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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"You state what other fields does the government and insurance companies tell you what you will be paid. "
My first response is that generally speaking every business transaction requires a "willing buyer and a willing seller" both having an understanding of market coming to an agreement on price. However that is too broad a discussion and will carry us away from your valid question.
Government and insurance are the sole payers of healthcare costs. they have a fiduciary obligation to be prudent spenders of taxpayer/policyholders taxes and premiums. History is replete with examples of "build it" and unethical opportunist will surely come. This is not to slight anyone but human nature is such that if no one is looking and I can get more, well then...........
I do not like the idea that government or insurance get so involved but I do understand the why of it.
Personal Best Regards: