Earlier this week, I posted a reference to the Kaiser Health News article on the proliferation of high deductible health insurance plans and how hospitals have noticed an increase in the number of unpaid accounts as a result.
Reader William Ertel, a Charlotte financial planner, wrote to suggest the problem should be viewed differently.
People should be expected to pay their bills, he said. But how are patients supposed to be responsible consumers if they can’t find out the cost of the services they are buying?
Ertel said he’s had a high-deductible policy for years, and a health savings account to build up a pot of money to use for medical expenses. But "the novelty of this has disappeared for me," he said.
That's because: “No one at a doctor’s office can tell you what anything costs... In my business (or just about any other) we would say that is crazy!”
When a doctor recommends a test, Ertel said he asks for the cost, and the answer is often, “It depends on your insurance.”
“This is, of course, factually incorrect. My insurance might dictate how much I will pay (which is important) but it certainly should have no bearing on what it costs. Should a (procedure) cost more if I have a (Blue Cross Blue Shield of North Carolina) high-deductible plan or if I am uninsured?
"So the original story about hospitals complaining about high deductible delinquency could easily have been -- Hospitals Are Unable to Tell Patients the Costs."
One of Ertel's relatives recently went to the emergency room, and was released after about an hour. The bill from the hospital said "ER services" for $1,200, which was discounted to $900 based on the insurance contract. It was due within 15 days. And there was no more explanation.
Ertel called the billing office for details. Five days later, he got a list of insurance codes and cryptic descriptions – “none of which could interpreted or understood by an average person,” he said.
Instead of focusing on patients not paying their bills, Ertel said: “You ought to let people know how poorly medical service providers communicate their fees and provide billing information....Again, I think people should pay what they owe, but hospitals are failing at providing timely information on amounts and explanations. I think this may contribute to the hospital being paid slowly."