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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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  •  somewhat recent hospital stay (9+ / 0-)

    I have health insurance and the Explanation of Benefits (EOB) forms I got from my insurer after a hospitalization last year were a real eye opener. Each statement shows: the hospital’s “retail” price, the negotiated price agreed to between the hospital and my insurer, and how much not covered by insurance that I owe out of pocket.

    At the bottom line, the negotiated price between the hospital and insurer was about 70% less than “retail.” In other words, whereas my insurance company was billed $5,000 an uninsured individual would be billed $16,700 for the exact same scope of services. The hospital makes a profit on that $5,000. You can assume that because if they didn’t make money on privately insured patients they would be out of business.

    So, the 335% markup for uninsured patients is explained….how? Is this a fantasy number cooked up to make it appear the hospital is spending astronomical amounts on charity care? Is it to gin up large dollar amounts for purposes of tax deductions for business losses? I’m asking because I honestly don’t understand where these numbers come from. Meanwhile, they are definitely not a fantasy for real uninsured people who have these bills handed to them. The financial liability is real and people are pushed into personal bankruptcy for it.

    Let this be a lesson to anyone who is uninsured and is presented with a huge hospital bill they can’t pay. Ask for at least 60% off, and don’t feel the least bit shy about it. The hospital’s expenses will be covered and they will still make a profit from you.

    Outside of a dog, a book is man's best friend. Inside of a dog, it's too dark to read. - Groucho Marx

    by Joe Bob on Thu Feb 21, 2013 at 09:34:03 AM PST

    •  It's called a "good negotiation starting point". (11+ / 0-)

      Everybody in the game knows the score, except of course the patients.

      Moderation in most things.

      by billmosby on Thu Feb 21, 2013 at 09:42:51 AM PST

      [ Parent ]

    •  When a patient can't pay their bill, (6+ / 0-)

      after a certain amount of time it sells the bill to a collection agency, who pays for it for pennies on the dollar.   Hospital writes off the unpaid amount as a loss.
         The collection company reports to the credit bureaus the unpaid balance in full, and then continues to call and harass the patient until they get paid in full, while the patient suffers all the problems of ruined credit. They, in turn, sell uncollectable bills to other collectors at further discount.  Collection attempts at full price continue.
         Too bad that the hospital won't write down the value of that for the patient to pay off, clearing the books.  
         One the things the Occupay people have been doing is collecting donated money and buying debt from hospitals and then clearing it so that the sick people aren't ruined.  

      •  Just last week, I got a "personalized" robocall (0+ / 0-)

        from a collection agency. Second time in two years with the same thing, they wanted $3500. I could not figure out what this was for, redialing the phone # got the do-do-do This call cannot be completed as dialed...

        Well I got through, with the help of my phone company, and it involved a bill for $35 copay
        from 2.5 years ago when my husband died.

        Collection agent said they would eat the $35. What if I had paid them $3500? Someone inputting numbers got a little wild with zeros? And how in the hell did they get my name and phone # since it's not in the phone book?

        Americans, while occasionally willing to be serfs, have always been obstinate about being peasantry. F. Scott Fitzgerald, the Great Gatsby

        by riverlover on Fri Feb 22, 2013 at 02:07:27 AM PST

        [ Parent ]

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