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Hospitals should be a refuge and not a place for predatory billing: Doctor

Dr. Marty Makary, Johns Hopkins Bloomberg School of Public Health Professor & The Price We Pay" Author joins Yahoo Finance’s Anjalee Khemlani and the Yahoo Finance Live panel to discuss how the pandemic has engulfed people in debt and how hospitals and doctors should respond to patients.

Video Transcript

AKIKO FUJITA: Welcome back to Yahoo Finance Live. Many Americans delayed their medical care during the pandemic. But those costs are expected to catch up and balloon in the next year. It's expected to rise another 6 and 1/2% next year. That's, at least, according to new research out from PwC's Health Research Institute.

To talk more about the affordability, or the lack of affordability, we should say, around health care, let's bring in Dr. Marty Makary, Johns Hopkins Bloomberg School of Public Health professor and the author of "The Price We Pay." We've also got Yahoo Finance's Anjalee Khemlani, who covers the sector for us.

Doctor, it's good to talk to you today. Just give me a sense of where things stand right now on these cost issues because it feels like there's a number of threads that really emerged during the pandemic.

Number one, there's a lot of people who didn't get the medical care they needed during the pandemic. That's now catching up to them. But also, concerns about the health habits that were formed during the pandemic and how that could be adding to costs as well-- how are you looking at these dynamics at play?

MARTY MAKARY: Yeah. It's very concerning. Right now, we are seeing people defer their medical care. And that means that we're seeing a lot of new breast lesions, a lot new-- of new characteristics on mammogram that require follow-up. We're seeing people defer colonoscopy and other things that were elective. And so we're going to see an increase when people come back and consumer confidence is up again.

Also, you know, the debt situation wasn't good to start with. And when we get back into full billing cycles, it's going to be a problem again.

ANJALEE KHEMLANI: I'm glad that Akiko mentioned that PwC report because there was one thing that did stand out to me. And I know that, on one hand, we're looking at debt from health services as well as the ongoing trend of bankruptcies.

But on the other hand, a lot seems to have changed, especially because of the pandemic. And that is remote monitoring, telehealth, all the tech devices that really came into play as, you know, elective services went away. So do you see that as sort of balancing and playing a role and maybe curbing the cost trend?

MARTY MAKARY: You know, one thing we've learned during COVID is that our systems are very archaic. And we work way too slow, even in research. MRNA vaccine technology has been around since the 1990s, for example. It took COVID to really get it to market quickly. We should have had an mRNA vaccine for HIV and malaria and other problems, maybe even some forms of cancer.

So we're learning now that the way we were doing things was not a good way. And if you go to the doctor and have to park in a complex garage and navigate a campus and sit in a waiting room for half an hour and then see a doctor for 10 minutes for something that did not require a physical exam, that made no sense. That has been disrupted. And so that's a good trend right now.

ANJALEE KHEMLANI: Well, let's also talk about something else that's kind of in the headlines right now. I'm sure you've heard about UnitedHealth and their ER policy, and also delaying rolling it out, basically denying non-emergency visits. And that is something that I know many health experts have been looking at for quite some time, just the general idea that the emergency room is a costly entrance for health care services is not always appropriate. How does this, you know, set the company up and, really, the industry up for discussions about pricing now?

MARTY MAKARY: Well, it doesn't make sense to go to an emergency room for something that could be treated at an urgent care or family medicine doctor. And we know emergency rooms have been abused.

The concern about this new policy and the reason there's a backlash against its announcement by UnitedHealthcare is that sometimes, when you're sick, you don't know what's an emergency. You may be concerned. Some-- a lot of stuff is in the gray zone.

So if you go to the emergency room and they tell you this is something that's not an emergency, that's reassuring. We can't rely on people to make their own ICD-10 diagnosis for their medical conditions.

JARED BLIKRE: Doctor, I want to jump in here and just ask you about the general state of the vaccine rollout. We're sending vaccine-- our supplies around the world now. I'm just wondering if you have any update and insights into how this might be progressing.

MARTY MAKARY: Well, first of all, it's a disgrace that we'd let so many vaccines on the-- in the global market expire. We're allowing over a million vaccines for the J&J vaccine to expire. We've also been hoarding hundreds of millions of doses in between Canada and the United States. Those doses should have gone overseas.

We've got California spending $116 million in payment incentives to get people vaccinated. Meanwhile, people in Brazil and India are dying. They're vulnerable.

We should be thinking about the global supply. And you're going to see an announcement later today from President Biden about how to move some of those vaccines overseas. But you can't turn that supply chain on overnight. And it's coming too late.

ANJALEE KHEMLANI: And doctor, returning back to the original topic about debt, there has been a lot of concern about the cost of care as well as that trend I mentioned about bankruptcies. Have we seen any improvements in that and/or will this debt that is currently stacking up from the pandemic lead to a surge in bankruptcies later on down the line?

MARTY MAKARY: Well, medical bills are the number one cause of household bankruptcy in the United States. And unfortunately, health care, as I describe in the book "The Price We Pay," has adopted a business model of price gouging and predatory billing to people who are vulnerable and come to us as doctors when they're sick and in need.

Hospitals were built to be a safe haven and a refuge to be a safe place when-- where people can come when they're sick, not to be taken advantage of financially. Some hospitals do good on their billing quality. And they've got fair practices. And others are taking advantage of people.

Billing quality is medical quality. And financial toxicity is a medical complication. So my team and I are working now through several platforms. One is Sesame Care, which is an online portal where you can shop for care. We've worked with policymakers in DC and got the bipartisan executive order signed by the last administration to require hospitals to list real cash prices and for insurance companies to disclose their secret discounts. These are all things that are moving businesses in the direction where they can now use apps for their employees to navigate care.

JARED BLIKRE: Doctor, you hooked me at Sesame Care. I'm going to have to look into that. Dr. Marty Makary, Johns Hopkins Bloomberg School of Public Health professor and author of "The Price We Pay"--