The High Cost of Essential Services: What a $13,000 Ambulance Ride and Expensive Court Reporters Have in Common

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In July 2023, 25-year-old Jagdish Whitten was struck by a car while jogging across a busy San Francisco street. Remarkably, after being hit, he managed to move himself to the curb. Bystanders called an ambulance, but Whitten opted to have friends drive him to the nearest hospital. After an initial evaluation, doctors decided to transfer him via ambulance to a trauma center. This second ambulance ride, covering a mere six miles, resulted in a staggering bill of nearly $13,000. To compound the issue, his insurance provider, Anthem Blue Cross, denied the claim because the transfer wasn’t pre-authorized, leaving Whitten responsible for the entire amount.

This incident highlights the pervasive issue of exorbitant and unexpected medical bills in the United States, particularly those associated with ambulance services. Patients often find themselves caught off guard by the high costs of emergency medical transportation, especially when insurance companies refuse to cover these expenses due to technicalities like lack of pre-authorization.

In a seemingly unrelated sector, California’s legal system is grappling with its own financial challenges. Court reporters, who have been indispensable in courtrooms since 1872, are facing criticism for high fees and service gaps. These professionals are responsible for creating verbatim records of legal proceedings, a task that requires specialized skills and equipment. However, the rising costs associated with their services have led to concerns about accessibility and fairness within the legal system.

Attorney Karl A. Gerber has been vocal about these issues, pointing out that the high fees and inadequate court coverage are problematic. He suggests that these challenges are pricing court reporters out of the market and potentially hindering the legal process. In response, Early Langley, a representative of the court reporters, argues that these criticisms overlook historical and systemic factors that have contributed to the current situation. Langley emphasizes the adaptability and dedication of court reporters despite these challenges.

At first glance, the exorbitant ambulance bill and the high fees charged by court reporters may seem like disparate issues. However, they both underscore a broader systemic problem: the lack of transparency and regulation in service-related industries, leading to unexpected and often unaffordable expenses for consumers.

The Common Thread: Lack of Transparency and Regulation

In both healthcare and legal services, consumers frequently face opaque pricing structures. In Whitten’s case, there was no prior indication that a short ambulance ride would result in a $13,000 bill. Similarly, individuals involved in legal proceedings may not anticipate the high costs associated with court reporting services until they receive the bill.

This lack of transparency prevents consumers from making informed decisions and leaves them vulnerable to financial strain. Without clear information about costs upfront, individuals cannot adequately prepare for or contest these charges.

The Role of Insurance and Reimbursement Policies

Insurance policies and reimbursement rates play a significant role in both scenarios. For medical services, insurance companies often have complex policies that can lead to claim denials based on technicalities, as seen with Whitten’s ambulance bill. In the legal field, court reporters’ fees may be influenced by reimbursement rates set by the courts or negotiated with law firms, which can vary widely and lack standardization.

Potential Solutions and Reforms

Addressing these issues requires a multifaceted approach:

  1. Enhanced Transparency: Service providers in both sectors should be required to disclose pricing information upfront. This would allow consumers to make informed choices and anticipate potential expenses.
  2. Regulatory Oversight: Implementing regulations that cap fees for essential services could prevent exorbitant charges. For instance, some states have introduced legislation to limit surprise medical billing, which could serve as a model for other industries.
  3. Insurance Reform: Insurance companies should streamline their policies to reduce claim denials based on technicalities. Simplifying the pre-authorization process and ensuring coverage for necessary services are essential steps.
  4. Stakeholder Collaboration: Engaging all stakeholders—including service providers, consumers, insurance companies, and regulators—in open dialogues can lead to more equitable solutions. Collaborative efforts can help align interests and address systemic issues effectively.

Conclusion

The cases of the $13,000 ambulance bill and the high fees charged by court reporters illuminate a critical need for systemic reform in service-related industries. By enhancing transparency, implementing regulatory oversight, reforming insurance practices, and fostering collaboration among stakeholders, we can work towards a more equitable system that protects consumers from unexpected and burdensome expenses.

Ultimately, these issues reflect broader societal challenges related to access, fairness, and accountability. Addressing them requires a commitment to systemic change and a recognition of the interconnectedness of these seemingly disparate sectors.

Published by stenoimperium

We exist to facilitate the fortifying of the Stenography profession and ensure its survival for the next hundred years! As court reporters, we've handed the relationship role with our customers, or attorneys, over to the agencies and their sales reps.  This has done a lot of damage to our industry.  It has taken away our ability to have those relationships, the ability to be humanized and valued.  We've become a replaceable commodity. Merely saying we are the “Gold Standard” tells them that we’re the best, but there are alternatives.  Who we are though, is much, much more powerful than that!  We are the Responsible Charge.  “Responsible Charge” means responsibility for the direction, control, supervision, and possession of stenographic & transcription work, as the case may be, to assure that the work product has been critically examined and evaluated for compliance with appropriate professional standards by a licensee in the profession, and by sealing and signing the documents, the professional stenographer accepts responsibility for the stenographic or transcription work, respectively, represented by the documents and that applicable stenographic and professional standards have been met.  This designation exists in other professions, such as engineering, land surveying, public water works, landscape architects, land surveyors, fire preventionists, geologists, architects, and more.  In the case of professional engineers, the engineering association adopted a Responsible Charge position statement that says, “A professional engineer is only considered to be in responsible charge of an engineering work if the professional engineer makes independent professional decisions regarding the engineering work without requiring instruction or approval from another authority and maintains control over those decisions by the professional engineer’s physical presence at the location where the engineering work is performed or by electronic communication with the individual executing the engineering work.” If we were to adopt a Responsible Charge position statement for our industry, we could start with a draft that looks something like this: "A professional court reporter, or stenographer, is only considered to be in responsible charge of court reporting work if the professional court reporter makes independent professional decisions regarding the court reporting work without requiring instruction or approval from another authority and maintains control over those decisions by the professional court reporter’s physical presence at the location where the court reporting work is performed or by electronic communication with the individual executing the court reporting work.” Shared purpose The cornerstone of a strategic narrative is a shared purpose. This shared purpose is the outcome that you and your customer are working toward together. It’s more than a value proposition of what you deliver to them. Or a mission of what you do for the world. It’s the journey that you are on with them. By having a shared purpose, the relationship shifts from consumer to co-creator. In court reporting, our mission is “to bring justice to every litigant in the U.S.”  That purpose is shared by all involved in the litigation process – judges, attorneys, everyone.  Who we are is the Responsible Charge.  How we do that is by Protecting the Record.

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