Health Insurance Survey Reveals High Fees Are Part of the Problem

Health Insurance Survey Reveals High Fees Are Part of the Problem in General Healthcare

A survey released by America’s Health Insurance Plans reveals exorbitant out-of-network fees — and charges that these are playing a significant role in rising health care costs.

Some of the figures in the study are definitely striking. For example, a cataract surgery that Medicare pays $675 for cost one patient in Illinois $12,712. A knee operation that Medicare pays $584 for cost a California patient $20,120. And a New Jersey patient was charged $72,000 for a spinal fusion procedure that Medicare covers for only $1,629.

“It’s the wild, wild West when it comes to prices of anything in the U.S. health care system, whether for a doctor visit or for hospital charges,” said Jonathan S. Skinner, a health economist at Dartmouth in an interview with The New York Times.

This could cause a whole new ripple in health insurance and health care reform since there don’t currently exist any specific proposals to control prices for out-of-network medical services.

State laws protecting patients from getting stuck with medical bills in excess of their normal deductibles or co-payments vary widely. And the laws often offer little or no protection to patients who seek care outside their insurance networks.  

AHIP, which represents 1,300 health insurance companies, did the survey in reaction to recently becoming a target of criticism. They stated that they compiled the report to point out doctors’ fees as one of many other factors increasing health care costs.

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