Drew Altman, Kaiser Family Foundation
December 9, 2019
Reproduced from Kaiser Family Foundation;
Chart: Axios Visuals
People who are in the middle of a health crisis often
are at an especially high risk for surprise medical bills, according to
previously unreleased data from the Kaiser Family Foundation.
The big picture: The new data
underscore the importance of a legislative solution to help patients who are
powerless to protect themselves.
Details: People having
surgery or receiving mental health and substance abuse treatment at an
in-network hospital are the most likely to experience a surprise bill from an
out-of-network provider.
- Among people with employer-based
insurance, out-of-network charges were 50% higher among heart-attack
victims than for other diagnoses.
- 21% of women undergoing
mastectomies experienced out-of-network provider charges.
My thought bubble: It’s hard to
imagine many patients who are so prepared and insurance-savvy that they could
protect themselves from an out-of-network bill in the middle of a heart attack.
Why it matters: It doesn’t
take a headline-sized bill to wreak havoc on family budgets.
- Half of the American
people say they would have to borrow
money or go into debt to pay a $500 medical bill, or wouldn’t
be able to pay it at all.
- Unexpected medical bills
are the public’s top health
cost concern, ahead of deductibles, premiums, drug costs, and
even paying the rent or the mortgage.
- People with major
medical conditions and chronic illnesses are most likely
to experience problems paying their medical bills.
The bottom line: Congress is
torn between two competing ideas solving this issue and settling payment
disputes between insurers and providers. Each plan has its own implications for
premiums and industry negotiations, but for patients, just getting a fix is the
most important thing.
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