RALEIGH -- North Carolina's Supreme Court heard attorneys argue Monday whether consumers should be able to take hospitals to court to justify bills that seem excessive.
The high court took up the case of Robert Talford, 68, of Charlotte, who maintains that Carolinas Medical Center should have to prove why it's reasonable to charge him up to 24 times more than a local pharmacy for medications.
In 2007, Talford was taken to Carolinas Medical Center in Charlotte after experiencing heart problems. He objected to a $14,419 bill for his three-day stay, in addition to the $5,556 charged for his hospital room.
The state's Court of Appeals ruled last year that the hospital bill submitted into evidence by the Charlotte-Mecklenburg Hospital Authority, which operates CMC, doesn't itemize the charges, and the only evidence that the costs were reasonable come from hospital employees. So a trial should weigh whether the hospital's price was right.
"I don't see anything wrong with paying a fair and reasonable cost because I'm standing here," Talford told the court's seven judges. "How long would it take them to prove to me and to you that their cost was reasonable? ... They are telling you that 'we charge $5,000 for a bed in a hospital and we don't have to tell you what the charges consist of.' "
Talford said he was overcharged at the hospital for drugs including diltiazem, which is used to treat high blood pressure and control chest pain. He said the hospital charged 24 times more for the medication than what a local pharmacy would charge.
The N.C. Hospital Association and hospital groups based in Durham, Asheville, Greensboro, Winston-Salem and Raleigh want the Supreme Court to rule against Talford and make it easy for them to collect overdue bills through court without a trial.
A consumer advocacy attorney said the courts should be a neutral third party open to deciding what's reasonable.
"If a patient has any sort of evidence that a bill or a charge, whether it be for a hospital or for anything else, they should be allowed their day in court," said Stephanie Ceccato, who directs the consumer protection program at Legal Services of Southern Piedmont in Charlotte. "I would think that hospitals should be subject to challenge of reasonableness of their charges."
A judge can't be expected to decide the reasonable price for a hospital to charge for rubber gloves or medications, said Jim Fuller, a former Court of Appeals judge representing Carolinas Medical Center.
If the state Supreme Court forces hospitals to go to court to justify their bills, the additional cost of collecting overdue bills would add to the already high cost of medical care, Fuller said.
"If every single contested hearing becomes not an hour or two but days, there will be a significant impact on the court system, as well as on doctors and hospitals," Fuller said.
'Necessarily high cost'
The fact that medications delivered at a hospital are pricey is no secret and no surprise, since charges must cover the overhead costs for nurses, doctors, equipment, meals, and constant cleaning, Fuller said. But Fuller said that it's also true that chicken piccata might be $20 at a restaurant he frequents, but he said he's willing to pay it - though the cost of the ingredients may be 10 times less - because of the value of the eatery's atmosphere, Fuller said.
For hospitals, "every item has a cost increase that covers that tremendous overhead," Fuller said. "This is a case about the necessarily high cost of the best medical care in the world."
