Insured, but Still Owing $109K for a Heart Attack

If you have a hospital with a certain list price for a particular procedure, why is it legal for them to charge one insurance company 5% of that price and charge another insurance company or someone without insurance full price? It seems like exactly the kind of scenario that price discrimination laws are meant to prevent.

Similarly for the insurance plans themselves, why can you sell basically the same plan to employees of a large company for much cheaper than you sell it to employees of a small company? (This one might need to be a new law specific to insurance companies, because clearly there are many other products that give group discounts when selling to large companies, but I think health insurance should be treated differently).

I'm sure I'm missing what some of the downsides might be, but it seems like making these kinds of backroom network-based deals illegal in health insurance would go a long way in making prices more understandable/predictable, and that might allow for more fair competition on price to emerge.

Not ostensibly, but actually.

The article goes on to identify some concrete charges that independent auditors felt were ridiculous, including charging $19k for stents that the hospital most likely purchased for about $2K.

> It's just a contractual reason he owes this money?

The hospital just straight up dropped all but $800 of the charges when they got PR heat.

She told them "I'm on Social Security for $1000/mo, I'll pay you $50/mo". It was basically that or sending it to collections and never getting a dime from a retiree. So they accepted and told her a "non-profit" paid for the doctor's portion of the bill, which was all but about $40k.

She'll probably be around another 10 years max, which means she'll end up paying about $10k of that balance.

Medical debt is the least concerning type of debt for most lenders. If you ever fall into this hole, don't sweat it. [Unsolicited advice.] Just let it go to collections. You'll get harassed for a little over a year. Debt older than a year is almost never pursued by collections agencies. After things quiet down start sending letters to the credits agencies saying the collections debt has been settled. The collections agency will usually slip up and not respond at some point and it'll be gone from your credit history.

Patients shop on reputation. In a country with less regulation, like India, you see competing hospitals across the spectrum of price and performance. Everyone knows which ones are good and which ones are expensive. People know which hospitals they're going to attend before they fall sick. The outcomes in their top cardiology departments are way better than those in top American cardiology departments.

Their doctors perform way more surgeries and are therefore far more practiced and experienced. They are far cheaper because there are so many more of them.