A reader writes:
This summer my son needed to have tubes put in his ears. These tubes are very small and resemble miniature shoelace eyelets, a design that enables them to stay in place mechanically once inserted. The insertion takes about 10 minutes but requires that the child be anesthetized. For this relatively simple procedure, the surgical center billed us approximately $10,000. Our insurer cut a reimbursement check to us in the amount of approximately $900. As per verbal instructions from the surgical center, we signed the check over to the surgical center who then adjusted our bill to equal the amount of the reimbursement. Aside from several small co-pays to the ear doctor and anesthesiologist, that adjustment settled our obligation to the surgical center.
While this is admittedly unremarkable, what would have happened if we did not have insurance, or if they did not decide to “adjust” our bill? We were legally on the hook for the full $10,000, a price that was clearly inflated by at least a factor of 10 in the hope that the insurer would pay more. I am no fan of insurance companies in general, and I do think that reasonable regulation is a good idea, but it does bear mention that doctors and medical facilities are gaming the system too, and gaming it in a way that could easily bankrupt a normal family. How are the proposed health care reforms proposing to remedy what I consider to be bad-faith billing?