The price of healthcare

Jolie, BSN · Jun 22, 2007

I am not making any statements about "sicko" or universal healthcare, but I do believe that there should be one price.

I agree wholeheartedly! It is illegal in most industries to charge different customers different prices for the same service. The only other example that comes to my mind is the travel industry, but there I understand the different pricing, to an extent. Reservations made way in advance usually cost less, as they allow the airline or hotel to make plans for staffing, supplies, etc. Reservations made at the last minute are sometimes discounted as well, as they fill otherwise unused and costly seats or rooms.

But with healthcare, I don't see the rationale for charging differently-insured patients such widely ranging amounts. In November of last year, I began to see a counselor who accepted my insurance. I was billed approximately $150/visit, which my insurance negotiated down to $146. Big discount! In January, my insurance changed to a new plan (same employer, new insurance plan for the calendar year). Those same $150 counseling sessions are now reduced down to $89. Instead of being grateful for my "better" insurance coverage, I am mad as he** that I was charged so much more last year for the exact same service!

Tweety, BSN, RN · Jun 22, 2007

Sometimes it's really a marketing ploy done by the insurance companies, doctors and facilities: the patients in your HMO's/insurance plans to this hosppital/cath lab etc. and we'll give you a discount.

It's takes some choice out of the insured's hands. I have to go to certain doctors and the hospital I work at in order to receive the discounts. For instance if I went to the same place you did and it wasn't on my plan, I'd pay the same price the uninsured patients would pay.

It puts a lot of power in the very large companies. For instance they can say to facility "we won't reimburse our members for going to your facility, unless you give us a deep discount". If this provider, such as United Health Care, has thousands of members, the organizations are going to give them a deeper discount, than the smaller company. Thus the same service is charged two different prices depending on the negotiated price.

It's a racket.

P_RN, ADN, RN · Jun 22, 2007

Amazingly my daughter's insurance paid 6000, of her 19000 hospital bill and that left her a 400 co-pay.

5 years ago she had no insurance and had emergency surgery (GB) for $17000. What was her bill? $17000.

She had her wages garnished and we helped pay it off. The difference-insured vs no insured. This isn't fair is it?

Nightcrawler, BSN, RN · Jun 22, 2007

Tweety: they are already steering you to certain providers. If I had gone to an "out of network" provider, they would only have paid 35% of the bill, instead of 90% regardless of any "provider discounts" So while they may have paid more, believe me I would have paid it

Nightcrawler, BSN, RN · Jun 22, 2007

I had a patient go for a EP study yesterday, but without the ablation. This is a man who has had a CABG with an extended bounce-back admission for CHF, who has been out of work for a month, is uninsured, with no sick leave. I cannot even fathom his bill. It has got to be hundreds of thousands of dollars. This man is a truck driver. And we wonder why people file bankruptcy?

Remember, in my case I spent a total of 11 hours in the hospital, did not even stay the night. And I may end up going back in the future as the procedure was not completely successful.

bigsyis · Jun 22, 2007

In my area, and particularly in our practice, there is a discount, right off the top, for people who are self-pay. Contrary to popular belief, people without insurance often receive price breaks like that. However, because the cost is SO high for everyone, even one illness could suck a person without insurance financially dry for a long, long time.

I used to think that Socialized Medicine was the answer, but I've been reading the BBC on line for the past several years, and from what I've learned there, it is NOT the answer. I don't know if there really IS an answer, to be honest.

classicdame, MSN, EdD · Jun 22, 2007

I don't know if I want price fixing by the govt or anyone else. I still believe in capitalism and the right to set your own prices for your business. I do believe that people SHOULD have insurance. If prices were fixed then so would be our salaries.

Megsd, BSN, RN · Jun 22, 2007

In my area, and particularly in our practice, there is a discount, right off the top, for people who are self-pay. Contrary to popular belief, people without insurance often receive price breaks like that.

I've been fortunate enough to have medical insurance continuously, but I haven't had vision insurance for a while, and regularly get a discount on visits because my doctor's office is glad they don't have to hassle with a third party to get paid.

That said, the cost of healthcare is incredibly high. Thanks for sharing those numbers... it gives you more of an appreciation for the hardship and stress an illness or other medical problem can put on patients and families.

Nightcrawler, BSN, RN · Jun 23, 2007

I haven't had vision insurance for a while, and regularly get a discount on visits because my doctor's office is glad they don't have to hassle with a third party to get paid.
I too have received cash-pay discounts in the past, but only if I was paying at the time of service, and how many people stop to empty their 401k before heading to the ED with their crushing chest pain
That said, the cost of healthcare is incredibly high. Thanks for sharing those numbers... it gives you more of an appreciation for the hardship and stress an illness or other medical problem can put on patients and families.

I went uninsured for years, and if my SVT had kicked in then I don't know what I would have done. I would not have even been able to afford the meds, that didn't work, that I was on before the procedure.

I knew going in that this was going to be an expensive procedure, I figured probably around $12,000. I figures insurance covered 90%, and I would owe around $1200. I was shocked to find out that the total bill was twice that. I was doubly shocked to see such a discrepancy between the "original" charges, and what was charged my insurance.

Fuzzy · Jun 23, 2007

To make healthcare fair, the lawyers, the insurance companies, the pharmaceutical companies and the government need to be less involved. In another words human healthcare needs to be more like veterinary medicine which when compared to human healthcare is certainly more affordable and available. IMHO.

Fuzzy

fergus51 · Jun 23, 2007

In my area, and particularly in our practice, there is a discount, right off the top, for people who are self-pay. Contrary to popular belief, people without insurance often receive price breaks like that. However, because the cost is SO high for everyone, even one illness could suck a person without insurance financially dry for a long, long time.
.

I do the self pay thing for regular office visits. It's a 40% discount. It's beneficial for them because they get paid immediately and don't have to waste time and money filing insurance claims.

I had my gallbladder out over a year ago and the total bill was over 20K. That's for an outpatient procedure that probably took less than an hour. I of course used my insurance for that:)