From $10 to $10 Million: The Exorbitant Cost of American Healthcare

Cara Leonard

9/19/24

Simply walking down one set of stairs, I could never imagine that my right ankle would cave in, and I would soon meet the cold, hard pavement face to face. Even getting back up afterwards I could feel my body struggle, seeing stars and feeling like my head was weightless. After almost fainting, the pain from that injury finally subsided and I was able to continue on to my next class.

Out of fear of a potential ankle fracture, I decided to make a visit to the Hoboken University Medical center. It was a very simple, albeit long visit, with an x-ray and consultation with the practicing physician. And of course, when checking in the front desk asks a series of questions on name, age, date of birth, and insurance. Not long after the visit, I found myself with an envelope containing the hospital bill. At first, I didn’t think anything of it since it was very common to have extra fees in American healthcare. Of course, that was until I opened the envelope and saw the total inside: $19,700.

This story is unfortunately commonplace rather than the exception as healthcare in the United States is notorious for its expenses. Hidden fees, such as the x-ray, use of the office where the physician meeting takes place, or standing in the corner for too long, always manage to appear on the bill, and without insurance, can be impossible to fight for. Even standard procedures can get hundreds of dollars tacked onto them. Some of these procedures can include mammograms and x-rays. Though they are designed to be readily available to the public, hospitals, especially privately-owned hospitals, tack up the price to make it impossible to receive.

One article titled “Hidden Hospital Fees Cost Patients Hundreds of Dollars” also describes another individual who had a simple appointment and came out with a complex bill full of hidden fees. One visit came to $348, but this patient received an additional bill for $645. According to the article, the hospital system had charged this patient for “use of the office where he met his physician. It is what is known as a facility fee, which included overhead for the system’s hospitals though [he] hadn’t set foot in one” [1]. These kinds of additional charges are becoming impossible to avoid as systems add them to every bill they can, raising prices for standard procedures including colonoscopies and heart screenings. The article continues on about the prices, but also notes that hospitals are buying out local clinics and doctors. This allows them to add the extra facility fee which charges for the use of the entire hospital, even if the patient is using a clinic 20 minutes away from it.

 Additionally, treatments and medications, such as insulin, are often marked up at unobtainable prices to account for the cost and “hidden fees” of synthesizing the drugs that companies proclaim exist. David Cutler’s article, “The World’s Costliest Healthcare” from Harvard magazine, states the cause of these extra fees and high prices of medicine quite simply. According to him, the public deems the cause of absurd prices to be “unconstrained greed. Pharmaceutical companies put profits above patients, and insurance executives are paid millions to deny coverage” [2]. When drugs and medical treatments are synthesized and approved by the FDA, they go through the pharmaceutical companies themselves before they are shipped off to hospitals and clinics. As a result, they also have to go through a dramatic price increase, a way to turn out the most profits for that particular corporation. Insurance companies also employ what is called a high cost-sharing strategy, where people who are willing to pay more money can have access to that level of care. This results in higher costs for medicines specifically [2]. 

I waited over three hours just to be told that my ankle was sprained, and I was lucky to be seen by someone so quickly. So just imagine how patients have to jump through hoops just to get a diagnosis for serious illnesses such as depression or cancer. This can take years, and hundreds of dollars worth of doctor visits, just to be pointed to the right treatment. Other times, patients are diagnosed with the wrong disease or just over diagnosed. Overdiagnosis is a common problem, especially in cancer treatment, where individuals go in for an unnecessary screening and end up getting a false positive result. As a result of this, they go through potentially harmful treatments (such as chemotherapy) even though they did not need them in the first place. John Horgan delves into this topic more in his critique of the cancer industry in “The Cancer Industry: Hyper vs. Reality”. Specifically, he notes how “increased, higher-resolution testing leads to increased overdiagnosis, the term for diagnosis based on detection of harmless anomalies. Overdiagnosis leads in turn to overtreatment with unneeded chemotherapy, radiation and surgery” [3]. This generally results from the irrational fear of needing early screening out of fear of catching a disease too late. It is something often ingrained in television commercials and billboards, so people rush to get a screening they do not need to get. This results in more treatments, which the patient often pays for out of pocket, and the purchase of overpriced medicines, allowing for the hospitals and pharmaceutical companies to make a higher profit. 

One would think that with such a high price in American healthcare, it would be the best quality in the entire world. However, Loren Adler, a health economist from USC-Brookings Schaeffer Initiative for Health Policy, states that “you’re not getting anything extra” from the visit despite paying as much [1]. There is no special treatment or a magical x-ray machine being used for these standard procedures. Additionally, in a 2012 comparison of U.S. healthcare to other countries, author Jason Kane points out several aspects that set America back in comparison to other countries. For example, “There are fewer physicians per person than in most other … countries. In 2010, for instance, the U.S. had 2.4 practicing physicians per 1,000 people — well below the … average of 3.1” [4]. There are other factors including a lower life expectancy and fewer hospital beds per hospital than the average in other countries. With this being said, there are many fields within U.S. healthcare that are more efficient and higher quality than other countries, including but not limited to development of treatments for cancer.

Though the American healthcare system seems bleak, there are some proposed solutions to lower the cost and remove the unnecessary fees for patients. The most recent of these ideas is called shared savings, where a target is set for spending on the average patient in place of cost per procedure [2]. This specific method, while moderately successful in some states, cannot lower the medical cost to prices seen in other parts of the world. This instead would come from a universal healthcare system, where the prices are instead paid through taxes. This, however, can come with its own issues, but at the very least patients would not have to pay hundreds of dollars out of pocket for a medication that can save their life. Additionally, the U.S. healthcare system, one ingrained in capitalism, can prevent it from making the switch to a more socialist universal system.

Regardless, I believe that there can be a positive future for healthcare, whether it’s the shared cost for physicians, or accurately diagnosing people instead of having them pay for a treatment they don’t actually need. There are many individuals within the industry that put the wellbeing of the patient over profit. With a reformation of the overall system, these individuals can thrive and set the standard for healthcare. Additionally, many of the hidden fees can be removed from the bill by law. Though hospitals are stubborn with these prices, they are not completely impossible to overcome, and with the right tools, patients can fight for their rights and lower their medical bills. 

Works Cited

[1] M. Evans, Hidden Hospital Fees Cost Patients Hundreds of Dollars, MSN. (n.d.). https://www.msn.com/en-us/health/other/hidden-hospital-fees-cost-patients-hundreds-of-dollars/ar-BB1ku63D#:~:text=The%20fees%20are%20spreading%20as%20hospitals%20press%20on,added%20cost%20isn%E2%80%99t%20justified%2C%20physicians%20and%20economists%20say. (accessed September 23, 2024). 

[2] D. Cutler, David Cutler on trimming U.S. Healthcare Costs, Harvard Magazine. (2020). https://www.harvardmagazine.com/2020/04/feature-forum-costliest-health-care (accessed September 23, 2024). 

[3] J. Horgan, The cancer industry: Hype versus reality, John Horgan (The Science Writer). (2024). https://johnhorgan.org/cross-check/the-cancer-industry-hype-versus-reality (accessed September 23, 2024). 

[4] J. Kane, Health costs: How the U.S. compares with other countries, PBS. (2012). https://www.pbs.org/newshour/health/health-costs-how-the-us-compares-with-other-countries (accessed September 23, 2024).