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First off, if something this large can drop by 75% in price then you're being bamboozled, extorted, or potentially both. "Under our current system, it’s nearly

First off, if something this large can drop by 75% in price then you're being bamboozled, extorted, or potentially both. "Under our current system, it’s nearly impossible for people with health insurance to find out in advance what anything covered by their insurance will end up costing." It's worse than that. Not only can you find or figure out how much everything will cost, most places (particularly hospitals and outpatient centers) will not even tell you how much they charge for their services. Some news outlet did a study and called the top 25 hospitals in the country and asked them how much a hip replacement would cost. Only around 3-5 actually gave a number and it varied wildly. The rest refused to pin down any number at all. That's one of the most common surgeries there are and they don't know what they will charge for it? On the moral/philosophical side - how can a person be held financially liable for something they cannot possibly know the cost of in advance, even if they try to find out? Such practices are illegal everywhere else in this nation. And there is no legal exception for healthcare providers. How do I know that? Because a few years ago Rand Paul tried to pass a law that would exempt healthcare providers. It failed - which means it is still currently illegal to be doing this. Yet not one of these providers or operations has been charged accordingly. If you went to a mechanic and they took a look at your car and you asked how much it was going to cost to fix it and they responded with "which insurance do you have?" or "I don't know until I'm done" they would get shut down and charged, and rightfully so. Because the logical conclusion is to say it costs some extravagant amount of money and then "settle" for something less. Which gee, doesn't that happen a lot in the medical industry when people can't pay their bills? People face bankruptcy and can't afford a $10,000 bill but somehow the hospital is just fine accepting $3,000 instead?

mschuster91 7y ago
> Not only can you find or figure out how much everything will cost, most places (particularly hospitals and outpatient centers) will not even tell you how much they charge for their services. Some news outlet did a study and called the top 25 hospitals in the country and asked them how much a hip replacement would cost. Only around 3-5 actually gave a number and it varied wildly. The rest refused to pin down any number at all. That's one of the most common surgeries there are and they don't know what they will charge for it? Because in the US model the insurances negotiate with the hospitals what they pay, and you will almost always be given a number that is way higher than the highest insurance amount - as when you pay yourself the hospital has a high risk of never being able to (even partially) collect the bill. Also, it must be higher than the highest insurance amount so that if you were an undercover agent of your insurance you would still believe you pay less than others.
- turc1656 7y ago
  That's not how any other insurance works. Providers charge the same amount regardless of coverage, insurance, etc. and whatever your insurance covers (including nothing at all) you are responsible for. But they also tell you up front what they are going to charge you and you acknowledge that you accept responsibility for making sure they get paid that amount either out of your own pocket or by covering the gap of what insurance pays. The idea that having insurance changes the cost is sort of a misdirection. There's a chance my plan doesn't cover some or all of things that will be billed. So there is always a risk of non-payment or partial payment. Yes, they sometimes do pre-approvals for specific procedures but that doesn't always translate to proper billing/coding that gets covered. The vast majority of healthcare are not ER visits which means people have a chance to review and accept the responsibility of payment. But that would also mean they would know what the hell they would be charged. There's no good reason for a hospital to say "oh you don't have insurance so we're going to basically mark your bill up 3x just to be safe. Marking the bill up 3x, for example, doesn't change the fact that they are really only seeking 1x so the people who can afford to pay 3x are legally required to do so because for some reason this is viewed as a legit practice and not fraud. And the people that can't settle for something less than 3x, usually much less. Maybe 1x...in which case the providers gets what they were after anyway and just indicates further that this is a sort of fraud and extortion.
  - creaghpatr 7y ago
    >That's not how any other insurance works. Providers charge the same amount regardless of coverage, insurance, etc. and whatever your insurance covers (including nothing at all) you are responsible for. This is incorrect. It's absolutely the other way around.
    - turc1656 7y ago
      You're talking about something outside of healthcare charging different prices to people based on which insurance they have and said practice is legal? I've never heard of such a thing. You're not referring to the common practice of bill inflation are you? For example, a tree falls onto your house and the damage is covered by insurance but the contractor knows insurance is paying for it so he jacks up the price once he finds out what you are getting from the insurance company (they tend to ask so that they can "plan" accordingly to stay within budget, but really they just want to make sure to capture the entire insurance check). This is 100% illegal but very hard to prove, hence it goes largely unenforced. With healthcare it's well-documented but still unenforced. If you are referring to something else I would be very interested to know what else operates in such a manner.

mschuster91 7y ago

> Not only can you find or figure out how much everything will cost, most places (particularly hospitals and outpatient centers) will not even tell you how much they charge for their services. Some news outlet did a study and called the top 25 hospitals in the country and asked them how much a hip replacement would cost. Only around 3-5 actually gave a number and it varied wildly. The rest refused to pin down any number at all. That's one of the most common surgeries there are and they don't know what they will charge for it? Because in the US model the insurances negotiate with the hospitals what they pay, and you will almost always be given a number that is way higher than the highest insurance amount - as when you pay yourself the hospital has a high risk of never being able to (even partially) collect the bill. Also, it must be higher than the highest insurance amount so that if you were an undercover agent of your insurance you would still believe you pay less than others.

turc1656 7y ago
That's not how any other insurance works. Providers charge the same amount regardless of coverage, insurance, etc. and whatever your insurance covers (including nothing at all) you are responsible for. But they also tell you up front what they are going to charge you and you acknowledge that you accept responsibility for making sure they get paid that amount either out of your own pocket or by covering the gap of what insurance pays. The idea that having insurance changes the cost is sort of a misdirection. There's a chance my plan doesn't cover some or all of things that will be billed. So there is always a risk of non-payment or partial payment. Yes, they sometimes do pre-approvals for specific procedures but that doesn't always translate to proper billing/coding that gets covered. The vast majority of healthcare are not ER visits which means people have a chance to review and accept the responsibility of payment. But that would also mean they would know what the hell they would be charged. There's no good reason for a hospital to say "oh you don't have insurance so we're going to basically mark your bill up 3x just to be safe. Marking the bill up 3x, for example, doesn't change the fact that they are really only seeking 1x so the people who can afford to pay 3x are legally required to do so because for some reason this is viewed as a legit practice and not fraud. And the people that can't settle for something less than 3x, usually much less. Maybe 1x...in which case the providers gets what they were after anyway and just indicates further that this is a sort of fraud and extortion.
- creaghpatr 7y ago
  >That's not how any other insurance works. Providers charge the same amount regardless of coverage, insurance, etc. and whatever your insurance covers (including nothing at all) you are responsible for. This is incorrect. It's absolutely the other way around.
  - turc1656 7y ago
    You're talking about something outside of healthcare charging different prices to people based on which insurance they have and said practice is legal? I've never heard of such a thing. You're not referring to the common practice of bill inflation are you? For example, a tree falls onto your house and the damage is covered by insurance but the contractor knows insurance is paying for it so he jacks up the price once he finds out what you are getting from the insurance company (they tend to ask so that they can "plan" accordingly to stay within budget, but really they just want to make sure to capture the entire insurance check). This is 100% illegal but very hard to prove, hence it goes largely unenforced. With healthcare it's well-documented but still unenforced. If you are referring to something else I would be very interested to know what else operates in such a manner.