For the most part, it's true that medication is too expensive. There are many reasons for this. One is that the U.S. healthcare pricing and payment structure is broken. This contributes to the constant rise in prices.

 

While there's a lot of focus on the price of medicines, the bulk of the cost of U.S. healthcare lies in Hospitals and Clinics. One author indicated that these organizations are responsible for over 90% of the costs. Yet, no one seems to be focusing on that.

 

And according to some other reports, the U.S. spends the most money in the world on healthcare, yet we are still only about 37th in overall quality. These are very poor results that lay squarely at the feet of healthcare executives.

 

Hospital bills are crushing people, with many hospitals suing their own customers. Consumer protection bills have not caught up enough to address this practice.

 

However, there's a good way to reduce the risk of going to the hospital. Taking the right medicine in the right way can help keep you out of the hospital. For most folks, the cost of all their medicine for a year won't add up to even one night's stay in a hospital.

But if you do get stuck with a really burdensome bill from a hospital, these tips may help. How you use them depends on your particular situation:

 

- If you have insurance, wait until the Estimate of benefits comes in before you pay

your hospital bill. Otherwise you may over pay.

 

- Hospitals typically have a huge markup on their prices. Sometimes the overpricing

is hard to spot. For example, the hospital may offer a decent price on a common

medicine. If an aspirin costs a $1, they may only charge slightly over that. However,

for the less well known things, like an IV fluid, which may also cost only $1, the

markup may be $80 - $100. These are called 'charges'. Most insurance companies

do not pay full charges. Neither should you.

 

- If the hospital is demanding you pay full charges and you have no insurance,

push back. The starting point for what you owe should be no more than Medicare,

Medicaid, or whatever insurance company (that they accept) pays the cheapest rate.

If they can accept it from them, they can accept it from you.

 

- If it isn't documented, it didn't happen. Hospital bills are notoriously inaccurate. If

you believe there's an issue, ask for the documentation from your medical record. They must provide this same documentation to the insurers to support their claims, therefore, they can provide it to you.

 

- Watch for 'balance billing'. Most medical providers have an agreement with insurance providers about what they will get paid. For example, they may have a regular charge of $30, but their agreed discounted rate with the insurance company is $14. Outside of your co-pay, they shouldn't try to charge you for the balance (the other sixteen dollars). 

 

- Medicare gets a 'refund' if you are re-admitted anywhere within 30 days of a previous hospital discharge. It's essentially a 30 day money-back guarantee. Surely you should also be entitled to some credit if you have to go back into the hospital within that time frame.

 

- Hospitals need to get paid and we are not at all encouraging you to avoid paying your bill. Often, hospitals and their clinics will work out a payment plan. This is more common in not-for-profit organizations than for-profit ones. Your payments shouldn't any more than you can afford, because if you go without medicine, you'll be right back in there.

 

- Hospitals and their case managers and financial people are often aware of resources available to help folks in need. Don't be ashamed to ask for assistance.

 

- Wait or decline to participate in 'patient satisfaction' surveys until you see that you are fairly treated on your bill. These ratings are hugely important to providers as they have an impact on what they get paid in the future. The rating you give should reflect how they treated you overall - including handling your bill.

 

Click on the link below for one story out of many. Only a few hospitals are mentioned, but nearly all follow this same pattern.

 

https://www.msn.com/en-us/money/insurance/the-hospital-treated-these-patients-then-it-sued-them/ar-AAGJvv2?li=AA4Zoy

 

In short, you'll want to take the right medicine in the right way to help keep you out of the hospital. Go to the hospital only when you really need it.

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Nothing herein constitutes medical advice, diagnosis or treatment, or is a substitute for professional advice. You should always seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition.

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