John Stockman’s Medical Bills Topped $1 Million. What Happened?
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The prices charged for health care vary widely depending on your in- or out-of-network status and your insurer’s undisclosed price agreements with hospitals. In one example from Mr. Stockman’s case, he was charged more than 30 times what a Medicare patient would pay for a particular procedure.
The total charges were about eight times what they would have been for in-network care, according to Cigna Corp. , Mr. Stockman’s health insurer. Even when insurance policies cover out-of-network emergency care—as Mr. Stockman’s did—if those charges go beyond what an insurer considers “customary and reasonable,” all bets are off on who will pay.
The undisclosed tiers of pricing are helping drive up U.S. health-care spending, which grew 3.8% in 2017 to $3.5 trillion. The overwhelming charges in many cases are, after long negotiations, absorbed by insurers, and those costs trickle down into higher premiums, copays and deductibles for consumers, say health-industry experts, including the trade group America’s Health Insurance Plans.
Prices—not a higher level of utilization—are a big reason the U.S. spends nearly twice as much as 10 other high-income countries on medical care, according to a report this year in the Journal of the American Medical Association. Medical-care prices have risen far faster than overall inflation for decades.
Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction
January 7, 2019 at 8:12 AM #9359CharlesParticipant
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Egregious over charges by the hospital, denial of coverage by the insurance company, and an American citizen stuck in financial quagmire.
America needs to clean up this mess and pass Medicare for All once and for all…
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