Regular readers will remember that a couple of months ago my wife he almost died because of me. She was complaining of stomach pains and she thought that she should go to the emergency room. It’s probably nothing, I told him. They will charge you a million dollars for telling you that you have indigestion.
Luckily, he ignored me. Turns out he didn’t have indigestion, but appendicitis which caused a medical emergency. The bill for the operation, which arrived this month, was not for a million dollars, but yes very high, almost heart attack. According to our insurance company, the hospital had billed $83,135.08 (about 78,300 euros) for the intervention, but—what luck!—we would “only” have to pay around $2,000 (1,880 euros).
How can it cost so much money to remove an appendix? Those things are the size of a small worm. Well, it doesn’t really cost that much. This is what happens in the United States: nothing has a fixed price in its ridiculously unfair and ineffective health care system. Extraordinarily high numbers are simply pulled out of thin air and all parties involved—insurance company, health care provider, patient—haggle until they settle on a slightly lower number.
There are some strategies to lower the medical bill in United States. Paying the amount in a single payment usually entails a discount if you require it. (They offered us a $300 discount if we paid right away.) Another strategy is to ask for an itemized bill. Interestingly, hospital bills are often riddled with errors. And what’s even weirder is that those mistakes always seem to result in you being overcharged, not undercharged. When you receive an itemized bill, you can discuss, for example, why you have been charged 500 dollars (470 euros) for a paracetamol pill and, magically, those charges tend to disappear.
Of course, it takes a long time to do all this. My wife has already spent several hours on hold on the phone talking to various insurance agents, listening to music that she swears was developed by psychologists to drive you crazy and force you to hang up in frustration.
In the United States, it is always possible to negotiate the bill, but in the process of saving money, one can lose one’s mind.
Arwa Mahdawi is a columnist for The Guardian.
Translation by Julian Cnochaert.