The Wall Street Journal recounted one such example and a (partial, I say) solution in Benedic Ippolito’s (of the American Enterprise Institute) Tuesday op-ed.
The example was a man with a broken jaw who was transported, unconscious, to a hospital ER for treatment. The hospital turned out to be in his medical insurance network, but the treating surgeon turned out not to be. The latter’s bill was for $8,000, which the insurer refused to pay. The man was unaware of that fee until after the treatment had been effected.
The solution described by Ippolito (one of three and the one favored by him; the other two were just price fixing in one form or another) is this:
[an] “in-network guarantee,” is a better solution. Hospitals would ensure that all providers treating insured patients are also considered in-network. Some already do this. Doctors at these facilities would have two options: come to an agreement with the insurer (as most already do) or receive payment directly from the hospital. This would eliminate the inflated surprise bills, reduce premiums and federal spending, and leave it to doctors, hospitals, and insurers to work out market prices.
While a good start, this option is incomplete. All of those prices and fees need to be known to the patient and to the public at large beforehand. Further, this needs to be the case for all the medical facilities in a region—hospitals, urgent care facilities, clinics. Such prices and fees easily could be posted on each facility’s Web site, or on the facility’s entrance if it hasn’t joined the 20th century.
The patients and potential patients in the general public need to be in on the working out of market prices.