The US Healthcare Scam Illustrated In The Impossibility Of Getting A Bill For Five Stitches

Let's just start off by noting that if you're not in the US and you live anywhere with some form of single-payer/universal healthcare, we know. You don't need to tell us. We know. The US healthcare system is a fucking mess.

A decade ago I wrote an article about how the US healthcare system wasn't a free market, but rather that it was a giant economic scam. The key point made there was that it wasn't even health insurance companies that were the issue, which is what many people assume. Rather it's the hospitals. The hospitals, many of them non-profits in name only, present themselves as caring organizations there to help you out when you're in trouble. When the reality is that these non-profit" hospitals are basically eating up the entire American economy, and always looking for ways to charge more.

Health care spending is currently 18.3% of our GDP. It's $4.3 trillion.

This is why you hear stories of people being charged $50 for a single Tylenol.

Hospitals can basically charge whatever the hell they want, and they effectively never have to tell you. Every time you make use of the US healthcare system, no one will tell you ahead of time what it costs. Only later will you start receiving a random series of unclear bills.

I recently experienced a bit of this after getting into a minor bicycle accident, and needing to get five stitches. I had gone to an urgent care facility that had cleaned up all the basic bruises, but I had a gash in my chin that required stitches. The urgent care facility told me they wouldn't stitch faces because the liability risks were too big, and they charged me nothing at all. So I was mostly cleaned up (for free) except for needing the stitches. I went to the local ER and was in and out in about an hour (it was Super Bowl Sunday and not crowded).

Over at the Daily Beast I've written a longish article about my experience trying to get an itemized bill from the hospital trying to understand why they charged over $8500 for five stitches. Note, this is not for the stitches that were done by an ER physician. The doctor charged me $65 for his time. It's just the hospital, that sent a bill many, many months later. The total bill was over $8500, and my insurance agreed to pay $6500 of it leaving me with a $2,000 bill.

US law requires them to give me an itemized bill, but Dignity Health aka CommonSpirit Health, one of the largest non-profit healthcare facility providers in the country, has pulled out every stop possible to not deliver what they are required to provide by law. Among the tricks they pulled (described in detail in the article) are:

• Not sending me the bill after I requested it
• After requesting it again, sending me a form to request the itemized bill I'd already requested
• Making sure that the form didn't tell you how to return it to them (no return address to send it to, no details of any kind about what to do with the form)
• Having a phone system that repeatedly hung up on me
• Giving me an address to send the form to that does not exist.

There's more in the article, but it seems clear that CommonSpirit Health, who has a CEO in Wright Lassiter III who is likely making well over $5 million (remember, non-profit!), and recently reported $34.6 billion in revenue for 2023, is basically designed to deliberately squeeze as much money out of its patients as it can get away with. And, it's kind of hilarious, given that the history of the hospital chain is that it was founded by some Catholic nuns, and the chain plays up over and over again how it's focused on health justice" and human kindness" based on their religious beliefs.

Those religious beliefs seem mainly focused on robbing its patients blind any way they can, and then ignoring them when they simply ask for the hospital to provide an itemized bill they're required to provide under the law.

But, one of the more interesting things that I discovered in reporting out the article was in talking to two executives from the company Goodbill. Goodbill is one of a bunch of companies that have sprung up to basically negotiate with hospitals for you, because of this mess. Just the fact that there's an industry necessary to do this should make it pretty clear just how broken the system is.

Even more eye-opening though, was that while I was on a video call with Goodbill execs, they were able to get access to the information I was trying to get about my bill (the details are in the Daily Beast story), where we discovered exactly what trick the hospital was pulling (in this case, what's known as upcoding").

Goodbill had access to the information because it's been able to setup API access to various large insurance providers, including mine.

In other words, the information is there. It's even accessible in seconds.

Just not to me.

The patient.

The reality is that there's no reason at all that US hospitals couldn't tell you upfront what everything costs. They just don't. Because, then when they send you an $8500 bill months later, they can make it close to impossible to figure out what games they're playing with that bill.

I'm sure that makes Wright Lassiter III a bit of an extra bonus each year when his hospital chain reports its billions in revenue, but at the very least, he should stop pretending that he runs a non-profit hospital with a focus on humankindness and health justice." Or one that is named Dignity" health. He should just admit that his company's mission" is to rob people blind at their worst moments.