Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win

Marshall Allen’s Never Pay the First Bill starts off slow with a $445 overcharge issue. Initially it may seem like a snoozer, but this book is filled with practical information on how to prevent overcharging for your health care. He summarizes everything in easy-to-read language, and just to make it super convenient for future referencing, there is a handy bullet-pointed summary at the end of each chapter. Though one could hardly call the guide humorous, there are quotable quotes including, “We have to stop acting like someone else is funding the system [health care].”

The author links flat wages to the cost of health care and cites many expert sources in his guidebook to avoiding overcharging for health care. Further he reveals how the insurance companies never really lose money in the long run as the customers merely experience cost increases at their next renewals. “The insurance industry operates like a cartel—a coalition of players working together to keep prices high and limit competition.”

“The customer is always right, but health care power players don’t consider you their most important customer.”

“The business of medicine exploits your sickness for a profit.” Boy, does that ring true for those with insulin dependent diabetes, who must fork over astronomical amounts for their daily medicine to stay alive, and for drug patents that have continuously been extended to keep prices high. Diabetes is a gold mine for pharmaceutical companies.

As a former insurance industry refugee, even I found new information in this wonderful handbook to avoiding rip-offs by the insurance industry. The examples he provides on checking discounts for services if paying cash versus using the insurance plan are eye opening. It seems those fantastic discounts the insurance companies and third-party administrators promote through their provider network contracts aren’t real at all. And the true cost of your prescription if paid in cash may be less than your drug copay! To quote Dr. Zubin Damania, “What’s the point of paying tens of thousands for family health insurance if the insurer, with all of their leverage, can’t negotiate a better price than I can?”

“I guess that’s why we have the most expensive health care in the world.”

Giant hospital corporations are even more mercenary, leveraging their brand name and bargaining power to gain higher reimbursement with insurance companies and provider networks. Those organizations then negotiate for lower reimbursements for smaller independent clinics and hospitals, essentially starving them of revenue and forcing some to close or consolidate. In other words, giving you the health care customer less choice and making you pay higher fees for services, directly or indirectly. It is a win-win for huge health care organizations and a negatively reinforcing loop for the rest of us.

Allen’s guide should be used as a textbook in colleges throughout the nation, which would at least inform the public and give them a chance to avoid overpaying for health care. His suggestion to use available information on Medicare pricing as a guide for a fair charge for services is astute. It is replete with actionable methods to ascertain the cost for services before undergoing a procedure, how to compare prices from different facilities, and how to question and avoid unnecessary procedures. Employers will also find a useful section on methods to cut costs without curbing care for their employees, which to no surprise, often means leaving the traditional insurance networks and processes.

Finally, it also seems big healthcare insurance companies are not rigorous in fraud prevention either, so private employers and individuals must take on this challenge as well. “It’s just not worth it for your insurer to ferret out fraud.”

Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win is easily understandable for anyone with a high school education and should be kept at the ready for any health care consumer who wants to avoid getting ripped off by the ingenious US healthcare system more geared to profit generating than appropriate patient care.