Angry Patients Stuck With Big Medical Bills After “Bait And Switch”

By Joe Shortsleeve, WBZ-TV

BOSTON (CBS) – The national health care reform law requires insurance companies to cover 100% of the cost of screening tests for dozens of potentially deadly diseases. But thousands of patients are finding out the hard way that free doesn’t always mean free.

When Jim Dungee had his first colonoscopy, doctors found several polyps, which are a precursor to colon cancer. “Therefore, I had to come back in three years,” he said. The three year mark was back in December. Knowing the test could save his life, Jim did not hesitate to make an appointment. He even called his insurance company to make sure it was covered. “I was told as long as it was put in as a preventive procedure, it was covered 100%,” he recalled.

WBZ-TV’s Joe Shortsleeve reports

Jim had the test and never gave it another thought until the bills started rolling in for his free screening. “Clearly a bait and switch, I was told one thing and they did the opposite,” he said.

Here is what happened. Doctors found more polyps during Jim’s second colonoscopy and removed them during the procedure. That, according to gastroenterologist Giancarlo Mercogliano, changed everything. “When we do the procedure and we find something, it’s no longer considered preventative. It becomes diagnostic,” he said.

That distinction left Jim on the hook for all kinds of co-payments and deductibles. He got one bill for $388 dollars and another for $64. “While you’re under anesthesia, they are actually changing the way you are going to be billed,” he said.

These surprise bills are not isolated to colonoscopies according to breast surgeon, Dr. Jennifer Sabol. She sees it happening to patients who are called back when their screening mammogram turns up something suspicious. “You have to come back on a separate day for that. That procedure is then called a diagnostic test,” she said.

Some insurance plans will cover the entire cost, but many of the more affordable plans with high deductibles, will not. “It’s been a big problem because patients are going to the less expensive insurance plans,” Dr. Sabol explained.

“It’s sort of an unintended consequence,” explained MIT professor John Gruber, who advised President Obama on health care reform. According to Gruber, the plan is not perfect but it does provide free access to screening tests that many patients might not get if they had to pay for them. “It used to be it cost money no matter what. Now, it might be free and it might cost money,” he said.

Jim Dungee believes doctors need to be upfront about all the potential fees, particularly when it comes to test patients assume will be free. “I just feel so, you know, ripped off,” he said.

When a CBS producer contacted Jim’s insurance company they agreed to waive his fees, but under the rules, they didn’t have to. If you are having a screening test, talk with your doctor to make sure you understand all the potential costs involved.


One Comment

  1. Ellen Sing says:

    I just saw this clip on channel 4 boston. I was horrified by the term “free.” Paying premiums to health insurance companies do not make preventative procedures “free.” In Massachusetts, we pay dearly for our health insurance premiums and nothing is “free.” We pay into the insurance companies and can spend months and years not going to physicians or using our insurance health care benefits. When we use one benefit that is a covered service, all of a sudden you consider it free? No, no this thinking is very wrong. We could spent years not utilizing benefits while still paying hefty monthly premiums.
    If you have car insurance for 5 years and all of a sudden you get into one accident, is the insurance company giving us a free service by fixing our car.
    No they are not. That is what insurance is for and that is why we pay premiums and this is what insurance is for.

    1. John says:

      This commwnt is right on!!! Whoever screens the “news” as it is finally aired should hold his/her head in SHAME. The whole piece is disingenuous, and obviously intended to scare the public, not report the news (of course, we know that these are not news programs, but rather entertainment, for ratings. Aren’t world events in the public domain? If so, how can reporters accept payment for their “work” yet chastise medical facilities and doctors for charging for their services? (and consider the relative salaries of all involved) Finally, if this “news” piece were truly news (which, considering the inaccuracies and the clear editorializing, as well as the intentional scare tactic, it is not), how, then, can WBZTV advertise for this piece for several days in advance? It is disgraceful!!!!!

      1. OBAMANATION says:

        Another 5 letter word for Fraud…

      2. mike Smith says:

        I don’t quite understand your comments. The article was about a sort os shell game that patients aren’t aware of. This patient was not given the correct information, or not enough. It’s not a scare tactic, it is simply scary. I’m assuming, you are a supporter of Obamacare, but if I’m wrong, please forgive me. Many of us are having ar difficult time understanding Obamathink and Liberalthink. With apologies, it is without logic, all emotional and without any rational conclusions.

      3. Ignorant Cons says:

        O’Romneycare starts in 2014

        We only have Romneycare today, and that has nothing to do with this article.

    2. Uncle Omar says:

      Auntie Zeituni says you are wrong, that healthcare is free.

      1. Batman says:

        It’s free for most of 0bama’s supporters. The taxpayers foot the bill

    3. Pilot.Dave says:

      The takeaway from the story should have been that Healthcare Reform as written was never intended to change the COST of healthcare, but spread the PRICE around to many healthy people who were not buying insurance in the first place. So, the cost will continue to rise after the initial equilibrium is reached. Just look at MA’s system….

      Root causes of the high cost range from malpractice litigation, settlement, and insurance, “defensive medicine”, the customer never see’s the price of what they are buying before they purchase (us patients), and the structural fact that we are the only country in the world where MOST people receive their healthcare coverage from our employer (with most of them NOT buying actual Insurance but rather paying an “Insurance company” to pay the bills, and pass them on to the employer to pay with a small administrative fee.

      1. bumpkin says:

        Not only that, but a patient asking a doc what charges they can expect to incur is like asking a fish what bait s/he will be offered! Look; the docs never, EVER know what the insurance companies will cover and not cover- they are too busy doctoring.- being docs. Ask the receptionist- the outer office is the responsible party for billing insurances, et al. You can expect doc to refer you to the front desk, then the person that tends to coding/billing part of his/her practice. It’s MUCH easier to call the insurance office, BEFORE the test, and BE sure to ask for the rep’s name and employee number, if they use one, when you ask for the information, then write it down, verbatim, while they wait-so you have a ‘leg’ to stand on when you complain that you were misled. Then you can ask “is this correct?”, when you finish writing. THEN, and only then, will they have to consider making their information stand after you were told something.

    4. Peter says:

      What’s the point of “screening” people for “free”, if they can’t afford the treatment? If they’re fit, the screening accomplished nothing. If they’re sick and can’t afford the cure it also accomplished nothing.

      1. snewsom2997 says:

        Free is like fly to honey for people, you could give free anything and they will be happy to take it, without caring what is involved, I venture not 1% of average people have read the legislation regarding Masscare or ACA much less their actual Insurance or Medicare Documentation, chances are most wouldn’t understand it either.

  2. Harriet says:

    A very weak,misleading story. Was the physician to leave the polyps in place? Either way, patient incurs the deductibles at some point. Does patient prefer to have a 3rd procedure at a later time to remove the polyps–maybe when it’s too late for a cure?

    Shame on you for headline “Bait and switch”!

    1. Floater says:

      +1 @Harriet. That $452 could possibly have saved him $1000’s if those polyps turned into tumors and possibly saved his life. Had they not found anything that would not have been charge (not free).

      Our society has become so short-sighted. Instead of being thankful he healthy, he’s p!ssed because he’s out of pocket a few hundred dollars.

      Whatever happened to the old saying – “at least I have my health”?

      1. maxtor says:

        not the point!!!

      2. kiabuk says:

        Don’t think it’s about out of pocket, but the big lie of Obamacare being more affordable, while getting the best quality care Americans have come to expect. No way this will happen. Obamacare = increased cost and subpar care.

    2. JC says:

      Exactly. Great point. And it’s actually the lousy coverage these people have from their coverage that is to blame, not the preventative tests.

    3. Ryan says:

      The point is this: They almost ALWAYS find polyps, and they don’t TELL you what it will really cost. It just happened to me. Mr. Doctor said I’d turned 50 and time for a routine screen. I called insurance and they said “it’s covered”. I had two Polyps, and now have a total bill of $3148! which I do not have. If they had told me the truth and given me the facts, I could have made a better decision. It IS bait and switch. It’s a total scam.

    4. JMac says:

      I agree completely. For $452 this man is blaiming the doctors for his obese life style and the doctor may have saved his life. Pretty cheap to extend his life for a few more years of sloth.

      1. Linda says:

        What planet are you on? I am a 50 year old woman, who regularly passes for 35. I am 5’6″ tall and weigh 120 lbs I am fit, healthy – no meds, exercise, eat well and guess what?! My Dr found 2 polyps during my exam. So, whatever….

    5. picklewalker says:

      You are right. It wasn’t the doctors fault that the insurance company did not cover the procedure.

  3. Stuart Steller says:

    I just saw this clip on channel 4 boston this evening and it seemed like Dejavu. I recently went through the exact same procedure and was billed similarly upon completion of the Colonoscopy. I have spent countless hours on the phone with the Insurance provider as well as the GastroIntestinal Group, the Hospital where the procedure was done and the Lab to re-submit their billing as a Preventative measure. My Primary Physician’s office would not even make a call to anyone of the parties to try and help with a resolution. Last I was told, it was under 2nd level review and may get some type of resolution within a few months but that the resolution may not change the outcome. Can you make any suggestions or can the Investigative Team at the station assist me in getting a resolution?? Thank you, Stuart Steller

  4. TG says:

    It really gets me steamed that Dr’s are being characterized as con artists in reports like this. As a medical biller you see insurance policies with these insane regulations of what is covered. We have to bill what the Dr does and I’m shocked that after the Dr removes TWICE polyps from this colon that anybody thinks it’s cosidered “preventive” . The adverage Dr’s office cannot tell prior to a testing like this if it will be 100% covered not knowing if polyps developed again. The sad thing is if the government makes this Medicare cut quality care as we know it will get worse because the other insurance companies will follow with cuts. Patients need to question their coverage and be educated of benefits. If gov is looking at Dr ‘s they also need to look at the insurance companies too because their greed makes Dr’s jump thru hoops to get paid.

    1. EF says:

      exactly TG I work for a health insurance company and what is and is not covered in in the member’s evidence of coverage handbook, but I doubt very many people read that.

      1. tray117 says:

        And most Americans can read this handbook in its entirety and completely understand the legal mumbo-jumbo and double-speak. Right.

      2. Geroge Bush says:

        That book is about 100 pages of double-speak and I get a new one every year. I bet you never read yours cover to cover either EF.

        That is like the credit card terms, I read them to a class of MBA candidates and they could not agree with what was being said. I bet it is the same if you read that coverage handbook to a bunch of Doctors.

  5. RS says:

    Company I work for- coworker goes to New England Baptsist Hospital, colonoscoy, no charge, covered by our BC/BS plan. I go to a Colonoscopy Center, They accept BC/BS- who has informed me that this is exam covered under the plan. They are not happy with the payment from BC/BS- bill me for whatever they feel they would like to. How about we do not execpt BC/BS as payment before procedure– Bail & Switch, YES!

  6. Jim says:

    I have the insurance that screws you if they find a polyp. I have money, so I get the test done regardless of any extra expenses that may be incurred. Now think about someone who is troubled financially, they are going to think twice before having a procedure that could end up costing them money. As a result, these people may put off or not have this very important test. Now, some of those people may develope full blow cancer. That ends up costing the insurance company hundreds of thousands of dollars for long term care and everything else.
    Instead of nickle and diming people that are found to have polyps, the insurance companies should send thank you cards to everyone that has had this test and has very curable polyps removed, instead of punishing them with bills.
    The current system that is in place sounds stupid because it is stupid.

    1. Terrance says:

      Many of you are missing the big picture. There is no such thing as “free.” When Obamacare mandated that screening procedures be covered 100% with no co-pay, what did you think would happen? That the cost wouldn’t shiff? That the insurance companies would just absorb this? Sorry to break it to you but they aren’t in business to give their services away. And it’s also about time that we as consumers take some responsiblitiy. Imagine what your car insurance would cost if you demanded that your insurance company cover every expense related to owning an automobile: all your oil changes, tires, batteries, gas — your premium would be ridiculous. Yet we expect health insurance to pay for every last aspirin – and then we act all shocked and surprised when health insurance premiums go up. It’s only going to get worse – the more stuff that Obama and his minions decide has to be given away, the more it’s going to cost you in the end (so to speak).

      1. Resist Now says:

        If you think medical insurance is expensive now, wait until Obamacare makes it free!

      2. Geepa says:

        Well said and exactly right.

        I’ve been in healthcare for almost 40 years. The only time I’ve ever seen medical costs go down was with out-dated/out-moded treatments/medicines.

        Obamacare was sold to the American people with the idea, in part, that it would decrease costs. Hear me now and believe me later – costs are NOT going down.

        The best thing you as an individual can do is vote Obama out of office so the new Rebublican president can repeal Obamacare.

      3. JMac says:

        Exactly right. If you have ‘real’ insurance, wait to see how expensive it becomes. But, if you have Medicare, or no insurance, it’s all free. More entitlements for people who don’t work, or lie and live off the government. Stop the entitlement run away train, NOW. Vote Oblama out. But since more than 48% of people live off the government, out debt will only doulbe again. Here comes Greece.

  7. tsalnew says:

    It is not clear whether the gentleman called his doctor to find out how he bills the procedure. A call can never stop with an insurance company. It’s bad enough we have to start with one since mostly they are full of double talk. I had four colonoscopies last year and wasn’t charged. I have another this April and my husband has a three-year in a few weeks. You all may not like this article but I think it brings to light what we need to do to advocate for ourselves

  8. firemanmark says:

    Do what Aunt Zoonie and Uncle “I think I shall like to call the White House” would do.Send the bill to Obama,Pelosi,Reid and the rest of the Socialist criminals on Capital Hill. They want socialized medicine? Let them take it out of welfare and medicaid accounts.Stop giving the real”free stuff” to illegals related to Obama!

  9. travis says:

    Nothing is free. We pay threw the nose every week for Medical Insurance that most people use maybe once a year. So we get told it preventive checking and then they do something to cost the ins company less in the long run and we get billed for it. Why should we get checked then. I rather get really sick and make them pay through the nose for all the treatments you will need. If treatment is done in a preventive matter it shold not be looked at as a seperate percedure.

    1. BevfromNYC says:

      And THAT is what insurance should be for – for when you are really sick. Not when you get a routine coloscopy. We should bare the cost for the preventative procedures and the insurance should pick up the cost of the diagnostic procedures. Not the other way around.

      Car insurance companies don’t pay to have the oil changed and the tires rotated. Homeowners insurance doesn’t pay to change a lightbulb or checking for termites. Why do health ins. companies have to pay for routine preventatvie maintenance?

    2. Resist Now says:

      This is like not changing brake pads and ultimately running into a wall and then demanding everything you can from the insurer to get the car fixed.
      You, travis, are a moron.

  10. Nick C. says:

    Joe Shortsleeve was once a respected news man. Now he’s a caricature of a tabloid reporter. Sad.

  11. Cindy Lou says:

    Joe – Thanks for doing this story. Same thing happens with Mammograms…if radiologist wants an additional picture a week later, it is no longer a wellness coverage but a diagnostic…even the folks I spoke with a BCBS think its unfair. They won’t cover the additional call back at $250 but BCBS is fine paying the $100k for breast cancer…makes no sense!

    1. Leslie says:

      Especially since there could be a hundred different REASONS the mammogram comes of suspect. Some of those reasons can because it’s a bad picture or the radiologist sucks at reading them or you moved minutely during the x-ray….who knows, but I think a follow up should be included for any test.

  12. ThE ARBITER says:

    FIRE OBAMA! 2012!!!! Go SANTORUM!

    1. Immolator says:

      I’d rather set myself on fire than vote for Santorum

  13. Tom in NY says:

    Obama is as Obama does.

    When you mandate “free” someone always still pays for it.

    1. Resist Now says:

      The trouble with Socialism is that eventually you run out of other people’s money.

      1. Geroge Bush says:

        So you don’t like your socialist Romneycare?

        Reagan raised taxes 11 times was he a communist?

  14. suzy000 says:

    It happened to me too….my son’s pimples has turned out to be a $1300.00 Bill…NO LIE! In the days BEFORE OBAMA..we paid our co-payment up to $250.00 max and we were done…now after our premiums have gone up 87% in the last 3 years I am paying out of my ying yang for silly stuff. We have stopped getting healthcare because we are tired of not being able to have what we need throughout the month. It is either EAT or have GOOD HEALTH…what a shame we have to pick. No way am I voting for Obama…anybody but Obama!

  15. Brian says:

    Sooo, for less than $500, he prevented a possible horrific death. He obviously has money to spend on food, so why he’s whining about a life saving procedure boggles my mind. Glad they got rid of the polyps, zero pity for him.

    1. Elsa says:

      Exactly my thought. He probably eats 500 bucks a week in junk food.

      1. Linda says:

        What planet are you on? I am a 50 year old woman, who regularly passes for 35. I am 5’6″ tall and weigh 120 lbs I am fit, healthy – no meds, exercise, eat well and guess what?! My Dr found 2 polyps during my exam. So, whatever….

        Oh, and just to be clear – I hate Obamacare

  16. Richard Williams says:

    “$388 dollars and another for $64.” And that’s all he’s got to complain about?! What a cry baby. From the looks of him, he’s not missing any meals. Good grief. Insurance companies are not benevolent societies. They HAVE to make a profit to survive. This entitlement attitude is going to be our downfall.

    1. george says:

      And empty promises of “free” medical care play right into that very same entitlement attitude. The more something is “free,” the more it ends up costing in the long run. Somebody has to pay for everything.

  17. mike says:

    Why is this guy complaining about bills totalling less than $450?? I pay $130 a month for my health insurance, and the last time I had an MRI it cost me $900 out of pocket. So this guy should stop whining and be happy that the docs removed the polyps, good grief.

  18. ClearyJ says:

    the problem is very simple: The Messiah is trying to order some people, whoever he can bully, to work for free. If it’s not the doctors, then it’s gotta be those working at insurance companies. If it’s not them, then there has to be some other villain – perhaps wascally Wepuwicans. But no one works – willingly works – for free. And being forced to work, whether paid for or not, is slavery. Essentially, The Messiah wants to find some slaves somewhere that other people will accept. And given the ancestry of half of him, he should know better. That he doesn’t is an atrocity.

  19. Radiologist says:

    People have no problem spending several hundred bucks on the latest iphone yet for some reason expect the skill and knowledge of physicians who spend 10+ years in post-graduate education to be free. It’s sickening.

    1. Trey says:

      Get me my free medical care while I finish this Big Mac and Fries.

    2. rodlou9 says:

      No one expects “free” healthcare, but considering how many people those wonderful and skillful “physicians” kill every year due to misdiagnosis and malpractice, you might want to back off a little on the praise.

      1. snewsom2997 says:

        People go to doctors when the are sick and dying sometimes the doc cannot do anything about it. Doctors are people not gods, want perfection in your healthcare pray to god, want man’s best efforts go to the doctor.

    3. Herzen says:

      Yeah. And did you notice you work in the ONLY two segments of modern commerce that are largely EXEMPT from racketeering and the most basic consumer protection laws? Can’t remember who the segment entities are?

      1) Hospitals

      2) Universities

      Even the major political parties don’t have the brass to overtly practice and actively commercialize racial phrenology and eugenic racial hygiene under the guise of postmodern euphemisms like social justice or ‘medical ethics”. Which human life is worth more? What credentials are necessary to function as a gatekeeper in denying any citizen access to technology capital? Who else but postmodern medical academics could rationalize a national policy of mass murder by exclusive neglect. And here they so pridefully voted for the first Black President who was also half-white by application of the same delusional scientism on which the neo-Hegelian academy is precariously based.

      Medically-speaking, and with the highest academic integrity, perhaps someone can empirically demonstrate in double-blind tests how many drops of what blood made our President the first Black President who was half-white?

      Perhaps they might the Pantone chart of blackness and whiteness these great minds have used to craft the modern hegemony of discredited europhilia that animates the childish institutionalism that neuters candor and forbids its members bold action as intervening, responsible adults.

      No wonder Obamacare is a disaster. It came from an academy awash in intellectual sepsis, molested identity and malignancies of narcissism.

      Perhaps this is why university physician-product of today is largely stillborne.

      Those who escape the conditioning will have to learn anew, and with an authenticity that cannot be found in academic medicine.

      “Free” care is the big lie that universities have championed where the academics within plot to impose upon those who actually see patients for a living. As all have been dehumanized, it doesn’t feel like telling self-enriching lies that provoke predatory entitlement in others to expect a human right to steal from others.

      Mark my words. Millions will be killed before their time under Obamacare. For their own good, of course. We’re just too unsophisticated to understand our betters. There are so many clever ways to orchestrate ‘murder by neglect.’

      And thousands of typed pages of unproven regulations, policies and procedures to help cover the tracks.

      Welcome to the Age of Academic Experimentalism.

      Hegelian Supremacists without a Clue.

  20. AJ says:

    Same thing happened to me a few months ago with some blood work. I go to the doc one every three years or so. Insurance clearly siad preventative appointment free. Doc did some additional testing, and then put it as diagnostic on paperwork. That’s why I have catastrophic coverage only and that still costs me $400 month. Medical system is terrible.

    1. lou skunt says:

      problen is medical insurance and moronic reimbursement system that is driven by government mandates. Doctors have to jump through hoops and get paid less for a colonoscopy than a plumber would charge you to fix you toilet. CPT code for colonoscopy is 45383 – look this up on a Medicare fee schedule – doc gets paid less than $350. Lets see, 8-10 years of school, $50,000 year in malpractice insurance, $100,000+ in school loans … and you get to look up some old guys hairy azzhole for 350 bucks!

      1. snewsom2997 says:

        It would be far less if they actually ran medicare like it is legislated, hence the reason for DOC FIX every year,

  21. PCWarn says:

    Seriously, $388 & $64 is what this guy is carping about. What have we become…

  22. snewsom2997 says:

    Sucker’s, nothing is free, no one can promise you anything for free, people reap what they sow. Learn how to read your contract and learn the difference between preventative and diagnostic, all those words actually have meanings, real ones in a dictionary. Go in for a Colonoscopy and they find nothing and it is free, just like they advertised. Once they find something it is no longer preventative.There is a price to be paid for only having an 8th grade vocabulary.

    1. Myself says:

      I went to get a check up and vaccinations under the 100% preventative. The doctor discussed my dry skin – no treatment plan or Rx was advised. Dr. billed insurance for the preventative visit and a visit for a medical condition; and billed for vaccines and for administering each one. To summarize a 15 min preventative visit was billed at $600 to insurance. And, I now have a doctor visit charge to pay for. Had I known, I would not have seen the doctor.
      This is why the AMA supported Obamacare – to increase patient visits to come in for wellness, and then to have the chance to “find” a problem. Now, they can double bill. And, never do they think that they have an obligation to discuss the charges they will be submitting to the insurance company. The day needs to come where doctors are transparent with their pricing so that we as consumers can know beforehand what our financial liability will be.

      The only ones that lose are those of us that pay for our insurance as the insurance companies have just built this additional cost into the premiums we pay.

      1. doc says:

        I’m a doctor. I’ve worked at three places. I’ve never known what we charge. Its dictated by the insurance companies. I could never answer that question if you needed me to and I wanted to.

        All we do is document what is discussed with the patient and exam findings as well as an assessment of what is going on (diagnosis) and then a plan. Billing is done according to documentation. Not billing according to the documentation can be labeled as fraud by the government.

  23. Joe says:

    for $450 Dollars??! Holy Crap.. And it probably saved his life…

  24. Peter says:

    So he had to pay $400 bucks. What is the actual cost of that test without the insurance company chipping in? I’ll tell you, at cost the price ranges from $2000 to $3700 depending in part on the geographic region where it is performed. Nothing in life is free and the rest world owes the individual zippo. If you are destitute, there are federal programs already in place to help financially. If you are too cheap to pay the 10% to 20% of the actual cost to receive the test then don’t get it. Take your chances. Oh I’ve got a great idea “free” government healthcare. That will be great until the government says you aren’t eligible for the procedure because due to your age and other health conditions, the process would not be cost effective in your particular case. Take this pill for the pain and wait to die. Coming soon…..

  25. Small Shot says:

    I had one done several years ago with the same insurance lie. I just finished paying the bill and I am a year and a half late for my 3 year follow-up. It’s a fearful shame when the medical community is not committed to financial honesty.

    When I finished paying, the practice sent me letters saying it was time for another procedure. When they called me to set up an appointment, I told them I had no insurance and they stopped contacting me altogether for the procedure.

    It makes you wonder if their integrity is also hindered when it comes to the medical procedure itself. I wonder why they don’t deduct the original procedure amount and forward the difference to the patient. It’s all or nothing. Maybe that’s why they started selling that type of insurance. It would bait the people to buy the seemingly “win, win insurance’ for the preventative only, when they know full well how much they would save with these “finding something” rejection situations.

  26. Geoff Caldwell says:

    OMG, $452 dollars for removing possible life threatening growths. For crying out loud have we really become so STUPID in this country that we expect EVERYTHING for NOTHING?

    1. jay says:

      Unfortunately we have!

    2. FGump says:

      Couldn’t agree more. Thirty years ago this fellow would have been dead. Of course, he wouldn’t have gotten the bill for a procedure but his family would have to have paid his funeral expense.

      1. Leslie says:

        NO the fact is that people pay THOUSANDS OF DOLLARS every year for insurance and most don’t even approach the total they pay in. NOW, these same policies are paying out farless. IT WAS NEVER FREE. We pay a large part of our salary for the insurance. FREE never factored in. Nobody expects services for free– except those that have grown up getting handouts.

  27. Bob T says:

    To be honest, I don’t get this story at all. I am self-employed, which means I have been buying health insurance in the private market for years – more than 20 years, in fact. Prior to health care reform, I had a high deductible health insurance plan like the one described in this article – a $5,000 deductible. It covered nothing with regard to screenings. If I went in for a colonoscopy, for instance, I would have paid the cost of the colonoscopy – which is about $5,000. Since health care reform, I’m entitled to a free screening as long as it is preventative. However, if it became diagnostic and I had to pay the $450 or so described above, well, that would be a huge discount over the $5,000 I would have paid before health care reform. To me, $450 to save my life is pretty cheap. I think the complaints are coming from folks who either had no health insurance in the past, and went without care, or had employer-provided health insurance. What’s available now is a huge, huge improvement over what was available just two years ago.

  28. lou skunt says:

    I be saying the rich folk in this here country needs to be paying their fair share. We po-folk cants afford our healthcare and these 1%’ers thinks paying 90% of all tax revenue is too much… greedy SOBs. I want healthcare, 5 years of unemployement, mortgage forgiveness, and free lottery tickets on me birthday!

  29. RHO says:

    Oh no! Don’t tell me there is no “free”. That is the entire basis for the Obama presidency.

    1. george says:

      Those deficits don’t exactly fall within the notion of “free.”

      1. Geroge Bush says:

        But Bush gave us a free war! He said oil revenues would pay for it? But itwas not about oil right? Bush also doubled the national debt and Reagan tripled them. Obama is doing his share but he is paying still for Bush’s war and Reagan and Bush’s interest on their debt that was never paid.

  30. Ellen Sing says:

    When you all pay $1587 a month for a sjngle person blue cross premium you will never consider anything free. It is a covered service not a free service.

  31. NeverSurrender says:

    So instead of paying the $450 he wanted the doctor to wake him up, charge him $0 for the preventative procedure then put him back to sleep and charge him all over again for the diagnostic procedure?

    Last I checked $450 for a colonoscopy was a pretty good deal, and if he would have paid his deductible already then the price would have been even less.

  32. footguy says:

    Please, seriously, dont blame it on the doctors, they get just as confused as the patients when it comes to dishonest insurance companies. I guess this guy wouldve been happier if theyd just left the polyps in!

    1. Myself says:

      Why do we need to defend the doctors. Why should we not expect that the doctors will inform us prior to the procedure of the potential for added costs.
      Why can we not know what a doctor charges, so that we can shop the price with other doctors that might be less cost? In what other business would the consumer authorize a service without knowing the cost or actually the scope of the project.
      This is a major part of the problem where the doctors have no obligation or flatly refuse to release their rates. How hard is it to provide the patient with the pretreatment estimate as the charges would be submitted to the corresponding insurance company that they have a pre-negotiated rate with? If the rates are pre-negotiated then they certainly should be able to inform the patient beforehand and let them make the decision to proceed or not.

      1. snewsom2997 says:

        Because fixing a human is not the same as fixing a gas engine, No two illnesses are alike. 2nd the cost will change from patient to patient, and since half of healthcare customers, mostly Medicare and Medicaid, pay well below cost, what your procedure costs depends on how many medicare and medicaid patients the doctor has in the practice. More mean more expensive healthcare for you, less mean less expensive healthcare.

      2. footguy says:

        no problem with that, anytime patients want to know what a procedure costs a doctor can tell them, problem is most people dont ask till theres a billing problem like this! doctors can and are willing to share prices with patients, most are contracted with the same plans anyway so it there prices are set by the insurance co’s not the physicians when it comes to the final bill. Thats the price the physician pays for being an in network provider, they lose the option to charge what they want. I agree that pt’s should have the ability to make informed choices the problem is in this case the doctor needs to take the polyps as he sees them but then the insurance co’s change the rules because he did. I bet you see these kinds of things happening more and more over the next year or so.

      3. lou skunt says:

        simple right? Your lack of understanding (as well as the majority of the people in the country) the reimbursement process is a “major part of the problem”. An average doctor’s patient base typically includes hundreds of different insurance “plans” all with different coverage terms and amounts. To expect a doc to explain the coverage terms and amounts to each of his/her patients is unrealistic – the patients need to be responsible enough to educate themselves on their OWN insurance plans. The doctors don’t make the insurance plan rules and terms – don’t blame them.

    2. Cantstandya says:

      Why do we need to defend the doctors. Why should we not expect that the doctors will inform us prior to the procedure of the potential for added costs.
      Why can we not know what a doctor charges, so that we can shop the price with other doctors that might be less cost? In what other business would the consumer authorize a service without knowing the cost or actually the scope of the project.
      This is a major part of the problem where the doctors have no obligation or flatly refuse to release their rates. How hard is it to provide the patient with the pretreatment estimate as the charges would be submitted to the corresponding insurance company that they have a pre-negotiated rate with? If the rates are pre-negotiated then they certainly should be able to inform the patient beforehand and let them make the decision to proceed or not.

  33. JeffT says:

    ““It’s sort of an unintended consequence,” explained MIT professor John Gruber,”

    No, Obamacare is full of VERY INTENDED consequences. All of which lead to single payer, then we’re all screwed.

  34. sb36695 says:

    Oops! Anybody But Obama!

  35. Pat Alexander says:

    The problem isn’t that you have to pay. It’s that they are busy pushing the free, free, free thing to pump up the “benefits” of the new healthcare law. Every time I turn on the radio I hear the ads for “free” medicare screenings. When you go, the surprise follows. I went for a endoscopy and a colonoscopy and ended up getting $600 worth of bills from 5 or 6 different doctors. I was not prepared to pay. So it will be an extra $50+ a month out of my already cramped budget for the next year…

  36. Tex Geoas says:

    So… Joe Shortsleeve… you think $450 is BIG medical payment to save a life? Your headline should have read, “Man complains because ObamaCare won’t pay $450 deductible for SAVING HIS FREAKIN’ LIFE!” You are making a mountain out of a molehill and are part of the problem. NOTHING IS FREE. Never will be.

    1. JustAGuy says:

      Of course nothing is free. But Obama and his minions told us it will be free and too many Americans, especially the Obama Zombies believed him.

      Just wait until 2013, when ObamaCare is fully implemented. We’ll really be screwed then! So grease up because it WILL hurt!

    2. Trey says:

      Could not agree more

  37. JustAGuy says:

    How many of you voted for Obama in 2008?

    Elections have consequences. Let’s hope you’ve back to your senses from all that Hope and Change pixie dust and correct the 2008 error this November.

    1. Trey says:

      Nobody that can actually read or obtain an ID card. Bring back literacy tests. Only Federal income tax payers should be able to vote in federal elections. This country is 48% morons who are being cared for by the taxes on the upper 3%. At least prevent them from voting to destroy our country.

      1. snewsom2997 says:

        I would add only taxpayers should be able to get government benefits as well.

      2. george says:

        Bring back literacy tests? How about also bringing back REAL public education that teaches basic reading skills and, even more importantly, how to engage in critical thinking? Society at large was dumbed-down for a reason, you know.

  38. David Moore says:

    Living in Boston i bet he is a Catholic liberal Democrat
    Some one had best explain Obamacare to him.
    Its take away from the working middle class so that illegals and welfare folk can have free medical care better than yours –ha ha

  39. George says:

    What a whiner. As noted. a few hundred bucks to save his life–and he thinks that’s a bad deal? Wow, we certainly aren’t the Greatest Generation anymore, are we?

    1. JustAGuy says:

      You’re missing the point by a mile. He called the insurance company and verified the expenses for the procedure. The insurance company assured him. But when the doctor found polyps and removed them, the ObamaCare rules were invoked and the costs rose.

      Yet you’re scoffing that he has an issue with having to pay unexpected extra costs. Did you vote for Obama in 2008.

    2. John Barnett says:

      That’s not the point, it’s like that bit ch Pelosi said, we need to pass the bill in order to find out what’s in it. The Dems are simply crooks.

  40. Archy says:

    This from a news outlet in the home of RomneyCare?

  41. AK says:

    I can’t imagine being the doctor who has to scope…that.

    Switzerland has what is considered a model program; Swiss citizens pay-thru-the-nose for it. And it covers those who need help and can’t pay. But Switzerland is a small society of responsible citizens who are not afflicted with entitleitis like Americans are today.

    1. JustAGuy says:

      Yea, America is a mess! We are a very large country where one specific political party engages in vote buying by offering people from various interest groups government handouts.

      We’re well down the road to ruin and gathering speed. Already, the Democrats have insulated everyone making $48,000 / year and less from federal income taxes. If Obama is re-elected, I’m seriously considering my residency options. Canada and Australia are at the top of my list.

  42. Scott Lennox says:

    a few hundred Bernake Bucks to save my life? are you kidding? there’s no story here

  43. John Barnett says:

    For all you ignorant fools that believed this snake oil salesman, you get what you bought, a fraud.

  44. Beau says:

    Get used to it people. Next time, pay a little more attention to who you put in office to represent you.

    Quit being uneducated dummies.

  45. ToldYaSo says:

    So Hoax and Change didn’t mean change for the better!

  46. Betty Barclay says:

    Maybe he will have to cancel his cable to pay for his life saving procedures. Just another Democrat whiner who probably voted for Obama. No sympathy here.

  47. mrlemonjello says:

    I think if they had a more comprehensive ABN this wouldn’t happen, but from my experience, a lot of the MDs don’t know the rules either.

  48. John Barnett says:

    We will see how much these ignorant Demmocrats love this Kenyan when some of these other crazy rules kick in and their wife or child dies, or they have to sell their already worthless homes to stay afloat. That time is coming, and the Kenyan doesn’t give a sh it.

  49. archie says:

    Joe looks like he could use a big enema to loosen up some of that lard he carries around.

    1. John Barnett says:

      That’s not covered under Obamacare, Obama would just let him die.

  50. Steve says:

    What are you all crying about. This is exactly what you wanted. You were warned over and over and over again that if you voted Obama in to the White House this is what you would get. A do nothing Socialist President, And with that comes, Higher health care costs, Higher gas prices, Higher unemployment, Higher forclosures, Higher taxes, No pipelines, No drilling, Failed Energy Companies, Billions of our tax dollars for bailouts, More food stamps, More welfare, Failed foreign policies and on the verge of WW3. He wooed you sheeples with his speech and promises for change. Hows that going for ya. Stupid Americans!

  51. JC says:

    Don’t blame the law covering the preventative tests for free. Blame the crappy insurance coverage these people discover they actually have under our current “employer-based” when a problem is discovered.

  52. shawn says:

    i wouldn’t pay i wouldn’t even think about it. send it to collections sue me whatever i wont pay, hell id quit my job and work under the table before accepting getting RAPED by my health care provider, seems like a nice lawsuit to me.

  53. Gary says:

    This almost happened to me before I had my “Preventive Colonoscopy”. I went in for the Pre-consultation, and the doctor asked me questions about my family history. Based on the answer that a few of my relatives have had colon cancer, he determined that the procedure was “Diagnostic” instead of “Preventative”. When I called to confirm that the procedure was covered, I was informed that I would have to pay my deductable and Co-pay. I went back to the doctor and argued that by answering questions honestly, I was costing myself money out of pocket. He changed the billing submission, but I still took the chance that they would find something.
    No cost to me if I don’t need it, but steep cost if I do. Seems backward, I should pay if I “Just want it done”, but I have insurance to cover what “Needs to be done”.

    1. ALAN says:

      So to say money you would like to your doctor? God way to accidentally die.

    2. doc says:

      and now your doctor is potentially liable for fraud if medicare takes the time to audit his charts.

      doesn’t matter if you have medicare or not. if medicare finds your doctor is billing its patients differently than other insurance types, that is fraud.

    3. snewsom2997 says:

      Fiddling with billing codes is the number 1 way medicare and medicaid fraud are committed, your doctor just signed himself up for a giant fine and possibly criminal charges for fraud if and when the government decides to check. Once again thanks for making my care cost more so you could pay less, kudos on working the system.

  54. ALAN says:

    I am a physician in NYC and this idiot wants me to tell him what his insurance will and will not cover? Is he out of his mind? I treat patients, and have no idea whats in his contract with the insurance. We help the patient fill out the forms but he is responsible for the bill being paid, not me. Lets hear it for idiots who want others to pay for his service and do all the ground work.

    Note to you liberal idiots expecting to get free coverage. Let me explain to you what many of my friends are doing. They are establishing boutiqe practices in which patients pay upfront, 10K a year. For this money they get free healthcare from the office which includes general maintence and exams. What is not included is any additional costs like medication and such. We are going to let the patients deal 100% with their own insurance and we will not accept any insurance. In other words, we will demand payment up front or no treatment. Many of us already do not accept medicaid and medicare. Good luck in finding a quality physician who will accept the obamacare garbage. ,You get what you pay for.

    1. snewsom2997 says:

      Concierge Medicine has been popping up in St Louis and many other markets as well, and even PCP’s are starting to offer cash prices, just so they don’t have to deal with Ins Co’s. People with money pay their bills, they pay with cash and they pay promptly, and you do not need an army of office people to deal with the government and the insurance companies. This will be the start of a truly two tier system, those with money will get whatever they want and can afford, those without will get the county hospital wards of old.

    2. george says:

      Will this type of practice still be legal when Obamacare kicks in fully? In the U.K. it is apparently legal, but I seem to remember that under Hillary’s universal-care plan it was specifically forbidden. Oh well. The bill has passed, and I guess we’ll still be finding out what was in it until, as they say, the cows come home.

  55. Ron says:

    The last line of the article says to talk to your doctor so that you can understand the costs. I am a surgeon and I can tell you that we doctors have no idea about what is and is not covered by any patient’s individual insurance plan. They really need to call their insurance company themselves.

    1. doc says:

      Can’t agree more. I’m a doctor also. I treat medical problems. I don’t know jack about how a patients insurance works. If I did, you don’t want me to be your doctors.

  56. Lipstick says:

    The guy should have gotten the colonoscopy for free and had to pay for pylop removal.

  57. Ellen Sing says:

    From the various comments I get the feeling that people thought that our health care for all meant that people would actually be covered for services at the hospital and doctors. No it meant that everyone must buy insurance and if they can’t afford the high premiums for a very good plan than they still must pay for insurance premiums because they will be penalized but have to pay for most things out of pocket that way health insurances have gotten their premiums and won’t have to pay very much in benefits.

    Why do you think the insurances in Massachusetts agreed to Roomneycare to begin with?

    Now the hospitals and doctors are agreeing to accountable care organizations because they will be paid not to treat. It will be a whole new way to ration health care and the subscriber or patient will really get screwed because they are paying for something they will never receive. Good healthcare. Why pay insurance premiums at all if the hospitals are getting paid before you use their service at all.

    1. snewsom2997 says:

      They will also be penalized for 30 day re admits for particular DRG’s, no matter the cause of re admission, and bundled payments while now voluntary will destroy any ability to operate a hospital and still accept medicare and medicaid, which hospitals can choose to or not to accept, if they choose not to accept they don’t have to allow everyone into the ER either.

  58. Ed Ward II says:

    I can’t believe these idiots are complaining. You pay a few hundred dollars or you die. Which would you prefer?

  59. bobby quinn says:

    So this guy thinks you don’t pay anything? Ever? 452$. Are you kidding me?
    It is truly scary how stupid people in this country are becoming.

  60. stoptouchingthatmabel says:

    Obama hasn’t a clue and the people appointed to carry out his mission are even more obtuse.

  61. Pilot.Dave says:

    The story should have been about the fact that Healthcare Reform as written was never intended to change the COST of healthcare, but spread the PRICE around to many healthy people who were not buying insurance in the first place. So, the cost will continue to rise after the initial equilibrium is reached. Just look at MA’s system….

    Root causes of the high cost range from malpractice litigation, settlement, and insurance, “defensive medicine”, the customer never see’s the price of what they are buying before they purchase (us patients), and the structural fact that we are the only country in the world where MOST people receive their healthcare coverage from our employer (with most of them NOT buying actual Insurance but rather paying an “Insurance company” to pay the bills, and pass them on to the employer to pay with a small administrative fee.

  62. austin says:

    sounds like shortsleeve is more like shortonbrains

  63. samuel madison says:

    It just feels good to say I told you so…

  64. pyeatte says:

    I recently had mitral valve repair heart surgery. I won’t say what the cost was but my share was $750. I gladly paid with no complaints.

  65. Free is never without cost when the government is involved. When you have and use your own money, you call the shots. When the government is the one that details what the insurance company and hospital are to do to you and for how much, you are their slave and you are no longer in control.

    Pay us what we EARN (at least 16.5% more than we get to take home now just because of the employee and employer FICA withholding, plus more for the costs of insurance our employers pay, retirement benefits, unemployment insurance, etc.) …and let us control our own life!

    I want the FREEDOM to be RESPONSIBLE!

    It is important to have laws that require insurance companies to bid across state lines, not cherry pick by location, health, etc. But when the regulations get between me and my doctor and become a very non-productive shell game, government has gone TOO FAR!

    It keeps getting worse and worse… now they tell us what to eat, what our children can eat, what we can believe is moral and not, who is rich and who is not, and now they are even changing the meaning of the word “marriage”!

    Give us equal RIGHTS, then protect our RIGHTS, but quit micromanaging every little thing with the result of “helping” us be irresponsible!

    Re gay marriage: rather than redefining marriage, simply remove all mention of man, woman and marriage from the laws! We’re not suppose to discriminate in the laws based on male/female anyway! The whole thing was a violation of the church/state separation ages ago when the state started regulating a natural law or religious law sacrament!

  66. statesrule says:

    He should feel fortunate it’s less than $500 for $20,000 worth of medical attention plus his pathetic he is to complain..get a grip

  67. Priscilla says:

    Wow, rather then be tolerant and practice what they believe by simply not saying the words “under God,” these atheists intolerantly want to dominate the rest of society. When I went through my “I may be an atheist” phase in high school, I said the pledge with a pause so those who wanted to believe our country was “under God” could say it and I rejoined at the next word. It is a very simple procedure and secures the rights of everyone rather then intolerantly discriminating against the majority of the folks. Tolerance allows both ways not my way or the highway.

  68. Vincenzo says:

    Rather than remove the polyps, Mr. Dungee should have immediately been awakened from his anasthesia and allowed the 2-4 hours of recovery with the hose still up his butt until he could be asked whether or not he wished to have the polyps removed. If he agreed then he could have been charged the full cost of the re-administering of the anasthesia, the surgery and the post-op recovery process………This is a classic case of “damn the cost, help me now” but don’t send me the bill.

  69. Nancy says:

    It is not up to the doctor to know what your coverage is with your insurance company. Take responsibility for calling your insurance company and clearly knowing what your benefits are. Be prepared. A doctor sees many patients with not only different insurance companies but also various plans from the same insurance company. If a doctor had to figure out each patients’ insurance before they saw the patient, or stop while doing a procedure, to see if it is covered by the insurance, that would be ridiculous and you would be complaining the doctor would not provide you with adequate medical care based on your insurance. I do not see a bait and switch here. I see someone who did not take the time to fully understand their own medical coverage.

    1. RS says:

      Nancy Called BC/BS – understood my coverage included at not cost Colonoscopy screenings – made appointment with doctor- they should inform patients that they do not perform the procedure for the fee BC/BS provides. I spcifically asked. Why would a ptatient go there when there are providers that will provide this procedure under the terms that BC/BS provides? When a patient calls thier office today- do you think that they will inform patient that they will not except BC/BS as full payment. No they will just book the appointment and bill latter- Bait & Switch!

      1. snewsom2997 says:

        It is up to you to know if your insurance company will pay, the doctor only provides the service, doctors are not your Insurance Reps, and the Insurance Contracts are 100 pages long for a reason, it is Insurance they do not make money paying out more money than they take in.

  70. Luke says:

    Think this is bad. Wait till we get the so called national health plan!

  71. Wendy says:

    I worked for a major health insurance company for years! This is not fall out from Obama’s healthcare reform, this has always been happening. If the doctor finds something and bills it as anything but a preventative screening it will be processed under your benefits for a diagnostic test. That’s the way it has ALWAYS been.

    1. Wendy says:

      The real difference is prior to Obama’s healthcare reform, many people with high deductible plans were going WITHOUT these screening tests because even preventative screening tests were covered the same as any other diagnostic test, either subject to deductible and coinsurance or with a co-payment.

  72. Beefo says:

    I got screwed by the insurance company twice. Once for the colonoscopy and another time for a mamogram. Both times they changed it from preventive to diagnostic. Then the Dr. had the nerve to ask me to come back for a repeat in 3 months. NOT

  73. Susan says:

    I read most of the comments and the only one that makes any sense is from Wendy who worked for a health care insurance company. Why is everyone blaming Obama for this? BTW, what is the definition of “Obama Care”? Most of what President Obama wants to put into place is not even in place yet and if you read what his plan is it is to help middle class Americans who are getting screwed by insurance companies all the time. I can not believe you idiots are defending the insurance companies who are laughing all the way to the bank and wall street by you paying your premiums and being denied what should be a covered benefit. Look at the stock market and see how well insurance companies are doing. If you want the truth about how we’re all getting screwed by the insurance companues read Deadly Spin by Wendall Potter.

  74. Susan says:

    To Alan the physician I just went over the comments again. Are you kidding me? You’re a physician and you won’t take medicaid or medicare. Didn’t you take an oath to do no harm? Not taking patients based on their insurance coverage is a disgrace. Why did you bother spending all those years in medical school, internship, residency and maybe a fellowship to come out as a greedy sob. I feel sorry for you and your other physician “buddies” who seem to care more about money than a patient. Wait until the day you’re the patient!

  75. Geroge Bush says:


    O’BamaRomenycare starts in 2014.

    We have just pure Romneycare in Mass. now, blaming Obama just makes you look stupid.

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    California long term proper care fees * how you can reduced the price of long lasting proper care insurance policy throughout florida ; locating the optimal along with least expensive term life insurance ; cheapest british isles existence Insuranceubezpieczenia anglia

  77. alfred brunell says:

    we only pay inssurance execs we do not get coverage for our illnesses i now pay for four insurances medicade medicare. a donut hole dental care and also perrscription drug coverage cocaine gives me the same relief i feel good after taking it then get down and take somemore i get no results from either drug deale astreet coner person or in the drug store plus i pay about the same for each and get the same results

  78. brianH says:

    Have had insurance with the samecompany for 20 years. Switched to “new” style policy in november,2011, to get screening colonoscopy as i am 57 and never had one. Even advised by thier phone agent to update my policy for these benefits.One polyp removed and you know the rest of the story-now is coded as preventative. My bill for full cost.4500$. I dont borrow money and have my house paid for so think i will just let my credit rating take a hit and not pay the bill-have never not paid a bill in my life–time to take a stand

  79. Fishing tackle sale says:

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