Dear POTUS: please don’t worry about food delivery.. help Americans with healthcare costs!
Dear POTUS: please don’t worry about food delivery.. help Americans with healthcare costs!
A few simple things can improve the lives of hundreds of millions of Americans and improve the situation around trillions in spend annually
When was the last time you reviewed the detailed invoice that your hospital sent to your insurance company? I’ve started looking a bit deeper at these invoices. Something is REALLY wrong. And it’s a matter of national importance. I am urging the President and all lawmakers to fix this problem before it causes more serious harm to our country and all our citizens.
Personally, I don’t have any serious medical conditions. I’m fortunate. I try to monitor my heart health and take preventative measures. This typically includes a biannual VO2 max test (where you run on a treadmill and they take an image of your heart afterwards) and an annual echocardiogram. This time, I looked deeper at the invoices. Stanford Hospital charged my insurance $21,388 for the VO2 test. This was a 45 minute non-evasive procedure using all reusable equipment and less than an hour of people’s time (no MDs were present at the time of the exam, and perhaps an MD spent a few minutes reviewing afterwards). They then charged $12,096 for the echocardiogram which was even shorter, about 15 minutes, using technology that has been around for a long time (no MDs present for this either). When my niece went to the ER for stomach pain, the hospital charged her insurance $55,600 for a basic visit with no overnight stay. Do these numbers seem right to you, Mr. President? Since when do you have spend a Mercedes Benz in order to get seen at the ER?
It turns out that my visits costed me, out-of-pocket, about $832 for the VO2 test and $687 for the echocardiogram. These out-of-pocket costs were a complete surprise by the way, but I’ll get to that shortly.
It seems reasonable that the VO2 test costed the hospital about $832 in total and the echocardiogram costed the hospital $687 in total. So is this a game being played by the hospital and insurance company to trick me into paying for the entire cost? It feels like the insurance company and hospital are in cahoots to bamboozle me into thinking they are “covering” most of the costs (using ridiculous unreal numbers), and that my out-of-the-pocket costs are trivial compared to the total. I seem to think that $33,484 of cash never traded hands and I suspect there is something like a shadow economy of “credits” between hospitals and insurance companies. I simply don’t pay my insurance company enough money to justify them covering $33,484 for me across just two simple tests which is just a small fraction of my health services for the year. If they really spent this much, they would be belly up. Something is really wrong. The math doesn’t add up. It all smells fishy. We Americans must DEMAND visibility and truth about the situation.
Not only is there is a visibility problem, but hundreds of millions of Americans are also being harmed by surprise invoices from hospitals every single day. Today, a healthcare service provider has NO OBLIGATION to tell customers how much a service will cost them out-of-pocket before they are treated. This leaves consumers with invoices amounting to hundreds, thousands, or even tens of thousands of dollars as a complete surprise. It is the responsibility of our government to protect the people from these sorts of surprises. It is the responsibility of our government to intervene in the ludicrous “charges” that are occurring between hospitals and insurance companies and get to the bottom of it. We need the truth.
I propose two simple things that should be enacted right away:
Extend the US Consumer Protection Act to require healthcare providers to tell patients their out-of-pocket costs BEFORE services are rendered. Part of this should be to require healthcare providers to also give patients payment plan options BEFORE services are rendered. Don’t leave patients with surprises. Don’t allow patients who are less experienced in the healthcare system to fall prey to opaque billing practices, only to be faced with thousands of dollars in bills that they can’t afford. It happens millions of times every single day in America and it must stop.
Sign into law a new “Healthcare Transparency Act” that requires hospitals and insurance companies to provide an auditable ledger of cash transfers so that consumers are informed about the actual spend that is occurring between their hospitals and insurance companies. This includes dismantling all shadow “credit” programs between hospitals and insurance companies. Consumers need to know the truth about how much services actually cost and not be fooled. Hospitals and insurance can’t tell consumers “the total bill was $1 million but you’re only paying $1,000”- this is a bold faced lie and trick. Personally, I don’t know the complexities of how all this works. What I do know is that the VO2 max test and echocardiogram did NOT cost anyone $36,000. An ER day visit did not cost anyone over $50,000. There is something deeply wrong here that needs to be investigated and fixed. For the good of our citizens and country.
It might feel tempting to go after DoorDash and UberEats (easy wins before the election?) but we beg you to please go after this bigger problem. Millions of American lives are at stake.