This $55,000 Bill Is The Perfect Example Of Our Broken Hospital System

[sendero]

4. Hospital billing....

.... is a byzantine mystery shrouded in secrecy. It's completely broken and needs to be fixed with LEGISLATION, the only thing short of single-payer that will work.

Most of the care hospitals provide is done under an insurance contract. Each insurance company (payer) contracts with each hospital (provider, usually at the "chain" level) exactly what the reimbursement will be for each procedure.

These reimbursements are often based somewhat on "charges", a fictional sum that nobody except poor saps with no insurance actually pays, or gets billed at least. The actual reimbursement is typically a small fraction of the "charges" number, something like 15 or 20 percent.

The net effect of this scheme is that if you have insurance, your insurance company gets billed something like a reasonable amount for your procedures and services. If you do NOT, you get billed the "non-contractual" rate which is an inflated beyond belief fictional number pulled out of thin air.

The LAW I want to see passed would set the amount billed to a non-insured patient at either the minimum that the hospital gets from any insurance company for the procedure/service, or at worst the average reimbursement for the procedure/service.

Then at least someone who has the misfortune of having to go to the hospital without insurance would have a fighting chance of getting a bill that has some basis in reality.