August 29, 2018

THE PROBLEM WITH MEDICAL PRICING IS THAT IT’S ENTIRELY PHONY: A heart attack left him with a $109,000 bill. His story aired, and now he owes $782.

First, Drew Calver had an unexpected heart attack, collapsing in his bedroom on a spring morning in 2017.

Then came the bill: $164,941 for his four-day hospital stay, which included the cost of having four stents put in a clogged artery. As a teacher and swim coach at a public high school in Austin, where he lives with his wife and two daughters, Calver is luckier than some, with health insurance provided to him by Aetna. But even after the insurance kicked in and covered $56,000, Calver was left with nearly $109,000 in unpaid fees billed to him by the hospital.

Calver’s story, which was first reported by NPR and Kaiser Health News as part of a series that examines health-care costs, has captured attention far and wide, a cautionary tale about the way that even those with health insurance can find themselves buried under bills after receiving treatment because of loopholes and surprises in hospital and insurance policies and fine print. . . .

After the story was reported on Monday, the hospital said that it was willing to accept $782 to resolve Calver’s balance, based on a financial-assistance program it has, according to the two media outlets. But Calver said he doesn’t know if he’ll pay the balance and said he remains shaken by the experience.

If we required pricing transparency and consistency, a lot of problems and unfairness would go away.

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