07.07.25 Epidemic Of SCAMS On Social Media / Fight Health Insurance Denials

Summary

The Clark Howard Podcast – Episode Summary: "Epidemic Of SCAMS On Social Media / Fight Health Insurance Denials"

Release Date: July 7, 2025

In this episode of The Clark Howard Podcast, host Clark Howard delves into two pressing issues affecting consumers today: the surge of scams proliferating on social media platforms and the challenges consumers face when dealing with health insurance claim denials. Additionally, the episode touches upon the growing trend of wearable technology and its impact on personal well-being. Below is a detailed summary capturing the key discussions, insights, and conclusions from the episode.

---

1. Epidemic of Scams on Social Media

Clark Howard opens the episode by addressing the alarming increase in scams on social media platforms, particularly Facebook and Instagram. He emphasizes that the vast popularity of these platforms makes them fertile ground for scamsters seeking to exploit unsuspecting users.

Key Points:

• Rise of Social Media Scams: Clark notes that while affinity fraud—where scammers build trust within a community—has been a long-standing issue, the digital age has amplified its reach. Social media platforms have become primary avenues for both blatant and subtle scams.

• Influencer Exploitation: A significant concern highlighted is the phenomenon of "finfluencers"—financial influencers promoting questionable investment opportunities. Clark warns listeners to remain skeptical of influencers who may unknowingly or intentionally promote scams due to paid endorsements.

• Platform Responsibility: While Clark asserts that platforms like Facebook and Instagram are not inherently malicious, he stresses the importance of users maintaining vigilance. He urges platforms to take more proactive measures in identifying and removing fraudulent accounts but ultimately places the onus on users to protect themselves.

Notable Quotes:

• "People let down their guards on social media in ways that we haven't in the past done with strangers." [00:39]

• "Don't get me started on the finfluencers. Finfluencer is a what a funny contraption of a word." [04:00]

• "I'm asking of you is to be skeptical when people start befriending you on Facebook or you really get caught up following somebody on Instagram." [04:55]

---

2. Listener Experiences with Scams

Clark invites listeners to share their experiences, providing real-life examples of how scams unfold on social media.

Ray from Texas’ Scam Story:

Ray recounts his unfortunate experience with a fraudulent wine tasting festival advertised on Facebook. After registering and paying $29.71, the event was abruptly canceled, and despite assurances, he hasn't received a refund. Further research revealed the company's poor reputation with numerous complaints filed against them.

Clark's Response:

Clark discusses the deceptive nature of such scams, pointing out that while $30 may seem insignificant, scammers often rely on targeting a large number of people to accumulate substantial gains. He advises diligence in researching events, especially those requiring higher payments, and reminds listeners not to blame themselves for falling victim to low-cost scams.

Notable Quotes:

• "That's a cheap lesson from a scam. If this is going to turn out to be a scam." [06:15]

• "There's no excuse not giving refunds." [06:26]

---

3. Electric Vehicles and Consumer Confusion

A caller from Florida seeks clarity on the costs associated with charging electric vehicles (EVs). Clark provides an in-depth analysis of the complexities surrounding EV charging costs, contrasting them with traditional gasoline expenses.

Key Points:

• Home Charging vs. Public Charging: Clark explains that approximately 80% of EV charging happens at home, where costs are generally lower. However, for those who rely on public chargers or live in apartments, costs can vary significantly.

• Operational Efficiency: He highlights that electric motors are over 90% efficient in converting energy to motion, compared to gas engines, which waste about three-quarters of their fuel.

• Market Trends: Despite the benefits, public interest in EVs has declined, leading to a surge in hybrid vehicle sales as a more palatable alternative for consumers.

Notable Quotes:

• "You look and you see at a gas station, oh, it's this much a gallon. But you ask me, how much does it cost to charge an electric car? I can't answer that in 15 minutes you couldn't, right?" [08:11]

• "Hybrids are for many people in America, the compromise." [09:50]

---

4. Wearable Technology: The Aura Ring Debate

Clark engages in a light-hearted discussion about wearable health technology, specifically focusing on the Aura Ring and its competitors. Listeners share both positive experiences and concerns about the potential for "aura paranoia."

Key Points:

• Market Saturation: With various companies, from tech giants like Samsung to startups, entering the wearable market, consumers now have multiple options for biometric tracking devices.

• Subscription Concerns: Clark expresses reservations about devices that require ongoing subscription fees for data access, highlighting the short-sightedness of such business models.

• Personal Experience: Clark shares his long-term use of the Aura Ring, emphasizing his ability to manage the data without succumbing to anxiety, unlike some users who develop "aura paranoia."

Notable Quotes:

• "Aura has created some vulnerability for itself by having monthly dues for the data." [11:36]

• "It's like a game for me and I don't develop aura paranoia." [13:53]

---

5. Fight Health Insurance Denials

A significant portion of the episode is dedicated to discussing the rampant issue of health insurance claim denials. Clark sheds light on the systemic problems within the health insurance industry and offers actionable advice for consumers facing such challenges.

Key Points:

• Prevalence of Denials: Clark cites that approximately one in six health insurance claims are denied, with less than 1% of consumers taking action against these denials.

• Challenges in Appeals: He explains that insurers often employ tactics to wear down consumers, hoping they'll abandon their appeals. However, data suggests that a majority of appeals are successful, indicating that initial denials are frequently unfounded.

• Consumer Rights: Clark encourages listeners to challenge unjust denials, leveraging their rights under health insurance contracts. He emphasizes the importance of persistence and thorough documentation when appealing decisions.

• Systemic Issues: Highlighting the misaligned financial incentives in the U.S. healthcare system, Clark critiques both hospitals for inflating bills and insurers for withholding payments, leading to a convoluted and expensive system for consumers.

Listener Stories:

• Clark Ross from Illinois: Faced with a $2,700 bill for a non-emergency ambulance ride, Clark advises negotiating directly with the ambulance provider and exploring state protections under the No Surprises Act.

• Dan from Wisconsin: Expresses distrust in health insurers following questionable practices by a major insurer. Clark reiterates the importance of exercising appeal rights to hold insurers accountable.

• Tim from Florida: Shares a distressing experience of being billed excessively due to being transported to an out-of-network hospital during a medical emergency. Clark directs him to the No Surprises Act for potential relief and advises negotiation strategies.

Notable Quotes:

• "Do you know that the best guess in the industry is roughly one in six claims are now denied by health insurers? One in six." [17:00]

• "The system we have right now for health care in the United States, all the financial incentives are misplaced." [25:44]

---

6. Conclusion and Final Thoughts

Clark wraps up the episode by reiterating the importance of consumer vigilance both in safeguarding against social media scams and in navigating the complexities of health insurance. He emphasizes empowerment through knowledge and encourages listeners to actively engage in protecting their financial and personal well-being.

Notable Quotes:

• "Everything we do is just that, that you gain ideas, you gain empowerment so that you can save more, spend less, and avoid getting ripped off." [31:15]

---

Final Takeaways:

• Stay Informed and Skeptical: Whether interacting on social media or dealing with health insurance, informed skepticism is crucial in avoiding scams and ensuring fair treatment.

• Advocate for Yourself: In the face of health insurance denials, persistence and understanding of consumer rights can lead to successful appeals and rightful claims.

• Evaluate Wearable Tech Mindfully: While technology can enhance health monitoring, it's essential to balance data use with personal well-being to prevent anxiety related to constant tracking.

Clark Howard’s comprehensive discussion in this episode provides listeners with valuable strategies to navigate and mitigate the challenges posed by modern scams and the fraught health insurance landscape. His emphasis on empowerment and proactive action serves as a guiding principle for consumers striving for financial and personal security.

Transcript

[Sponsor Voice]

This podcast is brought to you by Progressive Insurance. Fiscally responsible financial geniuses, monetary magicians. These are things people say about drivers who switch their car insurance to Progressive and save hundreds. Visit progressive.com to see if you could save Progressive Casualty Insurance Company and affiliates. Potential savings will vary. Not available in all states or situations. This message is brought to you by Apple Card get 3% daily cash back when you buy an iPhone 16 with your Apple card at Apple. Subject to credit approval. Apple Card issued by Goldman Sachs Bank USA Salt Lake City Branch terms and more at applecard.com.

[Clark Howard]

It'S my pleasure to welcome you here to the Clark Howard show, where our mission is to serve you with advice and information that empowers you so you make better financial decisions in your life. Today we're going to start talking about how you have to be so careful on social media is it's become one of the main platforms for scamsters to cheat you. And we're going to talk about insurers delaying, delaying, denying and what you do about it when you have a health insurance claim and they're just not treating you right in your opinion. But let's talk about the epidemic, if you will, of scams. I keep seeing that phrase exactly because it's catchy and it's accurate. Because people let down their guards on social media in ways that we haven't in the past done with strangers. You know, it used to be that the main entryway to scams was was what was called affinity fraud. It was where an individual would gain your confidence and then you'd suspend your normal disbelief and hook, line and sink or buy whatever junk or con or ripoff they were selling. It's just been a pattern of humanity for not just now, for centuries that people would get taken by a con artist who would befriend them. What is so curious to me is how people are getting taken on social media. And the top places people seem to be getting taken are Facebook and Instagram. Not because there's something inherently evil about Facebook or Instagram. They're so crazy popular that the scamsters are going there to those two platforms electronically creating followings or befriending people and then scamming them. And some things are out and out scams, others are more gray. How do you put the category of a paid influencer? Somebody who has developed a loyal following who's really great at whatever. And then they start touting something they're getting paid for and because of your emotional connection to them for the great information they have about Fashion or design or whatever it is that suddenly they do a wreck on something completely unrelated. And you go ahead and you're like yeah, I gotta get it because she loves it or he loves it or whatever. And remember they're being bought and paid for that they don't know they're scamming you many times but the result is the same. And then don't get me started on the fenfluencers. Finfluencer is a what a funny contraption of a word. It's where people are touting different investment opportunities. Opportunities, different investment systems, whatever. And you know we've had this with phony baloney investing schemes forever. You know I could every day I read a report that appears in Barron's magazine and it will talk about, it's geared towards the investment advisory business. I'll talk about various scams that brokers and investment people have stolen people's money through. I mean it's almost like a training platform for people want to steal people's money. And those were traditional ways that they write about embarrass through the investment community. What's happening on social media is people just say that they're whatever they are and when people's confidence and steal their money. This can be so many different things. It can be just people running straight out scams, whatever on Facebook and Instagram. And again, I don't hold Facebook and Instagram responsible for this. They are platforms that they make available to people. If they find out that somebody's dirty, they should pull them down. But it's not the platform's fault that scamsters have figured out this is such a lucrative area. What I'm asking of you is for you to be skeptical when people start befriending you on Facebook or you really get caught up following somebody on Instagram and you end up before you know it with money of yours that ends up being money of theirs.

[Caller]

All right, speaking of scams, Ray in Texas wrote him with this one. I, I want to make Clark aware of an active scam that's going on in Texas. Unfortunately, I was a victim. The real irony is I know to do my full research and I neglected to do so. I hope that Clark covers this. And here's my story. In March I came across a Facebook post regarding a wine tasting festival and decided to visit the website to verify its authenticity. After reviewing the site, I registered for the event paying 29,71 the festival $2971. No, no. $29.71.

[Clark Howard]

Oh good. Okay. That's a cheap lesson from a scam. If this is going to turn out to be a scam.

[Caller]

The festival was scheduled for April 26th of this year. However, on April 25th, I received an email from the company informing me the event had been canceled. I promptly responded to the email and after several exchanges, I was assured that a refund would be issued. Unfortunately, I've yet to receive this refund. Following this experience, I conducted some research online and discovered that this company has a reputation for scamming individuals as evidenced by their F rating on the Better Business Bureau and a total of 112 complaints filed in the last three years, primarily concerning event cancellations without refunds. They are advertising on both Facebook and Google.

[Clark Howard]

Ray, thank you for this. I'd say these are not the smartest con artists because if they're stealing $30 a person, they have to go to a lot of effort to steal from a lot of people to make it lucrative enough to do it. It's possible these people are just incompetent, but there's no excuse not giving refunds. And you said you feel like you didn't do the proper research. I mean, what would that be, you think about a wine festival if they were asking you for hundreds and hundreds of dollars? Yeah, I would have expected you to do more research, but you like wine sounded cool and it was 30 bucks. Don't beat yourself up. There's a threshold above which, whatever the point, pain point is for you, that you do more digging, you do more research. And even if they're not con artists, you would know from the research you did after the fact that they are at the very least really terrible business people for sure.

[Caller]

Okay, Larry in Florida says Clark talked about gas cars. I would like him to let us know how much it is to charge electric cars and how much a week or month cost.

[Clark Howard]

So that is one of the most complicated things to answer. And I should point out that the public's attitude in the United States towards electric vehicles has been going down four years in a row. I've seen the most recent polling. I think it was by Triple A. And the percent of Americans that are really interested in buying an electric vehicle is the lowest it's been in half a decade. The the reasons are all the things that no one can answer easily. You just ask me a simple question. You look and you see at a gas station, oh, it's this much a gallon. But you ask me, how much does it cost to charge an electric car? I can't answer that in 15 minutes you couldn't, right?

[Caller]

I couldn't. And I charge mine in my garage now.

[Clark Howard]

That's cheap. 80% of charging takes place at someone's home. And then you're paying a fraction of the cost effectively per mile for the conversion of electricity and a range of miles on an electric car versus range of miles filling up at a gas station. But when it involves a road trip, where are you going to charge it? When it involves knowing what that charge is going to cost, People who live in apartments and have to use public chargers, you're at the mercy of how much it is in that community to use that public charger. So there is no simple answer to this question. What is important is that an electric motor, the energy put in, 90 plus percent of it, is then used to operate the vehicle, moving it forward. A gas engine, three quarters of the fuel you buy is burned off, producing no forward motion in your vehicle at all. That's why electric vehicles to operate are much cheaper. Plus they don't have all the parts. But the story is so confusing to people that it's really hard right now to get people excited about buying electric. You know what Americans have done, though? In reaction, the sale of hybrid vehicles in the United States has skyrocketed. Before all the conversations started with electric, almost nobody ever bought a hybrid. And now hybrids are ultimately going to be the dominant powertrain in the United States because people get the idea of traveling for a lot less per mile. And for many people, the gas engine is so comfortable and you know how it works and all that, you know what you're going to have to pay to fill it up. The hybrids are for many people in America, the compromise. For me, having driven electric vehicles now for 14 years, I can't imagine driving anything else.

[Caller]

Okay, a couple about your Aura ring, Clark. First, Tom in Illinois wanted to tell you Clark loves the Aura, but check out this. The Oura Ring just got a new rival with a titanium design and 247 biometric tracking with no subscription required. And then here's a link there for you to check out this product.

[Clark Howard]

I should tell you, I've been reading reviews. There are now a number of companies, from big like Samsung to small tech startups offering their versions.

[Caller]

It's the Acer Free Sense ring.

[Clark Howard]

That one I've not heard of. But Aura has created some vulnerability for itself by having monthly dues for the data. I'm grandfathered in because I've been an aura wearer for more than five years. So as long as I stick with the generation, I'm on which is the three. I don't have to pay the fees when this one dies, then I'm going to be a free agent and I will consider one of the or a competitors that don't charge the $60. I think $60 a year or $70 a year fee for data.

[Caller]

Okay. And then Nitty in North Carolina says Clark thought this would be a fun read addressing your aura ring craze. Read this on Kim Commando's newsletter. Destroying my mind. That's how 22 year old Sarah Hills felt about her aura ring. Every spike in heart rate or dip in her readiness score sent her into a panic. It's called aura paranoia. She's not alone. Aura's own head of science says he takes breaks from wearing his ring. You might want to do that with a wearable too. I doubt this will phase you and give you an aura paranoia knowing that you are loaded with smart watches too and love that even if aura's own head of science takes a break from wearing it. And we do joke that like you could wake up feeling good, but if your aura gives you a bad score, you're like, oh my gosh, my day is. I feel terrible.

[Clark Howard]

I have no idea when I wake up in the morning and I see my aura rating if it's going to be good or bad. You know, it comes up with data on how I sleep. Kind of like a health score. They call it a readiness. And it's just so weird from day to day. My readiness today is very high. You got a 91. My sleep score was an 85. My activity is a 98. My heart rate's really high right now. But it was not over or paranoia but my resting heart rate. Look at it day by day. I had terrible numbers yesterday and my overnight heart rate was high. But generally I found that I'm competitive with myself anyway. And the aura is like a game for me and it doesn't it. I don't develop aura paranoia.

[Caller]

I think you need a smartwatch and aura detox like weekend where you just don't have any of it. You don't worry about your time. There's this one tearing them in. This is the. Which ones is the Samsung.

[Clark Howard]

Samsung. I've been garmin longer than anything else.

[Caller]

And your aura.

[Clark Howard]

There's my aura.

[Caller]

All right.

[Clark Howard]

Okay. Here's my brain.

[Caller]

You can go 24 hours.

[Clark Howard]

I'm not feeling any bad reaction to it at all. No, I guess, I guess that's true that it would be helpful for me to detox from all the overload of data I look at every day.

[Caller]

Oh my God. You're getting dings on both of these watches right now. Wow.

[Clark Howard]

Really?

[Caller]

This is very distracting.

[Clark Howard]

Really? I. I don't even notice that they're dinging or anything. We're gonna see if I can go. We'll try an experiment. We'll see if I can go 24 hours without any tracking at all.

[Caller]

Okay.

[Clark Howard]

Maybe that's when I'll go crazy.

[Caller]

I know.

[Clark Howard]

With no tracking devices, Clark goes dark. We'll see. Coming up ahead. This is not a laughing matter because I wear this stuff for health. How about when you're sick and then you get the bill? Then you got a lot sicker. What do you do?

[Sponsor Voice]

This message is brought to you by Apple Card. Each Apple product, like the iPhone 16, is thoughtfully designed by skilled designers. The titanium Apple Card is no different. It's laser etched, has no numbers, and it earns you daily cash on everything you buy, including 3% back on everything at Apple. Apply for Apple Card on your iPhone in minutes, subject to credit approval. Apple Card is issued by Goldman Sachs Bank USA Salt Lake City Branch terms and [e-mail].

This podcast is brought to you by Progressive Insurance. Do you ever think about switching insurance companies to see if you could save some cash? Progressive makes it easy. Just drop in some details about yourself and see if you're eligible to save money when you bundle your home and auto policies. The process only takes minutes and it could mean hundreds more in your pocket. Visit progressive.com after this episode to see if you could save Progressive Casualty Insurance company and affiliates. Potential savings will vary. Not available in all states.

[Clark Howard]

If you went on a road trip and you didn't stop for a Big Mac or drop a crispy fry between the car seats or use your McDonald's bag as a placemat, then that wasn't a road trip. It was just a really long drive. Ba da ba ba ba at participating McDonald's.

[Sponsor Voice]

This episode is brought to you by Greenlight. Get this. Adults with financial literacy skills have 82% more wealth than those who don't. From swimming lessons to piano classes, Us parents invest in so many things to enrich our kids lives. But are we investing in their future financial success? With Greenlight, you can teach your kids financial literacy skills like earning, saving and investing. And this investment costs less than that. After school treat start prioritizing their financial education and future today with a risk free [e-mail] Spotify greenlight.com Spotify.

[Clark Howard]

You spend a lot of money for health insurance or Your employer is spending a lot of money for health insurance. You only see part of that with the portion, they bill you for it. And then you got co pays and deductibles and blah, blah, blah, blah, blah. And then the chips are down and you need care or you receive care and then you get a denial for payment or a refusal to approve something. Do you know that the best guess in the industry is roughly one in six claims are now denied by health insurers? One in six. This is a game on their part. What happens with those 1 in 6 claims? Do you know that less than 1% of people do anything when a claim is denied? Less than 1%. Less than 1 out of 100 people. You say, oh well, insurance doesn't want to pay, so I'm just going to get sicker or I'm going to have this collection agency calling me about a bill. Don't roll over, don't roll over. You know that if you appeal, insurers know that 99 plus percent of people just roll over on them. What happens with people who stand up to the health insurance bully? What happens with bullies? Most of the time their bark is worse than their bite. So when you appeal, depending on whose study you believe, three out of four times or four out of five times, you're going to win your appeal. Because the insurer is gaming you, they're playing games with you. And the deal is when you have a small routine claim goes right through the system automatically. It's when and who knows at each insurer what the black box is, when they decide, hey, we're going to mess with people because this is so expensive. But it gets to the point that the insurer is going to not approve it just because they're not going to approve it. And I don't know if you know the scam with the medical review that happens with a lot of insurers where they will have an in house medical professional whose job is to turn claims down. That is their job, to turn claims down. So you talk to doctors in practice, they'll tell you how much of their time is now wasted trying to get a procedure approved for a patient. The whole thing is set up to wear people down and just go away. But it's your money, you or your employer paid for you to have that insurance and you're in a contract for that insurance and the insurer behaving dishonestly, unethically becomes your problem. If you roll over and say, oh well, you know, a lot of times the squeaky wheel Gets the grease. And there's no more squeaky wheel than medical care. And so when you get that denial, you need to appeal. Because again, most of the time, remember, if people went on appeal 3/4 to 80% of the time, it means the insurer wasn't behaving ethically and in good faith in the first place. So once you present your documentation or the medical provider provides that documentation to you, you then get that claim paid. The worst of all though, is the stall. When somebody needs expensive care, the insurer just doesn't want to pay and they're waiting you out hoping you die so they don't have to pay. And that's not okay. And if you are too ill to fight your own battle because sometimes you could be too sick to really fight for the coverage and care you need, that's when a family member or a friend needs to step up and be your advocate.

[Caller]

All right, well, I have some questions that are related here. Clark Ross in Illinois says, I received a $2,700 bill for a six mile ambulance ride between two branches of the same hospital.

[Clark Howard]

Whoa.

[Caller]

My child was not in a life threatening situation and I offered to drive him myself, but the ER staff said they couldn't allow it. They warned me it would have to be treated as a new case and even hinted that child services might get involved. I. Come on, I felt totally cornered. My Insurance only covered $500. What are my rights here and how can I fight or negotiate this outrageous bill?

[Clark Howard]

I don't know what happened with the lobbyists with the ambulance industry, but they were carved out of the no Surprises Act. No Surprises act is something that is a term surprisingly few people have heard of. And it's even harder to to understand the provisions of it. But it does not offer the ability to have help in negotiating an ambulance charge. Although roughly about a third of the nation states have the equivalent of their state system for no surprises on an ambulance charge, Illinois does have protections for public and private ambulance services, but it's only for people in HMO versions of insurance policies. What you do is you. You try to negotiate. Not with a collection agency, you negotiate with the ambulance provider itself. If your health insurance is not considered in Illinois to be an HMO plan, and that's what we have here is it's haphazard with states that represent about 65% of the nation's population, but only a third of the states, the big states, Texas, Florida, California, New York, Illinois, all have ambulance surprise act kind of policies. So if you get a big ambulance bill about 2/3 of Americans will be covered. The other third. It's all about the negotiation that you do over the bill and the hospital strong arming you when your child was not in a life threatening situation. I don't know the circumstance, but how weird that is for them to behave that way.

[Caller]

Okay. Dan in Wisconsin says the continuing revelations about UnitedHealth's patient treatment practices have made me increasingly uncomfortable with health insurance in general. I am able to choose my own insurer, but how do I know my other options aren't doing the same thing if I find myself needing major medical care? Don't all insurers have the same incentive to prevent me from getting the care I pay for? I know I need to be insured to protect myself, but what if the insurers won't hold up their end of the bargain? Then what's the point?

[Clark Howard]

Well, I mean you're, you're giving an additional bit of ammunition to what I was talking about, the top, I mean, routine stuff. Insurers do what they're supposed to do. It's when the big thing comes along that insurers aren't behaving. But again, you heard what I said. I mean, they turned down one in six claims and nobody does anything about it among consumers, among patients. You be that person who does something about it and you're going to get the insurance to do what it's supposed to 3/4 or more of the time. So the important thing that I can do is to let you know what's going on behind the curtain. And that is that insurers are playing dirty pool. So what you have to do is you got to know how to play pool better than they do. That's why you immediately exercise your rights to appeal under your plan, period. I mean, that's what's involved.

[Caller]

I have to just quick success story for me on this and I have more to appeal that I haven't yet for my daughter, but my son. I submitted a bunch of bills from a provider and they rejected it. And I called and they just said they were looking at it and trying to figure it out and they just said, well, you know, and I said no, this was, I provided everything. She said the reason stated is that you didn't provide dates of service on this. So I pulled up the document, I was like, they're on there. And she pulled it up and she was like, oh, they are resubmitted it and now we just got finally paid months later. It's just, you know, you just don't know the Reason. So it's just frustrating.

[Clark Howard]

The reason is that they're playing dirty. I mean that's the reason. The rest of it is all details and you don't let them wear you down. How much money was involved in these bills?

[Caller]

Over $1,000.

[Clark Howard]

Yeah. Do you have $1,000 just to say I well over you? Don't you fight for yourself. And really the problem is the financial incentives are wrong in capitalism. Capitalism works best when financial incentives are aligned. But the system we have right now for health care in the United States, all the financial incentives are misplaced. Hospitals, their only incentive is to run up as big a bills as they possibly can. Insurers incentive is to not pay for anything that they can avoid paying for. Both are completely wrong. We have a health system that's too expensive, too hard to use and too difficult for patients to navigate. And so we got some work to do here. We got to make this work. You know, it's almost 20% of the US economy now. Any other country the largest that health care spending is thing is eight and a half percent.

[Caller]

Tim in Florida, says Clark, I recently had a medical emergency that required a 911 call and transport to the hospital. I have insurance and but I would find out several days later after being discharged that the hospital I was taken to is out of my insurance plans network. I was in the hospital for three days. Had this been an in network, my deductible would have been $3,000 which I actually paid while I was in the hospital. Since I was out of network, my deductible is $9,000. So basically because I was taken to an out of network hospital, I'm on the hook for the additional 6,000. This seems very unfair as I had no say at all as to which hospital I was being taken to. I've tried to negotiate with the hospital concerning the all they will do is allow me to set up a payment plan. I've been making very small monthly payments, but not the $250 a month the hospital is asking for. Now they are threatening to send my outstanding bill to collections.

[Clark Howard]

So Tim, you're a little late in this game and the fact that you're writing means that you recovered and I'm glad for that. But you were exactly what the no Surprises act was designed for and specifically covers your situation. I want you to look up the no Surprises Act. There are lots of medical advocacy organizations that explain how you use the no Surprises act to deal with this bill. The reality is your insurer and the hospital are not on your side here because it seems that nobody has considered where the no surprises act fits and what you should be out of pocket here. So I think no surprises act, again, is complicated. I think that you are not liable for this extra $6,000, but you're going to have to look at your situation and see if in fact the bill does step in for you in this case. The bill meaning the no surprises law.

[Caller]

So another quick thing, Clark, that I've noticed, and I'm wondering what your take is on this, is that if you go to an out of network doctor, for example, two examples here, my therapist doesn't take insurance, so I pay her $170 if I go see her or my son went to a medical doctor who's an expert not in network. I have to pay $250 upfront. So both of those I pay for upfront. I file insurance and the EOBs explanation of benefits. Say we saved you. We negotiate we saved you this much money. Like say it's $100 on the $170 charge. So your responsibility is 70. So toward your high deductible, you've paid $70, but really I've paid 170. So why do they do that for? Same thing with my son's medical doctor. They're like, oh, that should only be $100. So you've paid 100 out of, out of your deductible, but really I've paid 250.

[Clark Howard]

What is that? Well, because you went out of network, your coverages are not nearly as generous.

[Caller]

Right. And they're not really negotiating on my behalf. That's kind of the sentence that kills me because I'm like, you didn't negotiate anything. Right. Is that crazy?

[Clark Howard]

I guess that's pretty much true.

[Caller]

Okay. Anyway, sorry, it's my beef again.

[Clark Howard]

Health care in the United States is inefficient, crazy, costly, and nobody's happy with it. Providers aren't happy with it. Consumers aren't happy with it. That's what I call patients. We're consumers.

[Caller]

Yes.

[Clark Howard]

Employers aren't happy with what it's costing them and where. Where the guts and the politicians to do something about it. You don't hear anything about it, do you?

[Caller]

No.

[Clark Howard]

Yeah. So I'm ready to fix it. I knew how.

[Caller]

I know.

[Clark Howard]

Really, I'm ready to take it on. And by the way, if you tuned in only to part of our podcast, because start at the top, but maybe you skip forward and you see I'm naked here. Those of you on the YouTube show, you see, I'm naked. No ring, no watches, all my devices.

[Caller]

You're having a digital, not a total digital detox. You still have your phone, but you're detoxing from your wearables for 24 hours. And what did you say when we went into the break after I took your devices?

[Clark Howard]

I said, I don't know if I can handle it.

[Caller]

You said it in a very high pitched, whiny voice. You did.

[Clark Howard]

You did. You're so mean.

[Caller]

Oh, well, do my steps even count anymore?

[Clark Howard]

They don't count.

[Caller]

Am I even walking?

[Clark Howard]

I'm not. Okay. Well, on that lighter note, thank you so much for joining us today on the podcast and the YouTube show. I hope that you heard something today, learned something today that's useful to you in your life, and know what we're about with everything we do is just that, that you gain ideas, you gain empowerment so that you can save more, spend less, and avoid getting ripped off and have a great rest of your day.