There are several reasons for soaring health care costs. One is that doctors order unnecessary tests to cover themselves in case of a malpractice suit. Another is that, unlike, say, plumbers, there is no "warranty" for health care. For example, even after my mother got a pacemaker she was still sick. Oops. Wrong pacemaker. Medicare paid for both surgeries. It seems to me the first surgeon should not have been paid, or should have been required to return the payment. There doesn't seem to be any mechanism for accountability outside of a lawsuit.
A third reason is that providers often overcharge, double bill, or charge for services not provided, and the insurance companies pay up anyway. If they do investigate, they almost never ask the patient. A fourth reason is that providers try to make up Medicaid and Medicare losses by overcharging other patients. One hospital told me they boosted the cost on all supplies like kleenex, saline solution, bandages, etc. to make up for losses due to welfare patients. Basically they are taking unauthorized donations from all the other patients. These are just a few of the reasons for the astronomically high medical bills.
Health care consumers cannot wait for the government to step in.We have been waiting and nothing ever happens.
A few quick tips:
1. Never assign insurance payment to the provider. This guarantees that an itemized "Explanation of Benefits" (EOB) comes to the patient. Very often the patient can identify problems right then and deal with them. Patients should not allow themselves to be cut out of the loop. Granted, it may mean inconvenience for the patient, but if everybody took control of their health care, much of the nonsense would come to a screeching halt.
2. Never go to a health care provider without a notebook. Take notes on everything. Just the fact you are writing stuff down will prevent many billing problems. If you can't do this yourself, have someone with you who can.
3. Never pay anything at time of service. Wait for the EOB. Getting money back is almost impossible without a string of letters and phone calls. You lose leverage if you pay upfront, and there is a problem later.
4. Always insist on an ITEMIZED detailed bill. Providers like to bundle stuff up. Get it unbundled.
5. Always get your hospital bills audited. All hospitals have a bill auditor, and it is your right, as a patient, to request an audit. This step alone will often shave as much as 10% off the bill.
6. Refuse to pay any unjustified charges, but do not withhold payment of justified charges. Providers get away with overcharging because people feel that their credit ratings are being held hostage. Stubborn providers will send your bill to a collection agency. Your case is greatly strengthened if you can show good faith by paying what you honestly owe. If the unjustified charges go to a collection agency, write a letter to the agency explaining the ground of your dispute. That is usually the end of the matter.
7. You may want to ask a private bill auditor to audit your bill after the hospital auditor finishes. I can usually guarantee savings of at least another 10% when I audit a bill. The aforementioned precautions can insure a fairer medical bill and make a private auditor unnecessary.
Now just for fun-- Kossacks have proven themselves to be really good at creating clever pithy monikers. I have fallen, so to speak, into consulting on the side. I do educational consulting, nonprofit group consulting, and medical bill auditing. I am planning to formalize this consulting into a business. What would be a good name for the business? Thanks, and I hope you can use some of the above tips to minimize your own medical bills.