The insane costs of health care

I have paid close to a grand out of pocket for everything related to my crash from the ambulance ride to the surgery. That's the price I pay for lower premiums I suppose. Could be a lot worse. Total billed charges so far: $74,896.47

"Write off" - the difference between what the provider charges and what insurance covers. 

I've always wondered why the provider doesn't just charge what the insurance covers - why this write off business? I should ask my Dad, he runs a medical billing company...

It does indeed make you wonder. I gave up trying to reconcile the bills I got vs the statements from my insurance company. And forget trying to figure out the medical codes. They could be billing for stuff they didn't do and I would never know. Right now there is a $2.34 difference between what I've paid and what my insurance company lists as "your responsibility" on the statements they send me. Can't wait to see what shows up next in the mail.

I find that interesting as well...

My appendix was something like 40k and I only paid 35 bucks... I had GOOD insurance!

I recently LOST my insurance between jobs, and had the WONDERFUL timing of getting thyroid cancer diagnosed.  I was seriously considering all kinds of options just to avoid medical bankrupcy.  My best option was going overseas where I would pay only 10% of the costs we have here (not including flights)...

Oh, and before anyone comments "surely the quality is less".  I don't think so.  The surgeons were all Ivy league grads and the facilities were top rated in many world wide reviews of health care.  Curious how they can do surgery for 7k when it costs 70k here.

Fortunately, with some effort, found some insurance (with a high premium) that would cover me.  STILL paid 7k out of pocket, but at least got to stay home and recover.

Not to mention the money you laid out for Philly Tri, which you didn't get to do! So how are you feeling?

Piranha offered me entry into any race next year, since I couldn't do Diamondman. I thought that was pretty nice.

Well, yes, to some extent. But it's not YOU who are underwriting their bills. It's your insurance. And once upon a time, about 15-20 years ago, that was the standard way of providing care for the indigent and helping money-losing ventures like teaching hospitals stay afloat. Then the insurance industry decided it was a bad deal for them, and started to cut what they would pay. Resulting in part in the current crisis, and the need to re-think the whole system a la the ACA/Obamacare.

It's not the 1.5 miles it took. It's the time it took to have 2-3 EMT's drive in their very expensive and specially-equipped vehicle to get to wherever it was you were, assess you at the scene, bundle you up safely without making anything worse, and THEN drive you the 1.5 miles to the hospital. Then they had to replace any supplies used, clean out the vehicle so that YOUR bodily fluids did not pose an infection risk to the next patient/passenger.  It was not your buddy spending 50 cents in gas to drop you off.

Your comment here reminds me of the story (possibly apocryphal) about Picasso. He was sitting at a restaurant when a woman approached him and asked him to sketch her something on a napkin. He did, and before handing it over, told her it would cost her $1,000. When she complained "It only took you a minute to do that!", he responded "Madam, it took me a lifetime."

It's all one enormous scam.  If you don't see the savings, then you start to question why you have insurance in the first place.  But when you see in black and white that your insurance saved you $26,000, it makes you happy to pay that $8000/year in premiums (what it costs me to cover a wife and two kids).

On the other hand, when the uninsured don't pay or pay a fraction of the costs, the hospital get to claim the difference from the gross charges to the amount paid as either bad debt or charity care and get the fat write off.  Even if the medical care only cost the hospital $1000, and the patient paid $1000, they still get to write off the remaining $30,000 as a loss.

It's a stupid game they play - both sides.  The medical industry knows the insurance companies will ALWAYS claim a procedure is worth less than what is charged.  So they bill more to offset the difference.

Well I went to the doctor and I got antibiotics and nasal spay.  they gave me a billed me for $127.  I am like I got insurance.  so they are like OK fine $20 then.

I had a ultrasound the other day.  I was billed for $3000.  insurance got it down to $450.

They don't have to pay the same outrageous malpractice insurance premiums and comply with all the US regulations from FDA to OSHA.

I know...  for the overseas question...

But I still don't know why insurance companies can "write off 50%" right off the bat, and asking the Dr for a cash price is like pulling teeth, and they still don't give you the 50% discount.  Trust me, I checked.

so you only have the hospital and the ambulance bills.  you are still going to get one from the doctor that treated you and anyone that reviewed those xrays and CTscans along the way   if there was any blood taken for any reason you will also get a bill from the lab who performs analysis on it.

Well my insurance company pays their bills with the money they get from their clients' premiums, so therefore I AM underwriting the cost of the uninsured using hospital services through higher premiums.

The same goes for the ambulance. I have no doubt it's expensive to maintain a fleet of vehicles and trained EMT personnel, but that bill reflects the fact that they will have to factor those who cannot afford to pay into their total costs.

We really do need some form of universal healthcare. It has got to be cheaper in the long run than have the uninsured use emergency services for what should be routine healthcare.

Oh I agree with you on that part.  That is part of what is wrong with the insurance/medical system we have now.

I saw a hand specialist who also reviewed the x-rays, and I've been to my PCP three times. All of those were just copays. I started PT this week, I'll be going twice a week, each time is a $25 copay.They didn't need to take any blood, I was giving it for free

No idea what else is going to show up in the mail!

Which is why I have been pulling for a universal, single payer system pretty much from the moment I got into medicine.

There is no free lunch!!  Sooner or later if everybody eats somebody pays.

True. And we all have to eat sometime. The old system, only some people pay, but everyone eats. Under universal coverage, we all pay (and we all get to eat).

No, many of the same people pay and the same people eat for free and new people get government checks to pay.  Price controls erode the quality and timeliness of care as well.