The Real Crime in Health Care
I just got the final bill for my appendectomy and looking at it, it's clear what the real ripoff for those without insurance is: the discounted rate you get by being an insurance company.
If I had absolutely no insurance, the bill for the whole incident would have cost about $11,000.
Then you look at the next bit on the bill and see that the insurance company negotiated the cost down to $4,000, telling the hospital, doctors, etc. that *no one* was going to pay the other $7,000.
I'm on the hook for just about $2000 of it. However, it's obvious that the insurance company actually saved me more money with their giant coupon than they did in actually paying their portion.
I mean, they got me a $7000 discount and paid another $2000. Anyone who was without insurance would be completely screwed in the same situation.
Everybody seems to focus on how much the insurance pays or doesn't pay. However, if we just all had access to the discounted price list for services, that alone would make a huge difference in stopping medical bankruptcies. I mean, come on, the same service at the same hospital costing anywhere between $4,000 and $11,000, depending on who you are, specifically skewed so that the entity who has the most cash on hand pays the least and those with the least amount of cash pay the most is completely messed up.
May 23rd, 2007 at 8:13 am
Yeap, cash is King.
May 23rd, 2007 at 9:24 am
It's a contracted rate that clinics agree to in exchange for insurance companies telling subscribers to go to that clinic…sucks for the uninsured, but there are people out there that are trying to make it a requirement to offer a discount for people with no insurance…
Also, you're appi was cheap, mine came in just under $20,000, not counting the month I spent in the hospital for complications…
May 24th, 2007 at 9:36 am
With a wife in Medical school I have been learning things about the relationship between insurance companies and doctors.
Let's say that your procedure COST 2000 to complete. If the Doctor were to bill the insurance company 2000 (the actual fair market cost of the surgery including profit for the doctor) the insurance company would come back and say that they think the surgery should cost 500 and only agree to pay that much money.
In order for the doctor/hospital to recoup all of their costs they must find a higher price (like 11,000) that the insurance company will not like and allow the insurance company to offer 4,000 in payment.
So because of this, there is a delicate balance of billing on the part of hospitals. It is a sad state of affairs created by greedy insurance companies and SCUM Doctors who raise the rates of everything with insurance fraud.
Medical billing is an art form.
Do not get me started on gov't health insurance. That is the main reason why there are no private doctors practicing in poor areas. If a Doctor's patient base was comprised entirely of medicade patients that doctor would be out of business in a few months.
June 2nd, 2007 at 11:37 am
There are actually "insurance policies" that are more or less just that — they get you the negotiated discount rate, but actually don't pay any of the resulting cost. And yes, you have to pay for the discount. IIRC the high-deductible HSA deals do this as well (you pay the discounted rate, but you pay the first $X thousand of your costs out of pocket, then the insurance covers the rest).
October 2nd, 2007 at 3:32 pm
I live in a country where healthcare is free for the moment, but we're heading towards a private system fast. So this is interesting.