Thursday, October 1, 2026
There are very few things that scare me. Black cats coming my way are a nuisance. Bumps on an airliner are expected, and I don’t panic. Those crazy e-bike drivers who can kill you in a heartbeat are dangerous, but I’m constantly on the lookout for them. Odd-looking people on the street can be frightening, but I cross fast to avoid them.
So what scares me? It’s the American health care system, which can frighten people to death, no pun intended. A month ago I wasn’t feeling peppy, and was sleepy in the middle of the day. It felt like a hangover, but I’m not a drinker, so that wasn’t it. I decided to go to an emergency room, fearing some malady that I didn’t recognize. It turned out that I had a pulse of 38, which is dangerously low unless you’re, say, a professional triathlete.
I arrived at the ER (of a purposely unnamed hospital) on a Friday, which means you’re destined to stay in the hospital over the weekend. In fairness, if you’re having a heart attack or a stroke, you’ll get immediate attention, but all other symptoms get lesser treatment. Once I saw some physicians, they gave swift attention to the issue and how to resolve it. I spent a total of four nights at the hospital, and a few weeks later I learned that the bill was $249,892.
Fortunately, I have coverage for the claim, which eventually was reduced to $13,405, which was paid by my insurer. The size of the original statement is typical in hospitals all over the country, which tend to inflate their charges to astronomical numbers in order to get to a fair settlement. For the better part of my life, I have seen dozens of bills that list crazy charges, all in the effort to get to a livable amount.
Are the hospitals the major culprit? No, it’s the entire system. There’s a massive game going on all over America, played by health care providers, insurers and Congress, which makes the system the mess that it is. Each one has to use all the gimmicks it knows to stay alive.
Let’s start with the hospitals. In 23 years in Albany, I heard countless stories about the hospital lobby and the steps it takes to protect its turf. Periodically, legislation is introduced that would correct a flaw in the delivery system, but if it doesn’t meet with the approval of the hospital industry, it dies a silent death.
Last year the health care industry spent $653 million on issues involving Congress. Hospitals are a part of that mammoth number, but there’s a heated competition among all types of providers. And the major blame is on Congress and the presidents.
Waiting for Congress to come up with a health care bill that satisfies all of the parties is an impossible dream. Part of the reason there’s never any compromise solution is the role of the president. The Obama administration passed a major bill that everyone agrees is in need of tweaking. But who’s going to tweak it?
President Trump promised to come up with a new bill “ within two weeks” — in 2020. House Speaker Mike Johnson said he had a bipartisan bill ready for action, but in the end he passed a one-house, partisan bill that is going nowhere. Over in the Senate they had a “great bill” three weeks ago, and it crashed and burned. At this moment, a bipartisan group of senators say they are “making progress” on a bill, but I’ll get many haircuts before their dream comes true.
Two presidents have come and one is gone since Obamacare was passed. No bill has come from a White House occupant or Congress, so what should health care providers do? Year after year goes by, and there are no changes to existing law. Obamacare patients are getting hit with horrifying increases. Congress is in a state of continuous gridlock.
The clock will continue to tick, and there will be many more patients dealing with $250,000 bills. Congress’s failure to find a solution is an indictment of our elected officials from top to bottom.
Jerry Kremer was a state assemblyman for 23 years, and chaired the Assembly’s Ways and Means Committee for 12 years. He currently chairs the Capitol Insight Group, a government relations firm. Comments? jkremer@liherald.com.
