<p>Exactly, alwaysamom. Our insurance system doesn’t work for anyone. Not the insured, not the uninsured, not providers, not employers. The only beneficiaries of our system are the big insurance companies and the pols who support them. But notice that Big Insurance really hasn’t fought Obamacare (after the public option was taken off the table, of course), and why should they? They’re going to be gaining tens of millions of new customers. Which means that the continuing opposition is coming from only one corner.</p>
<p>It seems like the patients are getting squeezed on one end with less and less services, the providers on the other end with fee reductions and administrative hoops that cost them a fortune in staff to comply with. The ever growing middle is going to the insurance companies who are not providing anything but administrative nightmares. </p>
<p>Insurance company executives are getting huge salaries and company profits are huge. Large parts of your healthcare dollars are going to insurers yet they are not providing care, which is what you should be paying for. Something has to give.</p>
<p>I feel that the billing process is a mess. You really do not know which bill you should pay even though it has due date. Acrually, my insurance company told us I should consult with them when anybody asked me to pay a bill.</p>
<p>Two events, I received a bill from a billing company for my sergeon which claimed I did not have the insurance and asked me to pay in full in 3 weeks. I called the billing department of my insurance company; a lady there called this billing company. In 5 minutes, the billing company admits that their billing computer system was not able to generate a bill with somebody like me with insurance automatically (what?!) - it were as if they had known I have the insurance but their system could not hane this – it is beyond me belief. My insurance then told then to so it manually with my insurance first. 6 weeks have been passed. Nothing happens yet.</p>
<p>Another is a huge hospital bill sent to me from the hospital. The total price and the portion the patient is responsible are listed. I called my insurance company again. It also told me to
To ignore that bill. The insurance company said since I have paid an amount exceeding the calendar year maximum and the deductible, I s
Do not need to pay more .</p>
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<p>hops_scout, that was my point. The entire system in the U.S. is a mess.</p>
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If they won’t pay it, you may not get the insurance discount and instead have to pay the inflated retail+ price that the lab charges the insurance company before the discount.</p>
<p>IOW, it is possible you will wind up paying much more than if you bought the test yourself. I have had this happen to me. Unfortunately, you won’t know until after the fact.</p>
<p>I also had a lab call me up to tell me that a particular test would cost $500 that I would have to pay out-of-pocket because I had a high deductible, but if I paid them directly without using insurance they would only charge me $80. I couldn’t figure out why they would do this, since they seemingly took money out of their own pocket. 
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<p>I learned the hard way never to pay a medical bill until the insurance company is clearly done with their part of the process. I had a bill from a local hospital for a ct scan. I paid it not knowing that my insurance would also cover it. When I received a statement from the insurance co showing they had also paid the hospital, I called the hospital to request they return my payment. The informed me that they were not required to do so, and kept BOTH payments. Greed apparently has no conscience.</p>
<p>Is the way that hospitals set the price in a secret, almost magic way also a problem?</p>
<p>It is like going to the store, the people help you decide what to buy,
but do not tell you the prices of these items. Sometime later, the store decides the price according to each some top secret book.</p>
<p>Will you go to a car dealer to buy your in this way?</p>
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<p>The provider side (including the physicians, hospitals, drug companies, medical device companies) also benefits from the lack of price transparency, since the lack of price transparency makes it more difficult for users to shop around for the best value. Even if one wants to be altruistic and not cost the healthcare system any more than the minimum for your need, it is difficult to do that.</p>
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<p>Could you sue the hospital? Something like this should get class-action status.</p>
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<p>I agree, transparency is needed with all of them. Did you see the 20/20 special the other night about the child who needed a tonsillectomy? The difference in pricing is staggering, and how would one know?</p>
<p>I think it used to be that medical professionals had a halo around them, and they were professionals that were not questioned and their costs were not discussed because it was “just not done.” Those days have to end and the consumer has to be given information to make informed decisions like they do with all of their other purchases. </p>
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<p>sylvan, the hospital is required to reimburse you. If you don’t get any satisfaction, try your state department of insurance.</p>
<p>^This was years ago, VeryHappy, back when I was in college. Maybe they assumed I would not press the point for the sake of $100.</p>
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<p>To a point. But buying healthcare isn’t like buying a car, and the big-dollar healthcare purchases are especially unsuited to smart shopping. If you’re having a heart attack, obviously you’re not going to have time to do price shopping. Or would you make your cancer-treatment decision based on who’s cheapest? Probably not.</p>
<p>Informed consumerism is a good thing, but in healthcare, there also needs to be some control from the supply end. We on the demand end are simply too vulnerable.</p>
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I think cancer treatment is rarely if ever an emergency treatment, unlike heart attack treatment.</p>
<p>So why wouldn’t I potentially shop that around, if I have to personally pay a large portion, or even all, of it?</p>
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<p>Well of course, especially with emergent care you can’t stop to negotiate. Perhaps those charges should be tied to medicare with a max above medicare negotiated rate placed on the hospitals. But, there are many cases, routine exams, elective surgery etc. where you can decide as with everything else how much you are willing to pay and in exchange for what level of service. And the opposite is true too. If you want concierge level service and are willing to pay for it, you should have the right to do that too. You just should have the information available to make an informed decision. </p>
<p>And for the most part, we were comparing comparable services at very different prices. And in those situations, knowing what the cost is will be helpful.</p>
<p>No, cancer treatment usually isn’t an emergency. It’s only life-or-death. If we shop around for chemo based on price, eventually those who don’t have insurance, or those who can’t afford the higher price, will be driven to the cheapest providers/treatments, which in a price-based market, will inevitably mean inferior care. And what about those who can’t afford even the cheapest treatment? </p>
<p>Price-shopping puts us right back at square one – health services rationed based on ability to pay, with the poorest receiving substandard care. That’s how a free market works, right? The rich drive Mercedes, the poor drive beaters. Maybe you’re OK with that model applying to healthcare as well, but I am not.</p>
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<p>Sure. Why wouldn’t you make a decision based on an informed cost/benefit analysis? It’s insane to purchase a procedure just because a procedure to try exists if the procedure is unlikely to improve your outcome…</p>
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<p>I think that’s unlikely in this case since it will be a package of annual physical tests ordered from one lab by my doctor and submitted to one insurance company who will pay some or all of it and log any unreimbursed amount towards my deductible.</p>
<p>The test is only $166 retail, so it’s not like I’ve got huge exposure! :)</p>
<p>I’m not even sure who will bill me. It’s the first time with this doc. With my old doc, their medical practice used an in-house lab, so the billing all came from one place. Not sure how this will be handled.</p>
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In an open market, the price would be driven down for <em>all</em> providers, or else they couldn’t compete.</p>
<p>To use a non-medical comparison, there’s a reason why gas stations on opposite corners of an intersection are priced within 1% of each other.</p>
<p>Competition would insure the quality remains high, otherwise no one would go there regardless of how cheap it was.</p>
<p>LasMa you have some good points regarding health care, but I still don’t see how it justifies people not seeing or knowing how much they are being charged. </p>
<p>I can’t help but think if both sides were held accountable there would be some pressure to reign in fees to be more competitive, not raise them so much that you are priced out of the market. </p>
<p>I don’t think the car example is that accurate because many people don’t put a lot of importance on the car they drive, but most do care about the quality of their healthcare. I think the pressure will still be to get and keep the patients because it will be a numbers game. If you are charging 2000 for a procedure that the also competent doctor down the road is charging 700 for, I think even the Mercedes driver will end up and the 700 doctor in many cases.</p>
<p>And just to be clear, I also don’t think that the actual Doctor’s office charges are really the biggest problem. I think the hospital fees and drug prices are the ones that are out of control, and not easily determined beforehand. I think the Doctor’s themselves are getting squeezed in this entire process too. In my original post I was referring to providers (as in the Doctors ), but the whole medical side somehow got rolled into the conversation.</p>