5 ms·

we have paid 90,000 ... and received 18,000 But have you seen how they gouge the uninsured? I was in a minor bike accident last year and I had a 5k deductible.

we have paid 90,000 ... and received 18,000 But have you seen how they gouge the uninsured? I was in a minor bike accident last year and I had a 5k deductible. Just had an ambulance ride and got checked out at the emergency room. The bill was $6000 without insurance, which was reduced to $1500 with insurance. Hospitals have such poor cost accounting.. they basically make something up if you're uninsured. It completely eliminates going without insurance. The charges would be outrageous. Edit: The 4x multiple in my bill isn't anywhere near the worst. There are hospitals that charge up to 12x (so 1500 turns into 18000): https://www.washingtonpost.com/national/health-science/why-some-hospitals-can-get-away-with-price-gouging-patients-study-finds/2015/06/08/b7f5118c-0aeb-11e5-9e39-0db921c47b93_story.html https://www.washingtonpost.com/national/health-science/why-s... Add to that, hospitals won't tell you what something will cost up front... so you get to find out when they send you the bill.

PaulHoule 10y ago
It's also an issue for meds. There are plenty of generic meds that cost less than $10 with the discount negotiated by the insurance company but cost upwards of $100 if you don't get the discount. The calculation that "you get nothing with a high deductable plan" is not entirely accurate if you take these into account.
- deleted 10y ago
  [deleted]
- maxerickson 10y ago
  There are free pharmacy benefit managers that will get you similar negotiated discounts. There are also store programs like Walmart's $4 drugs https://www.walmart.com/cp/1078664 https://www.walmart.com/cp/1078664 . (that's what lots of drug discount cards are, you get a negotiated price instead of the cash price) So having a PBM price is an included detail of insurance plans, I'm not sure how useful it is (I expect the formulary used by cheap insurance ends up similar to the free stuff).
germinalphrase 10y ago
I had a similar experience. Burned the sole of my foot. Twenty minutes talking to a nurse at the hospital - two pain pills and the assurance that it was below the threshold for a third degree burn - and I walked out with a $3000 bill. They eventually knocked it down to $2500 and gave me a no-interest payment plan.
- sosuke 10y ago
  I've had uninsured hospital visits and when I called to pay they were shocked and surprised. I think they jack up the price so they can write it down because they don't expect to get paid.
  - toomuchtodo 10y ago
    No. The price is jacked up because insurance companies negotiate down, so providers have to price anchor high in order to receive payment at a sustainable level. They can't offer you a cash rate without hell from insurance companies, so you encounter the uninsured negotiation dance.
    - sosuke 10y ago
      They should just do the transparency shift and say everyone pays X and there is zero wiggle room.
      - toomuchtodo 10y ago
        https://en.wikipedia.org/wiki/Single-payer_healthcare https://en.wikipedia.org/wiki/Single-payer_healthcare
ptero 10y ago
To me, the #1 benefit of health insurance is not the insurance (i.e., swapping the cost of the unlikely, major expenses for a regular constant payment). It is price negotiation with service providers. I would love to be able to get, from my insurer, a low cost option just for this: patient pays 100% of their standard negotiated rates. I go to the same network, they pay the doctor and bill me for the payment. Premiums just need to cover their admin cost plus some insurance that kicks in if I do not pay. Doctors should not care -- they still get the same $$ from the same source the same way. Catastrophic coverage can be arranged separately, but the above schema I think would provide much of the current insurance benefits at the much lower cost.
- TheSpiceIsLife 10y ago
  provide much of the current insurance benefits at the much lower cost. The benefits of health insurance aren't those your alluding to here. The benefits of health insurance are the flow of money from your bank account to the insurer. Your premiums are going up 74% next year, what are you going to do about it? Complain on an internet forum. Go ahead.
sedachv 10y ago
For anyone interested, David Belck has some good lectures on how medical procedures get billed and how insurance (doesn't) work in the United States: https://www.youtube.com/user/davidbelk46/videos https://www.youtube.com/user/davidbelk46/videos
- raybb 10y ago
  This guy is excellent I wish this were higher up in the thread
gozur88 10y ago
The problem is insurance companies can negotiate bulk rates, but it's actually illegal for people to get together in a group and do the same thing without the insurance part. What's also annoying is you can't determine ahead of time what something is going to cost, so even when it's not an emergency you can't shop around.

PaulHoule 10y ago

It's also an issue for meds. There are plenty of generic meds that cost less than $10 with the discount negotiated by the insurance company but cost upwards of $100 if you don't get the discount. The calculation that "you get nothing with a high deductable plan" is not entirely accurate if you take these into account.

deleted 10y ago
[deleted]
maxerickson 10y ago
There are free pharmacy benefit managers that will get you similar negotiated discounts. There are also store programs like Walmart's $4 drugs https://www.walmart.com/cp/1078664 https://www.walmart.com/cp/1078664 . (that's what lots of drug discount cards are, you get a negotiated price instead of the cash price) So having a PBM price is an included detail of insurance plans, I'm not sure how useful it is (I expect the formulary used by cheap insurance ends up similar to the free stuff).

germinalphrase 10y ago

I had a similar experience. Burned the sole of my foot. Twenty minutes talking to a nurse at the hospital - two pain pills and the assurance that it was below the threshold for a third degree burn - and I walked out with a $3000 bill. They eventually knocked it down to $2500 and gave me a no-interest payment plan.

sosuke 10y ago
I've had uninsured hospital visits and when I called to pay they were shocked and surprised. I think they jack up the price so they can write it down because they don't expect to get paid.
- toomuchtodo 10y ago
  No. The price is jacked up because insurance companies negotiate down, so providers have to price anchor high in order to receive payment at a sustainable level. They can't offer you a cash rate without hell from insurance companies, so you encounter the uninsured negotiation dance.
  - sosuke 10y ago
    They should just do the transparency shift and say everyone pays X and there is zero wiggle room.
    - toomuchtodo 10y ago
      https://en.wikipedia.org/wiki/Single-payer_healthcare https://en.wikipedia.org/wiki/Single-payer_healthcare

ptero 10y ago

To me, the #1 benefit of health insurance is not the insurance (i.e., swapping the cost of the unlikely, major expenses for a regular constant payment). It is price negotiation with service providers. I would love to be able to get, from my insurer, a low cost option just for this: patient pays 100% of their standard negotiated rates. I go to the same network, they pay the doctor and bill me for the payment. Premiums just need to cover their admin cost plus some insurance that kicks in if I do not pay. Doctors should not care -- they still get the same $$ from the same source the same way. Catastrophic coverage can be arranged separately, but the above schema I think would provide much of the current insurance benefits at the much lower cost.

TheSpiceIsLife 10y ago
provide much of the current insurance benefits at the much lower cost. The benefits of health insurance aren't those your alluding to here. The benefits of health insurance are the flow of money from your bank account to the insurer. Your premiums are going up 74% next year, what are you going to do about it? Complain on an internet forum. Go ahead.

sedachv 10y ago

For anyone interested, David Belck has some good lectures on how medical procedures get billed and how insurance (doesn't) work in the United States: https://www.youtube.com/user/davidbelk46/videos https://www.youtube.com/user/davidbelk46/videos

raybb 10y ago
This guy is excellent I wish this were higher up in the thread

gozur88 10y ago

The problem is insurance companies can negotiate bulk rates, but it's actually illegal for people to get together in a group and do the same thing without the insurance part. What's also annoying is you can't determine ahead of time what something is going to cost, so even when it's not an emergency you can't shop around.