Solidarity President Chris Faddis recently appeared on The BS Show with Bob Sansevere to discuss an alarming trend in American hospitals, especially Children’s Hospitals, which is deep price gouging. Despite the concern, Faddis shared that there is hope for change in the No Surprises Act and the opportunity for patients to require a Good Faith Estimate for care needs.

Bob Sansevere (00:00):

We are joined by Christopher Faddis, co-founder and president of the nonprofit Healthcare Sharing Ministry Solidarity Healthshare, which is an ethical, affordable alternative to traditional health insurance and is faithful to the moral teachings of the Catholic Church. Chris, I got to ask you about something which is baffling to me, and I think a lot of people there are rules and most of us feel you should follow the rules. Well, one rule is that hospitals should post their fees and many of them don’t do it. There’s no penalty for that. How do they get away with this where you could go to a hospital and not know what it’s going to cost you? Let’s say you just need a tonsillectomy or you need your appendix taken out or anything you just don’t know.

Chris Faddis (00:43):

Yeah, I mean it’s a real problem. And actually only up until 2020 it was never required and you could really have a very hard time getting those rates from the hospitals with No Surprises Act that was passed at the end of 2020 and went in effect just in the last couple of years, that’s actually changed and now they are required to post their fees and required to give you something called a Good Faith Estimate. If your procedure is planned anytime, anything more than 72 hours before the surgery or the services is to take place, and it is an issue. They’re not complying with it. They’re not publishing their costs. If they are publishing, they’re publishing it in a machine readable format. So you and I could never read it. We’ve got to find somebody else who’s created an app to do it for you, and it’s a real problem. Now, Bob, they are starting to do it. It’s getting better.

Bob Sansevere (01:42):

Oh, okay.

Chris Faddis (01:43):

But I think we’re still at something like 65% of hospitals are publishing their prices, so they’re still 35%. And I think unfortunately the Center for Medicare Services has been very slow to enforce the penalties, which there are penalties. But I also have heard, it sounds like not that many people are reporting the hospitals. And so I think that’s another issue is people don’t realize that they can report a hospital for violating that and that’ll help. (Oh, I’m sure they don’t. )Don’t get a ding. Yeah,

(02:15):

And that’s something, the reason I know that is because we do it all the time. I mean, many times when we’re dealing with balance bills, we find that the hospital or the provider never provided an estimate. And so we will let ’em know, put ’em on notice, and then we’ll report ’em. And we hear back from CMS that many people are not reporting these things and they’re grateful for the report. So it’s an important thing to kind of find out how do you do it? I don’t have that information in front of me, but how do you report someone for that? Because a big issue, and you have a right to that information. What I always advise our members is if they’re saying you need payment upfront, then you need to ask for a Good Faith Estimate, which is the term under the No Surprises Act. And a lot of times that does get the hospital to act right.

Bob Sansevere (02:56):

Chris, how often does that happen where they ask for payment? Does that happen often?

Chris Faddis (03:01):

A lot of times it’ll start out that way and we’re able to convince ’em that they don’t need to take it upfront and do that. But yeah, it’s probably 30% of the time where they’ll want something, especially for surgeries. I mean, I was just with a family of ours yesterday who’s dealing with a really difficult childhood cancer situation, and I was actually in the room when the hospital said, well, how are you going to pay for the MRI? And by the end of the afternoon, our team had talked to the hospital and they’re not taking payment upfront. So we have ways to handle that. But yeah, I mean this Good Faith Estimate thing’s an important thing. In fact, Bob, what’s interesting is I had another member of ours who had to go in for somewhat of an emergency surgery. Their son basically had a sewing needle in his shin.

(03:44):

They couldn’t figure out why his shin was swollen and it was hurting. And they finally went to the doctor and they did X-rays, and he said, you need to get this out right away. So he scheduled surgery for the next day. They get there and the hospital’s telling them that the surgery is going to be $72,000, but if they pay $16,000 right now, they’ll let, they’ll what? Give them that discount. So they call me, and luckily I know them, it was early in the morning, and as soon as I said, Hey, go ahead and get a documented estimate, tell them you want a Good Faith Estimate, they gave it to ’em and then they came back and said, oh, I gave you the wrong one. And suddenly the new one was $16,000 and they were going to discount it to whatever, $7,000 if they paid up front. And I was like, wait a minute. It was totally different billing codes. So they basically were playing this guy to try to get more money out of them, and just by asking for the Good Faith Estimate, they realized they better do the right thing. They lowered the price to a more reasonable price. So we got ’em down to the right rate.

Bob Sansevere (04:41):

Even 7,000 seems outrageous. That’s ridiculous. Sounds like an outpatient thing at a doctor’s office.

Chris Faddis (04:46):

 Exactly. Exactly. (Oh my God.) Yeah, that’s the kind of stuff you deal with. So I think asking for those things is a good way to keep them honest, honestly.

Bob Sansevere (04:56):

Well, that one is absolutely stunning that they would pull, and that happens much, much more often than anyone would realize. Now I want to ask you about, I had cataract surgery yesterday. I had it on my left eye years ago, and in my right eye, I was told every year when I go for an eye checkup, you need to get this taken care of. And so I did. But here’s what I wanted to ask you about other than cosmetic surgery, which I understand because it’s elective and I’m sure you don’t, and traditional insurance companies don’t pay for elective, things like that. But I had to document yesterday who goes for cataract surgery as an elective? They said, well, if you don’t have a reason, I said, well, what do you mean? They wanted me to tell me the problems I’ve had. And I told ’em, I have trouble driving at night and it’s a little fuzzy. So I had to document it and I said, who does cataract surgery as an elective? You know what I mean? The fact that you have a cataract means your eye vision is impaired. That’s what it is.

Chris Faddis (05:58):

It’s one of the requirements. Yeah, I mean, I think it’s strange. It’s one of the requirements of Medicare that there has to be medical necessity, but honestly, typically the doctor writes that up. They’ll ask those questions about your driving history and all that stuff, and they’ll do that. There’s a couple extra layers to the surgery. You got options. You could do the upgraded lens and you could do certain things. And some of those are considered elective.

Bob Sansevere (06:28):

I just told them.

Chris Faddis (06:28):

– Just for Solidarity.

Bob Sansevere (06:29):

No, I didn’t do anything.

Chris Faddis (06:30):

 We actually, whatever the extra thing, there’s an extra layer of the lens. It’s a better process. People have less need for more, I don’t remember what it’s called, but for more recurrent surgeries. And so we’ll actually help with that if there’s medical necessity. But yeah, it is one of those that’s kind surprising. It’s not just LASIK. I mean this is actually, no,

Bob Sansevere (06:52):

That’s an elective. Yeah, LASIK is a choice.

Chris Faddis (06:53):

You’re going to go blind if you don’t fix those cataracts. So it’s a medical necessity

Bob Sansevere (06:57):

For sure. And that’s the other thing I could have had and I didn’t had ’em address the astigmatism, which also affects your vision. But that would be something that would not have been covered either by Medicare.

Chris Faddis (07:09):

Right.

Bob Sansevere (07:11):

But I’m wondering, there must be so many things like that that people don’t realize. And if you don’t say the right thing, you’re potentially putting yourself in peril for it being paid.

Chris Faddis (07:21):

Yeah, yeah, for sure. For sure.

Bob Sansevere (07:24):

There’s so much. Let me ask you this, the one you told me earlier, the $7,000 that it actually came down to from $72,000, have you had any other outrageous things like, and by the way, I do want to back up a second for a family to be in a position that son has cancer, a child has cancer, and not be able to pay for an MRI potentially for the kid. Oh my God, these hospitals. I get it. They’re a business, but you got to have some kind of compassion for a family.

Chris Faddis (07:52):

Exactly, exactly. Yeah. And it’s frustrating because again, you know us, Bob, we’ll work with anybody, but these children’s hospitals especially are the worst to deal with because they refuse to want to work with your healthshare with this kind of thing. So now we do it. We figure out a way. We always do, but it’s always a frustration. And in fact, this family is, he happens to know an executive at the hospital. So I told ’em last night, I just happened to be in Dallas. I know these people and they’re Members, and so I was able to take the parents out to dinner and just give them a night of just relaxing, going through what they’re going through. This cancer, Bob is so rare, they literally can only identify five other tumors that were even similar to this, but it’s still not the same.

Bob Sansevere (08:35):

Oh my God.

Chris Faddis (08:36):

It’s a completely new cancer.

Bob Sansevere (08:37):

But is it a recoverable cancer? Do they know that?

Chris Faddis (08:40):

We don’t know. Because yeah, they don’t know The other five tumors that they found that are similar. They have a treatment path based on that. And those were successful. So hopefully –

Bob Sansevere (08:49):

Hopefully, It works out.

Chris Faddis (08:50):

But yeah, so they’re dealing with this, so going through this with them, but the beauty is I will be able to get ahold of the executive at the hospital and hopefully be able to work with ’em. But children’s hospitals are near impossible to deal with. They’re some of the worst offenders at overpricing.

Bob Sansevere (09:04):

You want to know why I find that so outrageous, Chris? Because they’re the ones always looking for money and putting poor kids on –

Chris Faddis (09:11):

Always. You can’t go to Panda Express without them asking you for money or you can’t go to any fast food place every event. And I always say, whatever they ask me, would you like to give to the blank Children’s Hospital? I just say, no, thank you. They make plenty of money off of the children they serve because it’s just the truth. And they’re, they’re actually not that great with their charity cares. Well, I don’t know what they’re doing with that money.

Bob Sansevere (09:32):

Oh, I know where it’s going to -Executives.

Chris Faddis (09:33):

 I’m sure it’s not bad maybe, but it’s not. Okay. When you’re overbilling and over charging .

Bob Sansevere (09:39):

 Chris, it’s going to the executives to pay their salaries. So that’s what’s happening.

Chris Faddis (09:42):

I’m trying to be positive, Bob. (I know. )But you’re probably right. You’re probably right.

Bob Sansevere (09:46):

 You go to Solidarity Healthshare solidarityhealthshare.org, check that out. Great alternative to traditional healthcare. And Chris is one of the co-founders of course. And I mean, they do a great job there. Alright, we’re going to take a quick break and The BS Show will be right back.

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