Quote:
Originally Posted by AmeliaG
Doctors have to spend a lot of staff time on dunning insurance companies to pay, so they can afford to give a cash patient, who will just pay at the time of service, a more reasonable price. If insurance companies can negotiate awesome prices, do you really think the USA would have the highest healthcare costs in the world? If insurance is helpful for pricing, then why are government systems like Japan and free market systems like Thailand so much better priced?
Where can you insure a family for $350 a month?
Have you ever had a problem where you needed your car insurance to go to bat for you? Not that long ago, I got rear-ended while stopped at a stop light. Both the other person in the car with me and I were injured. The other guy's insurance company adjuster refused to pay any of our medical and told me I should just get my bumper repainted and they saw no need to replace any crumpled parts, no matter how nice and new the car had been. My insurance company told me that, as the accident was so obviously not my fault, there was no need for them to participate in the negotiation, although they might need to raise my rates, if I had been in an accident.
If I need a cancer operation, I do not want people like that deciding whether I get to receive life-saving surgery?
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The $350 was for a single person, since I was under the impression we were talking about the case of an individual. My point was the house does always win, but you can't judge it soley on a case by case basis. Insurance plays the odds. If just one person pays for their own health insurance their whole life and they get stricken with cancer or need major surgery requiring a hospital stay - provided the insurance co can't find a loophole - that person will have saved money by having health insurance. If a sole provider covers their spouse and children under a family plan and no one ever needs major surgery, well the house wins that one.
I also didn't mean to give the impression that the insurance company is getting clearing rack prices. We could probably play round robin all night trying to figure out why the hospital charges $60 for 2 motrin tablets, but I don't think the fracton of the billing department that wrangles with insurance providers is the root. I do know individuals have bargaining power with docs and hospitals, so maybe you or I could get that knocked down to $40 or $50, the insurance company might pay $20 or $30, but still the emergency room is making money hand over fist on something that costs them mere pennies.
I find the current state of insurance far from perfect. Actually I find it pretty deplorable. Ideally I would want a single payer / univeral healthcare, this is a compromise but one that ,as I stressed in earlier conversation, needs for tighter regulation (which will also come with the new bill). I do know what it's like to have an insurance company try to cut corners. Not sure if it was in this thread or not but there was a time, only a little less than 2 years ago, when my doctors thought I had a rare form cancer, a very agressive type. I hate to repeat the story but it illustrates the point. The insurance company initially denied me the tests I needed, so what was a week of thinking I may be dying turned into two weeks, and so on. All the while fighting to get the tests I needed. My doctor didn't go to bat for me- they worked with me, but in the end I had to do the dirty work to finally get it pushed through.
Personally, in my case, if I hadn't had health insurance I would be pretty screwed right now. I'd probably not have any capital at all. I'm not sure what the costs are like in Japan, but I don't think I'm willing to go to thailand to have major surgery done, no offense to the expats living there.
Maybe car insurance was a bad example, home owners insurance is probably a better comparable since you're alot more likely to get in a wreck than you are to get a serious illness or have your house decimated. Also car accidents rarely have the same financial impact as a serious illness or a flood can have.
Just a question, but do you have homeowners insurance? Most people I know have homeowner's insurance, in fact more people I know pay for home owner's insurance than health coverage. To me its the same principal. Most people won't have their house knocked down and most people won't need major surgery, but if you do and you're uninsured you're fucked.
Sorry if this is tl , I understand if you dr