The complication I see is that a provider will give an insurer who brings large volume their way a significant discount. They won’t offer that discount to you as an individual or to an insurer with low volume in their area.
So if a surgery charges are $7k and a local health plan can get the service for $4k and your health coverage from out of area gives you $4k, you are stuck with the $3k balance while if you were with the local coverage you’d not be balanced billed the difference. In fact the provider would probably want the $7k in advance and let you keep the insurance check when it comes in. Kind of a pain compared to flashing a card.
But maybe I’m missing something because a lot of people seem to think this makes sense.
Appreciate your comments, I’m still trying to sort this out much of this issue. I lean towards models that deregulate, drive competition, and make medical services just another professional commodity.
I’m cynical about a local provider acting in our best interests any moreso than a out of state firm. Perhaps a local provider will have a better grasp on what pricing is appropriate. A provider on the other side of the country may not care, possibly apply a blanket rate vs. a local market rate. It would be like saying the appropriate salary for a worker in NYC is equal to that of someone in a rural Alabama area.
I would rather have a local provider. To talk to someone that could be a neighbor, understands our community, is accessible in person, etc. While it’s my preference, if the service provided by another firm out of state is acceptable and cost is attractive... sign me up.