Medical care is expensive and continues to get more costly. Many people in Arizona only become aware of this after they get a bill for their care.

According to the Arizona Public Interest Research Group Education Fund one in 10 adults in the U.S. carry medical debt, including nearly 11 million people who owe more than $2,000.

Patricia Kelmar, health care director for the group, said whether you have insurance or not, medical bills can quickly become a financial headache. It is why she helped create a medical guide to help navigate medical bills and know your patient rights to avoid unnecessary charges.

"Bills come in dribs and drabs and it is hard to keep track of what you owe and what you don't owe," Kelmar observed. "Particularly in a situation where you might have been hospitalized for a week or a few days, ask for an itemized list of all the services that you got with the prices."

Kelmar noted regular people are putting your bill together, and there is a good chance billing mistakes are being made. She encouraged people not to assume your bill is accurate. She added hospitals are required to now post the prices of their top 300 most "shoppable services," which means knowing their cash or insurer prices can help you negotiate your bill down.

Under the No Surprises Act, those who are not insured have the right to ask for what Kelmar called a good-faith estimate for the needed care. She encouraged everyone to hold on to the estimate because if your final bill's total is $400 or more over the initial estimate, you can hold the provider accountable.

If you do have health insurance, Kelmar advised the most important thing you can do is use an in-network doctor or hospital to keep out-of-pocket costs down. The No Surprises Act protects you from "surprise medical bills" when you receive emergency care in an out-of-network emergency room, but not an urgent care center.

"One important thing to do in advance for emergency situations is to understand where your in-network urgent care center is, even when you go on vacation," Kelmar recommended. "'Where can I go where I can be in-network and get the treatment that I need?'"

Kelmar also warned Arizonans about credit cards being offered in medical settings. She pointed out they often promise zero interest for a number of months, but will then charge much higher interest than a regular credit card, up to 30%.

She emphasized unless you're sure you can pay off the debt in the short time allotted, she does not recommend taking the offer.

The number of Medicare enrollees is projected to rise over the next few years as the baby boomer population ages. More than 2 million Illinoisans are currently enrolled in the federal health care program, according to Healthinsurance.org,

The Office-Based Facility Association, a coalition of practitioners, is calling for a change in what they view as an ineffective and unfair pricing structure of the Medicare Physician Fee schedule.

Jason McKitrick, executive director of the association, said other payers linking themselves to Medicare is one of the issues.

"When you've got ongoing cuts to Medicare, that means you've likely got ancillary cuts going on with the private side, with the Medicaid side, etc.," McKitrick explained. "It's the Centers for Medicare and Medicaid Services, CMS, ultimately, that's the agency and the federal government that sets the rates for the Medicare Physician Fee Schedule."

The association pointed out the current fee schedule addresses doctor's fees only, not the costly and necessary supplies and equipment needed for their practices. According to the Centers for Medicare and Medicaid Services data, there are 300 office-based services under the fee schedule for which Medicare reimbursement is less than the direct costs, before even considering other costs like overhead and physician work.

Dr. Sreenivas Reddy, a vascular interventional radiologist in Hinsdale, said in addition to seeing patients, he has to monitor overhead expenses such as office space and employee salaries, both affected by inflation. Not having the proper medical equipment and supplies, he added, limits his ability to perform specialized procedures and forces patients to seek care elsewhere.

"That makes these patients go to the hospital-based facilities," Reddy noted. "We have to close our offices and try to join these hospital-based models. They would love to come to the office, get the procedure done in one or two hours, versus it takes like a whole day in the hospital setting."

Reddy emphasized physicians' reimbursement, based on the current physician pay schedule, has been on the downtrend for the last five years. The group has further concerns about a decrease in the number of private practices causing more medical deserts for interventional radiology, cardiology, vascular surgery, radiation and oncology care.

Farm advocates say price gouging on meat and poultry are taking a toll on Montanans.

A farm group cites U.S. Department of Agriculture data as proof of corporate greed, and says companies are still using supply-chain issues as an excuse for inflated prices.

Companies faced massive supply-chain disruptions during the pandemic. But Ag Department data show most of those problems are gone - and food prices in Montana haven't dropped.

Groceries here are 5% higher than the national average and egg prices are up 50% since last year, according to the Consumer Price Index.

Joe Maxwell, chief strategy officer with Farm Action, said food producers are looking for ways to keep prices artificially inflated.

"And it's just a part of their doing business now," said Maxwell. "They find excuses in the markets to gouge that consumer. And one thing we want to be very clear on is that the consumer knows it's not the farmer. The farmer's getting squeezed just as much as is the consumer."

Food producers have blamed the supply chain, but also plant closures and a strain of avian flu for supply and demand issues - driving up production costs.

Farm Action is the same group which, not long after the official end of the pandemic, asked the Federal Trade Commission to investigate egg prices - which had tripled in some cases.

Maxwell said Ag Department data show the numbers did not justify the price hike, and adds corporate food producers have positioned themselves to have outsize control over the market.

"They've got that control over the farmer, not unlike oil companies have over oil fields," said Maxwell. "They now have that control because there are very few buyers of farmers' commodities, so they have that control over the farmer, the producer."

Farm Action has also been critical of large, corporate operations that raise thousands of animals in confined spaces, which have been known to pollute air and groundwater.





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CORRECTION: The legislation mentioned in this story was passed by the Wisconsin State Assembly. It has not yet been voted on by the state Senate. An earlier version of this report incorrectly stated 'the new law would go into effect Jan. 1, 2025.' (5:45 p.m. MDT, Nov. 21, 2024)


A recent wave of racist texts targeting Black Wisconsinites has sparked concerns about data privacy.

The personal information people voluntarily disclose on various online platforms is often used for marketing purposes and can be sold to data brokers, who then sell it to others.

Chad Johnson, assistant professor of computing and new media technologies at the University of Wisconsin-Stevens Point, said industry estimates show most data brokers have no less than 15 data points on every American including age and ethnicity, detailed contact information and even Social Security numbers.

"Since there's no regulation over who can buy those, of course, it could be other advertising agencies, it could be other platforms," Johnson pointed out. "But there's also nothing stopping, for example, a white supremacist movement from buying that information for purposes exactly like this."

Personal data can also be stolen or leaked. Johnson added there is currently no comprehensive federal law to protect data and privacy in the U.S. However, a new data privacy law in Wisconsin could go into effect next year.

The Wisconsin Data Privacy Act, was passed by the State Assembly a year ago today. It includes requiring businesses to inform people if their data is being collected and the purpose, as well as the right to access their personal data and request it be corrected or deleted.

If passed by the Senate and signed by the governor, the act would become effective Jan. 1, 2025.

Johnson said because anyone can have such detailed information about their targets is where an intimidation factor comes in.

"It kind of sends the message, also implicitly, well what else could they possibly know?" Johnson explained. "If they have my ethnicity, do they have my address, do they have my children's names, do they have my school or my children's school? Do they have my web history, or anything along those lines? It's impossible to know."

He added until people come together to demand better regulation, little can be done to prevent cyberattacks, making individual precautions more important than ever.


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