A provocative article in yesterday’s New York Times, Put Your Hospital Bill Under a Microscope, details horror stories of the financial aftermath of hospitalization. Below is the comment that I submitted.
What a messy situation.
Hospitals and doctors commonly get shortchanged by insurers and Medicare. It is not uncommon to get paid less than what it costs to deliver a service. Charges are therefore inflated to make up for the losses wherever possible–receipt of the full amount is not expected. To avoid getting into legal trouble, charges must be kept fairly consistent, which unintentionally results in bloated bills for individuals with less than 100% medical coverage.
Of course, health care is different than most any other consumer “purchase.” It can be highly complex, incredibly expensive, and the language almost foreign. Minute details of insurance coverage are impossible to know. Care is mostly rendered based on what the medical situation appears to require, rather than the patient actively picking and choosing. And, of course, penny-pinching and delay of care can sometimes result in real harm.
A single payer system might simplify the system, but the issues would largely remain the same.
Just as there is nobody assigned to each of us for scrutiny of our bills from the plumber, mechanic or airline, there will unlikely ever be a universal health care cost advocate. Who is going to spend money so that you can save yours?
Unfortunately, the best we can do is to ask questions, stay as informed as possible and remain politely vigilant.
Stephen Meyers, MD