Here's an example of ins. hurts YOU!

I have ins. with one of the very large insurance co's. On July 22nd, I fell in the kitchen and really twisted my knee joint. I went to the ER, they too & Xray, didn't see any breals bur referred me to an orthopedist the next day. They insisted on an MRI because they suspected a tear or other things that wouldn't have shown up on an xray.

The MRI did show the tendon was torn away from the bone & there were 2 bone chips and a crack in the femur, but nothing that required surgery.
SURPRISE! Today's mail brought me the bill FOR THE MRI ONLY!

MR-Lower Extremity With & Without Contras $3,500.00
Injection gadpbenate dimeglumine $ 28.50
Payment from insurance $ 479.79
Contractural $2,683.43

Patient Balance Due $ 365.37

What geniuses come up with these numbers? If I hadn't had any ins. at all, I would have been billed $3,428.50!!!!!

What happened to the days when, if you had ins. the bills were paid...period!

As I said, this is the FIRST bill I'vve received. I wonder what tomorrow's mail will bring?

"What happened to the days when, if you had ins. the bills were paid...period!"


Depending on the insurance you have, you could be responsible for none to all of the bills in this case. There is no "standard" policy that pays all of your medical bills...

If you didn't have insurance, you wouldn't have been billed $3,428.50- that is the "plum" insurance price. You would have been billed much much much more.

You might have been able to settle it for less in cash. If you didn't have the money, the doctor would sell it to a collection agency for $750-$900, and they would try to squeeze the full $3,500 out of somebody. Of course, if you get enough of those bills, you go bankrupt, and they don't get squat. Or, if you're an illegal immigrant or poor person with no property to attach or wages to garnish, you skate, too.

It's a corrupt system, with bullshit prices designed to build in the costs of those who won't/can't pay.

at Sears, etc. Only worse.

Four years ago, I had a job where I went up a ladder in the wee hours of the morning, and changed a sign that said, "40% off" to "50% off", and in a few days, I'd go back up and put the 40% sign up again. Flip, flop, flip, flop. In other words, you really didn't have to pay retail more than a few days out of the year, and nobody in their right mind would buy that item on those days.

What's the point? To trick the poor sucker into thinking that he/she is "getting a deal".

Now, with medical, there's the full bore ream of the $3,500 that you were quoted, but let's face it: Your portion was $365.37, the insurance company admitted that they paid only $479.79. Therefore, the doctor's office only charged $845.16.

Still feel like you got a deal?

That's one of the reasons I was willing to get bashed last week for defending the Whole Foods CEO's high-deductable with health savings account plan. I'd bet money that they doctor you saw would be glad to take $750 from you without having to hassle with your insurance company.

You pay your premiums, know you have a $500 or $1,000 deductible and all the bills submitted by the hospital or drs are paid?

I dont have to pay extra if I happen to hit a Lincoln instead of a Kia!

Allstate would be charging me a LOT more because they'd be paying for my annual safety inspection, my oil changes, and brake & tire replacements. That's what a lot of people want, in effect, from their health insurance, and it doesn't make sense for each of us (or our employers) to pay a pantload of money to an insurance company to hand out a pittance to our doctors for relatively inexpensive routine things that we could pay out of our pockets.

I keep a high deductible ($1,000) on my collision and comp, I don't want to be in the position of having to submit a $500 repair to Allstate (and have them pay only $300 of it) then watch them jack my rates for the next few years to get it back out of me. If I graze a concrete wall at the supermarket, I'm not going to do any damage to the wall, just my own car, and I'd rather just find a way to give the body shop guy some cash under the table to fix my stupidity.

An office visit to my local GP is $165! I don't call that a pittance.

I'm old now, but when I was in my 20's, an office visit was $5.00 and sometimes you even got your pills at no charge because the doc had samples to give to you. HC ins was called hospitalization because that's what it was! I've been very lucky and the only times I was in the hospital in the past was to give birth to my 2 kids. The first one, I paid the Dr. $250, and that covred all the office visits & delivery. The second one cost $500 (3 years later) and also covered everything.

Let me also add that for a lot of years, I'd call the Doc at his office, explain that the kid had an earache, I had a urinal infection, etc....and he'd say OK I'll callthe drug store with a script for you.

I would have no problem going back to those days and have an office visit cost $25-$30, get a diagnosis and a script that didn't cost over $30!

As far as I can tell, those days are gone! 2 days ago I had to get a script for my cat that cost $35 for 20 pills!

Everybody wants their piece of the pie. The Doc charges a lot if you don't have ins. The pharmacy charges a fortune if you don't have ins. The ins co tries every way they can not to have to pay!

have people who do nothing but bargain with hospitals. Last year my wife was having chest pains, a four hour visit to the emergency room cost us over 10 grand. Not to mention that they wanted to keep her overnight for "observation" which we denied due to lack of insurance.

"It is essential for American to understand that while it looks
like they can have ... someone else pay for their health insurance...
they cannot. The money comes from their own pockets.
Understanding this is essential for any sustainable health care reform"
Ezekiel Emanuel & Victor Fuchs, "Who Really Pays for Health Care"
Journal of the American Medical Association, Mar 5 2008

So they may be encouraging the co-pays. But then, in Japan
the co-pay is 35%. The difference is that over there
both doctors and MRIs cost less.