The Price We Pay: What Broke American Health Care--and How to Fix It

by Marty Makary

His son needed a standard procedure. Jeffrey looked up the billing code and called the hospital to ask how much it would cost. The first place he called said it would be $37,000, but not to worry, his insurance would pay most of it. That didn’t sit right with Jeffrey. He had to pay the first $5,000 himself because of his deductible. He became curious about the system and asked how they came to their price. He knew of other, much more invasive procedures that didn’t cost as much. Since he had the billing code, he wondered if they could cut through the fluff and explain why it cost so much. The hospital representative got flustered and said she would call him back. When he got the return call, the price had dropped to $15,000 once she factored in a possible network discount. Again, the hospital employee assured him his insurance would pay everything above his $5,000 deductible. Jeffrey said “Thank you” and called the surgeon who would be doing the operation. “Do you do this same operation at any other facility?” Surgeons often work at multiple hospitals. And sure enough, this surgeon said yes. The surgeon directed him to a different facility and assured him that the operation would be the same quality at either place. Jeffrey called the new facility for a quote and they told him $1,500. His son had the surgery at that facility and everyone left happy. Jeffrey mulled over the experience in the following months. He couldn’t let it go. The first price quote had been almost 25 t...