What do you think?
Rate this book
Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win
From award-winning ProPublica reporter Marshall Allen, a primer for anyone who wants to fight the predatory health care system--and win.
Every year, millions of Americans are overcharged and underserved while the health care industry makes record profits. We know something is wrong, but the layers of bureaucracy designed to discourage complaints make pushing back seem impossible. At least, this is what the health care power players want you to think.Never Pay the First Bill is the guerilla guide to health care the American people and employers need. Drawing on 15 years of investigating the health care industry, reporter Marshall Allen shows how companies and individuals have managed to force medical providers to play fair, and shows how you can, too. He reveals the industry's pressure points and how companies and individuals have fought overbilling, price gouging, insurance denials, and more to get the care they deserve. Laying out a practical plan for protecting yourself against the system's predatory practices, Allen offers the inspiration you need and tried-and-true strategies such Analyze and contest your medical bills, so you don't pay more than you should Obtain the billing codes for a procedure in advance Write in an appropriate treatment clause before signing financial documents Get your way by suing in small claims courtFew politicians and CEOs have been willing to stand up to the medical industry. It is up to the American people to equip ourselves to fight back for the sake of our families--and everyone else.
287 pages, Kindle Edition
First published June 22, 2021
230 people are currently reading
1725 people want to read
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 30 of 104 reviews
May 27, 2021
There appears to be no bottom to the deception, self-dealing and criminal behavior that is the US healthcare system. In Never Pay The First Bill, healthcare investigative reporter Marshall Allen has collected a well-rounded and well thought-through range of stories to understand the enemy, and successfully fight back. His advice could save numerous bankruptcies, both corporate and individual.
Allen doesn’t mince words. He calls the system a “moral travesty” and “a predatory industry built on deception and price gouging.” It thrives on customers’ continuing ignorance , and operates on the bulldozer principle of running over customers repeatedly and universally, so they all think this is normal and the only way it could possibly be.
First of all, the patient is not the customer, Allen says. Insurers really don’t care what happens to patients. Their interest is milking those payers to feed their real interest: the hospitals and the doctors. Without them, there is no golden egg. Their networks would shrink along with their credibility. So they cater to and side with the medical establishment as a first principle. This is why people with billing issues have such an incredibly hard time with their own insurers.
The other point is that everything, absolutely everything, comes from the pockets of the payers. Even if you are relieved that your insurance has covered the entire cost of something, the inflated price you avoided and it paid will simply be billed back to everyone in double-digit premium increases next year. It’s the main reason insurers don’t have to care; no one is going to stop them raising prices as desired. They pay (very) good money to elected officials to keep it that way. Allen hammers at this one point repeatedly, throughout the book. Be vigilant, because they will (over)charge for every little thing.
Amazingly to normal people, insurers don’t even bother to go after fraudsters. Allen cites a repeat offender, racking up tens of millions of dollars posing as a doctor, offering services he called different names to fit the coding scheme, attracting new patients for services not covered. Rather than bring him to justice, they eventually asked for some of the money back, threatening to take it out of his future billings(!). He simply defaulted on the agreement and carried on. Once again, insurers don’t care how much they pay out; they will get it all back and more next year. No need to bother the police with these things, and the police confirm it in the book.
Some 600,000 payers undergo treatment they don’t even need every year. Hospitals charge what they want, different for each case, for whatever they feel like charging at the moment. Nothing will be agreed to in advance. Price lists on websites are fluid numbers the hospitals can veer from at will. A surgeon offered to pierce a little girl’s ears as long as he was performing another procedure anyway. Sure, said her mother, why not. The bill came to $1187.00 and she had to have the job redone at Walmart because the surgeon botched it.
Hospitals don’t care how much they charge patients for drugs they could have purchased themselves with a GoodRX card for less than ten bucks. Drug pricing is a well-known scam, with Americans paying the highest prices in the world – a captive audience of suckers. Prices on decades-old drugs can multiply overnight for no reason except bigger profits. Middlemen like pharmacy benefit managers (which have all merged so there is nowhere else to go) have intricate programs of payoffs to keep the merchandise moving, and those commissions come from higher than necessary prices.
The tactics Allen recommends to fight back are fairly classic. They include researching codes to verify you are being billed for the right thing. The system is justifiably famous for upcoding – claiming higher payment for a more involved test or procedure. Then there is turning the tables and demanding an immediate refund for services that were not performed or absurdly charged. There is also media pressure, as Allen has discovered: when he calls, a bill is suddenly cancelled out of “compassion”. Pestering higher ups can work, for the simple reason that it only takes one “yes” to walk back a bill. Allen has a comprehensive, six-point list of tactics that sadly, everyone should internalize.
Allen wants you to know that if your bill is sent to collection, all is not lost. Debt collectors, he says, pay no more than five cents on the dollar for the past-due accounts they purchase. So if debtors negotiate, say, 50 cents on the dollar, that’s a huge windfall and case closed. Work with the agent, he says. Get to know them. Make them understand they will be successful in their case. And avoid dings to your credit score or a trip to court by executing a decent settlement before it comes to that.
Medicare is the standard everyone refers to. It has payments for every code, adjusted for location. Hospitals and practices are comfortably profitable on Medicare schedules of payment. For them to charge ten times the Medicare rate is an obscenity they get away with at will.
Payers can go to Small Claims Court and show how unreasonable the charges are, that the hospital refused a reasonable offer of say, twice the Medicare rate, and that the payer only paid under protest. These things can work, depending on the judge, the circumstances, and if the hospital bothers to send a lawyer or not.
There is no reason you can’t add your own codicil to the stack of paperwork you must sign in order to have an operation or procedure. Allen suggests: “I consent to appropriate treatment and (including applicable insurance payments) to be responsible for reasonable charges up to two times the Medicare rate,” on the Informed Consent Agreement. It’s supposed to be a contract between two bodies; there is no reason why the patient can’t modify it.
It is an absurdity of America that the quality of your healthcare depends on the quality of your job. Lousy jobs force people into lousy healthcare (if any at all) with gigantic deductibles in the thousands of dollars every year. God help you if you get injured in December.
Employers are up against it as well, if not worse. They are ripped off by the consultants and administrators as well as by the insurers. They have to fight to see bills they must pay, often with no success, even when they are the payer. The bonuses and chargebacks in the system keep the brokers and consultants happy, and make employees’ healthcare more expensive. A single company account for fifty employees could mean $50,000 a year, every year to the broker. The add-ons, additional options including dental, vision, life insurance, disability and upgrades can earn the broker over 50% of the additional annual premium. The money is definitely not going towards better service to the patient. The average worker pays $4000 to the broker over their career at the company.
Allen cites several company success stories, where audits were successfully made, where companies set the new rules, refused to pay extreme multiples of Medicare rates, beat back unnecessary treatments and fraudulent programs. They save millions. One gave it back to employees in major company outings. Another wrote a check to everyone. The rape and pillaging of employers keeps them from hiring (say, more teachers) or paying more (to keep employees solvent and loyal). It can be stopped, but it takes bullying as bad as the insurers’ bullying.
The most impressive story is about the State of Montana, which hired a woman to straighten out their public employee healthcare mess, which cost taxpayers millions every year. She spent years trying to obtain her own data, and then arm twisting and shaming the medical establishment into a more reasonable payment scheme, never knowing if she would succeed. She broke it down to incremental steps, for small incremental victories that rolled upwards into finally beating back the biggest players themselves. One very large hospital refused, and of course was furious to be cut out of public employee business as a result. It took all her smarts to push them over the edge, but she did it, totally restructuring healthcare as a reasonable and still highly profitable service in Montana. It can be done.
And for all this, the American Healthcare establishment is the laughingstock of the world. Everyone knows what a miserable failure it is. It is the third largest cause of death in the country, a country where life expectancy has been falling in recent years – unprecedented in western countries (until COVID dented everyone’s stats).
The nonsense seems to extend to every branch. Currently, COVID-19 vaccines are free, and in many instances not even an appointment is necessary. Yet COVID-19 tests require a prescription (Why? Are they a danger to the patient?), which might require a visit to the doctor, involving payments, co-pays, billing and collections. How does that make sense? Things like this and the ugliness examined throughout the book are a terrible indictment of the whole sector such that it needs an entire manual for people to defend themselves against healthcare.
The final twist is that nearly every story Allen tells is about a victim who works in healthcare. They are healthcare workers’ own fights for justice. From nurses to doctors, lawyers and administrators, the healthcare system rips off anyone who comes in for help. It’s not just the public at large. If there’s a sickness to be cured, it’s the healthcare system itself. Never Pay The First Bill will bring back ugly memories from times you too were ripped off and never achieved satisfaction. It is unfortunate, but absolutely everyone needs to have a copy of this book for emergencies brought on — by the healthcare system.
David Wineberg
Allen doesn’t mince words. He calls the system a “moral travesty” and “a predatory industry built on deception and price gouging.” It thrives on customers’ continuing ignorance , and operates on the bulldozer principle of running over customers repeatedly and universally, so they all think this is normal and the only way it could possibly be.
First of all, the patient is not the customer, Allen says. Insurers really don’t care what happens to patients. Their interest is milking those payers to feed their real interest: the hospitals and the doctors. Without them, there is no golden egg. Their networks would shrink along with their credibility. So they cater to and side with the medical establishment as a first principle. This is why people with billing issues have such an incredibly hard time with their own insurers.
The other point is that everything, absolutely everything, comes from the pockets of the payers. Even if you are relieved that your insurance has covered the entire cost of something, the inflated price you avoided and it paid will simply be billed back to everyone in double-digit premium increases next year. It’s the main reason insurers don’t have to care; no one is going to stop them raising prices as desired. They pay (very) good money to elected officials to keep it that way. Allen hammers at this one point repeatedly, throughout the book. Be vigilant, because they will (over)charge for every little thing.
Amazingly to normal people, insurers don’t even bother to go after fraudsters. Allen cites a repeat offender, racking up tens of millions of dollars posing as a doctor, offering services he called different names to fit the coding scheme, attracting new patients for services not covered. Rather than bring him to justice, they eventually asked for some of the money back, threatening to take it out of his future billings(!). He simply defaulted on the agreement and carried on. Once again, insurers don’t care how much they pay out; they will get it all back and more next year. No need to bother the police with these things, and the police confirm it in the book.
Some 600,000 payers undergo treatment they don’t even need every year. Hospitals charge what they want, different for each case, for whatever they feel like charging at the moment. Nothing will be agreed to in advance. Price lists on websites are fluid numbers the hospitals can veer from at will. A surgeon offered to pierce a little girl’s ears as long as he was performing another procedure anyway. Sure, said her mother, why not. The bill came to $1187.00 and she had to have the job redone at Walmart because the surgeon botched it.
Hospitals don’t care how much they charge patients for drugs they could have purchased themselves with a GoodRX card for less than ten bucks. Drug pricing is a well-known scam, with Americans paying the highest prices in the world – a captive audience of suckers. Prices on decades-old drugs can multiply overnight for no reason except bigger profits. Middlemen like pharmacy benefit managers (which have all merged so there is nowhere else to go) have intricate programs of payoffs to keep the merchandise moving, and those commissions come from higher than necessary prices.
The tactics Allen recommends to fight back are fairly classic. They include researching codes to verify you are being billed for the right thing. The system is justifiably famous for upcoding – claiming higher payment for a more involved test or procedure. Then there is turning the tables and demanding an immediate refund for services that were not performed or absurdly charged. There is also media pressure, as Allen has discovered: when he calls, a bill is suddenly cancelled out of “compassion”. Pestering higher ups can work, for the simple reason that it only takes one “yes” to walk back a bill. Allen has a comprehensive, six-point list of tactics that sadly, everyone should internalize.
Allen wants you to know that if your bill is sent to collection, all is not lost. Debt collectors, he says, pay no more than five cents on the dollar for the past-due accounts they purchase. So if debtors negotiate, say, 50 cents on the dollar, that’s a huge windfall and case closed. Work with the agent, he says. Get to know them. Make them understand they will be successful in their case. And avoid dings to your credit score or a trip to court by executing a decent settlement before it comes to that.
Medicare is the standard everyone refers to. It has payments for every code, adjusted for location. Hospitals and practices are comfortably profitable on Medicare schedules of payment. For them to charge ten times the Medicare rate is an obscenity they get away with at will.
Payers can go to Small Claims Court and show how unreasonable the charges are, that the hospital refused a reasonable offer of say, twice the Medicare rate, and that the payer only paid under protest. These things can work, depending on the judge, the circumstances, and if the hospital bothers to send a lawyer or not.
There is no reason you can’t add your own codicil to the stack of paperwork you must sign in order to have an operation or procedure. Allen suggests: “I consent to appropriate treatment and (including applicable insurance payments) to be responsible for reasonable charges up to two times the Medicare rate,” on the Informed Consent Agreement. It’s supposed to be a contract between two bodies; there is no reason why the patient can’t modify it.
It is an absurdity of America that the quality of your healthcare depends on the quality of your job. Lousy jobs force people into lousy healthcare (if any at all) with gigantic deductibles in the thousands of dollars every year. God help you if you get injured in December.
Employers are up against it as well, if not worse. They are ripped off by the consultants and administrators as well as by the insurers. They have to fight to see bills they must pay, often with no success, even when they are the payer. The bonuses and chargebacks in the system keep the brokers and consultants happy, and make employees’ healthcare more expensive. A single company account for fifty employees could mean $50,000 a year, every year to the broker. The add-ons, additional options including dental, vision, life insurance, disability and upgrades can earn the broker over 50% of the additional annual premium. The money is definitely not going towards better service to the patient. The average worker pays $4000 to the broker over their career at the company.
Allen cites several company success stories, where audits were successfully made, where companies set the new rules, refused to pay extreme multiples of Medicare rates, beat back unnecessary treatments and fraudulent programs. They save millions. One gave it back to employees in major company outings. Another wrote a check to everyone. The rape and pillaging of employers keeps them from hiring (say, more teachers) or paying more (to keep employees solvent and loyal). It can be stopped, but it takes bullying as bad as the insurers’ bullying.
The most impressive story is about the State of Montana, which hired a woman to straighten out their public employee healthcare mess, which cost taxpayers millions every year. She spent years trying to obtain her own data, and then arm twisting and shaming the medical establishment into a more reasonable payment scheme, never knowing if she would succeed. She broke it down to incremental steps, for small incremental victories that rolled upwards into finally beating back the biggest players themselves. One very large hospital refused, and of course was furious to be cut out of public employee business as a result. It took all her smarts to push them over the edge, but she did it, totally restructuring healthcare as a reasonable and still highly profitable service in Montana. It can be done.
And for all this, the American Healthcare establishment is the laughingstock of the world. Everyone knows what a miserable failure it is. It is the third largest cause of death in the country, a country where life expectancy has been falling in recent years – unprecedented in western countries (until COVID dented everyone’s stats).
The nonsense seems to extend to every branch. Currently, COVID-19 vaccines are free, and in many instances not even an appointment is necessary. Yet COVID-19 tests require a prescription (Why? Are they a danger to the patient?), which might require a visit to the doctor, involving payments, co-pays, billing and collections. How does that make sense? Things like this and the ugliness examined throughout the book are a terrible indictment of the whole sector such that it needs an entire manual for people to defend themselves against healthcare.
The final twist is that nearly every story Allen tells is about a victim who works in healthcare. They are healthcare workers’ own fights for justice. From nurses to doctors, lawyers and administrators, the healthcare system rips off anyone who comes in for help. It’s not just the public at large. If there’s a sickness to be cured, it’s the healthcare system itself. Never Pay The First Bill will bring back ugly memories from times you too were ripped off and never achieved satisfaction. It is unfortunate, but absolutely everyone needs to have a copy of this book for emergencies brought on — by the healthcare system.
David Wineberg
October 24, 2021
Everyone using the US health care system needs to read this book. I read it because I recently had to go to the ER, spent four hours there and now owe about $4000 (I have crappy insurance; without the crappy insurance it would have been over $7000). Thanks to this book's advice, I was at least able to look up the codes for what was being billed and ensure none of the charges were fraudulent (which apparently happens all the time) and I have some good ideas on how to get some relief for this ridiculous bill. Regardless of the outcome, the book makes it clear how ridiculous the system is and how it's up to us to fight back wherever possible. It includes advice for people faced with bills right now, people who have already had bills go into collections, people who are seeking ways to save on medical care before they have procedures or appointments done, and how employers can cut down the costs of employer-funded plans. It also talks about prescriptions, asking for cash prices, and going to small claims court.
I really appreciate this book. It makes me feel empowered to have a plan for my bills and unlike books that might focus on the problem, it acknowledges the problems and then suggests real solutions which can at least help with being faced with a large, unexpected bill that was a result of needing medical care without being overwhelmed or feeling ashamed.
Please read this book and let's take our health care system back!
I really appreciate this book. It makes me feel empowered to have a plan for my bills and unlike books that might focus on the problem, it acknowledges the problems and then suggests real solutions which can at least help with being faced with a large, unexpected bill that was a result of needing medical care without being overwhelmed or feeling ashamed.
Please read this book and let's take our health care system back!
August 27, 2024
This book is dedicated to anyone who’s been pushed around by the healthcare system. It is a specific guide on how to avoid being one of the millions of people being taken advantage of by the health care industry. The book is told in three parts: how to fight back, how to avoid the fight in the first place, and an employer section. If you are not an employer looking to educate yourself, then you could probably skip that section.
The five hidden reasons you should fight back:
1- We are the ones paying for healthcare
2- Healthcare doesn’t consider you important
3- The business of medicine exploits your sickness for profit
4- The healthcare industry wastes obscene amounts of money (Insurance companies make so much money there is no urgency or incentive for them to fight fraud.)
5- Our healthcare system is not broken, it was made this way
Medical bills are overwhelming to read. They can be hard to understand and can feel redundant when you receive 3 or 4 Explanation of Benefits statements for one medical visit. However, it is imperative that we take ownership of our medical bills. Oftentimes, upon closer look, insurance is either billed incorrectly or upcharged. Billing codes are really simple to look up online and you are the best resource to verify the legitimacy of medical charges.
If your medical bill happens to go to debt collectors, Allen provides specific resources on how to deal with them. Interesting fact, debt collectors buy your bill from hospitals/doctors for pennies on the dollar…don’t be afraid to negotiate paying a lowered amount. They’re going to make a profit either way.
Each chapter had a call to action at the end. I appreciated these summaries. Allen made the book easy to follow and understand. It was a quick and informative read.
People shouldn’t be intimidated by insurance companies and medical bills. They are spending their hard earned money and should not sit back and be taken advantage of.
Now, maybe Allen can help me fight against the travel insurance company that kept my money during the pandemic.
The five hidden reasons you should fight back:
1- We are the ones paying for healthcare
2- Healthcare doesn’t consider you important
3- The business of medicine exploits your sickness for profit
4- The healthcare industry wastes obscene amounts of money (Insurance companies make so much money there is no urgency or incentive for them to fight fraud.)
5- Our healthcare system is not broken, it was made this way
Medical bills are overwhelming to read. They can be hard to understand and can feel redundant when you receive 3 or 4 Explanation of Benefits statements for one medical visit. However, it is imperative that we take ownership of our medical bills. Oftentimes, upon closer look, insurance is either billed incorrectly or upcharged. Billing codes are really simple to look up online and you are the best resource to verify the legitimacy of medical charges.
If your medical bill happens to go to debt collectors, Allen provides specific resources on how to deal with them. Interesting fact, debt collectors buy your bill from hospitals/doctors for pennies on the dollar…don’t be afraid to negotiate paying a lowered amount. They’re going to make a profit either way.
Each chapter had a call to action at the end. I appreciated these summaries. Allen made the book easy to follow and understand. It was a quick and informative read.
People shouldn’t be intimidated by insurance companies and medical bills. They are spending their hard earned money and should not sit back and be taken advantage of.
Now, maybe Allen can help me fight against the travel insurance company that kept my money during the pandemic.
October 18, 2021
Just a mere fact, that this book happen to occur, is quite telling about American healthcare system.
The book is exactly what the title and cover suggest- compilation of tips how to fight medical bills. It's a manual and needs to be treated as such. Nothing more, nothing less. Good guidance for lay people how to interpret medical bills and appeal them. Author gives specific examples and websites which can be helpful for many people.
This book is not an analysis of American healthcare system by any means. It does not offer any potential solution to it. Anyone from anywhere in the World coming to the U.S. and having any interaction with healthcare system, should be prepared for a cultural shock. Most Americans don't experience other system and consider current situation as a status quo. And very rarely, you find them pondering on the fact, that America has the most expensive healthcare in the World with quality of care far behind other developed countries.
Book is very repetitive. Personally, I was looking for something much deeper but I didn't read any reviews before, so can only blame myself.
The book is exactly what the title and cover suggest- compilation of tips how to fight medical bills. It's a manual and needs to be treated as such. Nothing more, nothing less. Good guidance for lay people how to interpret medical bills and appeal them. Author gives specific examples and websites which can be helpful for many people.
This book is not an analysis of American healthcare system by any means. It does not offer any potential solution to it. Anyone from anywhere in the World coming to the U.S. and having any interaction with healthcare system, should be prepared for a cultural shock. Most Americans don't experience other system and consider current situation as a status quo. And very rarely, you find them pondering on the fact, that America has the most expensive healthcare in the World with quality of care far behind other developed countries.
Book is very repetitive. Personally, I was looking for something much deeper but I didn't read any reviews before, so can only blame myself.
April 11, 2023
This book is extremely practical and useful, and I recommend it for every American who needs healthcare (which is every American). Straightforward tactics and principles to "fight the system" and overcome unjust/predatory practices in healthcare. Do read it, because it isn't just a guide on how to recover from a devastating medical bill situation but also on how to avoid those situations in the first place. I will definitely be rereading to take further notes, and keeping it in mind for my future self.
January 7, 2023
This book was an excellent read! I’m new at being an adult and have always found health insurance confusing. Marshall Allen’s book helped me understand how the health care system works, the many ways you can be taken advantage of by insurance companies and hospitals, and how to effectively fight back. This is the information I wish I would have learned before I got my first job with benefits. I’m glad I’ve read this now and have a tool to help me in the future. I recommend this book to any young adult getting their first job and adults who want a better understanding of how they can save money on their healthcare.
December 3, 2022
Great, practical manual for telling hospitals and insurance companies to go to hell.
If you love the trappings of the law but were kept from considering law school by well-meaning people who accidentally tipped you into an even more precarious graduate education (hypothetical) you will be happy to know that reducing your bills will in some cases involve certified snail mail, faxing documents, and the threat of small claims court. You're going to be just like John Grisham.
If you love the trappings of the law but were kept from considering law school by well-meaning people who accidentally tipped you into an even more precarious graduate education (hypothetical) you will be happy to know that reducing your bills will in some cases involve certified snail mail, faxing documents, and the threat of small claims court. You're going to be just like John Grisham.
September 27, 2022
Skimmed this more than read it, as most of it isn't something I need to know right now--but it's good to know where to find this information should we ever have medical bills that regular negotiating and pushing for a fair price don't succeed.
March 19, 2025
This is a helpful book in understanding the state of healthcare billing in the U.S., which is a mess. This book will help you navigate through or around some of the most predatory parts of the system with your eyes open.
May 28, 2024
excellent read if ur getting fucked in the ass by the american healthcare system! ha ha, so informative. lol love it!
November 8, 2021
FASCINATING!
May 27, 2023
Really informative. I thought I knew it all, but learned so much about how insurance works on the backend.
The best lessons were:
1. Bill are riddled with mistakes. Always inquire if you are in doubt about something.
2. Through one of the dumbest features of insurance, sometimes its cheaper to pay out of pocket. Not through insurance.
3. Insurance does not care about the cost, they just pass it on to you and your employer. As a result, rising insurance costs are hurting our ability to earn more. Employer and employee must fight for a better system.
Highly recommend for anyone looking to understand our messed up health care billing system.
The best lessons were:
1. Bill are riddled with mistakes. Always inquire if you are in doubt about something.
2. Through one of the dumbest features of insurance, sometimes its cheaper to pay out of pocket. Not through insurance.
3. Insurance does not care about the cost, they just pass it on to you and your employer. As a result, rising insurance costs are hurting our ability to earn more. Employer and employee must fight for a better system.
Highly recommend for anyone looking to understand our messed up health care billing system.
October 8, 2024
If you ignore the more political and philosophical bits of this book (all the usual blaming of greed and corporations for the problems in the US health care system), it is a great handbook for individuals and small businesses. I thought I was a pretty savvy health insurance consumer but I learned many new practical tactics.
So sorry to find out that Marshall Allen died recently.
So sorry to find out that Marshall Allen died recently.
October 28, 2021
A fantastic book with truly applicable ideas and step-by-step instructions. How to quit putting up with the BS that is the American healthcare system and defend yourself as a consumer.
July 7, 2021
Who among us hasn’t received some kind of outrageous medical bill? What’s worse is when we pay a ton of money for health insurance, and somehow we still seem to be paying way more than we should. Personally, I’ve had this happen far too many times, and when I call to dispute, I feel absolutely powerless, which is why I’m so grateful for this book from Marshall Allen. Like most Americans, Marshall had some issues with insurance and healthcare providers, and as a journalist, he decided to learn as much as he could to see what he could do about it. Now, with this phenomenal book, he teaches all of us the ins and outs of the healthcare system and gives practical tips for what we can do in a wide range of situations.
My concern was that this book was going to flood me with information that’d make me say, “It’s not worth it to even try.” And that’s kind of what the healthcare system wants us to do. Fortunately, Marshall laid everything out in an easily digestible way, and you can return to specific chapters in this book if you ever run into an issue with medical bills. I highly recommend everyone in the United States reads this book, because until we have universal healthcare, there’s nobody who can’t benefit from the information that Allen provides.
My concern was that this book was going to flood me with information that’d make me say, “It’s not worth it to even try.” And that’s kind of what the healthcare system wants us to do. Fortunately, Marshall laid everything out in an easily digestible way, and you can return to specific chapters in this book if you ever run into an issue with medical bills. I highly recommend everyone in the United States reads this book, because until we have universal healthcare, there’s nobody who can’t benefit from the information that Allen provides.
May 19, 2025
Great tips! Already applied some of them in my life - SUCCESSFULLY!!! Great practical book! Well written! Loved personal stories….
May 22, 2025
I would rate this book 10⭐️ if I could. Everyone should have a copy.
January 21, 2023
[3.5/5]
I picked this book up because the title is something my mother said to me, entirely verbatim, when I called her panicking over a 900 dollar doctor’s bill. 900 dollars is nearly a whole paycheck for me, and I was freaking out. Her advice was essentially, once you give them your money, you have very little recourse for the mistakes they made. What happened with that bill was identical to the first story Allen tells in this book; despite my notifying them of a change in insurance, they hadn’t billed my insurer and passed the cost on to me. A horrifyingly common error, that many people might not even question.
Marshall Allen tells stories that will be undoubtedly familiar to any person reading this book. The insurance industry or a medical provider has probably screwed you over and you probably felt powerless because of it. Allen challenges us to see these organizations for the bullies they are and gives a practical guide to how to fight back. This book will be particularly valuable for young people who are overwhelmed by making and paying for their medical decisions. Or for people needing the references to specific conundrums. I could see myself pulling this book from the library again when in crisis. It's exceedingly practical to have on hand.
My only notes are that it can be fairly dry…but it is a book about insurance policy. It’s spiced up by the personal stories throughout, that will definitely get you riled enough to fight back. There are a few places where it can be repetitive, which is why I could see it being used as a reference easily. One thing to appreciate here, is that Allen has a whole section dedicated to employers. I wish I could make every HR department read that section. On this issue, great progress could be made if employees and employers realized they’re on the same team, you know, the team that’s getting fleeced by billionaires perpetuating fraud.
I picked this book up because the title is something my mother said to me, entirely verbatim, when I called her panicking over a 900 dollar doctor’s bill. 900 dollars is nearly a whole paycheck for me, and I was freaking out. Her advice was essentially, once you give them your money, you have very little recourse for the mistakes they made. What happened with that bill was identical to the first story Allen tells in this book; despite my notifying them of a change in insurance, they hadn’t billed my insurer and passed the cost on to me. A horrifyingly common error, that many people might not even question.
Marshall Allen tells stories that will be undoubtedly familiar to any person reading this book. The insurance industry or a medical provider has probably screwed you over and you probably felt powerless because of it. Allen challenges us to see these organizations for the bullies they are and gives a practical guide to how to fight back. This book will be particularly valuable for young people who are overwhelmed by making and paying for their medical decisions. Or for people needing the references to specific conundrums. I could see myself pulling this book from the library again when in crisis. It's exceedingly practical to have on hand.
My only notes are that it can be fairly dry…but it is a book about insurance policy. It’s spiced up by the personal stories throughout, that will definitely get you riled enough to fight back. There are a few places where it can be repetitive, which is why I could see it being used as a reference easily. One thing to appreciate here, is that Allen has a whole section dedicated to employers. I wish I could make every HR department read that section. On this issue, great progress could be made if employees and employers realized they’re on the same team, you know, the team that’s getting fleeced by billionaires perpetuating fraud.
November 4, 2025
This book describes how people stuck in the American health care system can keep their money for themselves.
I liked it very much, since it provided a useful answer for what to do in my particular situation, though I hope that I myself never have to go through what this author must have had to have gone through in order to write something like this, in the future.
I myself have had my mother as an intermediary for my long spate of vexing healthcare bills - now that she is no longer with us, I took this book out since I had a feeling I might have to field the next long wait on hold with the insurance agent by myself.
This book says 150 million Americans fall into the category of being bullied so I looked up how many Americans there were and estimated ~343.6 as of last census. That is ... almost 45%.
When I went on the author's website, it said he passed away last year. I hope that isn't a bad sign for the future!
I liked it very much, since it provided a useful answer for what to do in my particular situation, though I hope that I myself never have to go through what this author must have had to have gone through in order to write something like this, in the future.
I myself have had my mother as an intermediary for my long spate of vexing healthcare bills - now that she is no longer with us, I took this book out since I had a feeling I might have to field the next long wait on hold with the insurance agent by myself.
This book says 150 million Americans fall into the category of being bullied so I looked up how many Americans there were and estimated ~343.6 as of last census. That is ... almost 45%.
When I went on the author's website, it said he passed away last year. I hope that isn't a bad sign for the future!
August 5, 2021
I like his writing style -reader friendly and is hell of a book on how to armed yourself against as Allen calls them the big bully.
Tips: Read through every bill, the author say 80% of bills contained errors. Get an itemized list of the bill if you don’t agree with it, get codes. That is the language of medical Billings and so much more. He gives great examples of people fighting some becoming experts on fighting insurance.. if the dispute is about thousands of dollar consider hiring an expert patient advocate.
The weak part for me was on what an employer should do, I am not an employer so I skip that part. He has great sample letters at the end to get you started. A really good book on getting educated and being your own advocate. Highly recommend this book. Keep it handy in case you get a bill and you get hundreds or thousands of dollars and you go into shock for the surprise.
Tips: Read through every bill, the author say 80% of bills contained errors. Get an itemized list of the bill if you don’t agree with it, get codes. That is the language of medical Billings and so much more. He gives great examples of people fighting some becoming experts on fighting insurance.. if the dispute is about thousands of dollar consider hiring an expert patient advocate.
The weak part for me was on what an employer should do, I am not an employer so I skip that part. He has great sample letters at the end to get you started. A really good book on getting educated and being your own advocate. Highly recommend this book. Keep it handy in case you get a bill and you get hundreds or thousands of dollars and you go into shock for the surprise.
January 21, 2022
I have an MS in Integrated Health and Wellness, as well as worked in a health nonprofit as a Community Health Worker for three years. On top of my CHW services, I always offer to help with finding loopholes and grants to assist low-income, rural individuals and families who are often times uninsured with medical expenses. I knew some of the strategies in this book, but I am more excited than ever to apply what I have learned. I ordered three more copies of this book for the Executive Director and the other two CHWs in our nonprofit for them to reap the benefits of this book. I am also circulating my own copy, complete with highlights, to my family members so we can all be better advocates for our health. This book is absolute GOLD.
May 3, 2022
Fantastic book giving insights into the American medical system and how it interacts with insurance. A bit verbose at times but you can quickly skim through it to figure out what you need. I could have used this a few years ago. In 2015 I needed emergency medical care, and during a follow-up visit the hospital improperly billed me in a way that bypassed my insurance. I contested this with the hospital and insurer, but ultimately after a bunch of back-and-forth the hospital sent it to collections. I was able to successfully challenge the bill at that stage, and ended up owing nothing, but I could have gotten this resolved a lot sooner (and without needing to brave the shady US debt collection system) had this book been available back then.
February 5, 2023
3.5 out of 5
I picked up this book because I was doing a reading challenge and one of the categories was to read a book where I would learn something. I did a Google search and this book popped out at me because I use health insurance along with countless others. Also like many others it looks like we have been taken advantage of by the same people that are supposed to care for us. This book was interesting to me because it points out what the healthcare industry does to exploit us as consumers and take our money as well as provide steps that the consumer could take to fight these exorbitant prices. Along with the steps he shares stories of how these steps worked in real life situations. Very informative.
I picked up this book because I was doing a reading challenge and one of the categories was to read a book where I would learn something. I did a Google search and this book popped out at me because I use health insurance along with countless others. Also like many others it looks like we have been taken advantage of by the same people that are supposed to care for us. This book was interesting to me because it points out what the healthcare industry does to exploit us as consumers and take our money as well as provide steps that the consumer could take to fight these exorbitant prices. Along with the steps he shares stories of how these steps worked in real life situations. Very informative.
November 26, 2024
About half of the book reads like a Matt Taibbi rant against unfairness from the perspective of the system, providers, and insurance networks. Which is to say it's a good explanation of the broken system.
Maybe a quarter of the book is advice for employers on how employer-funded plans have fought back against the lack of transparency and kick-backs, which while eye-opening is not that helpful to a patient.
There's maybe about 5-10 pages of real content for patients, with the rest of it being glossed-over anecdotes. Be prepared to read the scant tips twice as the chapter ending summaries are just as long as the first presentation.
TLDR: Read your EOB and lookup fair prices for each service online.
Maybe a quarter of the book is advice for employers on how employer-funded plans have fought back against the lack of transparency and kick-backs, which while eye-opening is not that helpful to a patient.
There's maybe about 5-10 pages of real content for patients, with the rest of it being glossed-over anecdotes. Be prepared to read the scant tips twice as the chapter ending summaries are just as long as the first presentation.
TLDR: Read your EOB and lookup fair prices for each service online.
December 6, 2021
My favorite line: “Our healthcare system isn’t broken. It was designed this way.” As a five-time cancer survivor, I should be expert at reading medical bills and navigating the health insurance system, but honestly, I’m so exhausted from managing my disease and care that I have just been frustrated and angry about the costs, lack of coverage and denial of claims. My first thought whenever I have to see a doctor or get a test is about money, not about my health. It SHOULD NOT be this way. I highly recommend this book that lays out the system as it was designed - for huge corporations - and not you and me. It highlights people fighting back and how we can join their ranks.
January 6, 2023
We are the ones who end up getting stuck with the bill through higher premiums & oop payments. We need to stand up to the bully. The healthcare system is not broken. It was purposefully designed that way to maximize profits for the hospitals, providers, and insurers. It’s not the insurers paying for our care. We pay for it. It’s a part of our compensation package. The customer is always right. And while we, as the patients, should be the customers, that ends up not being the case most times. So, we need to advocate for ourselves. Ask for EOB and an itemized bill. Ironically, sometimes paying the cash price is cheaper than billing through insurance.
July 24, 2022
When you start reading this book you'll be outraged, so be prepared. A lot of good information. Can come across a little like rabble-rousing in a few places, but for the most part gives the information without prejudice. If you take away nothing else from this book, at least you will learn that most everyone in the healthcare system (doctors, hospitals, insurance companies, etc.) are looking out for themselves and their bottom line first and then (maybe) you. As is becoming the norm in so many areas now, we have to become our own advocates and be assertive in taking care of ourselves.
November 14, 2022
I will keep this book on hand in the hopes I never need to read it again. I’ve had unusually good health insurance and good health my entire life. Now I’m retired and on Medicare so I don’t anticipate issues like those in this book. But for people with less than the best health care insurance I recommend reading this book before anything happens that could compromise your financial well being. And then there’s the principle of being accurately billed. And pushing back on the terrible state of health care administration in the US.
July 28, 2023
How to fight the predatory medical system in the US
Every book that I have ever bought on negotiation has more than paid for itself. We need to be encouraging our elected officials to read this book. In just one instance, I negotiated a $3100 medical test down to $1300. It is ridiculous having to negotiate at least 5 bills per ER visit. My wife has been sick, and I have had to negotiate over 20 bills. We have CHM, and they require you to negotiate for discounts. This book has been helpful.
Every book that I have ever bought on negotiation has more than paid for itself. We need to be encouraging our elected officials to read this book. In just one instance, I negotiated a $3100 medical test down to $1300. It is ridiculous having to negotiate at least 5 bills per ER visit. My wife has been sick, and I have had to negotiate over 20 bills. We have CHM, and they require you to negotiate for discounts. This book has been helpful.
February 2, 2024
Incredible and 100% would recommend to everyone I know. Really good tips on how to double check medical bills (with step-by-step instructions) and what the next steps are if your insurance or the provider won’t budge. I implemented the strategies in this book on the first medical bill we received after reading it, and found a $180 price discrepancy that I would not have caught otherwise. If I could give this 10 stars I would. It should be a required textbook for anyone on their own health insurance.
Displaying 1 - 30 of 104 reviews