People worry most about unexpected medical bills

Surprise medical bills could be a powerful campaign issue

By Drew Altman
Axios, September 24, 2018

As the chart shows, unexpected medical bills are the number one health cost problem people worry about, ahead of all the cost issues that get more attention, including deductibles, drug costs, and premiums. They're even a bigger concern than other family expenses, such as paying the rent, mortgage, or utilities.

* Surprise medical bills also affect a lot of people. In a recent Kaiser Family Foundation tracking poll, four in ten adults (39 percent) say they had a surprise bill from a doctor, hospital or lab in the past year.

* 10 percent report that an unexpected bill was from an out-of-network provider.

* Almost 18 percent of inpatient admissions result in non-network claims for patients with large employer coverage.

Percent who are very or somewhat worried about being able to afford...

67% - Unexpected medical bills

53% - Health insurance deductible

46% - Gasoline or transport costs

45% - Prescription drugs

43% - Monthly utilities

42% - Monthly health insurance premium

41% - Rent or mortgage

37% - Food

The bottom line: Unlike consumers, experts do not generally put surprise bills at the top of their list of the problems in the health system. But people talk about their unexpected bills a lot, and with a sense of outrage.

Discussion draft of "Protecting Patients from Surprise Medical Bills Act":



By Don McCanne, M.D.

According to this survey, unexpected medical bills such as the surprise bills from out-of-network providers are the number one health cost problem that people worry about. Even if insured, an individual may be exposed to large medical bills that were not expected.

Currently under discussion is proposed federal legislation that would limit the patients' exposure to these unexpected bills but would shift at least some of the extra charges to the insurer. Not only would those costs be transferred to the insured through higher premiums, but we should also ask if it is fair to pay physicians who agree to becoming a network provider less than is paid to those physicians who refuse to cooperate. Although opinions on that would certainly vary, we can say that such a payment scheme is, at least, inequitable.

The fundamental problem is more than the fact that insurers deliberately limit the breadth of their provider networks; it is that private insurers include a multitude of design features to enhance their business model for the benefit of their investors.

Under a well designed, single payer, improved Medicare for all there would be no surprise medical bills, nor would there be any of the other injustices that a market model would inflict upon their enrollees. Plus everyone would be included and it would be affordable for all. We spend a lot of time talking about the injustices of our fragmented, dysfunctional system such as these surprise bills, but it is the last point - affordable care for everyone - that should be the driving force behind health care reform.

Stay informed! Visit to sign up for daily email updates.