The New York Times - USA (2020-08-07)

A2 N THE NEW YORK TIMES, FRIDAY, AUGUST 7, 2020

My reporting obsession with medical

bills started with a bandage. A very, very

expensive bandage.

Four years ago, before I worked for The

Times, a reader emailed me a surprising

story. He had taken his 1-year-old daughter

to the emergency room because after her

nails were clipped a bit too short, her fin-

ger started spurting blood. The little girl

was fine and received a disposable band-

age that fell off on the car ride home.

Then the bill came: $629 for the visit.

How could such a simple visit cost so

much? I discovered that the real cost lay in

fees that every emergency room charges

just for walking in the door. I also discov-

ered something else important.

At the bottom of my article about the

little girl’s case, I asked readers to reach

out if they had similar bills to share. I

expected a few dozen emails. I ended up

with hundreds. Frustrated readers desper-

ately wanted to share their billing experi-

ences — and, I learned, had access to some

of the most valuable, most private informa-

tion in the American health care system.

Now, I’m turning to the readers of The

New York Times, where I work as an in-

vestigative journalist, to help me report on

what people are being charged when they

get tested or treated for the coronavirus.

This week, The Times introduced a new

form, a link to which is at the end of this

article, so patients may submit their bills,

which contain insights that are nearly

impossible to find elsewhere.

That’s because in the United States,

hospitals and doctors’ offices typically

keep their prices secret. Powerful lobbies

want to keep things that way. But people in

the Trump administration sees transparen-

cy as a way to reduce medical costs. Last

year, when it proposed a rule that would

make public the prices that providers

negotiate with insurers, the American

Hospital Association sued to stop it. (The

hospitals recently lost in federal court but

plan to appeal the decision.)

The secrecy that surrounds health care

prices is a huge hurdle for health care

reporters like me. I know from academic

studies that America’s health care prices

are the highest in the world, and that fees

can vary drastically from one hospital or

doctor’s office to another.

But it’s still difficult, sometimes impossi-

ble, to write a story about which hospital or

doctor is the most expensive or the least.

That’s the information that readers, and I,

want. And it’s the hardest to get.

The emails readers sent me after I wrote

about that $600 bandage gave me a solu-

tion. Many included medical bills with the

price charged, what the insurer paid and

what the patient was responsible for. The

secrets were suddenly in plain sight.

Since then, readers’ medical bills have

become a crucial source for my reporting.

They are the documents that say exactly

what medicine costs in the United States.

Just last month, I got exceptionally

lucky when four patients who received

coronavirus tests in one Texas emergency

room decided to send me their billing

documents. Three patients sent them in

totally unconnected to one another, each

aghast at the prices. (The fourth came

from one patient’s friend.) They showed

that the price of a test could range from

$199 to $6,408 — all in the same facility.

That story made me eager to better

understand what the price of testing and

other coronavirus care looks like in the rest

of the country, and, working with my

Times colleagues, I decided that readers’

bills were the best way to tell the story.

(When handling sensitive information,

access is highly restricted and is never

published without prior consent.)

Collecting medical bills is, admittedly, a

slow, inefficient process that doesn’t lend

itself to automation. A few — the ones I

now swoon for — include detailed, itemized

information that shows the price of every

pill and scan. Others, frustratingly, lump

everything together into one price.

Running a project like this is equal parts

stressful and exciting because I don’t know

in advance what stories I’ll tell. Instead,

I’m waiting to see where the readers’

submissions will guide me.

Right now, I’m mostly excited: Since

starting on Monday, we’ve had nearly 200

submissions. The more I read, the more

interesting patterns I start to notice.

Inside The Times

THE STORY BEHIND THE STORY

SCOTT GELBER

Your Medical Bills Tell Secrets

By SARAH KLIFF

To share your medical bills with The Times, visit

nytimes.com/costofcare.

They reflect the true price of health care in America, and I want to use them.

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