my insurer, paid nothing because the agreement between Aetna and the Hospital is that the maximum payable is $454 when an insured party is treated for an emergency room visit and has not yet used up his/her deductible. I paid that in full because I had not come close to using up my yearly deductible of $2,500. I assume the $454 charge is based on actual costs to the Hospital averaged over all emergency room visits. That makes more sense that $4,331 in terms of actual costs incurred.
I pay Aetna $348/month as my single-person premium as a 55-year-old male in excellent health. I do not have immediately available data, but I probably have been paying roughly this amount monthly for 3-4 years without incurring more than a few $30 charges (to the insurer - I have a $30 co-pay) per year for check-ups with my primary care physician. Point is that I have paid in 3-4 times the amount of the emergency room charge in premiums.
I cite this as purely an example of the extraordinarily high charges for medical care. The service, as noted, was excellent in every way aside from check-in which took longer than I would have liked given the pain I was in and my borderline delirium. In this case I would have strongly preferred to have handed the administative person a stick drive with my data or given the person access to my medical information available through the Internet. Big savings in time, cost and somewhat in accuracy. I point this out to illustrate the value of immediately available medical records for any such situation.
Much more on the topic of medical care costs, but this an illustrative case.