Hospitals charge Insured patients 1/4 the price of NON-insured. Congress should pass a law OUTLAWING separate pricing.

????...I just had surgery at a major hospital in Phoenix, AZ...I have a high deductible insurance plan and the lady in billing told me if they ran it through as if I was uninsured it would be half of the price as if I was insured...we figured out my deductible would surely be covered so I used my insurance - the procedure cost about 15K - cost me $2,500 which was my deductible...if I had no insurance it would have been $7,500... I have been in similar situations where Dr's and Dentists charge less for the uninsured...

I needed to get an exercise stress test to get my masters amateur boxing passbook. Everyone told me to say I had chest pains and have my insurance company pay for it, but the problem with that scenario is the minute you claim any kind of chest pain you are not eligible for your boxing passbook. I saw my Sports doctor who said he would have to run it thru the local hospital. We called them and they said $3600 with no negotiations. That was way more than I could afford, so I got on the net. Found out that Medicare reimburses less than $100 for the test. Finally I found a clinic that does them for the local firefighter applicants and charges the city $175. They gave me mine for $225. The whole thing just didn’t seem fair, from $3600 down to $225.

hey where do you live?

medical care overseas wrote:

This is yet another reason why I choose to live overseas:

Get rid of hospitals and doctors.

Why shouldn't the poor pay their fair share?

By the way, if the government outlaws price differences in medicine, it will become impossible for doctors to offer reduced-price or free care to the uninsured.

mwwwin wrote:

????...I just had surgery at a major hospital in Phoenix, AZ...I have a high deductible insurance plan and the lady in billing told me if they ran it through as if I was uninsured it would be half of the price as if I was insured...we figured out my deductible would surely be covered so I used my insurance - the procedure cost about 15K - cost me $2,500 which was my deductible...if I had no insurance it would have been $7,500... I have been in similar situations where Dr's and Dentists charge less for the uninsured...

Mwwwin,

I think what people are saying is that the "$15k" procedure, was probably billed to the insurance company at that price, but then the price was negotiated down to a lower price. My hunch tells me that the insurance-company negotiated price could possibly have ended up lower than the $7500 price she quote you as "uninsured". The point is the insurance companies end up paying FAR below the sticker price, so much that the 50% off they offered you was likely in the doctor's office self-interest. Not to mention, you would have paid on that day, and they will likely have to wait weeks/months before receiving payment from the insurance company, and spend the time in that process.

Not. The law can state that no person can be charged more that what an insurance company is charged. Which is fair.

The Feds need to track prices and charges in real-time to prevent rip-offs by insurance companies, hospitals, and doctors. Every hospital charge should be monitored by Federal Regulators to protect the public from cheats.

My contractor gets certain rates from his subs (plumbers, electricians etc) and from suppliers.

I can't get those rates and prices. Is he gouging? Any difference?

I think you're right...15K was the adjusted price...would've been about 25K...so I guess I would've paid 12.5K...but still it appears that I would've paid exactly what the insurance company ended-up paying - no ridiculously over as mentioned...

You know politically it's a good thing to support making medical prices the same for everyone. Which politician is not going to vote yes on such a bill. Hah hah to you effing cheaters !

Hah hah to you effing cheaters wrote:

You know politically it's a good thing to support making medical prices the same for everyone. Which politician is not going to vote yes on such a bill. Hah hah to you effing cheaters !

That would cause big cost increases for Medicaid and Medicare since they pay doctors and hospitals about 60% and 80, respectively, what commercial insurers pay.

Every insurer is getting a different discount rate off the 'billed charges' from providers. That is how they compete. The largest insurers generally get the biggest discounts since they can drive market share to the provider.

As an earlier poster said, services for the uninsured are generally just written off as a loss. They just charge those with insurnace more to make up for it.

Doctors and hospitals in this country make a ridiculous amount of money. I'm a doctor so I think I can say that. It's a road to wealth in USA. Not so many other places on earth, and the health care there is equally good.

My clinic/hospital bills Medicaid $300 for a well baby check, another $300 for a trip to the hospital lab for the child to get a blood count, and then a third $300 for a trip to the hospital pharmacy to pick up a bottle of Tylenol and vitamins. Something is seriously amiss here.

Wow, you're a genius. Do you know what insurance is? Can you grasp that concept? That's why insured people pay a fee regardless of whether they are sick or not. Considering they don't pay this insurance fee, why would an uninsured person get charged the same at a hospital? That would be unfair. No one would buy insurance. Health care in this country would collapse. Oh wait, that's Obamacare.

I like NEW Laws wrote:

Clark Howard on CNN just said that hospitals charge Insured patients 1/4 the price of NON-insured. Congress should pass a law OUTLAWING separate pricing, kickbacks, bonuses, credits, etc. to insurance companies, unions, PPO, HMO, etc.

It depends on the policy. Car repair shops charge the same to insured and non-insured. The current policy should be changed by a new law that would mandate that doctors, clinics, hospitals, HMOs, PPOs, etc. charge the same to un-insured and insured patients. Hope this helps.

That will change with new laws that mandates the same price for everyone. Insurance companies will no longer be able to negotiate separate prices for their customers. Hope this helps.

it's complicated wrote:

Each insurance product (most companies have several) is negotiated with each individual hospital. Hospitals want to attract certain insurers and insurers want the best deal for their company.

And both sides employ a huge number of people whose only job is to do battle with each other over how much will be paid. All those salaries to people who aren't doing anything that actually provides health care is one reason health care costs are so high. Set the prices for services at one rate, and overall health care costs will go down.

This is what the state of Maryland does.

"Private insurers aren't allowed to bargain for discounts on hospital payment rates, though patients may not notice the difference. But that isn't the case for the uninsured. In other states, hospitals typically charge the uninsured steep prices that no insurer actually pays, forcing the hospitals to write off the charges they can't collect payment for. In Maryland, where hospitals know they will get reimbursed for charity care, hospitals charge the same rate whether a patient has insurance or not."

http://online.wsj.com/article/SB125288688445707403.html

life eternal wrote:

English is my 8th Language wrote:

you wont die if you don't get your apples.

So not getting apples is the key to eternal life? Cool.

He didn't say "you won't die if...", dumbass.

He said, "you wont die it...".

So, if you don't get your apples you will become accustomed to dying.