Posted on 04/29/2025 4:51:25 AM PDT by Red Badger
The absolute state of things.
https://x.com/i/status/1916677603299414361
Insurance is a scam. Cancel it. pic.twitter.com/wccD3V51YS— James Li (@5149jamesli) April 28, 2025
Customer: 'I think there's a mistake on the bill ... we got a bill and then we realized that you guys didn't have our insurance, so we sent you our insurance and it looks like the bill went UP.'
Agent: 'It went up?'
Customer: 'Yeah, the first bill we got without the insurance was 600 bucks, and then the second one was almost 1300 bucks.'
Agent: 'Yeah so the first invoice you received, that's a discount you received if you're uninsured, so you're not eligible for the discount because you are insured. So the bill was $2,342.14. We billed your insurance; your insurance only paid $1,078.85.
Customer: 'Can I go back to the discount without the insurance?'
Agent: 'No sir, you're insured, so you're not eligible for the discount.'
Click here: to donate by Credit Card
Or here: to donate by PayPal
Or by mail to: Free Republic, LLC - PO Box 9771 - Fresno, CA 93794
Thank you very much and God bless you.
So the question I have is who is making that decision?
Is it the hospital/doctor, or is it the insurance company?
Why wouldn’t insurance companies leverage their market share fight the bills for their customers?
It seems like they are fine to sit around and pay out rediculously inflated healthcare invoices!
In any business, the number one way (in a competitive marketplace) to increase your margins is to reduce your costs. Raising prices (premiums) causes you to lose customers and revenue.
Yep, didn’t have insurance 8 years ago. Paid about $325 for an mri of my lower back. 4 months later, still sore, and the doc ordered a ct scan with dye of the same area. I asked the billing agent before getting it done. She said $2,200 (about that anyway). I had it done, cash, for about $420, iirc.
A week later I woke up on Labor day with no pain. So I labored, replacing the front brakes on one of our suvs. Answered prayer.
So in actuality, the true price for service was $600. They make up the word “discount” to cover for those without insurance.
The people that already have insurance are expected to pay the second part of the bill, after the insurance company pays the first part.
It is indeed a total scam.
Been trying to explain this to the wife forever, but she just won’t believe it so to keep her happy I just pay the insurance premiums ... then again I don’t really go to the doctor unless I feel like I’ve broken a bone or something major
In any other business, doing this and concealing the real price from the consumer would be considered a clear case of fraud.
“California” has many invaders.
Invaders will sometimes pay on a medical bill if the amount is not insane, hence the discount for cash.
It’s better to bill and get $600 than $0 of $2200.
Medicare pays what it thinks an efficient provider should be able to sell a service for.
It’s my understanding that private insurers pay somewhat more than the Medicare amounts.
Hospitals set their list prices at absurd levels so the healthy folks have to buy medical insurance which subsidizes the sick folks that get lots of care.
Insurers negotiate discounts off hospital list prices, typically by percent. The percentage discount system encourages hospitals to keep list prices high so the middle-class healthy folks don’t dare self-insure.
Medicare insists on getting best first bill pricing, so you can’t get a discount price upfront from a Medicare provider.
Medicare providers have to try to ding you with a list price bill first so you take a big risk in not buying health insurance.
Are healthy folks getting scammed? Yes, by the trillion$ annually.
How did a CT scan resolve your lower back issue?
The number one way is to lay off employees and offshore the work.
RICO.......................
I was speaking to my Polish neighbor about dentistry:
https://dentatur.com/dentist-in-turkey-prices/
America needs health care “free trade zones.”
All cash, no insurance accepted, no medicaid/medicare, no government regulation, no drug price controls, no doctor liability / tort law. Its just you, and the doctor(s)
Start by putting them on Indian Reservations next to Casinos
Our present system is like Soviet Union. Too big, too expensive too bloated, too marxist controlled, too corrupt, and too big too fail - until it does. We need other options
Every hospital has a local monopoly on emergency care.
This is enforced by federal law that requires the ambulance to take you to the nearest hospital, not one a half mile further away that would be 30% cheaper.
Hospitals financially need to zing the middle class so Medicaid and EMTALA care can be subsidized.
To get access to emergency care for their insureds, insurance companies have to go along with the system.
To introduce competition, each hospital might be split ~50/50 between two hospital network systems.
You’re paying for a lot of middle men. It’s the difference between retail and wholesale.
“It seems like they are fine to sit around and pay out rediculously inflated healthcare invoices!”
Blue Cross was created by Baylor Hospital to help ensure its bills got paid. Other hospitals soon wanted into the system.
In my youth, the Blue Cross system still existed to support hospitals.
During Trump’s first term making hospitals publish prices for procedures for transparencies was one of the things he was working on to reduce medical costs.
He’s right the next time your at a pharmacy tell them you don’t have insurance it will be cheaper.
In any other business, doing this and concealing the real price from the consumer would be considered a clear case of fraud.
Agree.
Where’s RFKJ on this?
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.