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On 4 June 2015, a man named Todd Fassler attempted to take a selfie with a rattlesnake during a trip to the Barona Speedway racetrack. As San Diego's 10News.com first reported, it did not go well: The story gained a much wider audience after the reporter who broke that story tweeted a copy of the hospital bill Fassler received following treatment of the near-fatal wound. That image continues to be featured in memes and other social media posts years later. Fassler's stay, which lasted from 4 July 2015 to 9 July 2015, resulted in a bill for $153,000: The story is factual, and in the words of the Washington Post’s WonkBlog, it represents everything wrong with American health care. The most significant cost, at $83,341.25, was for pharmaceuticals. Here, the culprit was a lack of competition in the pharmaceutical industry (aided in part by patent lawsuits) and the resulting ability for a single company to drive the antivenom (also referred to as antivenin) market: As a result of the complex process of negotiation between insurance companies, hospitals, and drug manufacturers, the cost of an individual dose of CroFab is not easily represented as a simple dollar figure. As reported by CBS News, the wholesale cost of the drug — then around $2,500 — does not represent what ends up being billed to the patient: Fassler, it bears mentioning, depleted the anti-venom stash at two different hospitals, according to 10News. Due to the rarity of use, the amount of antivenom a hospital has on hand at any time is variable, as is the amount any given patient might need. Other notable rattlesnake bite cases have resulted in similarly astronomical costs. A Maryland woman received a $55,000 bill after a copperhead snake bite in 2013. A North Carolina man was hit was an $89,000 bill for a snake bite that same year. In 2012, a UC San Diego exchange student was given a $144,000 hospital bill after a rattlesnake bite. Beginning in October 2018, a new antivenom drug will be available to the general public, which will introduce competition into the snake bite pharmaceutical industry — although it is unclear what effect this will have on the overall cost of this kind of emergency treatment. The second most significant cost Fassler faced was $22,433.00 in laboratory services. A litany of bloodwork and other tests is indicated for cases of snakebites; these costs are also sometimes high, variable and ultimately negotiable between hospital and insurance company. The third most significant costs were for Fassler’s Intermediate Care Room and Intensive Care Room stays. According to a 2005 study that attempted (among other things) to quantify average costs of stays in ICUs, the costs of intensive care stays is high right from the moment a patient enters, and higher for people who require mechanical ventilation — something someone who was paralyzed by a venomous bite likely would require for at least some time. The costs estimated in this study are broadly in line with the costs presented in the Fassler’s bill: Other services are harder to pin down specifically, but a $947.00 charge for radiology is not out of the question, as X-rays are sometimes used to confirm that no bits of snake teeth remain in a patient’s system. All these costs are real, but they are not necessarily a reflection of what the hospital is expecting to be paid. According to the Washington Post: We were unable to contact Fassler, but we have reached out to Dan Haggerty (the reporter who first reported the incident for 10News) to see if he was aware of any updates to Fassler’s case, and what the final outcome may have been.
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