Surprise medical bills, such as the one I received, often stem from patients unwittingly receiving care from out-of-network providers, resulting in substantially higher costs that insurance fails to cover. These bills impose financial burdens on patients, precipitating stress and anxiety over the daunting prospect of affording necessary medical care. According to a study published in the New England Journal of Medicine, nearly one in five in a emergency department visits yields out-of-network charges.
Numerous Americans have found themselves ensnared in analogous predicaments while seeking medical attention, as evidenced by the myriad stories shared in response to my tweet. The opacity surrounding healthcare pricing makes it difficult for patients to ascertain the cost of their care upfront, engendering bewilderment, frustration, and financial distress when confronted with unexpected bills. Although the No Surprises Act (NSA) was passed to address just this issue, its implementation (beginning in 2022) has been contentious and some hospitals are still not in compliance.
In my case, had I been aware that I would be charged $10,000 for basic treatment that included IV hydration -- care that you can get in a hotel room or via mobile clinics in many cities for less than $500opens in a new tab or window -- I would have opted to hydrate at home. However, despite healthcare purportedly operating as a free market, I was not furnished with the requisite information to make an informed decision regarding my purchase. Moreover, I was not apprised of the cost of my care until 6 weeks later!
It is worth noting that emergency veterinary clinics furnish cost estimates to pet owners, enabling them to make informed decisions before proceeding with care. If we can do it for Fido, shouldn't we be able to extend comparable transparency to human healthcare as well?
Furthermore, the common practice of cost-shifting and up-charging in healthcare -- which many experts feel were exacerbated by policiesopens in a new tab or window like the Emergency Medical Treatment and Active Labor Act (EMTALA) under President Reagan and the Affordable Care Act (ACA) under President Obama -- emboldens healthcare systems to staunchly defend charging many times the market rate for services to insured individuals (or in many cases billing even more exorbitantly to self-pay patients, who don't have the market power of big insurance carriers to negotiate $10,000 down to $5,000). This practice is ostensibly justified by the assumption that charging some patients far more than their care actually costs is a perfectly legitimate way to offset the uncompensated care they provide (and to make a profit on the side -- healthcare is almost 20% of America's gross domestic product [GDP] after all).
WHAT IS THE LESSON? SOMEONE POPS THEIR HEAD INTO YOUR CUBICLE,ROOM...ASK IF THEY R IN NETWORK,OR LEAVE.....THIS SHOULD NOT BE HAPPENING....but people do not self advocate.
