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To: Pearls Before Swine
My own thoughts on this is that if you don’t have a pricing club, the insurance companies worry that you’ll hit the deductible level too fast. And, it just isn’t worth it to them to provide both price mointoring and a high-limit policy.

Monitoring provider prices without making a payout to the provider is an expense to the insurance company which counts against Obamacare's 80 or 85% payout for healthcare. If some bean counter tells your hospital that the procedure they billed $10000 for is really only $3000, but you pay the $3000 yourself because you have a $5000 deductable, that bean counter has save you thousands of dollars but has cut into the insurer's 15-20% administrative/profit share. That makes those policies less desirable or completely unsustainable for the insurer. Thus they won't or can't sell catastrophic plans even if they are still technically legal.

43 posted on 11/08/2013 11:32:33 AM PST by KarlInOhio (Everyone get online for Obamacare on 10/1. Overload the system and crash it hard!)
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To: KarlInOhio
If some bean counter tells your hospital that the procedure they billed $10000 for is really only $3000, but you pay the $3000 yourself because you have a $5000 deductable, that bean counter has save you thousands of dollars but has cut into the insurer's 15-20% administrative/profit share. That makes those policies less desirable or completely unsustainable for the insurer. Thus they won't or can't sell catastrophic plans even if they are still technically legal.

Agreed.

Look at how patently unfair this is to the end user. The prices are vastly inflated just so they can be discounted if you have "club pricing". This is illegal in virtually any non-medical area of commerce.

It's messed up in a number of ways. First, the monitoring to bring the prices back to some semblance of reality is, as you point out, costly. Second, it creates no end of non-productive screwing around and gaming by the providers. Third, it forces all sorts of administrative expenses. And, fourth, it legalizes the looting of the rare individual who has some resources but whose insurance has been cancelled through no fault of his own.

53 posted on 11/08/2013 12:24:47 PM PST by Pearls Before Swine
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