Don’t Bill Patients Like They’re Warren Buffett

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Taking place in Austin, Texas, each spring, South by Southwest has emerged as the US’s leading creative festival for the arts, design, and technology. It has become a cultural barometer of the America we live in today and a signpost to the shape of the America that lies just around the corner. 

But what does this have to do with medical bills and VisitPay? Well, we think quite a lot. 

The high cost and emotional distress caused by dealing with unexpected medical bills is unquestionably an issue of national attention and source of intense personal angst for many. Approximately 40 million Americans will receive collections calls this year because of unpaid medical debt (based on running the numbers behind this NPR story). Calls have been made for a Financial Bill of Rights for patients, in a deliberate nod to the language used when setting out cornerstone principles during historic breaks with the past in western society. And the high cost of medical care is perceived by foreign observers of contemporary America as a symbol of a broader societal dysfunction, as this BBC story highlights.

With this backdrop, then, it feels entirely appropriate to discuss the subject of medical bills on a national and problem-solving stage like South by Southwest. And so a couple of us at VisitPay got together to discuss how we could do this. We came up with a topic that we’ve submitted for selection for South by Southwest 2019, and we called it: “Don’t Bill Your Patient Like They’re Warren Buffett.”

Why did we choose this title? For two reasons. 

First, because we see an industry that is being challenged and changed by outsiders. The grand alliance of JP Morgan Chase, Amazon and Buffett’s Berkshire Hathaway group symbolizes this “barbarians at the gate” feeling more than any other. Formed ostensibly to search for ways of reducing the high cost of healthcare for three very large US employers, few doubt the ambition of the trio to move onto other problems with the determination, deep pockets and differentiation that shapes their other endeavors. As a newbie to healthcare myself, it’s been fascinating to see this tension play out over the last year. I don’t know how it will resolve, but it certainly feels like meaningful work to be a part of it. And, of course, all of us at VisitPay are outsiders coming in to this industry to help fix a problem that we have the skills and experience to take on, for the good of all participants.

Second, because like few others, Warren Buffett symbolizes the ultra-wealthy. When patients are faced with medical bills that run into thousands of dollars but most Americans struggle to pay an unexpected expense of more than $400 it must feel to many that you need to have pockets as deep as Buffett to be able to deal with medical bills in the US today. 

But, of course, we’re not Warren Buffett and neither are we ever likely to be. In fact, we’re all different — individual people with our own financial circumstances, likes, dislikes, fears, habits and hopes. 

Which leads to the vital question. Healthcare providers have, unwittingly, become one of the largest providers of consumer credit in the county. Our anecdotal analysis suggests that they’re second or third in most major cities — behind only banks and home furniture companies (of the “buy-now-pay-later” variety) — in issuing credit. Yet those other organizations are set up for the purpose. Health systems simply are not. As community servants and not-for-profit organizations, their motivations are different but surely the ideas and principles of other consumer finance organizations can be applied to help them do a better job, without compromising their mission. Can’t they?

We believe so. In fact, we know so, based on our work with leading health systems. 

But, today like every other day, millions of paper statements will be sent to Americans all over the country. Each makes undifferentiated, unclear and often unattainable demand for immediate payment for a service that the recipient possibly didn’t choose and almost certainly didn’t plan for. That’s just one example of how the industry is far from achieving what it needs.

We can, should and must do better. It is an imperative for modern America.

So, please read our abstract, vote for our topic and help get us on stage in Austin next spring so we can point to a new direction that will serve America and Americans better.

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