the high price… of normal saline!?

This is a great piece from the New York Times about the high price that hospitals charge patients for normal saline.  Yes, normal saline – the highly complicated combination of sodium chloride and dihydrogen monoxide.  Better known as salt and water.

One-liter IV bags normally contain nine grams of salt, less than two teaspoons. Much of it comes from a major Morton Salt operation in Rittman, Ohio, which uses a subterranean salt deposit formed millions of years ago. The water is local to places like Round Lake, Ill., or Rocky Mount, N.C., where Baxter and Hospira, respectively, run their biggest automated production plants under sterility standards set by the Food and Drug Administration.

Yup… Morton salt, which most of us have in the kitchen at home, and water – you know, that stuff that comes out of the faucet.  The cost to produce a “bag” (one liter or just over a quart) of normal saline was approximately $1.07 in 2012.  According to the article, a liter of normal saline is the “rare medical item that is cheaper in the United States than in France, where the price at a typical hospital in Paris last year was 3.62 euros, or $4.73.”

But the article goes on to dive into one of the biggest problems in health care costs, one not limited to normal saline but probably the most egregious given the humble nature of this life-saving fluid.  Health care has become like any other business, brimming with middle-men and excessive markups that are clouded in mystery due to disclosure agreements and proprietary rights.

One of the patients in the story was charged $546 for six liters of saline that cost the hospital $5.16, not including the charge for administration of the solution and emergency room services.  That amounts to a nearly 10,600% markup.

No wonder we have the highest GDP spending on health care in the world…


About justgngr

the ramblings of a medical professional by day, judgmental ginger by night
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4 Responses to the high price… of normal saline!?

  1. that’s 10,600% not 106%!

  2. sqhc says:

    Reblogged this on Students for Quality Health Care and commented:
    how simple salt water can become so expensive…

  3. Ray Wells says:

    Nationalize medicine. I know everyone hates government control but with the profit mongers..the billionaires wanting more and more money there has to be some control. The industry will not control itself. It’s profit motivated not care motivated. Besides the gouging there is out right fraud. Medicare has limits set on everything but they are vague in many ways. Example . A simple ambulance transport is $400. Now look at a transport of a walking patient 1/2 mile for $400. 20 minutes later transported back to the nursing home for another $400. A sick patient same $400 BUT, pause and start an IV of NS and it’s $800, add a cardiac monitor it’s $1,200. We are going 1/2 mile. This occurs in a small rural town almost daily. Move to a small city with 15-20 transports a day. An ER physician (joke) orders labs and an IV on every patient that comes in while he’s working. Cough , cold, rash, headaches hundreds of non emergent patients that should not be seen in the ER. Medicare should not pay one red cent for these patients A $60 office visit costs Medicare $2-3,000 and this happen 25-30 times a day in small city in an adjoining county. It’s fraud but it’s with in the regulations of Medicare. I ran into this article because I was looking for a source of normal saline for our EMS agency. Our local hospital stopped exchanging materials with EMS. We are a volunteer agency that does not soft bill. We are the only agency that is not billing in 4 counties. We have a low number of runs a year and soft billing may not make up for the donations we survive on. We do marginally better then if we billed and we know that several of our larger donations will stop if we start billing. We have been active for 35+ years and we have never turned over a call to another agency. No one in the state can make the claim or even come close to it. This gouging may actually cause us to close out doors. Maybe I can just start starting IV’s on every patient we put in the truck. But how do we bill when we go to a house to help get a 90 year old neighbor off the floor and back into his big chair. We love the thank yous and pats on the back but it won’t but a dam bag of salt water. Last word, of our very small group of volunteers there are several that will quiet if we start billing. I’d better go find some cheap saline.RW

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