The hospital bill looked like any other: White, with an orange and blue logo on top. But it was what the bill said that threw me: My daughter’s medical bill for a visit to a specialist was seemingly overcharged at $212. Digging out our insurance card, I confirmed: “Visits with in-network doctors cost $70.” It was right there, in black and white.
My husband and I are freelancers who pay a ton for a private plan for our family, with no union or employer to offset the cost. It’s the kind of plan where you have to meet a $9,000 deductible to get much covered. If my kids sneeze, I stifle the urge to yell that they’d better stay well. Hand sanitizer is a given in my house, and I have developed a needed belief that natural ingredients such as garlic and oregano ward off germs (so don’t sniff too hard around me in flu season). Still, I’ve always told myself I was lucky. Lucky that we had health insurance, lucky that we are a healthy family.
Calling the hospital’s billing office to investigate, I discovered that the doctor charged me one amount, while the hospital was billing me another. What was the hospital billing me for? We waited over an hour for the doctor in the wing of the hospital where his practice happens to be located. There weren’t even good magazines. When the doctor did come in, he made small talk, checked my daughter’s pulse and left nine minutes later. I know, because by then I had other kids to pick up, so I irritably checked my watch.
You see, the woman explained, if a doctor works for a hospital, he can change you one thing… but the hospital can charge you another, including a facility-fee, an equipment fee, a fee-fee... it’s all in the fine print of the billing manual. My scalp prickled as she talked.
If there is a woman out there who’s been in labor but managed to clarify the employment status of the doctor offering the nice drugs to make the pain go away, my hat is certainly off to her.
I recalled when I had an epidural during labor at another hospital and got triple-billed — one fee was to go to the doctor who actually administered the shot, another was for a doctor under whom the first doctor worked, but who I never actually met. A third bill was sent by the medical group all the anesthesiologists worked for, since they were freelancers and could charge separately. If there is a woman out there who’s been in labor but managed to clarify the employment status of the doctor offering the nice drugs to make the pain go away, my hat is certainly off to her.
As the hospital person yammered on about “standard billing practices,” a voice emerged from my throat. It was a harsh voice, almost a whisper, as if we were in a Western, me and the woman on the other end of the phone. You could almost see the tumbleweeds rushing by. I had never heard this voice before, and certainly hadn’t planned on its arrival.
“I will never, ever pay you $212,” I hissed with a menacing calm. “I will not be triple-billed by you, just for breathing in your hospital. I will take you to the mat. I will win, I don’t care how long it takes. You will be paid $70, you will be happy with it. Transfer me to your supervisor.” The woman did; after calls between her supervisor and my insurance company, I received a miraculously “adjusted” bill for — you guessed it— $70.
I was glad about this, but a little investigation revealed an astounding fact: Hospitals do not have standard fees. In fact, a 2017 study by the Journal of the American Medical Association, revealed that many types of doctors, including radiologists, ER doctors and neurosurgeons, charge more than four times the amount Medicare pays per procedure. Additionally, hospitals get away with tacking on charges for such supposedly built-in things like gowns and Band-Aids, sometimes at the rate of hundreds of dollars per item, as Vox reported in 2016. Why isn’t this in more headlines? Isn’t having a system where your doctor’s tab is as transparent as that chart at the dry cleaners — the one telling you how much it costs to press a suit — worth fighting for?
I’m steamed at how flawed the whole system is, not to mention that people on both sides of the political aisle who insist that universal health insurance is some fluffy dream not worth exploring.
I’m calling B.S. on the whole thing — not just the hospitals but the doctors, the insurance companies… and my own attitude. You see, the truth is, I don’t feel lucky. That was just something I had to tell myself to not feel scared about a catastrophe happening. Honestly, I don’t think money should be made off people’s well-being, as in at all. Dress it up with fancy terms, but what this hospital was doing was ripping me off with extra sleaze, please. And that’s far from the only one — I’m not even mentioning the time where my daughter needed an x-ray on the weekend, and the bill was $600. The cost of one snap of the machine at a local imaging center, not affiliated with a hospital? $60.
I’m also upset that so many open-hearted, passionate people have great health insurance through a nice, big company, just don’t get too riled up about this. Well, if your family has access to the best healthcare money can buy, you should be interested in this debate for the friends and family members who do not share your privilege. Today’s economy means you may not always have a cushy gig. I’m steamed at how flawed the whole system is, not to mention that people on both sides of the political aisle who insist that universal health insurance is some fluffy dream not worth exploring, when other countries have made it happen and cut overall medical costs, too.
It shouldn’t take me having to go all Cersei Lannister to get my overpriced health plan to work. Tax-paying families like mine are resentful at having no one look out for them, and politicians of all stripes should take note. Because someday, we may just get mad enough to grab a dragon and go breathe its fire at a corrupt Slaver’s Bay or King’s Landing, once and for all.