Too Few Facts

I was watching MSNBC tonight.  It is my preferred political talk source.  They generally provide backup to their claims, with videotape with dates and locations, etc.  They are generally thoughtful and complete in their presentations.  But sometimes even they go thin on the analysis and it irks me.

Chris Hayes did a piece on rip-off hospital charges.  And while it is generally true that US medical professionals and hospitals seem to get a lot more than in other countries (so that the costs can be legitimately questioned) the example he used was abysmal. 

He was talking about IV saline solution.  He said they use Morton salt and inexpensive bottled water.  I expect that its true because MSNBC doesn't slip on basic checkable information like that.  His big point was that some hospital charged a patient $91 for 88 cents worth of salt and water.  OUTRAGEOUS!

But wait-a-minute...  Aren't there other costs in providing that saline solution?

I'm no doctor and not even related to the least grade of medical assistant, but I can immediately think of a lot of costs involved beyond the saline solution.

1.  Someone has to mix the salt and water precisely.
2.  The saline solution has to be put in (I assume) a sterile plastic bag.
3.  A sterile tube has to be attached to the bag.
4.  The saline bag has to be delivered to the patient's location.
5.  A needle has to be inserted into the patient.
6.  The saline bag has to be attached to the needle.
7.  I assume there is a drip-rate control that needs to be set.
8.  The saline drip has to be monitored at some times.
9.  The use of the saline drip has to be recorded for billing purposes.
10. The use has to be billed.
11. The billing usually has to go through several cycles (the whole bill to medicare, then the uncovered amount to the insurance company, and finally some small bill to the actual patient.
12.  Some percentage of patient bills will never be paid, so those get distributed into other hospital overhead costs.  I'm a little uncertain on this last one, as those costs may be included in the above costs.  But even then, some of those costs will be distributed into hospital services that were not involved in the provision of the saline solution, so they aren't in the cost of the saline (meaning they got added to overhead for ER, cancer ward, meals, etc).

I'm not mentioning this to complain about medical costs (though that is worthy of attention and challenge).  I'm not qualified to accurately set the cost of an appendectomy (an operation I had once) or a heart transplant (which I haven't).

But if I can easily see a dozen more costly parts of a procedure, couldn't MSNBC's fact-checkers and editors see the same? 

I have to accuse MSNBC and Chris Hayes of pulling a sleight-of-hand with the facts on this issue.  Rather FOX-like, in "convenient factlessness"...