21–30 of 202 posts
Earlier quoted context omitted.
Hold on, you paid for a GP in the UK? That's not how the system works....
This was Ireland.
Edit: for extra fun, ask them what country Amsterdam is in.
One thing I've never understood about the US system is why do the doctors charge more for paying cash e.g. $200 for a visit, whereas insurance reimburses them less than half e.g. $80. In everything else e.g. car repairs, the cash price is always lower than insurance covered price. Any ideas why this is so?
Insurers negotiate a volume discount.
Earlier quoted context omitted.
Exactly. Imagine how much of a hassle car repairs would be if your car insurance company handled an oil change or a tire balance/rotation.
Imagine how much a hassle car repairs would be if cars were a staggeringly complex biological system where parts could not be replaced figuring out what was wrong was difficult and all work had to be done in while it was driving down the road and it was really easy for you to die if a mistake was made and other people had to pay for it.
Earlier quoted context omitted.
This was Ireland.
You might be surprised at how many Americans think Ireland is part of the UK. Source: I live in a hostel. Edit: for extra fun, ask them what country Amsterdam is in.
Earlier quoted context omitted.
Exactly. Imagine how much of a hassle car repairs would be if your car insurance company handled an oil change or a tire balance/rotation.
Imagine how much a hassle car repairs would be if cars were a staggeringly complex biological system where parts could not be replaced figuring out what was wrong was difficult and all work had to be done in while it was driving down the road and it was really easy for you to die if a mistake was made and other people had to pay for it.
https://twitter.com/paultoo/status/566379518261088258
The tweet: "I want to fund the 'Uber' of medical tourism Needs 5 star service, simplicity and safety Let me know if you apply - http://www.ycombinator.com/apply/"
It really has to happen. Health care in the US is just fucked, and everyone knows it.
One thing I've never understood about the US system is why do the doctors charge more for paying cash e.g. $200 for a visit, whereas insurance reimburses them less than half e.g. $80. In everything else e.g. car repairs, the cash price is always lower than insurance covered price. Any ideas why this is so?
However most, if not all, doctors will absolutely charge you less if you pay cash, you just have to ask for it and have the conversation.
One thing I've never understood about the US system is why do the doctors charge more for paying cash e.g. $200 for a visit, whereas insurance reimburses them less than half e.g. $80. In everything else e.g. car repairs, the cash price is always lower than insurance covered price. Any ideas why this is so?
For starters, insurance smooths risk. It is not there to save you money. By definition, insurance will always cost more than than paying out-of-pocket in the long run[0]. Think of insurance as a luxury that mitigates (but does not eliminate!) the worst-case scenario for you. It costs more (a premium[1]) because this luxury has value to you.
The fact that this does not always apply to health insurance is a sign that health insurance isn't entirely (in the economic sense) insurance; we just happen to use that word.
> One thing I've never understood about the US system is why do the doctors charge more for paying cash e.g. $200 for a visit, whereas insurance reimburses them less than half e.g. $80.
In general, Medicare and Medicaid reimburse the least - the amount that they reimburse is actually less than COGS (not on all individual services, but in the aggregate, it amounts to 7% less)[2]. As a result, providers have to overcharge private insurers and uninsured patients in order to cover their own costs.
The price that you see on your bill is basically a starting point for negotiations. A company like Aetna will say "okay, there's no way we're paying that, but we will pay you 250% of what Medicare reimburses for the same procedure".
As an uninsured patient, you can do this as well if you know to ask. It's less of a practice for outpatient care, since that tends to cost less and also have more predictable costs associated with it, but for (e.g.) unexpectedly large bills for inpatient care, you can always just tell them "I will pay $X today in cash if you reduce the bill to that amount." They'll always be willing to do it, because they literally do not care about the money that they get from uninsured patients - the large bill is intended to be received by an insurance company, not by an individual.
[0] ie, on an infinite time horizon.
[1] The fact that your fixed monthly payment to an insurer is also called a premium is not a coincidence.
[2] To preempt the inevitable question: COGS refers to the direct costs of providing a service, so this is before even accounting for the fact that an outpatient office has to pay rent, pay its staff, etc.
I am originally from India and came to the US 10 years ago. I still can't believe that you can not call up a doctor/clinic/hospital in US and get a price quote for something routine. Chris's experience is representative of what one can expect from the Indian health care system. If you are a working, middle class person, the free market health care works extremely well.
Part of the problem is you can thank the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low so their salaries remain ridiculously high. Here's another example: https://www.washingtonpost.com/business/economy/new-machine-... "Anesthesiologists tried to stop Sedasys. They lobbied against it for years, arguing no machine could possibly replicate their skills or handle…