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Mystery pricing systems contribute to medical debt

Virtually everyone in Washington understands the steep costs of medical care, but getting an exact number rather than a ballpark estimate can difficult. Medical debt is an enormous contributor to overwhelming financial burdens, and yet many patients are never told what the end cost will be for a procedure, treatment or visit with specialist. Without knowing what they will end up owing for necessary care, it can be surprisingly easy to fall into a seemingly endless pit of medical debt.

The reform that accompanied the Affordable Care Act led many people to believe that there would be greater transparency with health care costs, but most patients have not experienced this. In fact, a survey from the Catalyst for Payment Reform revealed that only 37 percent of patients know what the price for lab tests will be. Barely half of all patients believe that they fully understand the necessary payments for standard doctor visits, and 60 percent of patients still do not know what non-emergency hospital services cost.

Many hospitals and other health care facilities claim that it is not their fault that they cannot provide accurate pricing estimates to their patients. Instead, they point to the insurance companies that provide coverage for those procedures. Depending on what insurance company a patient has, certain procedures might be covered while others are not, and exactly how much will be covered by the insurance company varies from provider to provider.

Although most health care providers cannot provide a pricing estimate due to scheduling and time constraints, most patients in Washington schedule necessary treatments before the insurance company ever gets back to them with an estimate. Many patients end up having to undergo certain procedures without any knowledge of what their bill will look like because the insurance company dragged its feet and did not provide that information beforehand. The hidden pricing system in the health care system continues to bury sick and injured people under mountains of medical debt that they have little control over and sometimes have no way of dealing with. When this type of debt soon outpaces income and earning ability, bankruptcy can be a viable solution for finding debt relief.

Source:, "The cloak over health care costs: Why is it so tough to get prices for procedures?", Crissinda Ponder, Aug. 10, 2015

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