| Reasons I am dubious of the author's agenda, based on the structure of their arguments: 1. anchoring to high numbers, without contextualizing how big this issue is: "This contributes to the nation’s $2.8 trillion in annual health costs." How much does it contribute? 2. unequal metrics -- when discussing the expected charges: "Mr. Drier was prepared when the bills started arriving: $56,000 from Lenox Hill Hospital in Manhattan, $4,300 from the anesthesiologist and even $133,000 from his orthopedist, who he knew would accept a fraction of that fee." When discussing the out-of-network bills: "Two plastic surgeons billed more than $250,000 to sew up the incision, a task done by a resident during previous operations for Ms. Kaufman’s chronic neurological condition." Now we're thinking $133k isn't so bad b/c he'll only pay part of it, but the $250k is frightening because there is no mention of an expected discount. As a counterpoint, the author mentions the insurance company pays the full amount to Dr. Mu for the other anecdote in the story. 3. fearful language -- 'He was blindsided, though, by a bill of about $117,000 from an “assistant surgeon,” a Queens-based neurosurgeon whom Mr. Drier did not recall meeting.' Sounds like a 24-hour-news-cycle headline: "Patients billed by doctors while under anesthesia". 4. mentioning there are marketing firms who specialize in helping maximize billing with insurance, as if it's an unethical business. This happens every time a provider of a service or product interacts with a bureaucracy -- there is a whole layer of these services for defense contracting, for example. 5. they mention how the US has more neurosurgeons per capita, then link that (by proximity in the same paragraph) to providing motive by mentioning how neurosurgeon compensation has decreased recently. A more honest article would have given absolute numbers about how the costs of neurosurgery relate to overall health care costs, rather than making the niche appear large relative to the story, so the reader implicitly compares that impact to the $2.8 trillion number. Medical billing is absurdly complex and byzantine. I'm don't doubt the veracity of the anecdotes, but the structure of the presentation make me suspect the intent of the author. |