“Never pay the first bill” – a book review

I recently finished reading “Never pay the first bill” by Marshall Allen, and I highly recommend it. This book is a must-read for anyone looking to save money on healthcare in the US or simply wanting to understand more about why healthcare is so expensive here.

As a foreigner in the country, I have heard many times from friends, colleagues, and others complaining about the cost of healthcare in the US. But I haven’t heard or read a clear explanation of why. This book lays bare the reasons. It is the middleman (for example, brokers, pharmacy benefit managers, etc…), the hospitals, and insurance providers, who continue to make billions of dollars in commission, and profits.

The book starts with very strong wording to describe the medical industry and its players like predatory, profit-driven system,… I was a bit uncomfortable at first with the wording. But after the author listed out many (many) examples of how the system takes advantage of people like you and me, I can understand why. Some of the stats or case studies are truly mind-boggling.

  • The commission for the broker can be 40% of the first-year premium, the premium paid by the employer and you. 40%!
  • A hospital marked up the price of an implant from $3,500 (what they paid) to $70,000 (what they charged the patient). A nice 20 times.
  • etc…

In addition, one of the main themes of the book is the importance of being an active participant in your own healthcare. Allen argues that too often, patients simply accept the bills they receive without questioning them, even if they seem unreasonable. By taking a more proactive approach, however, it is possible to save significant amounts of money on medical expenses.

To this end, the book is packed with tips and strategies for negotiating medical bills, as well as advice on how to dispute charges that seem incorrect or unreasonable. Allen also provides guidance on how to choose the right healthcare provider and how to communicate effectively with doctors and other medical professionals in order to get the best possible care.

One of the standout features of “Never Pay the First Bill” is the level of detail and practicality that Allen brings to the subject. The book is filled with real-life examples and case studies that illustrate the various strategies and tactics that he recommends.

After each chapter, Marshall includes a short to-do list (as the summary) so that reader can take action easily. I hope that many people will take action, both as an individual, an employee or employers or other stakeholders, so that the situation can be improved over time. I have learned many practical lessons from the book and have started looking at the billing code from the most recent bill to understand it more :). It is indeed easy to search for the billing code and then read about it online to understand if the charge is accurate.

Overall, this book is an invaluable resource for anyone looking to save money on their bills. Allen provides readers with a wealth of information that is easy to understand and apply. Whether you are dealing with a single bill that seems unreasonably high or trying to navigate the complex landscape of healthcare costs more broadly, this book offers practical and actionable advice that can help you save money and get the care you need.

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