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Insured price $2,758, cash price $521

latimes.com

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Re: Insured price $2,758, cash price $521

#151

Post by vonmoltke »

moate wrote: post #80
vonmoltke wrote: post #23

Earlier quoted context omitted.

For-profit hospitals, maybe, but what about the non-profit ones?

"non-profit" doesn't mean "doesn't make money" its just rules on how you have to spend that money. There's nothing saying a non-profit can't raise prices of service and then expand the hospital to buy a new wing, or better equipment or hire more doctors. They need the money to provide their services.

I understand that, but there is a limited amount of that which can be done before it becomes spending for spending's sake, which is pointless.

Also "expand the hospital to buy a new wing, or better equipment or hire more doctors" sounds like exactly what they should be doing, because it means they can service more people at a higher standard of care (which is the reason they exist in the first place).

Re: Insured price $2,758, cash price $521

#152

Post by vonmoltke »

kazinator wrote: post #45

The cash price being lower is lucky. Sometimes uninsured cash prices are jacked up due to collusion with the insurance racket. We see a hint of that here: "Cigna gets a contractual discount of just over $1,000 because it’s, well, Cigna." In this particular case, the negotiated discounts didn't bring the price below the cash one, but in many cases it will.

I recently had a "$140" blood test that Cigna declined. I was billed $6.48 (which is what Cigna would have paid if they accepted). I'm pretty sure I would have been charged more than $6.48 without Cigna involved.

Re: Insured price $2,758, cash price $521

#153

Post by TheGRS »

crazygringo wrote: post #96

(American here.) Funny, my last several doctors visits the cash price has always been higher than the negotiated price. These are all for services in the $150-300 range, and I was told upfront what the cash price would be, but they couldn't tell me what my negotiated plan rate was. (I inquired because I have a high deductible plan so I'll pay in the end no matter what.) The negotiated prices were all at least 1/3 low…

A lot of the price has to do with doctor's vouching for certain costs as well. Other than the airline industry I can't think of a worse case of being built on a giant house of cards.

Re: Insured price $2,758, cash price $521

#154

Post by rossdavidh »

habitue wrote: post #136
drblast wrote: post #107

Insurance is not supposed to make routine things more affordable. It's supposed to spread the risk of catastrophic loss from unlikely events around to a large group of people so you don't have to worry about losing your house if you get struck by lightning. Everyone needs routine medical care at some point so an insurance model doesn't work there. You don't have gas or grocery insurance, do you? If that were a thing…

There's still a benefit in insurance for routine procedures to balance costs between the young and old. (As long as young people are required to have insurance)

...but the fact that the median income of young people (at the beginning of their career, whatever it is) is much lower than old people, pretty much nullifies this. If you want to balance out the costs over a person's life, there are much better ways than making the coffeeshop barrista subsidize the middle-manager's health costs.

Re: Insured price $2,758, cash price $521

#155

Post by johnwheeler »

slg wrote: post #147
johnwheeler wrote: post #25

I took my 4 year old to the ER because he had a 103 fever. The doctor put an ear thermometer to him and told me to give him some childrens ibuprofen. The visit lasted all of 5 minutes. The cost: $756.00. I refused to pay it. It was the first time I did not pay a debt and the first time I was sent to collections. I refused based on principle, and not because I couldn’t afford it. Collections called me for about 3 mont…

>I worked at Vanderbilt on their payroll system, and I would regularly see general practitioners making $350,000 a year, and this was 15 years ago! It wasn’t uncommon to see teaching doctors getting paid a million dollars. It isn't uncommon for software developers to make $350,000 a year or even over a million if they get equity in the right company. Maybe the Googles of the world wouldn't have to spy on their users…

You could make the same case for those on Wall Street. I think it’s a separate debate whether all that is fair. I think what’s different in medicine is

1. Medical care is not optional when you need it.

2. There aren’t readily available options to choose between.

3. You don’t know how much you’ll be paying when you need it.

4. Band-aids and tongue suppressors costing $30. stuff like that which is unquestionably egregious.

Re: Insured price $2,758, cash price $521

#156

Post by chiph »

lxe wrote: post #148

Are "cash" prices always cheaper than what's billed to insurers? What if one starts an "alt-isurance" company that just gives people cash for their medical bills that operates completely outside the medical industry network?

We already have that .. sort of. They're called Health Savings Accounts and by law they're tied to high-deductible policies. Mine is $2500, so I'm on the hook up to that amount. With some caveats, such as payments for drugs, etc. The good news is that money is yours to keep and use (only!) for health related expenses. So unlike a FSA the balance will roll over to the next year and continue earning interest.

The other trend along these lines are concierge doctors. They don't accept insurance, and typically operate on a subscription basis (X dollars per month).

Re: Insured price $2,758, cash price $521

#157

Post by Nextgrid »

Spooky23 wrote: post #140
dshep wrote: post #74

Earlier quoted context omitted.

I recently took my GF to the ER because she had been stung by a bee and was worried she was allergic. She was feeling dizzy but once we were in the ER she started feeling better. They basically took her vitals, waited 30 minutes or so, gave her a steroid, and then sent us home. They told us it probably wouldn't be very expensive as she was uninsured. Later the bills arrived: $1300 from the ER ($1900 minus a $600 unin…

Generally speaking, that’s an example of a fundamentally wasteful ER visit, and why the lack of universal coverage is so dumb. That’s why ERs cost a fortune. If you’re not bleeding, have a broken limb or other trauma or an expectation of being admitted, you don’t belong in the ER. Take a benadryl.

The ER is more like insurance. In this case she was fine and got better more or less on her own but what if she deteriorated quickly? The ER would have the appropriate skill and equipment in-house to save her, whether if she was at home it might’ve been too late to make it to the ER when things actually became critical.

Re: Insured price $2,758, cash price $521

#158

Post by maerF0x0 »

This adds to my recent thought stream that it ought to be charge 2 people a different price for the same thing (basket of things) ...

Why is it that someone who is a new customer for service X gets a sweetheart deal but those of us who have faithfully paid for months/years are charged a premium?

Why is it that 2 people in a hospital pay entirely different prices for the exact same thing?

on and on the insanity goes.

I am, of course, not talking about packages/bundles etc. Yes it makes sense that someone who buys 10 could get a better price than someone who buys 1.

Re: Insured price $2,758, cash price $521

#159

Post by JudgeWapner »

throwaway100773 wrote: post #98
avocado4 wrote: post #41

Earlier quoted context omitted.

https://www.politico.com/agenda/story/2017/10/25/doctors-sal... Providers are the core problem. Various doctor associations (AMA et al) have strangled supply side of healthcare through State licensure and scope of practice laws. Just read medical forums to get an idea of what an average doctor thinks about competition in the form of midlevels: https://www.auntminnie.com/Forum/tm.aspx?m=581583 "Don’t teach your mid le…

Well said. I get a lot of flak from, well, pretty much everyone for pointing out that your neighborhood doctor is likely a scam artist. Clearly I’m generalizing but just suggesting it may be the case is usually met with undue skepticism. Not to mention, having an inside look at med school gives you a different perspective on the motivations of most rising doctors. It’s rarely about anything but lifestyle and money. I…

> your neighborhood doctor is likely a scam artist.

I don't blame a Dr for trying to charge 7x the actual value of their time if 6/7 people don't pay them at all (the case in ERs). They're employing the same practice as insurance companies. But when a Dr does it he's a scam artist?

Re: Insured price $2,758, cash price $521

#160

Post by residentfoam »

johnwheeler wrote: post #25

I took my 4 year old to the ER because he had a 103 fever. The doctor put an ear thermometer to him and told me to give him some childrens ibuprofen. The visit lasted all of 5 minutes. The cost: $756.00. I refused to pay it. It was the first time I did not pay a debt and the first time I was sent to collections. I refused based on principle, and not because I couldn’t afford it. Collections called me for about 3 mont…

I have mixed feelings about this.

As society, we seem to be ok with millennials fresh out of college making hundreds of thousands of $$$ a year for a bunch Javascript that allows people to share pictures of their butt with their friends BUT we are not ok with doctors who literally - save lives - getting paid according to their responsibilities?

Same goes with football/basketball/etc.. players whose sole purpose in life and responsibilities are to throw a ball somewhere and for that, they are covered in gold!

I think doctors should be paid a lot of money and on the other hand, many other professionals should be paid way less compared to what they make now!

That said, this proves, yet another time, how unfair and inefficient this whole health insurance system is.

Health care should be a universal right and should be provided as a public service at a minimum cost for single contributors. People have the right to getting sick and receive the best possible care without going bankrupt or having to sell their houses for it.

It is that simple.

On this, the EU model wins hands down compared to the US one. And it's time for Americans to open their eyes and realize how unfairly they have been treated in this regard for their entire lives.

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