Former US Surgeon General Criticizing $5,000 Emergency Room Bill

Business Insider is reporting that Dr. Jerome Adams, US surgeon general from 2017-2021, is complaining about the $5,000 bill after treatment at the Mayo Clinic Arizona emergency room (ER) for dehydration (1).

Figure 1. Dr. Jerome Adams former surgeon general of the United States and currently Director of Health Equity Initiatives at Purdue University.

Local media has been slow to pick up on this story with none of the local television, radio, or newspaper sources reporting on the former surgeon general’s ER visit. Adams first shared his experience on X (formerly Twitter) in a post that went viral. In an interview conducted February 26 with Business Insider, Adams said he was taken by ambulance to the ER in January after becoming lightheaded while hiking. He had labs drawn, received 3 bags of intravenous fluid and was discharged. The shock came when he received the bill. He decided to fight and has been spending hours on the phone with hospital billing reps to get a clearer picture of why he was charged so much. The bill likely will climb higher since Adams has not been billed for the ambulance that took him to the ER. Adams said the experience has been "mentally taxing".

It's unclear why Adams' bill was so high since he said he had not received a breakdown of the charges. ER bills are notoriously expensive and can vary drastically from hospital to hospital. Adams said he was billed for a Level 5 visit, which is a code used for patients with the most complex and highest level of severity, such as chest pain or stroke symptoms. Level 5 visits fetch higher payments because they require more resources and time. Adams said he was fighting the bill because he believed his visit should have been coded at a lower level.

Another issue is that Adams is enrolled in a $7,500 deductible health plan. High-deductible plans have become more common as employers have shifted the cost of medical care to their workers. A survey by Kaiser Family Foundation (KFF) found the average annual deductible for individuals in one of these plans attached to a health savings account was $2,518 in 2023.

Adams said that with all these obstacles, it was no wonder many Americans ended up with medical debt. "If I'm in this situation with my knowledge and with my financial resources and with my bully pulpit, then the average Joe doesn't stand a chance. The system is just broken", Adams said. Medical debt is a widespread problem. An analysis by KFF and the Peterson Center on Healthcare reveals that 20 million people in the US owe medical debt, and 14 million people owe $1,000 or more. Research has shown that medical debt is a leading cause of personal bankruptcy (2).

Congress has provided some relief from unexpected medical bills. The No Surprises Act, which went into effect in 2022, is supposed to keep patients from getting stuck with a surprise bill if they inadvertently receive care from an out-of-network doctor but does not cover a situation similar to Adams’. Adams said patients should have a better sense of what they'd be required to pay ahead of getting care and more clarity about their options when they get a big bill. He also said, “patients shouldn't face drastically different costs for the same care at different facilities. People are so scared of these bills due to lack of transparency. They actually just don't go in at all until it truly does become an emergency. There are many flaws in the system that would've caused other individuals to have gone into debt, have their credit ruined, or have to make choices about things they needed to do. I've got three high schoolers, two kids heading to college. If I wasn't in my income bracket, I might be making a choice as to whether or not to pay my medical bill or to pay my kid's tuition”.

Richard A. Robbins MD

Editor, SWJPCCS

References

1. Shelby Livingston S. A former US surgeon general says he went to the ER for dehydration and ended up with a $5,000 bill. He called the healthcare system 'broken.’ Business Insider. Feb 27, 2024. Available at: https://www.businessinsider.com/former-surgeon-general-medical-bill-shows-broken-healthcare-system-2024-2 (accessed 3/4/24).
2. Himmelstein DU, Warren E, Thorne D, Woolhandler S. Illness and injury as contributors to bankruptcy. Health Aff (Millwood). 2005 Jan-Jun;Suppl Web Exclusives:W5-63-W5-73. [CrossRef] [PubMed]

Cite as: Robbins RA. Former US Surgeon General Criticizing $5,000 Emergency Room Bill. Southwest J Pulm Crit Care Sleep. 2024;28(3):34-35. doi: https://doi.org/10.13175/swjpccs014-24 PDF