A few hours after my daughter, Penelope, was born, a nurse came into the hospital room and asked my wife, Kate, and me if we wanted to have the baby taken to the nursery for a bit so we could get some sleep. Bleary-eyed and groggy after a long labor, we thought that was a fantastic idea. But we didn’t think so later on when we got a $1,420 bill for the nursery.

I saw red. Not just because $1,420 was equal to our monthly rent at the time, but also because we were being charged at all for Penelope’s two-hour stay in the nursery, a charge the nurse never mentioned.

Had she told us at the time that the nursery stay would cost several hundred dollars, we would have kept Penelope with us and I would have watched her myself so Kate could sleep. Looking back, it feels like a corrupt transaction.

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To be clear, I don’t think the nurse was trying to pull one over on us. But I do think the hospital’s bureaucracy was.

I paid the bill — directly — given that we had a high-deductible plan. Maybe in hindsight I shouldn’t have. But I work a lot and would have found it hard to make the time to fight the bill.

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As part of my job at the storytelling radio program “Our American Stories,” I’ve been working on a series called “What Happens When.” It’s about patients’ interactions with the health care system. A colleague encouraged me to dedicate the time — during work hours — to investigate that absurd nursery bill.

I called the hospital, Baptist Memorial — the only hospital in our town of Oxford, Miss. (which explains a lot of this) — with one simple question: Exactly what was included in that $1,420 nursery charge?

I had to call nine people to get an answer.

What I finally learned was that a newborn’s stay in the nursery costs $710 an hour. Penelope was there for about two hours, ergo the $1,420.

Let’s put that $710-an-hour charge into context. At home, we usually pay a babysitter $13 to $15 an hour. The average nurse makes $33 an hour, which is just about what I get paid. And the average doctor makes about $80 an hour.

If the hospital babysitter was to work full time at the rate Kate and I paid, she or he would make more than $1.4 million a year!

To be sure, the hospital must charge several times what a nurse is paid to watch a baby in order to keep the lights on, maintain the building, and do all the other things that go into running a hospital. But 21 times more? That’s not justifiable.

When I pointed out to one official that the hospital couldn’t reasonably think that I’d want to pay $710 for a babysitter to watch my child, she responded, “Well, it’s not a matter of watching, they have other things that they do.”

My story of this crazy hospital charge — and others’ stories of them — will keep happening as long as the following remain true.

  • There is a lack of competition between hospitals for our dollars, and we have hospital monopolies like Baptist Memorial. The only area of health care in which the price goes down over time is pharmaceuticals. That’s because of the presence of vigorous competition through the introduction of generic versions of brand-name drugs.
  • We continue to be lulled into an insurance-pays-for-everything mindset that makes it easier for health care providers to get away with not telling consumers the actual price of a service. Insurance is supposed to be for catastrophic events; we don’t use our car insurance for oil changes.
  • Hospitals aren’t up front about what they charge you for. It’s morally wrong for a hospital to charge you $1,420 for a service you clearly would have said no to if someone had been straight with you instead of pretending it wasn’t going to cost anything.

This was an expensive lesson for Kate and me that we need to be more proactive about asking what various hospital services cost, especially those that are “elective,” like Penelope’s stay in the Baptist Memorial nursery. I hope that you will do the same and see through any cost obfuscation.

Alex Cortes is the vice president of content development at “Our American Stories,” a nationally syndicated storytelling program. This article is adapted from his audio story, “An Investigation: The Most Expensive Babysitter in the World.”

  • This is such a frustrating situation, because while it’s obvious that a lab test is going to cost something and you can (try to) get a price ahead of time, sending your baby to the nursery does not seem like it warrants an extra expense. Both my babies spent a fair amount of time in the nursery so I could sleep. It never occurred to me that I should have asked in advance what the price tag was for that. Should I have asked how much their diapers were costing? How much does it cost to use the rest room?

  • I disagree with the comment below that “You shouldn’t have to pay for the baby being in the nursery because that is their job!” If it’s their job, they get paid. What may not be clear when you check in is that every “person” is a patient–mom and baby both–so if you take up a second bed, second nurse (especially a private nurse, essentially) you can expect to pay for each person.

  • That is outrageous, i myself really hate anything beurocratic, which unfortunately includes hospitals now because of the insurance companies, im not comparing your situation with mine but when i go to my primary care doctor im there a total of maybe 15 minutes and i get weighed and blood pressure taken my the assistant then the doctor comes in and listens to my heart and breathing then im asked if im still smoking, ” im cutting way down doc” and im on my way, they get a lot of money for that 13 and a half minutes!!

  • Excellent story and shameful for the hospital! I have a story too, about being called back to the hospital, at 10 p.m., to care for my husband, age 71, with mild dementia, who suffered a reaction to drugs administered prior to by-pass surgery which was cancelled for that day due to a contaminated operating room. Staff were finding my husband difficult to handle due to paranoia induced by the drugs. They expected me, age 69 with severe arthritis and using a cane to return and take care of him. I did, of course, and that was just the beginning of the outrageousness I encountered with that hospital for the next five years until my husband passed in 2015. Not a story about over charging but one of lack of empathy and caring.

  • Oh that’s nothing. When my 2nd child was born we were charged for a nursery stay that we didn’t use because the hospital didn’t even have one.

  • They should have told you at least the estimate of the bill. You shouldn’t have to pay for the baby being in the nursery because that is their job!

  • This article has a lot of problems. 1 is the suggestions that we should be shopping around for medical services of any kind. To be an informed consumer is just not realistic as even physicians like myself often have trouble knowing which test is better (for example) outside of our speciality. To expect the general public to do this is laughable. To expect anyone to make a decision in the high stress moments we use health care for is even more problematic. Applying “fair market capitalism” to life and death decisions is ridiculous and dangerous.

    • The problem with shopping around for services is many insurances list the doctors and hospitals they will pay for. Many times they aren’t the best. And many couples are hard out to pay for luxuries like the nursery at this hospital.
      There is only one hospital group with all doctors connected in 8 counties where I live. We have no choices.

    • The issue we patients are wrestling with is that while insurance companies have been successful in shifting a significant amount of the economic risk back to the patients in the form of high deductible out of pocket plans ( this was done in part to drive consumers to be more conscious of how they are spending their money with healthcare providers) the healthcare industry does not want the customers to know what the costs are. It is not in their best interest to have customers shopping around for services. Try calling a hospital or any lab and find out what a certain test/procudure costs. They cannot/will not give it to you even if you are saying you will pay cash price. They hide behind all kinds of confidentiality requirements with insurance companies. I do agree with the Dr. who posted that it is not practical to “shop” for services and costs when your life or serious health is on the line and time is short. In those circumstances, you have no leverage and the hospitals can charge whatever they want. They are incentived to spend your out of pocket dollars as quickly as they can ( $700/hr babysitter) I think very shortly for emergency type services for a patient that has insurance there will be a fixed base charge to the patient to walk in the door and that will be whatever your max out of pocket cost is on your plan and then the insurance company will assume all other costs. Yes you will have cases where an emergency room “false alarm” will cost you $10k but in essence they can do this know as none of us have any clue what anything does or should cost in this type of setting. In exchange for giving up any type of control/influence on emergency services costs, the gov’t should pass a federal law that requires providers to publish what their costs are for all services and procedures in a non emergency setting are so that consumers can shop around and the capitalist economy can work. This will help reduce overall healthcare in this country. One Mans Opinion….

  • I can see why you’re upset by this charge. However your suspected rationale for it is somewhat simplistic. The ridiculous charges are not just to cover some physical plant overhead, but also helps to pay for the many “self pay” patients do not end up paying and for the Medicaid patients whose bills are paid at a fraction of what it costs to provide the services. If hospitals did not charge inflated prices for the services to those who can pay (such as with Medicare or private payers), they wouldn’t be in business long given that the margins and hospitals around the country are somewhat narrow. This is known as cost shifting. I’m not agreeing with it, but to compare it to the babysitter’s cost is irrational. I guess I could argue that if you had one babysitter in the whole area like you have a single hospital, then I think you’d be paying her many times more than what you would expect to presently.

  • You must be mistaken. President Obama and Democrat controlled Congress solved all these problems with the ACA don’t you know.

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