Marty Makary on Opaque Hospital Billing: warns against

Dr. Marty Makary warns against billing patients without clear upfront prices. In The Price We Pay (2019) and at his September 28, 2026 American College of Surgeons lecture, he described how he and colleagues used contract-law arguments in court to stop a Virginia hospital that had sued 24,500 people over medical debt — getting thousands of patients spared from wage garnishment.

Makary’s stated reasoning is that opaque billing lets hospitals extract prices patients never agreed to, and that patients who are told prices in advance — or who fight unlawful collection practices — can protect themselves. The case is his signature example of pricing abuse and of how transparency and legal accountability can push back.

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