As the political debate over healthcare continues to rage in Congress, one thing many Americans can agree on is that the cost of healthcare in the U.S. has become too high.
Elisabeth Rosenthal, a doctor and former New York Times reporter who wrote the book "An American Sickness: How Healthcare Became Big Business and How You Can Take it Back," gave tips in an interview with ABC News on how to protect yourself from being hit with exorbitantly high medical bills or how to fight back when that does happen.
Her new book examines where things went wrong and how patients can take back their rights within the healthcare system.
Wanda Wickizer, 51, from Virginia, told ABC News that following the death of her husband she lost her health insurance. Wickizer, who considers herself to be a normally healthy person, was working part time and raising two children, and felt she could not afford health insurance, so she went without it.
On Christmas Day in 2013, Wickizer ended up in the emergency room after suffering a series of debilitating headaches and vomiting. She later found out that a blood vessel in her brain burst, and the treatment required 15 days in the hospital and a medical evacuation.
Wickizer says, however, that even worse pain came later, when the bills for her treatment began coming in.
"The bills started coming in, we'd open them and it was just like unbelievable," Wickizer said. "I mean the helicopter was $50,000."
The total cost of saving her life that day amounted to nearly $500,000, Wickizer said.
"I cried a lot ... I couldn't pay all these bills and they kept saying, 'Well, you have to,'" she said.How the GOP health care bill failed without a voteRyan pulls 'fundamentally flawed' GOP health care bill following call from Trump
Rosenthal cites Wickizer's healthcare nightmare as proof that the cost of American healthcare has been hijacked.
"You're both a patient to the good guys, and an ATM machine to the bad guys," Rosethal said, but added that the medical professionals are not the only ones to blame for the skyrocketing costs of healthcare.
"Patients don't speak up, don't assert their needs," Rosenthal said. "Patients have been complacent."
One thing Rosenthal recommends patients start doing is to understand that they hold a lot of power when they are getting treatment.
"[What] every patient should know is you have power, you have control," Rosenthal said. "Don't just write a check."
She added that before any treatment, ask your doctor how much tests, exams, and even surgery will cost. If additional testing, like x-rays or blood tests are required, demand that your doctor use in-network facilities.
Wickizer's fight to contest her medical bills took more than two years, and she said that during this battle she often wished that she had never even gone to the hospital.
"I would have died, but I wouldn't have had went through this," Wickizer said.
Wickizer said that eventually she reached an undisclosed settlement.
"We were never asking for me not to pay anything," Wickizer said. "I just wanted to pay what I had, what was fair."
In her book, Rosenthal goes into detail about what questions you should ask your doctor, how to read a hospital bill, how to dispute a hospital bill, and how to negotiate with your insurance provider. She also examines the U.S. healthcare system holistically, questioning why things such as drugs, childbirth, and surgery are more expensive in the U.S. than nearly anywhere else in the world.
Rosenthal shared the following templates with "GMA" for patients to use when protesting certain healthcare bills. She also recommends utilizing websites such as Health Care Bluebook and Clear Health Costs to better educate yourself on what your medical bills should look like.
To Tackle a Surprise Out-of-Network BillDear Sirs:
The bills enclosed were for out-of-network services performed on __________ during my admission to __________ Medical Center, a hospital that is in my insurance network. I went to __________ Medical Center precisely because it was in my network. I was not informed of these providers' out-of-network status and did not consent to being treated by any out-of-network providers. Since I did not give informed consent for treatment beyond the terms and network of my insurance policy, I suggest you contact my insurer to work out payment; I will pay only that portion of the bill that I would have paid for in-network services. Please stop this effort to collect a bill I do not owe for a service I was never informed would be out-of-network. If I get another notice, I will report this collection effort to the __________ State Department of Insurance and __________ State Department of Consumer Affairs.
To Obtain Medical Records and Itemized Bills
I have now requested my medical records/itemized bill __________ times and have yet to receive the material. It is my right to receive these records in any form I request under the Health Insurance Portability and Accountability Act within thirty days and for a reasonable handling and processing fee. If this material is not quickly forthcoming, I will file a complaint with the federal Health and Human Services’ Office for Civil Rights, which prosecutes HIPPA violations.
To Challenge Outrageous Charges/Billing Errors
I'm writing to protest what I regard as excessive charges for my operation/hospitalization/procedure at your medical facility. The operation/hospitalization/procedure was billed to my insurer/me at $_____. This total included several itemized charges that were well above norms for our nation and our region, such as a $_____ charge for __________ and a $_____ charge for __________. The Healthcare Bluebook says a "fair price" is $_____ and $_____. Likewise, my bill includes entries for treatments I simply did not receive, such as $_____ for __________ and $_____ for __________. Before sending in any payment, I'm requesting that your billing and coding department review my chart to revise the charges, or explain to me the size and the nature of such entries. I have been a loyal customer of your hospital for many years and have been happy with my excellent medical care. But if these billing issues are not resolved, I feel compelled to report them to the state attorneys general/consumer protection agency, to investigate fraudulent or abusive billing practices.
"An American Sickness: How Healthcare Became Big Business and How You Can Take it Back" will be in bookstores nationwide on Tuesday, April 11, 2017.
- health insurance
- medical bills
- healthcare system