I love Elisabeth Rosenthal’s work.
She’s a medical journalist (an MD, but no longer practicing) who wrote a brilliant series of articles on the high cost of healthcare for the New York Times a few years ago.
Now she has a book on the same topic. Because, of course, our healthcare system with its punishing costs for services, drugs and insurance has not improved. If anything, it’s worse.
As a physician, Dr. Rosenthal has experienced first hand the perverse incentives—illness being more profitable than health, after all—and lack of price transparency in our healthcare system. Her book explores why our system is broken and how it got that way.
More importantly, she realizes what a terrible financial and emotional burden this dysfunctional system places on patients and their families. Her book offers lots of tips for pushing back on the medical billing machine. She also encourages readers to be more informed and to advocate for true healthcare reform.
6 tips to save money at the hospital
Hospital stays are notoriously expensive. I’ve posted several times that you should never go to the hospital alone, but should bring a family member or friend to stay with you as much as possible.
This is mostly for safety reasons, but an extra pair of ears and eyes can also help save money. After all, if you’re sick or sleeping or unconscious, you can’t be expected to keep track of all that is happening.
Dr. Rosenthal agrees, and here are some other tips discussed in the book.
1. Don’t demand a private room.
Most insurance companies base their payments on semi-private (2 beds) rooms, unless the hospital doesn’t have a semi-private room available. Insist on a private room and you may end up paying hundreds of dollars more in out-of-pocket costs. Know your insurance benefits!
2. Identify who comes into your room.
A hospital consult by a specialist can add hundreds of dollars to your bill. Sometimes several specialists will be asked to consult. It used to be your primary care doctor coordinated these visits, but not anymore. One specialist asks another specialist, and so on.
When a new doctor shows up, ask who ordered the consult and why. Keep a small notebook by the bed and log names and dates. This will be helpful when you get the hospital bill.
3. Refuse unnecessary medications, equipment and tests.
If you take prescription medications, bring them with you (well labeled, of course). Meds ordered through the hospital pharmacy will be really expensive.
Bring your own toiletries, too, to avoid being charged for a basin of cheap soaps and shampoos.
As for equipment and tests, second guess everything! Ask why something is needed. How will it change your care if you don’t have it? A lot of healthcare costs come from unnecessary tests, either because a patient demands them or a doctor wants to prevent a malpractice suit. Ask, ask, ask!
4. Avoid out-of-network charges.
As provider networks get smaller and smaller, patients are at more risk of being treated by an out-of-network physician. This is tough, as hospitals aren’t necessarily transparent about who is in or out of your network (although they usually know).
I liked Dr. Rosenthal’s suggestion that whenever you are asked to sign a consent form, write in that you consent only if the provider is in-network.
Again, know your insurance benefits! Some companies cover more out-of-network care than others.
5. Ask for an itemized bill.
Hospital bills used to be itemized, but now they aren’t. I wonder why?? Another trick hospitals use is to offer a small discount if you pay quickly.
Don’t be deterred. You have a right to an itemized bill, and you should use it. Look for errors: medications you didn’t take, tests that weren’t done, consults you weren’t aware of (see tip #2), duplicate charges, etc.
I recently read a statistic that 80% of hospital bills contain errors, so chances are good you will find something. Dr. Rosenthal explains how to read a medical bill and how to dispute it, if you need to.
She also encourages negotiating medical bills. Not everyone is comfortable with haggling healthcare costs, but luckily there is help available! Check out my Resources page for links to medical billing advocate services.
Dr. Rosenthal helpfully provides templates you can use to protest surprise/wrong/simply outrageous medical bills.
Overall, “An American Sickness” is a great addition to your healthcare library!