Chambers wrote:
> Jim Charter wrote:
>> But can you really blame the Health Insurance Industry for everything?
> 
> Absolutely not.  If so, then regulation would be an answer.  However,
> part of the problem is systemic, which is why reform is needed.
> 
> One of the problems is billing, for instance.  Insurance companies are
> experts at negotiating discount rates for their large volume in order to
> drive their costs down.

The other dirty trick is by not paying any doctor who charges less than
their rate to anyone not covered. In certain areas where there is only
one insurance company, either because there is only one major employer
or from state regulation, this can lock people out of receiving care.
And most doctors could not get by by only seeing patients without that
insurance.

>   The government funds (Medicare and Medicaid)
> look at bills and say, "We'll pay X% of these." Care providers are
> experts at padding bills in order to drive their costs up.
> 

Ask the care providers if they know what it costs. Sure, they know what
the machine cost to a few significant digits. And they often know what
the costs to operate it are, or the costs of the medicines they
prescribe. But the overhead that the hospital gets, to pay for the
stacks of paperwork or for profit, are often completely unknown. If you
find out what it costs, try to even find details on what the big
companies pay.

Finding the actual X% that the government pays is not too tough. They
factor in regional costs compared to national, and pay extra for clinics
serving the low-income bracket. The details are at
http://www.cms.hhs.gov/PFSlookup/ along with a way to lookup the amount
they pay for certain specific procedures.

> The end result is that, between private insurance & government funds,
> the healthcare industry gets the funds they need to operate, but it's
> only a percentage of their claimed prices.  This doesn't hurt the
> healthcare industry (they still get the money they need), the government
> (they pay what they can and then say "enough") or the insurance
> companies (they negotiate their discounts, remember?).
> 
> It hurts people without insurance, because they're left paying the
> inflated sticker price which they can't afford.
> 
> ...Chambers

I heard or read somewhere, that the best advice for someone without
insurance was to ask the management at a doctors office what they would
charge if you paid in cash, up front. Most doctors don't even know what
the office charges, but management knows what it costs to go through
stacks of paperwork.

Did that for an eye exam last year, after they quoted me the price they
would gladly bill my insurance, paid something like $50 for the whole
work up.

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