Q&A of the Day – The cost of medical care with insurance and without
Each day I’ll feature a listener question that’s been submitted by one of these methods.
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My son was admitted to (a hospital) ER in January with a broken arm. The hospital had trouble entering our insurance info. Afterwards we received an adjusted bill for $1950. I called the billing office to submit our insurance info. Our next bill was a real shocker.
With insurance, the adjusted bill soared to over $30,000. Yes, the cost went up by over $28,000. And we pay 30% coinsurance, so we are now facing a new bill over $8,000 just for the ER visit. That’s not counting all the other providers who were involved.
When I called, the billing department refused to budge on the amount. They even suggested I ask my insurance company why they couldn’t secure a better price.
So now the consumer is expected to sit in on annual negotiations between the hospitals and insurers?
Anyway, just wanted to give you an idea about the total lack of transparency in the health care industry. It’s enough to turn a Reagan Republican into a Bernie Bro.
Bottom Line: This is a sad and extreme example of what happens daily across the country but generally without people ever realizing it because it’s rare for someone to have the “cash” price of the medical care prior to receiving the insurance adjusted rate.
This note was a follow-up to my story from last Thursday in which I illustrated that health insurance doesn’t equal healthcare, healthcare costs have risen above the rate of inflation every year since the end of the 1960’s and the insurance first model is largely to blame. Without transparency you have a monkey feces fight between the insurance company and your medical service provider with you left holding the tab for your portion of whatever your obligation is once they’re done. We’d never stand for it in any other aspect of our lives, but we’ve been conditioned for decades to accept it.
Once again, the greatest failure of the Affordable Care Act was taking the single greatest obstacle to more affordable healthcare, health insurance, and mandating it. This is also why I strongly suggest you ask what the cost of healthcare is going to be (in non-emergency situations) prior to obtaining the care and signing the piece of paper that says you’ll pay whatever the price is once your insurance company has settled up with your medical service provider.
Years ago, I had minor surgery and found that it would have cost $7,500 had I gone through the usual process. By shopping around a little I found the highest rated doctor in the state would only cost $500 cash for the same procedure. You’d be amazed what the difference can be when insurance isn’t where the conversation begins. Consumer price transparency is the solution – the more we do on our end to be better consumers – even with health insurance, the more likely we are to begin making progress. Waiting on Washington for “fixes” hasn’t been an effective strategy.