A Medical Catch-22

Say you suddenly experience chest pains. Pains severe enough to make you think you might be having a heart attack.

So you rush to the nearest hospital emergency room.

A doctor examines you, then puts you through several tests.

Fortunately for you, everything seems to be alright. Your heart is fine. The pains were possibly indigestion, stress, or who knows what.

Unfortunately for you, a short time later you get a bill from the hospital. A large bill. For tests your insurance company won’t pay for.

You call your insurance company: “What do you mean you won’t pay for those tests? Why not?” “Because they were unnecessary,” the insurance company replies.

So you call the hospital: “My insurance company won’t pay for the tests you billed me for because they said those tests were unnecessary.” “Well,” the hospital tells you, “the doctor obviously thought they were necessary.”

You argue with the hospital, to no avail. You argue with the insurance company, to no avail.

In the middle of all this back-and-forth, the hospital turns the bill over to a collection agency.

What do you do?

Well, in the case of my son, to whom this happened last year – with a major Manhattan hospital as well as a well-known national insurance company – you pay the bill before your credit rating is severely damaged.

I’m sure there are countless hapless patients across the country who’ve gone through this same unfortunate scenario, or, perhaps, one far worse. Some, I’m certain, were crippled financially.

Which begs the question: Why can’t the hospitals and insurance companies put their heads together and solve this harrowing medical conundrum?