Is Zuckerberg San Francisco General Hospital Ripping Off Sick People?

I couldn't find a usable picture of Zuckerberg San Francisco General Hospital, but how about a nice picture of the Golden Gate Bridge instead?Rieger Bertrand/Hemis/ZUMA

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Sarah Kliff has been collecting hospital bills over the past year, and for the past couple of weeks she’s zoomed in on emergency room services at Zuckerberg San Francisco General Hospital, which are considerably higher than other hospitals in the area. Why are they so high? No one really seems to have a good answer, but the closest we’ve gotten is that SF General is required to provide lots of indigent and Medicaid services, which don’t pay much, and they have to make up for that with higher prices for people covered by private insurance.

I guess that sounds reasonable. But it got me curious about how much private patients are charged compared to indigent/Medicaid patients. This is for the entire hospital, not just emergency care, but here it is:

Kinda weird. Traditional private patients are charged, on average, $3,322 per day while private patients with managed care plans are charged $6,177. You can see the same huge disparity between Medicare and Medicare Advantage. And generally speaking, Medicaid patients are charged more than average, while traditional private patients are charged about the same as both indigent patients and traditional Medicare patients, even though this hospital is out-of-network with all insurers.

Overall, indigent patients make up less 1 percent of total patients, and private patients make up about 15 percent. These numbers are small enough that they hardly matter. Nearly 85 percent of all patients are either Medicare or Medicaid.

I can’t really make much sense out of this. The bottom line, however, is that SF General claims to lose money in every department except two: ER and lab tests, which break even. Their net loss for the year was $193 million. It’s all very confusing.

But I have a question: If SF General is really charging private patients sky-high prices in its ER, are there loads of private patients complaining about this? You’d think there would be. Are insurance companies outraged? You’d think they would be too. So why haven’t we heard many stories from them?


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