No one in the world wants to get an unexpected bill for $5,847.29, especially after undergoing two heart procedures within a month. The reaction is almost always anger, disbelief, and the impulse to fight and challenge and never surrender.
In our culture, we honor victory, not compromise or acceptance.
We are a land bursting with distrust and suspicion of almost every institution we come across; this is why we have a President like Mr. Trump.
I got hundreds of messages about my bill – I wrote about it yesterday – and almost every one of them suggested ways in which the bill might be wrong or the avenues I could take to challenge, delay or fight to pay it.
I thank you for each one.
Nobody had a good word to say about hospitals or insurers.
One or two said the bill was probably valid and that I would have to pay it.
The messages were a powerful testament to many Americans’ distrust and anger over their embattled and confusing, unpredictable health care. We all want to know if we get seriously ill, we can get help without going broke.
We’re not there.
But the challenge for me seemed different. I had two heart procedures, for which I am grateful and not angry. They both worked out well; I had the best care.
I wanted to find a principled acceptance of this bill, one without anger or lament, and I found one for me. I understand it isn’t the choice many others would make, but I’m clear that it is the right one for me.
I learned this morning – I called my doctor, my insurance company, and then the hospital – that my contract with my supplemental insurer (along with Medicare) required the insurer to pay 80 percent of a hospital procedure like this. I am required to pay the remaining 20 percent.
Although I didn’t understand that part of the agreement or read it carefully, I did sign it, and I am responsible for paying 20 percent of those two surgeries, which amounted to $5,847.29
The hospital was courteous and efficient. They got right on the phone, looked up my bill, explained the charge and my responsibilities.
That was the defining moment for me.
The bill might be unjust in many ways, but it is valid, and I accept full responsibility for it. I saw no need to subject anyone to weeks or months of conflict, paperwork, and challenges.
I choose to be grateful for my heart and for the resources I do have.
There is enough resentment and anger in the country, and I don’t wish to enable more. I don’t wish to feel more.
Somebody has to start somewhere if things are to change. Besides, I don’t have a case; I don’t believe in arguing for its own sake.
I gulped and took a deep breath, which is easier now, thanks to the hospital.
When I asked the hospital – the Albany Medical Center – if it was possible to spread out the payments – I don’t have 5,800 dollars to spare – they said sure. When I asked them how much I needed to pay, they said whatever I could afford, it was entirely up to me.
I said I’d like to put $2,000 down on the bill and pay $100 a month for the remaining amount. I can pay that over 38 months or sooner if I have the money which I expect will be the case. If nothing changes in my life, I intend to pay this off in a year or less.
And I don’t need or seek any Financial Aid from the hospital or anyone else.
I appreciate the fascinating and generous advice so many of you offered me. Still, when I thought about it this morning, I realized that I don’t want to spend my year demanding statements, poring over them, filing appeals, and arguing.
I see how suspicious people are of hospitals and insurers; that seemed heartbreaking to me. These are the people we turn to when we need help, and it would be wonderful if we could learn to trust them again.
Whatever happens in November, I want to spend my remaining time on this earth writing, taking photos, loving Maria, walking Zinnia, staying healthy, riding my e-bike, protecting my heart, and right up at the top – helping the refugee children and family at Bishop Maginn and doing what I can for the residents and aides at the Mansion.
That work with the Army of Good has been the best, most nourishing, and rewarding work of my life. That’s what I want to be doing, whoever wins in November, the need will remain great.
There are many wounds to heal.
Pain is inevitable; suffering is a choice, so is arguing. I didn’t spend the past four years arguing about Donald Trump, and I won’t spend the next year or two arguing with a hospital and insurance companies.
Much is wrong with our health care system, but this bill is neither dishonest nor invalid. There is no reason for me to fight it or avoid paying it.
I believe in honor and truth; even though I haven’t always lived up to that, I am no saint. I can assume I’m getting screwed or simply man (or woman) up and pay my bills.
I owed this money, and I am morally and ethically (and emotionally) obligated to pay the bill. The hospital and the doctors did their job, and the insurer spent more than $70,000 on my heart. That counts for something.
However insane our health care system is quite insane, unfair, and cruel – it’s the one we have and the one we have to live with until sanity reigns, which I believe it will.
I will do better working on behalf of fair and affordable health care than whining about my bill. I am one of the lucky ones; I can handle it.
So after I post this column, I’m driving to the Cambridge Post Office and mailing out a check for $2,000 to the Albany Medical Center. Next month, I’ll get my bill for $100 and pay it that much or more until my bill is paid.
I don’t know if this is radical acceptance or just the old-fashioned kind. But it feels right for me.
I would do the same. It’s a shock, but as you said, it’s the deal you made when you signed. Good for AMC allowing you to pay over time.
Hi Jon,
I am sorry to hear about your unexpected bill. It isn’t a welcome situation for any of us. However, I do have something good to say about one hospital and one of several experiences I have had there. The short story is I lost my insurance when my husband died and for the first time in my life I needed it. I have two injuries that have gone untreated for seven years as a result. In my attempts to work around this I have been offered imaging services from our hospital, St Charles, for free. Unfortunately it hasn’t been enough as I need the doctors and the therapies to follow and that has all been unavailable. Non the less I have had some help from the hospital. Then last fall I ended up with pneumonia, and a serious case at that, and ended up in the hospital for three days. The hospital gifted me the entire expense, no argument, little paperwork and a “we are so happy to help”. I cried with relief. And we have a wonderful hospital. I was very well cared for. The rest of the system is so very wrong and I have suffered for that, as have many others, but I do want to add this bit of good news about my hospital experience. I am hoping all turns out well for you in your situation.
Blessings Wendy
Good for you..medical systems might not be the best but 20% is perhaps a small amount over the total cost and your life..I think we have become a world where we think we are entitled to as much free stuff as possible..I wish all health care was free, but medical professionals have to be paid for their jobs too..their expertise and the amount of money it cost them in education to saves our lives..In Canada, we are mostly free but not all the way. If I were presented with a large bill like you were, I too would be hard pressed to come up with this money..but in the end it costs a lot more money to die and be disposed of..
” I think we have become a world where we think we are entitled to as much free stuff as possible..”
This is what we have to become careful of happening. Good reasons (e.g., equal opportunity, care for the distressed,…) need to be the basis for governmental “free stuff,” and implementation fair.
If there’s a way to insure against the 20% charge, we should use it. And maybe get a nudge to do so.
I’m glad you’re better!
It’s kind, and preserving sanity through acceptance. My husband and I had a similar experience and did the same thing, arranged for a payment plan and payed extra when we could. It felt good to make the final payment and the repair work done on my husbands leg after a motorcycle accident was well worth the bill. Take care and keep writing Jon! It is a gift to all who read this blog!
My concern this is just the beginning. You’ll receive bills from radiology, hospital MD, pharmacy, anesthesia….
Happy you’re well and good luck
Great decision!!! I did that with a lawyer when I got my divorce. I could only pay $50 a month, but as long as I paid something each month it worked. It’s all in the fine print. You are healing and this is a giant step in the easing of tension.
Jon – contest the bill as a nurse I can tell you the markup is insane this is simply profit over and above the insurance payment Although they will deny it I I would request an itemized list of what exactly you are being billed for and what exactly was covered by insurance . Our health care system is broken and to say it is non profit is a joke
Rural areas suffer more so as the choices are limited of where you can go.
Yesterday, you did mention that you have a supplement for the other 20%? Is that noted on the bill anywhere or deducted?
Are you old enough for a Medicare Advantage insurance option. We have Blue Cross Blue Shield coverage and it has been a god send.
Hello Jon, I have a cd that I got from a friend and while driving in my car I was listening to it. With the dogs that I had in the past I can relate to your dogs. I’ve had 2 puppies to start and 11 Rescue dogs . They stuck to me like glue. Every place I went, they went . The only place I couldn’t take them was to work. When it came time to put them down because of illness or other medical issues, it was the hardest thing I did. I always stayed with them until they closed their eyes and went to doggie heaven. I always had them cremated. One I buried in my back yard. I rented a backhoe and dug a hole big enough for a wood box and cover that I made. Put his blanket and a few dog bone to eat on the way to heaven. The second dog was cremated and buried with my parents which we all loved . They will always have a dog that they loved. The rest is cremated and buried in different locations where they loved to go. Two of the rest is in our curio cabinet and the last is still alive but close to the end. She slowing down. I want her buried with me when I go. By the way, They were all Australian Shepard’s. The first two were puppies and the rest were rescue dogs. Getting back to my comment: I would like to know how many of your dog books are on CD’S? I enjoy listening to cd’s while driving in car. I just bought 4 on Amazon and The one i’ve been listening to from a friend. I can relate to “THE GOOD DOG”. I need to hear more of your dog CD’S Thankyou
A better outcome than expected. Glad the hospital was able to set up a payment program that works for you and them.
Right now, my husband, a retired police officer 80 years old, is fighting the mayor of the city where he was a police officer, to keep their collective bargaining retiree health care. The mayor is covertly working to reduce the collective bargained health care and raise deductibles. These horrid actions by the mayor affect police, fire, UAW and Teamster retirees, retirees who are on disability, widows and widowers. The mayor wants retirees to have same health care as current employees……current employees with much higher salaries than when these people retired. Can this year get any worse?
Jon, I’m disappointed for your outcome. But I’m all for playing by the rules and accepting an honest decision.
When it comes to health care, I seek the best we can afford, and pay up. When my wife had a double valve replacement in 2019, I was grateful for her excellent surgeon, the skillful and compassionate hospital staff, and even our insurer who covered these expenses. Not a good place to cut corners.
Here are some descriptive explanations about supplement policies.
• Unlike with Original Medicare and Medicare Advantage, supplement policies are issued by private companies with little federal oversight. Policies are regulated by each state’s Department of Insurance.
• Supplement plans are standardized by Plan Type, and the specifications of each type determine your benefits. In 2020, the available types are A, B, C, D, F, G, K, L, M, and N.
• Note that Plan K and Plan M DO NOT PAY 100% of the Part B copayment. Plan K pays 50% and Plan M pays 75%. If you have one of these, that could explain the amount owed. Note, these plans have other limitations.
Our hospital/health system allows you to pay as much or little you can afford per month as long as you pay something each month. I’ve appreciated it so much over the years. I don’t let it upset me because they are so understanding and agreeable.. Yeah 5.8k seems like a lot but considering what was done it’s understandable. My son in law racked up a 1 million dollars bill due to his hospitalization from Dec-April for a life threatening illness. My daughter works for the same system which covers hers and her family’s bills as long as they stay in network. Luckily they did. Their final bill was: zero. There is still some good in the world.
Your bill is a small one compared to the ones I worked on to get paid, cleared up, disputed, etc.
Never mind the stories of a single $3.00 Tylenol, when $3.00 will buy a bottle at the drug store.
MRI, CT, CAT scans. X-Rays are now mature technologies, and the price per service makes no sense.
Here is where regulation is needed.
Most shocking is this: If you are 100% self-pay you will pay a WHOLE lot more! Hard to believe but true and tragic.
I was in health insurance for years. It is an industry that needs MASSIVE overhaul and a lot of new regulation, unwelcomed by the industry. There are all manner of agreements between insurance companies and health care provider chains for special pricing and reimbursements based on the number of lives the employer brings. There are different agreements between healthcare providers and insurance companies called “capitation” which rewards the providers for lowered cost of care which reduces the care the patient gets and increases the amount paid the provider gets. It’s a bonus to the provider for delivering less care per life. The dollars get really big if you have as many lives to offer an insurance company as a worldwide oil company. It’s another story for a small air conditioning company with just 50 employees. The AC company will pay through the nose in premiums, copay, deductible, co-insurance, and many more drugs on a more expensive tier of pricing.
Hi Jon, I commend your attitude toward this whole mess. Too late in my career I signed up for a high deductible plan with a health savings account. In exchange for lower premiums, I had a high deductible that gave me incentive to act like a rational consumer. I think that if more people paid providers instead of insurance companies, the whole system would operate more efficiently. With low deductible plans, when you have a good health year, the insurance company benefits. With a high deductible plan, you reap the benefit of a good health year.
Part of an experience I had with my husband:
By now most informed people have read the articles about the horrific costs of medical treatment in the U.S. compared to other countries for the same procedures, but until it happens to you, you don’t realize how horrific it is. When Maurice checked in to get the bronchoscopy and the clerk taking his info found he had no insurance in the States, she said the cost would be $24,000. No that is not a typo. We were shocked to say the least. They must have realized how appalled we were because they then said that if we paid now-for what would amount to a twenty minute procedure-the cost would go down to $14,000! As we didn’t want problems we put it on our credit card. Even the surgeon, the anesthesiologist and nurse were totally shocked. The nurse even said we shouldn’t pay it. Someone advised us to call billing and see what could be worked out. So we went, and they immediately took off 78% of the total cost – just because we asked. It all felt like one of those Nigerian ripoff scams, or what it must feel like to deal with racketeers. After that, any time a bill came I would call and ask for a lower cost and there always was one. Had we not known to ask, we would have taken all the costs at face value. And the TB meds for one month alone were $700. The doctor and pathologist costs were more reasonable but we still haven’t received all of the bills.
What I don’t understand about medical bills is why not an estimate of what the procedure will cost beforehand. In any transaction we make we usually know, or have some idea what the price is. If I’m buying a roof the roofer gives me an estimate. Does this exist in the medical field?
Thank you Jon for taking the high road!
I have a wonderful hospital system here in The Villages, Florida.
I am 85 years old, have a wonderful caregiver right across the street, who came here at Gods direction, to watch over me and he has done just that!
Keep on keeping on Jon!
Barbara Storey
Hi Jon,
Kudos for your attitude and values in the billing of your hospital stays. While I generally agree that you owe the money, I know for certainty that anything relayed to hospital procedures are greatly over-inflated price wise. So I am cynical at best when it come to anything related to healthcare. Two examples, my brother receives a monthly infusion for a degenerative spinal disease. The billed cost is over $20,000 per infusion. Obviously, only Donald Trump could pay for that. And last year, I was in the hospital for a day and a half for double pneumonia and the bill was over $40,000. So I asked for detailed billing statement just for grins. The box of generic 100 ct. Kleenex was $43.00 !!
My cynicism comes from usury . I truthfully don’t believe in screwing people regardless of the excuses. But that’s just me. I have raged against the healthcare system many times and lost every time. Now I’m too old and tired to fight.
Most importantly, I’m glad your’e better and I hope you continue to recover. I have contributed to many GoFundMe situations for hospital and medical bills and would do the same for you. Take care.
Congratulations on being a man of integrity 🙂
It’s a very rare character trait that many don’t possess anymore.