I was charged $1,950 for an ambulance ride. Until the ambulance company learned that I had insurance. Then the price dropped to $790 even though the ride wasn't covered by my benefits. I was charged 61% less because I had insurance. I can't imagine how anyone who is uninsured can financially survive even relatively minor injuries or illnesses. They have the least ability to pay, and get charged the most. It's so upside down, it pisses me off. And that's hard to do.
A large part of the problem is that insurance companies negotiate prices with care providers, and every insurance company can therefore get a different set of prices at the same facility. So even if we collectively reported what we paid to an open database, you couldn't be assured of getting the same price as me on the same procedure if we had different insurance companies.
This is not strictly an issue of bargaining out pricing contracts. Hospitals are not held to account by consumers to provide transparent pricing, so they don't.
The same hospital that will tell you "we don't know how much this operation will cost; it depends on too many variables" takes a lump-sum payment from Medicare (via DRG) for the same procedure - which ought to tell you they know damn well what, on average, that procedure is going to consist of. If they can tell you what codes it will generally include, that can be translated into cost.
They're not even trying to deceive you. The parts of the hospital that deal with you, vs. building around DRGs, are entirely divorced. Your physician literally doesn't know what the procedure will cost you. His office manager literally doesn't know. The billing department doesn't know. And the people who do know? They don't talk to physicians and patients.
I've worked /in/ clinical business ops. in an academic medical center and couldn't get my hands on that information (too politically sensitive).
This is why it is advantageous to have a national health system which can negotiate on the behalf of everyone. For example citizens of the UK enjoy lower drug prices than the US because the NHS negotiates the best prices with drug manufacturers.
I've also heard the opposite being true - being charged more because you're insured and the rate negotiated. If this is coming out of pocket on a high deductible plan it's insane. One place I see this continually is Rx drug coverage. For some generics it's cheaper for me to pretend I don't have coverage (totally legit and legal).
Take this one step further, to where people begin avoiding interacting with the health care... "system" for fear of the financial outcome -- one which is largely and unyieldingly opaque.
Not only is the system making care unaffordable. It is actively discouraging those in need from engaging in it.
It is the opposite of preventative care. It is actively preventing care -- not just through cost, but through psychological pressure.
The U.S. health care system is borderline evil, at this point. For some people, it is unquestionably evil.
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[ 3.4 ms ] story [ 22.6 ms ] threadIt is really bad.
I was charged $1,950 for an ambulance ride. Until the ambulance company learned that I had insurance. Then the price dropped to $790 even though the ride wasn't covered by my benefits. I was charged 61% less because I had insurance. I can't imagine how anyone who is uninsured can financially survive even relatively minor injuries or illnesses. They have the least ability to pay, and get charged the most. It's so upside down, it pisses me off. And that's hard to do.
A large part of the problem is that insurance companies negotiate prices with care providers, and every insurance company can therefore get a different set of prices at the same facility. So even if we collectively reported what we paid to an open database, you couldn't be assured of getting the same price as me on the same procedure if we had different insurance companies.
The same hospital that will tell you "we don't know how much this operation will cost; it depends on too many variables" takes a lump-sum payment from Medicare (via DRG) for the same procedure - which ought to tell you they know damn well what, on average, that procedure is going to consist of. If they can tell you what codes it will generally include, that can be translated into cost.
They're not even trying to deceive you. The parts of the hospital that deal with you, vs. building around DRGs, are entirely divorced. Your physician literally doesn't know what the procedure will cost you. His office manager literally doesn't know. The billing department doesn't know. And the people who do know? They don't talk to physicians and patients.
I've worked /in/ clinical business ops. in an academic medical center and couldn't get my hands on that information (too politically sensitive).
Not only is the system making care unaffordable. It is actively discouraging those in need from engaging in it.
It is the opposite of preventative care. It is actively preventing care -- not just through cost, but through psychological pressure.
The U.S. health care system is borderline evil, at this point. For some people, it is unquestionably evil.