I simply refused: Non-payment for shocking medical bills

John James' story:
When my son died as a result of the poor quality healthcare he received, I simply refused to pay any of the uninsured costs. For at least 6 months after my son died his cardiologists were sending their bills in his name to our home address in Houston. Even after the fact, if the outcome has been less than "advertised" let those who would bill you for poor quality care know you will make an issue of the quality if they insist on billing you.


In another instance, I negotiated some costs with a highly recommended urologist, including the cost of pathology that would be involved. I got his estimates in writing. When the pathology bill came in thousands of dollars over the urologist's estimate, I simply sent a copy of the estimate to the pathologist and said that it would be unethical to charge me more unless he had done something unusual, which I knew he had not. That's the last I heard from the pathologist. I know what it costs to do pathology and the bill from the pathologist was outrageous.

The classic definition of the Yiddish word "chutzpah" [ pronounced "khoots-pah"] refers to a defendant who insists the judge should look favorably upon him because his murder of his parents has left him an orphan. The staff involved in billing John on these two occasions showed exactly that kind of chutzpah.

Read John's draft of The American Hospitalized Patient's Bill of Rights in my book, Getting Your Best Health Care: Real-World Stories for Patient Empowerment. Thanks to John for sharing his story with the Facebook group, "IHI Patient Activists." John is a pathologist, and author of a moving memoir, A Sea of Broken Hearts.

Blue Cross Blue Shield's new policy on never events

Certain medical errors are so horrific that they should never occur: the wrong patient having surgery, or a blood transfusion of a mismatched type, as Tawnya Brown fatally received, for example.

These cases are tragic. Adding insult to injury, the billing system of the hospital or medical practice typically bills for the treatment, and is paid for the error. The national Blue Cross Blue Shield Association has just announced
that its 39 BCBS companies have followed Medicare’s lead and adopted a formal policy not to pay for certain “never” events:

"Wrong surgeries" (wrong patient, wrong body part or wrong procedure);

Pressure ulcers stages III & IV;

Catheter-associated urinary tract infections;

Vascular catheter-associated infection;

Surgical site infection, mediastinitis, following coronary artery bypass graft (CABG);

Air embolism;

Blood incompatibility;

Foreign object retained after surgery;

Falls and trauma (fracture, dislocation, intracranial injury, crushing injury, burn, electric shock);

Surgical-site infections following certain orthopedic procedures;

Surgical-site infections following bariatric surgery for obesity;

Manifestations of poor glycemic control; and

Deep vein thrombosis and pulmonary embolism following certain orthopedic procedures.

Advice to patient advocates: Forward this to your colleagues.