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News: How U.S. hospitals soak the uninsured: the varying charges for an appendectomy in the Detroit area

Same Operation, Different Bills

How U.S. hospitals soak the uninsured: the varying charges for an appendectomy in the Detroit area

Historically, America's health care providers have subsidized care for the uninsured by charging those with insurance slightly inflated prices. But in recent years, the pendulum has begun to swing the other way as HMOs and the government have pushed to reduce costs, demanding deep discounts from doctors and hospitals. Now, hospitals routinely charge the uninsured two or three times what an HMO or the government pays for the same procedure, often stretching patients' finances to the breaking point: Nationally, uninsured patients failed to pay roughly two-thirds of the $60 billion in hospital bills they racked up in 2001.

Below is a cost comparison of what's billed for a standard appendectomy in the greater Detroit metro area. Faced with the prospect of a $15,071 bill, patients without insurance sometimes cross the border to Windsor, Canada—where, thanks to national health care, the same operation costs one-eighth as much. -- Research by Mandy Erickson

Illustration by Gustav Katz