This is the best health policy book ever, largely because it’s not about making health policy. It’s conclusion: individuals and employers are going to have to make their own “policies.” Why? Well, when you read this book to truly understand this industry, you’ll be shocked, shocked to find that lying is going on in here!
I'll tell you who's not lying, and that's Quizzify. We are the only vendor featured in the two most recent bestselling healthcare policy books -- this one and The Price We Pay, currently on the paperback bestseller list. We have also been featured in the New York Times.
And lest you think that this is for-policy-wonks-only, it’s quite the reverse. It is specifically written for “anyone who has been pushed around by the healthcare system.” This cohort of “anyone” would include me, before Quizzify taught me how to nudge back.
The first eight chapters are specifically for individuals. They act as how-to’s for winning appeals, dealing with collectors, and, of course, avoiding surprise bills using Quizzify’s consent language. As coincidence would have it, this surprise bill example involved a United Healthcare subsidiary called Golden Rule Insurance. This is the same outfit that “negotiated” the in-network price of 28x Medicare (plus a $1700 tip for a no-show doctor) for the guy featured in our own surprise bill webinar in March.
One surprising lesson in the first eight chapters? Find out what the cash price is. Frequently, it is quite a bit lower than the price that your national insurer, with tens of millions of lives, has negotiated on your behalf.
Employers are getting snookered too
These are followed by three chapters specifically for employers. SPOILER ALERT: employers get snookered without even knowing it. How true that is! In addition to the multitude of examples in these chapters, I would cite my own experience with surprise bills and employers. When I suggest that employers teach employees how to avoid them, an employer will often say: “My employees aren’t having a problem with surprise bills.”
What I then reply is: “Oh, OK.”
What I want to reply is: “The reason they aren’t having a problem with them is that you’re paying them!”
It’s not like these hospitals are saying: “Oh, this guy has good insurance. Let’s charge him less.”
One thing you’ll learn as an employer is that sometimes the insurance company is not your friend. They auto-adjudicate bills that should never be paid, and then throw up roadblocks when you try to dig into these bills to identify the fraudulent ones that shouldn’t be paid. (Without mentioning names, it's the extremely big one that seems to be the culprit. On the other hand, the regional health plans seem quite on the level.)
Sometimes, they “find” the fraud themselves, congratulate themselves for finding it, and then take a big chunk out of the “savings” from reducing the bill that they themselves paid.
Further, each chapter ends with a summary of what you as a person or an employer can do. It is not just an exposé, but also a how-to.