© Fabrizio Costantini for the New York Times
Two-year-old Ben Bellar of East Lansing, Mich., getting stitches after a fall at home. The bill for his treatment came to more than $2,000.
With blood oozing from deep lacerations, the two patients arrived at California Pacific Medical Center's tidy emergency room. Deepika Singh, 26, had gashed her knee at a backyard barbecue. Orla Roche, a rambunctious toddler on vacation with her family, had tumbled from a couch, splitting open her forehead on a table.
On a quiet Saturday in May, nurses in blue scrubs quickly ushered the two patients into treatment rooms. The wounds were cleaned, numbed and mended in under an hour. "It was great - they had good DVDs, the staff couldn't have been nicer," said Emer Duffy, Orla's mother.
Then the bills arrived. Ms. Singh's three stitches cost $2,229.11. Orla's forehead was sealed with a dab of skin glue for $1,696. "When I first saw the charge, I said, 'What could possibly have cost that much?' " recalled Ms. Singh. "They billed for everything, every pill."
In a medical system notorious for opaque finances and inflated bills, nothing is more convoluted than hospital pricing, economists say. Hospital charges represent about a third of the $2.7 trillion annual United States health care bill, the biggest single segment, according to government statistics, and are the largest driver of medical inflation, a new study in The Journal of the American Medical Association found.
A day spent as an inpatient at an American hospital costs on average more than $4,000, five times the charge in many other developed countries
, according to the International Federation of Health Plans
, a global network of health insurance
industries. The most expensive hospitals charge more than $12,500 a day. And at many of them, including California Pacific Medical Center, emergency rooms are profit centers
. That is why one of the simplest and oldest medical procedures - closing a wound with a needle and thread - typically leads to bills of at least $1,500 and often much more.