* why is it OK to charge "hundreds of thousands of dollars" for a few weeks of hospital stay?*
Sigh... I've been a critical care nurse for years, and here is the answer:
When a person is in the ICU on life support, it's not just "staying in the hospital for a few weeks on a ventilator" it requires 24/7 care on a 1:1 or 1:2 nurse patient ratio. That is, every hour, on the hour a highly trained nurse goes in to your room, takes your vital signs, observes you for any minute changes in condition, documents those changes, monitors how much you've peed in the last hour. A person on life support is also probably on a myriad if IV drips that each have to be controlled with a separate pump.
I've cared for patients on death's door that have easily had 25 separate medications slowly dripping into the patient at rates of 3-5 cc's per hour, and any number of those medications in the wrong doses could kill the patient. Each of those medication rates are changed, and titrated from minute to minute or hour to hour depending on the patient's changing condition.
That's just nursing care, not to mention a Pharmacist with a Phd that's awake 24/7 to double check the safety, concentration and contraindications on each of those 25 drips. They have to be ready to send me a replacement does within minutes of my requesting it.
Not to mention having at least one doctor that's an intensivist. That is, she's gone to school for 15 years to learn how to manage cases like coral snake bites that they might only see once or twice in their entire career. They have to be on call 24/7. Not to mention a toxicologist, perhaps a cardiologist *(12-14 years of school) or a neurologist (easy 12-14 years of school) on call 24/7 in case the person develops a worsening neurological or cardiac symptoms.
And, you need to have a system in place to handle the dozens or hundreds of lab tests this patient is going to need on an on going basis. A lot of those results need to be made available on a "STAT" basis, which is, I need those results within 1 hour or less.
Plus all the added infrastructure: specialized beds to prevent pressure sores, IT infrastructure or organize those lab test and doctors orders.
I could go on.
Not to mention, antivenom is incredibly expensive to purchase. I worked in LA, 5 miles outside of Hollywood. We had a patient bit by rattle snakes in Griffeth park. Each vial of horse serum (rattle snake anti-venom) costs around $3000 each to manufacture. We gave this person 25 vials of antivenom in the first 24 hours, and he needed 25 vials a day for the next week. We indeed had to call the local zoo and all the area hospitals to obtain extra vials.
And, by the way, most hospitals work on a profit margin of 0.5 - 1.5% if they make money at all.
Health care costs a lot, because we demand a lot from our system, like forcing every hospital in LA to maintain a stock of 6 vials of rattle snake anti-venin, so that when one drunk ass hat tries to catch a rattle snake in Griffeth Park in Holly wood, we can save his arm from going necrotic.