五分之一的病人在手术后会收到意外的医药费账单
五分之一的病人在手术后会收到意外的医药费账单
Two bills up for debate and revision in the House this week aim to stop surprise medical billing — when patients are billed for services their insurance won't cover. New research reveals just how common surprise billing is after an elective surgery, like a knee replacement or hysterectomy.
本周将在众议院进行辩论和修改的两项法案旨在停止突如其来的医疗账单-当患者被收取他们的保险不覆盖的服务账单时。一项新的研究表明，在膝关节置换或子宫切除术等选择性手术后，突如其来的账单很普遍。
Tracking data from almost 350.000 patients with a large commercial insurer, the researchers found that more than 20% were hit with an unpaid balance, according to a study released Tuesday in JAMA. The average bill was over $2.000.
据《美国医学会杂志》周二发表的一项研究，研究人员追踪了一家大型商业保险公司近35万名患者的数据，发现有20%以上的患者有未付余额。平均账单超过2000美元。
The researchers didn't have the actual bills received by patients, so they calculated what health care providers could bill based on claims data:
研究人员没有病人实际收到的账单，所以他们根据索赔数据计算了医疗服务提供者可以收取的费用:
"For a large percentage of the public, getting one of these bills is really going to be financially devastating," says Zack Cooper, an associate professor of public health and economics at Yale University's School of Medicine, who wasn't involved with the study. A Federal Reserve report found that nearly 40% of adults in the United States in 2018 would have trouble paying an unexpected $400 bill.
耶鲁大学医学院公共卫生与经济学副教授扎克·库珀没有参与这项研究，他说：“对于很大一部分公众来说，拿到其中一张账单真的会在经济上造成毁灭性的后果。”美联储的一份报告发现，2018年美国近40%的成年人难以支付一笔意外的400美元账单。
Surprise bills are common after emergency care or nonsurgical hospital stays, when patients may not be able to choose health care providers covered by their insurance. (Twenty percent of inpatient admissions from the emergency department likely led to a surprise bill, a Health Affairs study found.) For elective surgeries, patients often have time to select in-network providers, but it didn't appear to make a difference.
在紧急护理或非手术住院后，当患者可能无法选择保险覆盖的医疗保健提供者时，意外账单很常见。(卫生事务的一项研究发现，急诊科20%的住院人数可能会收到一份出人意料的账单。)对于选择性手术，患者通常有时间选择(保险)网络覆盖内的提供者，但似乎没有什么不同。
The study found that most of the surprise bills come from either anesthesiologists or surgical assistants — who are typically not chosen by patients.
研究发现，大多数意外账单来自麻醉师或手术助理，而这些人通常不是病人选择的。
Chhabra doesn't always get to see his patients after they've received bills. But his friends and colleagues have dealt with surprise bills themselves. "The surgical community had to do something about this and find out exactly how often this is going on," he says.
查布拉并不总是在病人收到帐单后才去看他们。但他的朋友和同事们自己也处理过意外的账单。他说:“外科界必须对此采取行动，查明这种情况到底有多频繁。”
The study arrives during a time when Congress is debating how to address this problem. The two bills under discussion take differing approaches to resolving these outstanding payments when they're no longer placed on the shoulders of patients.
这项研究是在国会讨论如何解决这个问题的时候进行的。正在讨论的两项法案采取了不同的方法来解决这些未偿款项，因为它们不再由病人来承担。
Either of the two bills would be an improvement over the status quo, Cooper says. But it's unclear what measures will really make it into law.
库珀说，这两项法案中的任何一项都将是对现状的改善。但目前还不清楚哪些措施会真正成为法律。
"The devil's obviously in the details," Chhabra says.
“魔鬼显然存在于细节之中，”查布拉说。
Surprise billing was a focus in Congress last year as well, but legislation never made it through. There's now a lot of opportunity for Congress to take action, says Jean Fuglesten Biniek, a senior researcher at the Health Care Cost Institute, a nonprofit research center focused on health care.
意外的账单也是去年国会关注的焦点，但立法从未通过。医疗保健成本研究所高级研究员比内克说，现在国会有很多机会采取行动。该研究所是一个专注于医疗保健的非营利性研究中心。
