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Account of the month. Five stories of unexpected medical expenses
Medical bills are often a huge problem, putting additional pressure on already vulnerable people. The Bill of the Month project provides examples of absurdly high medical bills in the United States. MedNews shares with readers several stories described by the independent American media.
Photo: torange.biz /
Medical bills are often a huge problem, putting additional pressure on already vulnerable people. Thus, in the United States, 66.5% of individual bankruptcies are related to medical expenses. The size of the account comes as a bad surprise for one in six Americans.
It's not just uninsured people who suffer from the prices of treatment and diagnostics. Common causes of surprise bills are price gouging by private health care providers and people turning to clinics that are not covered by a particular insurance plan.
Since 2018, the creators of the Bill of the Month project, the independent agency Kaiser Health News and the largest American non-profit media outlet NPR, have regularly monitored “non-standard” medical bills in the United States. In addition to highlighting the problem, they try to help the victims of inflated bills whenever possible.
Before citing some of the examples described by the Bill of the Month project, we want to emphasize that this material is not intended to compare the medical systems of different countries and does not provide sufficient information to claim that the US has a poor health care system. These cases are just examples of possible abuse and tell about private stories of people.
First case. $ 17,850 urine test
This case was the first to be described by the project "Account of the Month". In 2015, Elizabeth Moreno performed a spinal disc removal for intense chronic back pain. The operation was successful. After her, Elizabeth was prescribed for some time the opiate analgesic hydrocodone.
In 2016, during a regular visit to the doctor, the patient was asked to pass urine for a drug test. She did it without a second thought, considering it a standard routine. However, she was only partly right.
On the one hand, such tests can potentially help prevent addiction to opiate analgesics: in the United States, there has been an epidemic of addiction to them for several years. On the other hand, they have become a cash cow for many medical centers.
After a while, Elizabeth received a bill for $ 17,850. According to Kaiser Health, these tests usually do not cost more than $ 200 (often orders of magnitude less). However, the medical center tested the urine for the presence of not only opiates, but also cocaine, anxiolytics, alcohol and more.
The analyzes were not just redundant, many were overpriced. The insurance company refused to pay such a bill. In the end, Elizabeth's father deposited $ 5,000 for her and filed a complaint that did not appear to have taken place.
NPR and Kaiser Health emphasize that when giving blood or urine tests, you should always wonder what each one is for.
Second case. $ 142,938 for help with a snake bite
A nine-year-old girl, Oakley, was bitten by a snake during a forest hike, presumably a copper-headed muzzle. The adults made the decision to use air ambulance so that help for a potentially fatal bite was provided on time. The helicopter took the girl about 128 kilometers to the nearest large hospital, where she was injected with 4 bottles of antivenom, after which she was transferred to another hospital.
The bill included $ 67,957 for a drug and $ 55,577 for an air ambulance. In passing, we note that the prices of air ambulance services are the subject of regular criticism in the United States, but the companies providing this service staunchly defend their right to issue five-digit and six-digit invoices.
According to experts, the hospital demanded a price five times higher than the average for the medicine. The average price for an antidote can also hardly be considered adequate: the drug cannot be called innovative, there are generics. However, at the time of the described incident, a monopoly had developed in the United States, which made it possible to raise the price.
This case ended in a surprisingly positive way for the victim's family. Their insurance company paid all costs in full, negotiating a drop in the total price to $ 107,863.
Third case. A stray cat bite cost $ 48,512
Biologist Janet Parker gave a bite of tuna to a stray cat, who bit her on the finger. Fearing rabies, the woman went to the nearest hospital. She spent about two hours in the emergency room, received two injections and antibiotics, and was sent home. According to her, she did not even communicate with the doctor.
Most of the $ 46,422 bill that came in was for preventive drugs. Thus, in this case, the medical institution also profits in a situation where a person does not have time to deal with and bargain.
According to experts, anti-rabies immunoglobulin in the amount Janet requires costs an average of $ 4,335 in the United States. However, the hospital that provided assistance to the woman replied that there were no errors in the bill, everything was in accordance with the tariffs of the day the assistance was provided.
Most of the bill was covered by Janet's husband's insurance, and she had to pay $ 4,191 out of her own pocket. “The funeral would be cheaper,” the woman notes with irony.
Fourth case. Allergotest for 48329
Janet Winston, a professor from California, has always had an increased sensitivity to ingredients in cosmetics and creams. The antifungal ointment prescribed to treat her persistent rash made the situation worse, and the rash got worse. The woman decided to find out what exactly she was allergic to.
Since in her town the queue to see a dermatologist was “packed” for several months in advance, Janet went to the Stanford University clinic. She underwent skin tests with 119 allergens, many of which were positive. The dermatologist warned her that this could be an expensive test, but she did not take it seriously enough as this clinic was part of a network of institutions that the insurance should have covered.
The bill was $ 48,329, 848 of which were for the services of a doctor. The insurance company negotiated a price of 11,376 with the clinic, 20% of which was to be paid by Janet herself.
Analysts interviewed by Kaiser Health News said the price of allergy tests was prohibitive. The starting price ($ 399 per allergen) was estimated to be completely astronomical. But the price bargained by the insurance company was still very high. The market price is $ 35 for the allergen in the San Francisco area where the reported case occurred. The national average for this service cost $ 16 per allergen in 2016.
Fifth case. Kidney failure, dialysis, half a million count
Fifty-year-old Sovereign Valentine was admitted to hospital in serious condition with kidney failure. He began to receive hemodialysis on an outpatient basis at the nearest specialized clinic, which was about 120 kilometers away.
A few days later, the manager of the insurance company called his wife and said that the selected hospital was not included in the network of institutions whose services were covered by the insurance, so dialysis would have to be paid in full on its own. Also, according to the transcript of the conversation Sovereign's wife had, he said that there are no dialysis clinics in the entire state that they can pay for. Later, representatives of the insurance company claimed that this statement concerned only one city.
Repeated questioning of clinic staff and insurers did not give information on how much dialysis will cost. After 14 weeks, the family received a bill for $ 540,842: almost 14,000 in a single session. Medicare can only cover $ 235 per dialysis session. On average, commercial institutions charge four times what Medicare offers. That is, in this case the price turned out to be extraordinary again.
In general, dialysis companies are quite profitable. In 2018, their revenues in the United States amounted to over $ 2 billion.
A few days after Valentine's story was published in the media, the dialysis company decided to forgive his debt. This case resembles the old KVN. Kaveenschiki often ridiculed certain Soviet bureaucrats and enterprises for shortcomings in the game, and before the start of the next game, a report was given on what was done by the guilty to correct mistakes.
But such an unprecedented debt forgiveness is rare. The practice of harassing former patients for debts in various ways is extremely common. And even people who purchase private insurance can get into huge debts, as numerous examples show.
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