The description of an article on KHN’s website reads:
"A medical billing specialist investigated her husband’s ER bill. Her sleuthing took over a year but knocked thousands of dollars off the hospital’s charges — and provides a playbook for other consumers.”
But can you and I actually use this playbook?
At issue was a $10,563.49 bill after the husband broke his arm. The ER service involved "only an exam, X-rays, pain relief, and an arm splint."
The husband with the ER bill is a doctor. His medical specialist wife is the office manager of his practice, and her job includes overseeing billing. At one point, "It almost didn’t seem worth the hassle” to continue to pursue the issue, but a KHN reporter responded to the couple's request for help.
The process took more than a year, involved having the bill sent to collections, and led the wife to complain to the state attorney general. It turned out that the hospital charged nearly $7,000 for a procedure that never was performed.
It seems to me that if it was this difficult for these people, with their savvy, to get this result, there’s little reason to imagine that the rest of us could do it.
As you know, I don’t want to take political positions in this blog.
But this affects everybody. And public outrage about surprise medical bills led Congress, despite its deep polarization and the pushback of firms backed by private equity, to enact legislation in 2020 to protect consumers.
A 2020 Brookings report reads: “Health care is one of the largest categories of consumer spending. A well-functioning health-care sector is therefore a prerequisite for a well-functioning economy. Unfortunately, the problems with U.S. health care are substantial. The United States spends more than other countries without obtaining better health outcomes.”
"The upper end of the distribution of out-of-pocket costs dwarfs the liquid resources of many U.S. households, meaning that many people faced with a negative health shock may also find themselves in financial trouble,” the report says. "Negative health shocks tend to be associated with loss of income, thereby compounding the problem. Unexpected health costs can generate bankruptcies and ongoing financial hardship."
Like most of our human problems, we created this ourselves. And we can fix it. If we want.