I have received one letter after another, one phone call after another, about an overdue bill my local hospital says I “owe.” One way that Americans can be responsible and help lower health care costs is to actually request and receive an itemized bill for all services, products, injections, etc. I have asked for an itemized bill on four seperate occasions from the hospital group (a huge conglamerate) and have yet to receive one. I have received what the hospital considers an itemized bill but, by definition, is not. Their bill shows very broad categories that tell me nothing. You and I would not be expected to receive a receipt for, say, groceries and only find:

Meat ——— $67.08
Vegetables — $41.73
Snacks ——- $31.07

Would we?

An itemized bill, by definition, is item-by-item.

MEAT
Pot Roast —-$11.95
Deli Ham —- $9.54
Prime Rib —-$21.00
Prime Rib —-$21.00

You get the idea.

Seeing a truly itemized bill for a surgical procedure from a hospital is eye-opening. You’ll see everything your insurance company and you were charged for. Some of it is legitimate and frankly, most times the bill is full of things you never used. You’ll see the cost for “Facility Fee,” “Recovery Room Fee,” “Warmed Blankets,” “Consultation.” (with who? For what?), “Wheel Chair Use,” (to take you to the car even when you tell them you are fine and will take it from here). I’m not sure what you call this, but the closest I can come to is — scam. The simple fact is that most people find a truly itemized medical bill for a hospital procedure is full of garbage that you didn’t ever use.

But first, the trick is to even get a truly itemized bill. They do not want you to see it and they believe the broad categories are enough for you to pony up a couple of thousand to their “Patient Billing” department. Even after your insurance company has paid them ten thousand dollars! In other words, we allow the healthcare industry to normalize doing things in ways that we would never accept with anything else.

And then, more bills for the same procedure: surgeon, anesthesiologist, imaging, radiologist (to read the images), the list can be quite long. Yes, you really need to get an itemized bill for all of these bills and challenge them when they are wrong or obviously padded. Many times you will find they are asking you to pay what the insurance company already did. Yeah, the more I think of it, I am absolutely certain “scam,” is the right word.

All of the above is another reason we need single-payer health care sooner rather than later. The Medical/Insurance/Hospital complex has seen their day. Huge profits have been made and it’s time to end it all by eliminating multiple payers in health care, offer menu pricing for all procedures and services, and bring the fleecing to an end.

– Mike Swickey