.@jbsgreenberg & I have covered medical debt collection for a collective 15 years.

We've seen hospitals sue patients, garnish wages, and skimp on charity care.

A month ago we got a tip about something even wilder.

It became this story. Here's how.
1/10
nytimes.com/2023/06/01/bus… The tip came from a doctor. They were concerned they kept getting this message, through the electronic medical record, telling them they couldn't see patients with too many unpaid bills. 2/10

Prenatal tests promise to detect rare genetic diseases in babies by scanning DNA.

Labs market them as "reliable." They tell women to have "total confidence" in results.

It turns out, the grave predictions made by those tests are usually wrong. (1/5)

nytimes.com/2022/01/01/ups… In our new @nytimes investigation, @aatishb and I spent months talking to experts, tracking down studies, and analyzing data.

What we found: the tests’ findings of disorders are wrong a surprising amount of the time, between 81 and 93 percent.
(2/5)

Eighteen months into the pandemic, triple-vaxxed and eight months pregnant, I got coronavirus this week. And so did my under-5, unvaccinated kid.

Luckily, we have mild symptoms - we are Disney-movie sick, not scary sick. A few thoughts on after going through this (1/7) It was *really* great that we had a rapid test at home Tuesday morning, when my son had a cough. It immediately came back positive, so we obviously kept him home from school and hopefully reduced his classmates' exposure. (2/7)

Lots of Americans are concerned about getting surprise bills for coronavirus vaccines.

A thread on why *no one* should have to pay out-of-pocket for a Covid vaccine, why vaccine sites ask for insurance anyway, and what to do if you get a bill. (1/10)
nytimes.com/2021/06/01/ups… First: know the rules!

The coronavirus vaccine is free, free, free. Free!

Vaccine providers had to sign a contract with the federal government promising not to bill patients for the service.

The consumer protections are, thankfully, pretty strong here. (2/10)

This is John Druschitz.

He spent five days in the hospital with COVID-like symptoms.

He gets a $22,378 bill.

How'd it happen?

He found loophole after loophole in our health care system. His case tells us so much about the fragmented way Americans get care.

Thread: (1/11) Most developed countries have a universal health care system that covers all people. Some (UK, Canada) do this through public insurance. Others (France, Germany) do it through private plans.

What's the same is that everyone has health insurance that looks pretty similar (2/11)

This is Monica Smith, a 45-year-old Indiana woman who was in a serious car wreck in 2016.

She had health insurance. The hospital refused to bill it, instead pursuing her for $12,856.

How'd that happen?

Her story is the wildest medical bill saga I've seen in months. (1/13) When Monica Smith was taken by ambulance to Parkview Hospital, she had Medicaid — the public program that covers low-income Americans. She showed her Medicaid card. The ambulance billed her coverage.

But the hospital refused to — even after she asked multiple times. (2/13)

As part of my reporting this year, I've read hundreds of bills for coronavirus tests.

Some of them are pretty big — over $1,000 for tests that patients thought would be free.

As testing numbers rise, here's a thread on how to avoid getting a surprise COVID test bill. (1/11) Step One: Get Tested at a Public Site if You Can.

These are the sites set up by your state, county, or city. Those facilities are much less likely to generate any sort of bill.
(2/11)

As we wait for election returns, let me tell you about something you might see on your medical bill soon: a COVID fee.

It's new, it tells you a lot about the American health care system, and its not always legal. A thread (1/10) Over the summer, some health care providers started charging patients a fee for the increased costs — more PPE, more staff time spent cleaning — of operating in a pandemic. (2/10)

Obamacare's drafters said, again and again, the individual mandate was a crucial policy. Economists said the same thing.

But it turned out to be relatively ineffective, and the source of endless political and legal headaches.

A few thoughts on how this all happened. (1/13) Eons ago in 2009, when Democrats were writing Obamacare, they constantly talked about the "three-legged stool."

To create universal coverage, you need 3 things:
—Ban on pre-existing conditions
—Premium subsidies
—Mandate to purchase

(2/13)

Last month, my son's daycare had a coronavirus outbreak.

Another student in his class was positive. Then, my son vomited. I wanted to get him a COVID test.

Even living in a big city with dozens of testing sites, it wasn't easy.

A thread (1/11). I first thought I'd go to the Walgreens a few blocks away — but turns out, they only test adults.

Next idea: D.C.'s free testing sites. There are lots of them! But turns out they only test kids over 6. (2/11)

I'm launching a new project today that will investigate the costs of coronavirus testing and treatment using readers' medical bills.

A thread explaining why I'm doing my reporting this way, and how you can help the @nytimes tell this story. (1/7)
nytimes.com/2020/08/03/rea… There are two big things to know about health care prices in the United States:

1. They are very high

2. They are very secret

Patients don't know what their care costs until a bill turns up. (2/7)

There's an obvious culprit when it comes to America's sky-high health care spending: high prices.

But there's something less obvious, that's worth understanding a bit better: insurers do not have strong incentives to negotiate well on behalf of members.

A thread (1/8) You can actually see that really clearly in the story I wrote yesterday, about a woman who got a drive-through coronavirus test. She used her insurance, and they were billed $6,408.

Her friend paid cash and was billed $199.

nytimes.com/2020/06/29/ups…

(2/8)

The biggest challenge facing hospitals right now isn't the lost revenue in recent months (which is, by all means, a significant challenge on its own).

The biggest challenge is a shift in the insurance landscape, that is already underway. A thread (1/9): About 27 million Americans may have lost their private health insurance in recent months, per one @KFF analysis.

Most of those people will do one of two things: enroll on Medicaid, or become uninsured (2/9)

I've covered hospitals for a decade.

I've never seen hospitals managed like the ones I wrote about in my new story.

A thread: (1/9)

nytimes.com/2020/04/26/us/… Between 2014 and 2017, a for-profit hospital chain called Alecto purchased three hospitals in Ohio and West Virginia.

They served rural populations. They were struggling financially. Employees expected Alecto would turn them around.

The opposite happened. (2/9)

A few thoughts on how America's patchwork health insurance system may end up interferring with our ability to fight #Covid_19
(1/8) For starters, there's the most obvious point: health care in the US is expensive. This makes patients who are told by professionals they need to seek care reticent to do so.

I've written about this a bit in another context at the link below.
vox.com/health-care/20…

(2/8)