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Assuming Responsibility for Patients' Pockets


Medical bills are a leading cause of personal bankruptcy and doctors decide what goes on the bill.

According to the Congressional Budget Office, the United States spends $700 billion dollars each year on tests and treatments that do not measurably improve health outcomes--a figure comparable to our total spending on the Iraq War. And here is where things become truly awkward: few doctors understand how the decisions they make impact what patients pay for care.

Let's recap. Medical bills are bankrupting Americans, doctors decide what goes on the bill ($700 billion dollars of which might not need to be there), and doctors rarely have information about what things cost. That seems like something we ought to fix, doesn't it?

If you agree and have a story to tell about it, there could be $1000 in it for you. Remember a time you got a medical bill that was higher than you expected it to be? Or a time when you wanted to know how much a test or treatment might cost and couldn't find out? Costs of Care, a Boston-based nonprofit, is offering $1000 for short anecdotes illustrating the importance of cost awareness in medicine. We want to hear your story.

The submissions will be judged by a high profile crew of policymakers, doctors, and journalists that include Atul Gawande, Michael Dukakis, Jeffrey Flier, Michael Leavitt, and Tim Johnson. Submissions will be due by November 1st to Additional details are available at

Dr. Neel Shah is the executive director of, and a resident in Obstetrics and Gynecology at Brigham & Women's Hospital in Boston.

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