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.
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
He’s right the next time your at a pharmacy tell them you don’t have insurance it will be cheaper.
YES health insurance is a BIG SCAM.
No Insurance, blood clot in knee, emergency room,tests,shots,... Total Cost about $2500
with Insurance $13,000, $7000 deductible, 30% copay on balance of $6,000, your cost WITH INSURANCE $8800!!!
My hospital list the 2 prices on every bill and I had NO INSURANCE so I paid about $2500.
In years I won’t meet my deductible I pay cash for all medical care. It’s usually cheaper than my deductible. When I asked I say I do t have insurance because I don’t on the first $8,000. One place doesn’t care but tells me take my pick because once they bill you in cash they will not bill insurance and will not cooperate if it is submitted.
Got a better one.
My son had surgery to remove some intestine. Later I went to get a coffee and met the surgeon in the elevator. She introduced me to a colleague.
A few weeks later we saw a line item in a bill. The dirtbag colleague billed me $800 for a consult.
We refused to pay.
I sent the insurer a letter showing the thousands of dollars in “mistakes” all in their favor. I told them that we haven’t begun charging $200 a hour forensic accounting services yet but that would begin on the next “mistake.”
Magically the “mistakes” stopped completely.
Many people use the ER for their family doctor, even though government assistance is available to them. They do not apply for what’s available to them and just walk out after treatment.
The hospital sends the accounts to collection. The collection people make application for the people who got treatment and the hospital gets pennies on the dollar… the collection guys get the rest.
Then the hospital can recover the rest of the money lost to the cheaters by padding the bill for everyone they treat … who HAS coverage.
1. The taxpayer is stiffed to fund government programs for the ‘underserved’
2. The taxpayer pays premiums on a health plan for himself and family
3. The taxpayer pays a deductible-out of pocket
4. The taxpayer pays for office visits-out of pocket
5. The taxpayer is overcharged by the hospital… to help the hospital recover money lost to collection guys
THE TAXPAYER JUST PAID FIVE (5) TIMES… and the doctor hasn’t touched him yet.
The insurance company owes the man $478.85.
Shows how much “free” health care is being doled out, especially if you’re an illegal.
Read about a case where a man was fighting his insurance company tooth and nail b/c he was charged for a surgery that was never performed b/c his wife died before the surgery was done. Didn’t matter, he still got a bill and the insurance company wouldn’t dismiss it.
This makes sense. Gov’mt buys votes from those who cannot hold a job with a company that helps out on insurance. It is YOUR tax dollars that fund this — so politicos can stay employed — and, ironically, covered by health insurance that you cannot touch with any amount of money.
So, yeah, this makes sense. There is nothing wrong with US health care — except we let politicos get their grubby little fingers into it.
Wut? You’ve never heard that anything gov’mt touches gets F@#$#$ up?
lol Self-pay all the way!
Wait until he figures out this also is a thing with auto insurance, homeowners insurance, pet insurance...
bookmark
Wait a minute...isn't Obamacare forced on everyone who doesn't buy their own plan or get it from an employer? So who gets a discount?
Our dermatologist just bills us twice and Medicare pays it. The government doesn’t care since there is no way to report the fraud.