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.'

• Former US Surgeon General Jerome Adams said he got a $5,000 bill for a recent ER visit.

• He said he was fighting the bill, which had been "mentally taxing."

• His experience highlights big problems with US healthcare, including high costs and no transparency.

A former US surgeon general just got a taste of what frustrates countless Americans: a massive medical bill.

Dr. Jerome Adams, who was the nation's top doctor from 2017 to 2021, said he was slammed with an almost $5,000 bill after being treated for dehydration at a Mayo Clinic emergency department, where he got labs and a few IV bags. He first shared his experience on X (formerly Twitter) in a post that went viral.

In an interview Monday with Business Insider, Adams said he went to the ER in Scottsdale, Arizona, in January after he became lightheaded while hiking on a work trip. He said getting the big bill was shocking — even for a doctor well-acquainted with the pitfalls of US healthcare system. Spending hours on the phone with hospital billing reps to get a clearer picture of why he was charged so much had been "mentally taxing," he said.

The Mayo Clinic didn't immediately return a request for comment.

Adams said his experience highlighted the exorbitant cost of medical care in the US and the lack of price transparency. Patients usually have no idea what a medical visit will cost ahead of time, and even if they do, it's impossible to shop around in an emergency. At the same time, patients increasingly shoulder a larger portion of healthcare costs as insurance deductibles have crept higher.

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.

Adams' big medical bill

Medical debt is a widespread problem. An analysis by the KFF and the Peterson Center on Healthcare suggests 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.

It's unclear why Adams' bill was so high since he said he hadn't 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 highest level of severity, such as chest pain or stroke symptoms. The most complex cases fetch higher payments because they require more resources and time. But 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 high-deductible health plan, requiring him to pay thousands of dollars out of pocket before he reaches the "deductible" and insurance starts picking up part of the tab.

High-deductible plans have become more common as employers have shifted the cost of medical care to their workers. A survey by 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 his deductible was a whopping $7,500.

The health plans allow patients to put pre-tax money in a savings account each month to help them afford their medical bills. But Adams said that since his ER visit occurred in January, he hadn't built up any savings.

Patients need more clarity on big medical bills

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 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," he said.

The ER visit isn't Adams' first brush with an unexpected bill, and he fears it won't be the last. He said the Mayo Clinic's billing department warned him he might receive another bill for his ambulance ride to the hospital.

He said he was fortunate enough to be able to swing these bills if he had to. That's not the case for many others.

"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," Adams said. "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."

Read the original article on Business Insider