Had paramedics kept driving another three blocks and delivered Megan Rothbauer to Meriter Hospital, instead of depositing her at St. Mary's Hospital, a facility out of her insurance network, the 30-year-old Wisconsin resident would have likely already paid off her medical bills. Instead, Rothbauer is fighting off bankruptcy after being buried in medical debt.
Rothbauer might have said something at the time, but she was incapacitated -- clinically dead, in fact -- having had a freak heart attack last September at the age of 29. The young woman spent 10 days in the hospital in a medically induced coma. She recovered, but instead of enjoying a new lease on life, Rothbauer found herself burndened by massive medical bills.
"It was the closest hospital to where I had my event, so naturally the ambulance took me there. No fault to them," Rothbauer told Madison News 3. "It's unfortunate that Meriter is in network and was only three blocks away from St. Mary's."
Nearly half of Rothbauer's bill was eventually covered by her insurer. She was also able to negotiate with St. Mary's to have her remaining balance of $98,000 reduced by 90 percent. Still, Rothbauer said she's overwhelmed by bills from the individual doctors, therapists, and others.
Rothbauer's insurance company, Anthem Blue Cross Blue Shield, blames the hospital for their high costs of services. And many healthcare policy experts agree, runaway hospital costs are one of the health care industry's major problems.
"Hospitals over-bill. And because hospitals routinely over-bill people's worlds can be upended over the 'cost' of treating a simple cut," Dr. David Belk, an internist in San Francisco, wrote in a Huffington Post blog post last year. "In fact, much of what health insurance companies offer now isn't payment for services, but rather 'protection' from over-billing."
Meg Gaines, head of the consumer healthcare advocacy group Center for Patient Partnerships, says patients like Rothbauer are at the mercy of large hospitals and unjust billing practices.
"It's devastating for people who plan, who get insurance, get coverage, do everything they can and then, at 29, have a heart attack and get taken to the wrong hospital, and can't get married, can't do anything because they have to declare bankruptcy because they can't afford to have gone to the hospital," she told Madison News 3.
"I mean, it's not enough to worry about having a heart attack at 29, you end up with a secondary one or a stroke because of your medical bills. I mean, it's just ridiculous. The level of frustration is astronomical."