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Patients are suffering sticker shock over American health care and the considerable problem of unexpected medical bills. The issue puts many patients at higher death risk. Experts contend that in the area of healthcare, there are many unexpected and unwelcome associated cost burdens placed on the patients, particular with any surgery-related or other medical services were hospitalization is required, even if the patients have planned procedures.
Recently, a banker from New York City, Peter Drier, was blindsided by an unexpected medical bill of nearly $120,000, which came as a complete surprise for the professional, who had undergone neck surgery to repair his herniated disks in December 2014. Being a business professional, Drier had done considerable research on his insurance coverage and medical expenses prior to the surgery. However, a staggering bill from an assistant surgeon, whom he could not recall meeting, was a big shock for him.
Having done his research, the banker was well-prepared for the medical bills from his surgeon, anesthesiologist, as well as the hospital where the surgery was performed, as they all were covered under his insurance plan. Moreover, Drier knew all three would accept their negotiated charges. However, the patient soon suffered sticker shock over the unexpected, additional fees incurred by the assistant surgeon, who also happened to be out-of-network of his insurance coverage. The banker’s insurer, Anthem Blue Cross Blue Shield, had agreed to protect him for the unexpected, out-of-network bill saying that it was not his fault and he is not liable to pay the assistant surgeon cost, so the insurance company cut him a check for nearly $120,000 to cover the total amount of the unexpected bill.
However, when Drier received the check from his insurer, he hesitated in forwarding it to the assistant surgeon and hoped to negotiate a more reasonable rate to save his insurance company from absorbing the full cost. However, he was forced to ultimately send the Blue Cross payment in full after he received a threatening letter from the lawyer of the assistant surgeon.
According to medical experts, it is virtually impossible to avoid such unexpected medical bills, especially when the surgeries performed require in-hospital stays. In such a scenario, even the most informed health insurance patient often faces trouble in tracking down the information that is required. Moreover, experts say the complete U.S. medical system and the financial aspect associated with it is extremely complicated. To comprehend this system properly is extremely difficult for even the most knowledgeable and insurance savvy patient. The New York State Department of Financial Services has said that the issue of unexpected medical bills has not been directly addressed in the United States, and it continues to pose a significant hardship for many patients, who suffer sticker shock over unexpected medical bills related to surgery and other associated costs incurred each year.
Lawmakers in many states have been slack in addressing this issue and for good reason. It is known that many well-placed individuals are making money off the medical industry and the application of ethics and standards into the equation would mean that easy money flow would get cut off or weakened. Moreover, not a single lawmaker yet has succeeded in passing laws for a comprehensive overhaul of the nation’s medical industry practices and unless the people themselves rise up, it is unlikely to happen anytime soon.
As patients are continuing to suffer sticker shock over the nation’s health care and the considerable problem of unexpected medical bills, the issue puts many patients at higher risk of death as a result. Experts contend that in the area of healthcare, there are many unexpected and unwelcome associated cost burdens placed on the patients, particular with any surgery-related or other medical services were hospitalization is required, even if the patients have planned procedures. Lawmakers in many states have dragged their feet in addressing this issue, due to the copious amounts of money made via the medical industry. Patients, who have experienced this sticker shock over unexpected medical bills for surgery-related and other medical services, must take a stand and report any excessive or suspicious medical billing practices, so that national attention is drawn to it and the issues will be addressed.
Opinion by Leigh Haugh