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Letters to the Editor: Nothing justifies shock billing. Sports has referees — so should healthcare

Emergency room staff move a patient to an exam area at a hospital
Emergency room staff move a patient to an exam area at the Riverside University Health System Medical Center in Moreno Valley in 2020.
(Gina Ferazzi / Los Angeles Times)
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To the editor: In my 20 years in healthcare working to improve payment of medical claims at four major health plans, I saw innumerable examples of the billing disparities cited by Dr. Renee Y. Hsia, who describes her friend receiving two wildly different bills for treating the same injury in her daughter.

Many plans contract with providers at rates slightly higher or lower than Medicare reimbursement rates. Medicare has provided a well-researched standard of payments for facilities and practitioners.

Something needs to be done to address opaque and unfair pricing. Whether or not profit should figure into healthcare at all, capitalism needs referees as much as or more so than sports; otherwise, cheating and exploitation will remain too tempting for too many providers.

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Philip Solomita, Palos Verdes Estates

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To the editor: A company that charges wildly different amounts for the same product or service is a sign of either intentional fraud or unintentional incompetence. I suspect both are at work in this broken system.

What else could explain this family’s experience paying for their daughter’s healthcare?

I challenge any healthcare professional, doctor, administrator or insurance lobbying stooge to defend this system. I think we all know it is indefensible.

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Nate Brown, La Crescenta

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To the editor: My daughter had the same minor elbow injury as the child in Hsia’s piece, and I took her to an urgent care center for a few hundred dollars.

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Why would the parents take this child to the emergency room not once but twice in the same day for something that could easily be treated outside a hospital?

Clearly, the parents knew it wasn’t a fracture the second time. Maybe the second bill was higher for wasting resources on something that did not require a hospital visit.

Sandra Carter, Long Beach

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