Health care confusion

By Tom Purcell, Special to the Katy Times
Posted 9/15/22

I'm confused.

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Health care confusion

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I’m confused.

I got the flu a few months ago, the worst flu I’d ever had. It wasn’t COVID—I have never tested positive for COVID—but it was a humdinger.

For more than a week, I was a lump on a bed, completely unable to move or do anything.

To make sure I wasn’t going to perish, I paid a visit to the hospital emergency room. They tested me for all kinds of things and, five hours later, said I had the flu and that I could go home.

It was nice to be assured that all I had to do was let my immune system wage a mighty battle for the rest of the week.

It wasn’t so nice when the bills started coming in, which totaled more than $7,000—from what I can gather.

I have a decent health insurance policy through my corporate client that has temporarily brought me on as an employee to support a big project, so, after deductibles are met, I owed $2,500 or thereabouts—from what I can gather.

Months later I am still in a state of total confusion and know it will take me hours to figure out how much I owe and to whom.

And I am not alone. Millions of Americans are befuddled by their health insurance policies and the convoluted bills they receive when, God forbid, they need to get health care.

According to the Portland Press Herald News, there are lots of hidden fees in medical bills that jack up the cost of services, and there is no continuity among providers.

One hospital may charge $750 for an MRI and another may charge $3,000 or more for the identical service.

Healthcare.com conducted a survey that found more than one in four Americans are befuddled by unexpected medical bills.

Don’t understand the difference between co-pays and deductibles or in-network and out-of-network providers?

Well, get in line, because you have a lot of company—but there may be hope for us all yet.

In January 2022 the No Surprises Act went into effect. It requires hospitals and health care providers to make the fees they charge for services public, according to MarketWatch.

The intent of this act is to prevent patients from getting crushed by surprise bills, such as “balance billing,” which healthinsurance.org explains well.

Balance billing occurs when providers bill a patient for the difference between the “retail price” they charge and the amount that the patient’s insurance pays—which is almost always less. When some providers bill the patient for the difference, or balance, it’s called “balance billing.”

In other words, if you have an emergency and you get care from a provider outside of your network, you will get a big fat bill.

But under the No Surprises Act patients are liable only for their in-network fees.

That’s a nice start, but the real problem is that our health care system is a confusing mess. It needs reform from top to bottom.

If a person does not have a decent health insurance policy—and decent policies are costlier now—he’s still at the mercy of receiving massive bills for needed care.

Now, if you’ll excuse me, I have to figure out who and how much I owe for coming down with the worst flu of my life.

Tom Purcell, creator of the infotainment site ThurbersTail.com, is a Pittsburgh Tribune-Review humor columnist. Email him at Tom@TomPurcell.com.