There are undoubtedly thousands upon thousands of these, the vast majority of which don't reach the public eye and are suffered quietly by the powerless victims. This story about a myocardial infarction successfully treated with stents was posted by Kaiser Health News:
Patient: Drew Calver, 44, a high school history teacher and father of two in Austin, Texas.Every now and then I allow myself to rant about matters that drive me to distraction, including health care financing in this county. I spent over 30 years in academic medicine, and I have immense admiration for the people who actually provide the hands-on healthcare in this country, especially the nurses and therapists. The problems arise from the vast army of administrators, coinsurers, financial analysts, billing clerks, chart analysts, insurance adjusters, collection agencies and others who feed off an ever-expanding and ever-more-complex web of regulations and policies.
... [as he was recovering from his MI and the stent placements], Calver asked whether his health insurance would cover all of this, a financial worry that accompanies nearly every American hospital stay. He was concerned because St. David’s is out-of-network on his school district health plan. The hospital told him not to worry and that they would accept his insurance, Calver said...
And then the bills came.
Total Bill: $164,941 for a four-day hospital stay, including $42,944 for four stents and $10,920 for room charges. Calver’s insurer paid $55,840. The hospital billed Calver for the unpaid balance of $108,951.31.
Medical Treatment: Emergency room treatment followed by four days in the hospital, most of it spent in the cardiac unit. During surgery, four stents were implanted to clear a blockage in his left anterior descending artery, the source of so-called widow-maker heart attacks, because they are so frequently deadly...
Surprise bills occur when a patient goes to a hospital in his insurance network but receives treatment from a doctor that does not participate in the network, resulting in a direct bill to the patient. They can also occur in cases like Calver’s, where insurers will pay for needed emergency care at the closest hospital — even if it is out-of-network — but the hospital and the insurer may not agree on a reasonable price. The hospital then demands that patients pay the difference, in a practice called balance billing...
This case “illustrates the dangers that even insured people face,” said Carol Lucas, an attorney in Los Angeles with experience in health care payment disputes. “The unfairness is especially acute when there is an emergency and the patient, who might ordinarily be completely compliant, has no say about the facility he winds up in.”..
St. David’s charged $19,708 apiece for two Synergy stents made by device giant Boston Scientific. Two other stents used were far cheaper.
The $20,000 price tag represents a significant markup of what U.S. hospitals typically pay themselves for stents. The median price paid by hospitals for the Synergy stent was $1,153 over the past year, according to the nonprofit research firm ECRI Institute.
There is no need for cases like the one detailed above to occur. The system doesn't need to be this complex. Even the people who administer the system realize it is fucked-up, but they don't have the power to make changes in a bureaucracy that is extraordinarily complex.
Look what happened in this case after the story was publicized:
UPDATE: Monday, shortly after publication and broadcast of this story by Kaiser Health News and NPR, St. David’s said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its “financial assistance discount.”Got that? They graciously offer a "discount" from $109,000 to $800. Because someone took the time to bring this story out of the darkness and expose it to daylight.
I don't care whom you vote for this November - Republican, Democrat, Independent - but please for the love of God and in the name of common sense, vote for someone who will totally gut this system of health care finance.
And don't accept the lame alternative of a politician who assures you that under his/her proposal "everyone will have health insurance." This case - and tens of thousands of untold ones - illustrates why that is an inadequate alternative.