WINNEMUCCA -- Kudos to the hospital board for voting unanimously to pursue a pricing study; perhaps they're beginning to see the light? Also, thank you Commissioner Brissenden for so actively pursuing this important quality of life community issue.

I believe that HGH's patient services/pricing schedules are beyond any concept of reasonable charges but fall instead into the category of a predatory billing practice.

On the evening of Sept. 5, 2011, I presented myself at the HGH emergency room with classic symptoms of a heart attack. I was admitted after a thorough "wallet biopsy" and given, what I imagined to be, their standard protocol for heart attack patients. I was placed in a bed with monitors, administered medications, blood draws were taken. I was observed for several hours and then taken to Renown in Reno by ambulance.

At Renown, once again, I was admitted to the ER, given a bed and placed on monitors, medications were administered, blood was drawn and I was observed for several hours before being admitted to the cardiac ICU.

I am sure that there were variations in the medications provided and the tests administered between the two ERs but certainly nothing that could possibly account for the discrepancy in billing. Charges for Renown's ER (and no one would consider Renown a bargain for medical care costs) were $4,000, HGH's were $17,339. This did not include the ultra-bumpy ambulance ride, in what I deemed to be basically a furniture van with a fancy paint job and a worn-out suspension system, which cost an additional $6,139.

My share of cost for Renown (after insurance payment) including the ER, the OR and 10 days of inpatient cardiac ICU care was $900; my share of cost for a few hours at the HGH ER and a ride to Reno in a tricked out furniture van was $800. For a senior citizen living on a fixed income, it's $800 here, $900 there and pretty soon you're talking real money.

Having suffered the expense as well as the extreme rudeness of the contractor that services HGH's billing and collections (who were after me even before I got home from Reno, not just for the $800 they wanted the entire $23,478 because my insurance plan had not yet had time to process the claim), I'll endeavor to avoid the HGH ER if at all possible.

I see a cardiologist from Reno in Winnemucca once every three months. In February of this year, I had a problem that couldn't wait for my regular appointment which I believed was related to my medications. I scheduled an outpatient appointment at HGH and was seen by an MD who ordered a blood draw and scheduled a follow-up visit a couple of weeks later. Normally, I would never have seen a bill under these circumstances. That's why I have insurance, right? Because HGH made some kind of error in billing my insurance, they sent me an invoice, "As is our policy." The bill for two office visits and some blood work was $1,500.

Maybe I shouldn't care how much my insurance company pays as long as I don't have to pay, but I do. My insurance premiums are more than substantial; they're a financial burden. Overcharging by providers is a big reason why, so when the cardiologist recently ordered some comprehensive blood work and an ultrasound, which could both be done at HGH, I waited until I needed to go to Reno anyway and got the tests done there. The Reno lab estimated the cost of the lab work at $120. The cardiologist charges $140 per office visit. Again, I understand that all blood labs are not equal; however, I have no reason to doubt that the care I received from HGH and billed to my insurance carrier at $1,500 could have been done in Reno for less than $500. I will try and avoid outpatient, laboratory or any other services provided by HGH as best I can.

The hospital's goal should be to provide quality medical care to the community without the primary concern being the bottom line financially, as appears to be the case to me.