Quote:
Originally Posted by suesiegel
We just recently turned old enough to get onto medicare.
Frankly while some of you complain, private healthcare insurance cost us roughly twice what medicare costs.
Our entire system of medical payment is insane.
What other field doe the government and insurance companies tell you what you will be paid?
I've read that 80% of all medical care is paid for by either insurance or the government. I expect your $27 vs $700 was an exaggeration brought about by your frustration.
I had a sort of similar event years ago with QUEST where AETNA was my insurance company. My doctor ordered a series of blood tests we received a letter from QUEST that Aetna would not pay for one of the tests and they were billing us, if I recall it was like 250 for this test. They bothered my doctor for a letter explaining why the test was necessary and Aetna still refused to pay. A quick check on the internet and I discovered AETNA would have paid $50 for this test-that would have been payment in full. YOU WOULD NOT WANT TO TO BE THE PERSON AT QUEST TRYING TO TELL ME WHY THEY WOULD TAKE $50 AS PAYMENT IN FULL FROM AETNA BUT WOULD CHARGE ME
$250. I paid $50 noting on the check PAYMENT IN FULL along with the name of the poor lady who took my call.
THE BILL WAS PAID IN FULL AT THE RATE AETNA WOULD HAVE PAID.
We paid 12,000 for private healthcare insurance the last year before I was old enough to qualify for medicare. Of course I considered self insuring. I spent 4 days at the Villages Hospital and the bill was 50,000. AETNA settled the bill in full for 30,000. WHY AN UNINSURED PERSON WOULD PAY 50,000 BUT AN INSURANCE COMPANY PAYS 30,000 CANNOT BE JUSTIFIED. You as a consumer are forced to support an insurance company to be able to get medical care at what is market rate.
You mention in your post about a doctor writing off 500 on a 1,000 bill because the insurance company paid him 500 against his $1,000 bill. I've heard that thought before and asked my accountant about it. Actually I had a similar event in my business. You cannot write off money not paid.
Today, the private single doctor practice is gone. It was killed by the paperwork, dealing with not only the patients but with the insurance companies to get paid AND THE OUTRAGEOUS COST OF MAL PRACTICE INSURANCE.
People are all upset due to overbooking on the airlines.
Typical-you have a 3:00 doctors appointment so you get there 2:45. At 3:15 to 3:45 you are let into the backroom to wait another half hour to forty-five minutes. Your doctor is now working 2-3 patients including you AND HE HAS 15 MINUTES TO SPEND WITH YOU.
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This is a great post and nearly 100% correct. I have long been an advocate of a change in the law that would forbid any provider from charging the uninsured more than they are willing to take from a Medicare patient. There are probably some legal obstacles to this proposal.
The only other comment I have is that contrary to popular belief, the cost malpractice insurance is NOT a major factor. In 2010, malpractice premiums were $ 10 billion, out of a healthcare industry that totaled $2.7 trillion. For each individual practice, the malpractice cost as a percentage of receipts will vary by specialty. In NY, as an internist, it was about 2% of receipts, but we also got back about 20% of our premium each year as a "dividend". High risk specialties, especially Obstetrics and Neurosurgery may get into the 8-9% range, and of course there are isolated stories of much higher premiums, but those are the exceptions. The real cost of malpractice is not the premiums, but the cost of defensive medical practices to avoid litigation, which is estimated between $300 BILLION and $750 BILLION per year.