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Nobody really knows what health care costs – and too many people receive surprise medical bills for thousands of dollars. In a new series, "Medical Price Roulette", CBS News will explore the reasons, and we are collaborating with ClearHealthCosts journalists to bring transparency to the healthcare markets.
Frank Esposito says it started last March with incessant back pain. He could barely move and an MRI soon revealed a swelling of the spine. A specialist told him to go to the nearest hospital – at once.
The doctors in the emergency room said that he needed a surgical procedure. The hernia was so severe that she could cut her nerves, said Esposito, and make him paralyzed.
The surgery was a success, but the bills began to arrive: more than $ 650,000.
His insurance company said his back surgery was not an emergency and was not medically necessary.
"What was my choice? Just be paralyzed for the rest of my life?" Esposito, a toolmaker from Long Island, New York, asks. "So to get those bills that were so overwhelming.You say, this can not be real, I mean, I really do not have to pay that.How am I going to pay that? And you sit there. And you start crying Because you do not know what you're going to do. "
According to a survey conducted in 2018 by Kaiser Health, four in ten consumers reported receiving a surprise medical bill the previous year. Half of these bills exceeded $ 500.
Aaron Carroll, a pediatrician and health services researcher, says health care is not transparent.
"It's somebody who's in pain, who is, you know, still, and now he's been told:" Okay, you could be paralyzed if you do not run to it. " How are they supposed to become good buyers and make complex and rational decisions? They will say: "Please, tell me what to do, because that's yours." work, "said Carroll.
Even though it is not an emergency, CBS News and ClearHealthCosts have found that the cost of a procedure or test can vary surprisingly.
We examined spot prices in two major metropolitan areas: Dallas-Fort Worth and San Francisco.
A simple blood test in the Dallas-Fort Worth area ranged between $ 10 and $ 176, and between $ 15 and $ 126 around San Francisco.
An abdominal ultrasound in Dallas ranged from $ 115 to an estimate of $ 2,459. In the San Francisco Bay Area, the same procedure ranged from $ 100 to $ 2,800.
Although not everyone pays a cash price – especially those who have good insurance – the cash prices reflect what the supplier will accept.
"The plans will have different deductibles, different amounts of co-insurance, different amounts of quota," said Carroll. "And that also depends, of course, on what they charge – what's the price, and how much you're responsible for that price." That number has become much higher than what we could This can be an important part of their income. "
Carroll added, "I think people assume, rightly or wrongly, that insurance will protect them, which is why, if we pay so much, we think we'll be covered, and we do not We will not see it, so when you do it, people are shocked. "
Esposito has already drawn $ 49,000 from his retirement savings. He hired a company to negotiate some of his bills. After calls, Esposito's insurer, Oxford United Healthcare, paid some of his doctors' bills. But he still owes $ 220,000 – CBS News is still waiting for an answer to questions about this balance.
"You work all your life, you work to buy a house, you work for a house," he says. "You have to save for everything, we would like to know that we can go to the doctor, that we can recover, that we can heal ourselves without losing all we have."
We would like to know what you paid for medical procedures. Share your story and find out how you can search ClearHealthCosts' Price Database for our sample markets. You can also email us at [email protected].
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