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View Diary: I feel sorry for health insurance companies. Yes, I said that. Why? This Time report must be read. (228 comments)

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  •  The insurance discount (15+ / 0-)

    Five years ago, I had a cardiac procedure that required an overnight hospital stay, and operating room, a specialist cardiologist (not a garden variety cardiologist), an anesthesiologist and a lot of other sundries.

    After I got home, I got the bill, which was in the neighborhood of $21,000. (Almost sounds like a bargain.) I am fortunate enough to have insurance through my employer, so I actually only paid my deductible, $250.

    But the bill also showed me what the insurance company paid, which was in the neighborhood of $7,000.

    That's right, the insurance company got a 67% discount on my hospital bill.

    The hospital negotiates rock-bottom prices with the insurer to get their business. Then, they make up the difference to make a profit by grossly overcharging individuals. This is devastating for people who are self-employed or work at no-insurance benefit jobs.

    It's absolutely unfair. The less able you are to pay, the more it's going to cost you. (Unless you're destitute, in which case you may have Medicaid.)

    Obamacare does very little to alleviate this injustice. Obamacare works through the private insurance system which is what causes the problem.

    Single payer would solve the problem. But it isn't the only solution. The Japanese system (no insurance, government regulated prices -- the same for everyone and affordable enough for anyone) would solve the problem.

    Getting sick will continue to mean total financial ruin as long as we let insurers and hospitals fix the game.

    Wealth doesn't trickle down -- it rises up.

    by elsaf on Thu Feb 21, 2013 at 09:26:03 AM PST

    •  exactly. What a racket. (2+ / 0-)
      Recommended by:
      elsaf, ladybug53

      If the plutocrats begin the program, we will end it. -- Eugene Debs.

      by livjack on Thu Feb 21, 2013 at 10:16:15 AM PST

      [ Parent ]

    •  Actually, that's the insurance inflation. (12+ / 0-)

      If you'd told them you had to pay out of pocket, you too would likely have gotten a discount, possibly even a larger one.  They grossly overbill insurance companies because they KNOW insurance companies will deny giant chunks of that cost.

      Last March, I spent 3 days in the hospital for a potential heart attack, having every test under the sun done to me.  Happily, it was not, but still there were over 30k in bills racked up in a year in which I had $330 in income.  Insurance paid around 14k I think, denied most of the rest, leaving me to pay a couple of thou in various doctor bills, and $2800 owed to the hospital.  The hospital, learning how much I'd had in income, wrote off every penny of the remaining bill.

      (I'm ineligible for Medicaid, btw.  In Ohio, if you're an adult without children, you can't get medicaid, no matter how small your income.  Thanks, Republican-controlled state congress!)

      •  Actually, it's all about write offs and selling (1+ / 0-)
        Recommended by:

        debt to third parties for collections.

        It's assumed that the uninsured will not pay bills over a thousand dollars.  Ever.

        income gains to the top 1% from 2009 to 2011 were 121% of all income increases. How did that happen? Incomes to the bottom 99% fell by 0.4%

        by JesseCW on Thu Feb 21, 2013 at 03:03:49 PM PST

        [ Parent ]

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