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Private health insurers don’t let you budget for your care

Written by Diane Archer

Kaiser Health News reports that people with the wherewithal to shop around for affordable health care can easily end up with bigger bills than they expected. Unlike traditional Medicare, private health insurers don’t let you budget for your care.

No one should have to shop around to ensure that their health care is affordable. Most people needing care have better things to worry about than whether their insurer, doctor, or hospital will charge them a fair price. Still, private health insurance companies force Americans to shop for care if they want to keep their costs down.

Kaiser reports that even people with private health insurance who try to budget for their care may not succeed at keeping their costs down. One couple, the Balzer’s, planned a laparoscopic hernia repair operation for after they had had a baby and had met their insurance deductible. Wolfgang Balzer also called the hospital and the doctors for cost estimates.

Still, the Balzer’s could not get an accurate sense of their costs. The anesthesiologist’s office would not return his phone calls. The hospital’s actual bill was more than 50 percent higher than its estimate. And the surgeon’s bill was more than twice the estimate. With insurance, the Balzer’s owed $2,304.51, $800 more than they expected.

The Balzer’s challenged their bill, a time-consuming and stressful process. The procedure had gone exactly as expected, and there was no reason the bill should have been higher than estimated. The Balzer’s learned that  neither hospitals nor doctors are required to give accurate estimates of patients’ costs.

The Kaiser reporter inquired about the Balzer’s charges, and the hospital ended up writing them off, six months after the surgery. That’s the good news. The bad news is that most of us do not have a reporter following up on our health care charges.

In other countries, where patients must pay a piece of the cost, providers are expected to give them accurate cost estimates. And, people’s out-of-pocket costs are nowhere near as high as they are here. It’s time to fix our broken health care system.

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