Regular readers may remember that I almost killed my wife a couple of months ago. She was complaining about stomach pains and thought she should go to the emergency room. It’s probably nothing, I told her. They’ll charge you a million dollars to tell you that you have indigestion.
Luckily, she didn’t listen to me. She didn’t have indigestion, it turns out; she had a lousy appendix that caused a medical emergency. The bill to sort it out, which arrived last week, wasn’t a million dollars but it was heart-stoppingly high. According to our insurance company, the hospital had billed $83,135.08 (£67,000) for the procedure but – lucky us! – we would “only” have to pay about $2,000.
How on earth could it cost so much money to remove an appendix? Those things are the size of a baby worm. Well, it doesn’t actually cost that much, does it? This is just what happens in the US: there is no fixed price for anything in its ridiculously inefficient and inequitable medical system; they just pluck extraordinarily large numbers out of the air, and all parties involved – insurance company, medical provider, patient – haggle until a slightly smaller large number is agreed upon.
There are various strategies for reducing your medical bill in the US. Paying the balance in one lump sum tends to net you a discount if you demand it. (We got offered $300 off if we paid immediately.) Asking for an itemised bill is another strategy. Weirdly, hospital bills tend to be full of mistakes. Even weirder is that those mistakes always seem to be overcharging rather than undercharging you. Once you get an itemised bill you can argue over the fact that you were, say, charged $500 for an acetaminophen (paracetamol) tablet and, magically, those charges tend to disappear.
Of course, you need a lot of time to do all this. My wife has already spent several hours on hold with various insurance representatives, listening to music that I swear is formulated by psychologists to drive you crazy and force you to put the phone down in frustration. It is always possible to negotiate your bill in the US but, in the process of saving money, you may just lose your mind.
• Arwa Mahdawi is a Guardian columnnist
