美国国家公共电台 NPR How A Urine Test After Back Surgery Triggered A $17,850 Bill

 

RACHEL MARTIN, HOST:

We now have the story of a really large medical bill. It's a surprisingly common sort of charge, which is why we're examining it. Steve Inskeep spoke¹ with Dr. Elisabeth Rosenthal of Kaiser Health News about the story of a $17,000 urine test. And Steve asked her who had to pay the bill.

ELISABETH ROSENTHAL: Oh, it was a young woman named Elizabeth Moreno who had some back surgery, a very common kind of surgery, and the surgery worked. And of course after her back surgery, you get a little prescription² of opioids. People...

STEVE INSKEEP, BYLINE³: Because if you need painkillers⁴...

ROSENTHAL: Painkillers...

INSKEEP: ...You want to be careful with them.

ROSENTHAL: Right. And she took them for a few days - not very long. And then when she went for a follow-up visit about two months later, the surgery worked great. She was long off opioids. The doctor said, oh, well, we have to test your urine. Just pee into a cup. And boom - $17,850 bill.

INSKEEP: OK. So this is an extreme case. But it happens enough that NPR and Kaiser Health News have begun an investigation⁵. We're going to be looking at big medical bills in weeks to come.

ROSENTHAL: So we want to understand - how do those charges get generated? How do they add up? - and in the process help all of those consumers/patients out there be better at reading their bills, be forewarned that they can get these kind of bills and also know the questions to ask so they don't end up being a victim like Elizabeth Moreno was.

INSKEEP: Let's focus on this $17,850 test. First, was that covered by the patient's insurance?

ROSENTHAL: No, it wasn't covered, to add insult to injury, because the lab that it was sent to was out of her insurance network. So the insurer's first answer was - oh, just out of network. They didn't even pass judgment⁶ on the bill. So first question to always ask is, is my sample being sent to an in-network lab or radiology facility?

INSKEEP: There's an issue of consent here because she obviously consented to a urine test but didn't consent to that expensive of one. And nobody asked her about which lab it was being sent to.

ROSENTHAL: Well - and poor patient, who would have thought you had to ask that? Some doctors would have said there's no real reason to have a urine test at all. I mean, this is a woman postoperatively who got some opioids, used them as needed and then, as far as everyone else knew and she said, she'd stopped.

INSKEEP: When you reached out to the doctor in this specific case or reached out to the lab, did they offer any explanation for why they felt this charge made sense?

ROSENTHAL: Well, the doctor wouldn't talk to our reporter. And it's unclear to me as a former physician. Did he understand when he sent this test off for a screen that it was going to be tested for 5,000 different things? Did he understand that that lab was going to do what it did? I don't know that answer, and he wouldn't talk to us about it.

The lab did respond. They said, basically, it's - we feel our charges are reasonable. Now, part of the problem and part of the reason you see all these huge price disparities is in this country, we don't have any standard for what's reasonable.

INSKEEP: What's an initial piece of advice you would give people if they have received a really large medical bill that they can't understand?

ROSENTHAL: Don't write the check.

INSKEEP: Don't pay?

ROSENTHAL: Don't pay first. Don't be intimidated⁷. I mean, ultimately, you may be forced to pay more than you want. But first step is don't write the check.

INSKEEP: And another thing, of course, that you can do is share your stories with us. NPR and Kaiser Health News want to see some of your bills, whether they're sky high or just interesting, bills where there's a story to tell that we can investigate. If you'd like to participate, go to NPR's Shots blog, where you can tell us about your experiences and upload your bills. There's a form.

Elisabeth Rosenthal of Kaiser Health News, thanks very much.

ROSENTHAL: Thank you for having me.

(SOUNDBITE OF GIANTS' "WHILE THE AGES STEAL")

1 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

2 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

3 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

4 painkillers   

n.止痛药( painkiller的名词复数 )

参考例句：

• The doctor gave him some painkillers to ease the pain. 医生给了他一些止疼片以减缓疼痛。 来自辞典例句
• The primary painkillers - opiates, like OxyContin - are widely feared, misunderstood and underused. 人们对主要的镇痛药——如鸦片剂奥施康定——存在广泛的恐惧、误解，因此没有充分利用。 来自时文部分

5 investigation   

n.调查，调查研究

参考例句：

• In an investigation,a new fact became known, which told against him.在调查中新发现了一件对他不利的事实。
• He drew the conclusion by building on his own investigation.他根据自己的调查研究作出结论。

6 judgment   

n.审判；判断力，识别力，看法，意见

参考例句：

• The chairman flatters himself on his judgment of people.主席自认为他审视人比别人高明。
• He's a man of excellent judgment.他眼力过人。

7 intimidated   

v.恐吓；威胁adj.害怕的；受到威胁的

参考例句：

• We try to make sure children don't feel intimidated on their first day at school. 我们努力确保孩子们在上学的第一天不胆怯。
• The thief intimidated the boy into not telling the police. 这个贼恫吓那男孩使他不敢向警察报告。 来自《简明英汉词典》