Opponents of the role of consumers and markets in health care have one go-to argument above all others: that you can’t shop for health care when you’re unconscious. The rising problem of gargantuan, surprise medical bills in surgical wards and emergency rooms shows that they have a point.
A close encounter with surprise billingWe were about to have our first child. I had warned my wife, Sarah, about the problem of surprise billing. She meticulously researched everything to make sure that the hospital she chose—part of the—was part of our insurer’s provider network. She then did the same for her obstetrician and her anesthesiologist.
Her frustration rising, the receptionist handed me a clipboard with a list of a hundred pediatricians on it, and said, “pick one.” So, as Sarah was being wheeled away, I pulled out my smartphone, went to the web browser, logged into my health insurer’s website, and began painstakingly typing in the names of the on-call pediatricians, one by one. Finally, after 15 tries, I found one who was in our network, and picked that one.
A study from UnitedHealthGroup, looking at its own claims nationwide, recently estimated that out-of-network emergency physiciansmajority would penalize emergency rooms that charge more than 200 percent above the average hospital charge for a comparable service.led by Sens.
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