There's a simple answer—it can't. Or at least it shouldn't. There's no way a simple throat swab intended to determine whether a patient has strep should cost more than a few hundred dollars (and in any other rich nation, it wouldn't). But in our health care system, the combination of doctors and labs and private insurance companies, has figured out how to make it so ridiculously expensive to get very basic care.
Alexa Kasdan is the patient in question. She went to her primary care doctor, Dr. Roya Fathollahi, in New York City, for a sore throat that hadn't gotten better in a week's time. She was preparing for a vacation and didn't want to have the trip interrupted, so she went to the doctor, had the strep test and a blood test, and was given antibiotics. She got better, went on her trip, and came home to find that her insurer, Blue Cross and Blue Shield of Minnesota, had been billed $28,395.50 for the out-of-network lab work on the throat swab. The insurance company paid $25,865.24. Fathollahi’s office told her that $2,530.26 of the bill was her responsibility.
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