Anna Anthony could never have predicted that her yearly eye exam, which she was told was covered by her insurance, would cost $40,000. For comparison, Vision Service Plan (VSP), one of the most popular insurance providers in America, estimates that the average cost of an eye exam without insurance is $194.
“The eye doctor waited until I was dilated and completely unable to see to hand me a paper — that I couldn’t read — with my charges for the day,” she said.
Before medical personnel briefed her on the estimated cost of the procedure, which included an MRI scan, Anthony, who is just shy of legally blind, was told to remove her contacts. Not only was she unable to see the paperwork that outlined the total cost, she said that she couldn’t even see the faces of the nurses who handed it to her.
Information about accurate pricing in the healthcare system is often difficult to access, despite hospitals being required by federal law to publicly share the costs of standard procedures since 2021. In fact, a 2023 study by Patients’ Rights Advocate revealed that only a quarter of American hospitals were in compliance with the Trump-era price transparency requirements.
Anthony said that if she had been informed of the charges before the procedure took place, she would have approached the situation very differently. But because she was presented with her charges after the procedure was complete, there was nothing she could do.
“I didn’t know I could go to an imaging center and have the MRI done for around $400,” she said. “I never would have gone to the hospital for my procedure or MRI if I had known that. It has completely messed up my finances.”
Anthony said she was charged $40,000 for the procedure and was asked to pay $2,500 after insurance. Over the next five months, she worked continuously with the hospital’s billing department to work the price down to a more reasonable number.
“I compared my itemized bill charges to the averages for my region, and I was charged roughly 200-250% more per item,” Anthony said.
The unexpected and debilitating cost of the procedure, which the hospital’s billing department told Anthony would be covered by insurance, has placed a heavy burden on the single mom.
“I have one income and a child with education needs that requires specialized therapies,” she said. “I was already scraping by, but this has made things so tight that I’m having to skip meals to make sure I can make the payments.”
Unfortunately, Anthony’s experience is far from unique. The United States spends more on health care than any other developed nation, yet has worse health outcomes, according to the Peter G. Peterson Foundation. In fact, the U.S. spent $4.3 trillion on health care in 2021 alone, which translates to about $12,900 per American.
According to IWF’s Vice President for Policy Hadley Heath Manning, “the frustration with hidden healthcare prices is so universal that 90% of Americans support public policies requiring hospitals and medical providers to disclose their prices. This level of agreement is almost unheard of in politics — particularly in today’s polarized environment.”
Due to many hospitals’ failure to follow price transparency guidelines, patients like Anthony are blindsided when they receive their medical bills. Patients deserve to know the prices they’ll be charged before they enter the hospital — not after the services have already been rendered.