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Add It Up: Pricing Out A Visit To TV's 'Dr. House'

Jun 9, 2010 (All Things Considered)

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Gregory House (Hugh Laurie) is rude, inconsiderate and doesn't like playing by the rules — but, man, is he a good doctor. Nearly every episode of Fox's House begins by presenting the diagnostician with a puzzling medical case that he spends the rest of the show trying to figure out.

Through trial and error and with the help of some of the most sophisticated therapies out there, House almost always manages to save the day — but how much would that actually cost? Andrew Holtz, author of The Medical Science of House, M.D. and an editor at MDiTV.com, joins NPR's Robert Siegel to help answer that question.

More specifically, Siegel asks: How much money would it cost to diagnose the patient in the "Ignorance Is Bliss" episode of House?

"This patient showed up with some odd symptoms," Holtz beings. "They said he had ataxia, anemia, a mild cough, and they started doing, as they always do in these episodes, a barrage of tests. Then they started throwing out all sorts of bizarre potential diagnoses — the more bizarre, the better."

At first, House and his helpers guess it may be thrombotic thrombocytopenic purpura, a rare but serious blood disease, but that's quickly scrapped in favor of a liver problem — the patient was a drinker. The first procedure on the books is a liver biopsy.

"I found one estimate from one insurance company that a liver biopsy might cost somewhere between $8,000 and $11,000, so not petty change," Holtz says.

Next, the patient collapses and needs MRI.

"An MRI can be anything from maybe a couple of hundred dollars to $1,000," Holtz says. "It often depends on the deals that insurance companies make with the hospital."

Then there's a splenectomy — but not just any splenectomy. It turns out the patient had suffered an injury years before that resulted in a broken rib, and that broken rib had punctured his spleen and caused 16 baby spleens to grow off the original. Holtz isn't sure if you can get a bulk rate on multiple splenectomies so, just in case, he puts the cost of the procedure(s) at $140,000 to $200,000.

There's a stroke in there ($60,000), some drug abuse treatment ($50,000) and an extra $40,000 for the ataxia — or lack of muscle coordination — the patient came in with.

That leaves our poor patient with a total medical bill of at least $298,200.

Of course, this is only an estimate. Holtz says the insurance companies he contacted had trouble giving him exact figures because of all the variables involved. They told him it depended exactly which variety of the procedure was being done, which institution they were doing it in, whether the moon is in retrograde ... you get the idea.

Holtz says it's also true that House has been known to make use of some pretty obscure illnesses that have only been mentioned "a handful of times in the entire history of medicine."

Even so, he says that bill of $298,200 isn't too far off the mark of what medical care is costing people these days.

"I think people often really don't realize how quickly costs mount," Holtz says. "Spending a few hundred thousand dollars on a complicated case is not at all unusual."

Let's just hope your doctor has a better bedside manner than Gregory House.

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