Washington Post Op-Ed: The health-care industry is letting surgeons behave like muggers

Patients continue to bear the serious financial consequences of surprise medical bills from private equity firms and hospitals. Cynthia Weber Cascio, a patient and former reporter, recounted her own personal experience navigating a hospital maze that ultimately landed her with a $17,000 surprise bill. Highlights from her Washington Post op-ed — The health-care industry is letting surgeons behave like muggers — is included below.

• “We’ve been hearing a lot about surprising medical bills lately — horrible stories about wages being garnished because of large unpaid bills, people losing their homes, even people taking their own livesbecause of medical debt. Yet the public still seems largely unaware that such horrendous situations could happen to anyone — even those with great health-care plans. That’s because our health-care system is ripe for bad actors to abuse patients in emergency situations. I should know; it happened to me.”

• “There were several options, but I felt so sick that we chose a nearby hospital, which we have long trusted for our family’s health. A CT scan and bloodwork quickly confirmed acute appendicitis. I would need surgery immediately. Not to worry, the ER doctor told me. They had a good surgeon on call. Things were moving efficiently and smoothly. We were impressed.”

• “Then we met the surgeon as I was being prepared to be taken into the operating room. He explained that if he didn’t operate right away, I might get sepsis and die. He also said he didn’t take my insurance but assured us I was in capable hands, as he was very experienced. After asking about our occupations, he announced his fee for my laparoscopic appendectomy would be $15,000. We were stunned by the timing and the amount. Was this supposed to be a negotiation?”

• “But there was no time for discussion. I was wheeled off for a straightforward surgery that took about 35 minutes — not much longer than a colonoscopy. The procedure went well. Eventually, the surgeon’s bill arrived: $17,000 including charges for an ER consult neither my husband nor I recall… Fortunately, my insurance covered all other related hospital costs — the ER doctors and tests, the operating room, medications, the anesthesiologist’s fee — but that still left us with the $17,000 charge from the surgeon. That’s more than seven times the out-of-network, uninsured rate for the hospital’s locale, according to FAIRHealth Consumer.”

• “I wrote to the head of the hospital and patient relations. Surely the surgeon mistakenly added an extra zero? Was the hospital aware business affairs were taking place in pre-op? Can an out-of-network surgeon simply make up any fee on the spot? I felt violated.”

• “Telling a patient to negotiate a bill directly with the provider, as my insurance company suggested, is akin to telling the victim of a mugging to ask the thief for their purse back. It’s uncomfortable and intimidating. And in an emergency, patients don’t have the luxury of time for research. Without any kind of regulation or oversight, it’s fertile ground for the opportunistic and unscrupulous. What if we had told the surgeon, as I was about to be wheeled off, we thought his fee was too high? What would have happened?”

Read the full piece here. To learn more about the fairest, most comprehensive to solution to taking patients out of the middle and protecting them from surprise billing, click here.