Show 1267: Unscrambling Unreasonable Medical Bills

Medical bills are notorious for being difficult to understand as well as expensive. Most people are intimidated by medical professionals and the bureaucracy. But we can and should fight back, according to our guest Marshall Allen. Errors in medical bills are common, and fraud is not unheard of. Why does Allen urge us never to pay the first bill?

Is the Proposed Treatment Really Necessary?

One way to make sure you don’t overpay medical bills is to refuse any treatment that isn’t necessary. Our fee-for-service healthcare system has a lot of incentives to offer treatments patients may not really need. Perhaps a quarter fall into this category.

How can you determine if your proposed treatment is really necessary? One way is to ask questions: What are the chances this treatment will work? What does it cost? What are the risks? Most importantly, what happens if we wait?

“The Healthcare System Is Not Broken:”

One of the most important insights that Marshall Allen shares with listeners is that trouble we all have unscrambling unreasonable medical bills is not a symptom of a broken system. The system is actually working exactly as it was designed to do, extracting as much money as it can from American patients, employers and taxpayers.

Why We Should Fight Unreasonable Medical Bills:

Among the reasons we should fight back are the huge amount of waste in medical spending (up to 25 percent of the total) and the unfairness that the business of medicine exploits our sickness for profit. In addition, although we patients are the ultimate consumers, the healthcare bureaucracy doesn’t treat us with the respect a business normally affords its customers. As a result, it is up to us when we get a bill to check that it is fair and accurate–and to object when it is not. Allen offers plenty of guidance on how to do that.

This Week's Guest:

Marshall Allen spent 15 years investigating the health care system as a journalist, including a decade as a reporter for ProPublica. (He recently left the organization.) He is a two-time Pulitzer Prize finalist and recipient of the Harvard Kennedy School’s Goldsmith Prize for Investigative Reporting.

Marshall Allen teaches investigative reporting at the Craig Newmark Graduate School of Journalism at the City University of New York. Before he was in journalism, Allen spent five years in full-time ministry, including three years in Nairobi, Kenya.

He is the author of Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win.

Listen to the Podcast:

Some of our conversation with Marshall Allen didn’t fit in the broadcast, but we’ve included it in the podcast. You'll want to listen to learn about the amazing insurance warrior Laurie Todd and her method for getting insurance companies to pay bills they'd rather decline. We also discuss coverage issues for chronic conditions, including long COVID. Is there anything we can do to change the way the business of medicine works?