Ever wonder why Insurance is stupid expensive?

[RiverRat1]

It’s amazing how under the radar and how huge this passing would be! Liberals should be thrilled for it also since it will expose expensive healthcare but it’s been very quite.

Liberals will never be thrilled with anything Trump does. No exceptions. Period!

Man I was fired up about this yesterday! My developmentally delayed (born early) 2 year old needs speech therapy. To file with insurance is $260 a visit, recommend twice per week.
Cash payment without insurance is $60.
We have a high deductible plan before 90/10 kicks in. So this is just a bull**** deterrent to keep us from filing anything towards that deductible.

Yep. It's at the point where I wonder why any of us pay for healthcare at all. Just go get done whatever you need and pay $50 per month (total) for the rest of your life.

At some point working people will have to call BS10 and stop paying while everyone else is free (while still having all luxuries).

Here’s another doozie - the twins mentioned above were on the NICU for 36 days.
Anyone want to take a guess at total cost per child before insurance??

1.1M per child! Really!? People were great, but that’s asinine!

Did you get an itemized invoice? That would blow your mind. My sister had brain surgery. We figured the doctors pattern. They go room to room and say "How are you doing today" Each 15 second to 2 minute stop they charge stupid money for like $130-250. The extra kickers are they have all sorts of "doctors" so it's a constant stream of them poking their head in.



Also I still can't figure out what my insurance covers. Does anyone? I think it's completely random what I get charged.

[Goldeneagle]

Back in 2016 I had to have 2 stents put in my heart. Went to Presbyterian and they tried a procedure that didn't work. Wound up at Baylor Heart Hospital. After it was all said and done, Presby billed insurance $90k just to use the OR. No doctors or anything. just to use the room. Baylor billed for the same only they billed for $40k. Less than half of what Presby billed!

[WItoTX]

I got bloodwork done last summer. I was told there would be no bill. I knew this not to be true because they said the same thing the year prior. Got a bill for like $500 or something from the bloodwork people. I call the bloodwork people, they tell me since it's not preventative, it's not covered. I ask how much the bill would be if paying cash. They have no answer.

So I call my Dr, explain to her my family has a history of Type II Diabetes and high blood pressure/high cholesterol. All of a sudden my $500 bill goes to $0, and the amount charged to insurance goes to ~$50.

Our system is absolutely broken.

[Hoggslayer]

I got a bill from a stand alone emergency room in Livingston, TX for $5k to remove a treble hook from my daughters foot. The Dr wasn't even strong enough to cut the barb off the hook and my Brother did it. Insurance paid them $3800 and they sent me a bill for the rest. I told them to go to hell.

[Johnny Dangerr]

Two years back we went on pay as you go. Had my PCP change the account to cash. Yes we do have BC/BS insurance. We have not turned in a penny to insurance so far, and the Dr gives us super cheep prices.
We will use BC/BS for only serious stuff........

[highspeed]

I’m working on a 500k bill at Texas Children’s

Worth every penny though

Bingo

[Pineywoods]

This is precisely why I have never had insurance. It is an absolute racket and to say that the system is broken is an understatement. With the current average deductibles and monthly payments for a family, it is not worth the cost for me. We will pay cash for the small stuff (just like the folks with insurance do) and negotiate and pay out any major thing should it happen. I am very thankful that my family is healthy thus far and I pray it stays that way. I understand why some older folks or folks with pre-existing conditions have to have it. It's sad that such a high percentage of one's income has to go to health insurance each month and then you still have to meet a very high deductible while not even being clear on what will be covered and how much it might be.

[RiverRat1]

I got bloodwork done last summer. I was told there would be no bill. I knew this not to be true because they said the same thing the year prior. Got a bill for like $500 or something from the bloodwork people. I call the bloodwork people, they tell me since it's not preventative, it's not covered. I ask how much the bill would be if paying cash. They have no answer.

So I call my Dr, explain to her my family has a history of Type II Diabetes and high blood pressure/high cholesterol. All of a sudden my $500 bill goes to $0, and the amount charged to insurance goes to ~$50.

Our system is absolutely broken.

When I had blood work done they have this new program where you can pay up front set prices. It was like $50..I asked how much I'd be charged if going through insurance and they had zero clue. Zero clue what the lab would even charge insurance. Zero clue what my insurance would cover or what they covered in the past... LOL It's freaking stupid.

I got a bill from a stand alone emergency room in Livingston, TX for $5k to remove a treble hook from my daughters foot. The Dr wasn't even strong enough to cut the barb off the hook and my Brother did it. Insurance paid them $3800 and they sent me a bill for the rest. I told them to go to hell.

How much went to your brother? Sounds like he was an independent contractor

Last hook I got in myself I just cut out myself. Made my brother hold my finger steady so I could cut. Figured it not only saved money but I'd have more fishing time....And they'd have cut it out the same way!

[jlp04c]

You didnt do your homework
We charge tens of thousands to the insurance companies bc they will deny most of the claims. We dont balance bill the pt but some facilities do... that is your responsibility as a patient to ask those questions before you go in for treatment.
If you only knew how much our electricity and maintenance bill is every month to keep our MR machine on you would understand. ... try 25 grand just to break even. But I dont expect you to know that or anyone else that is upset about billing practices.. I understand both sides but you should really know what you are signing or dont sign it

Every single business has expenses, and every single business pays a ton to keep the lights on. To me, it's a simple solution: Have a price list available. Like EVERY other business that's out there. You look at the price list, decide what you can/cannot afford and select it. It would at least create free enterprise between hospitals. An individual could "shop" a bit and decide whats best for their situation. This would drive lower cost. Instead you go into a medical office tell them you want the OUT THE DOOR COST, they CANNOT CANNOT tell you what that will be. It's unbelievable the amount of bills I have received AFTER I've "paid in full".

[yfz04drt]

My wife went to an Urgent Care/ER for what she thought was appendicitis. They did a CT scan, gave her an IV and pain meds but never diagnosed her with anything other than saying it wasn’t her appendix. I was new to my job so we didn’t have our ID number yet and went with self pay. The bill was $11k, but they reduced it to $2400. I gave them the insurance info once I got it, they were paid $4500 from insurance and sent a bill to us for $6500. I talked to a supervisor and she “lowered” it to $1500. I told them they were paid for their services and won’t see a dime from us. They sent several past due invoices and then haven’t heard a word from them and they didn’t turn it over to collections.

[BrianL]

Does anybody disagree that our healthcare system is broken!

The service side of the system is fine, it is the billing side that has past our ability to pay. People complain that insurance is high, but it cost most people $100-300K just to die in a hospital, unless they are DOA. And we ARE ALL GOING TO DIE.

[John Paul]

My wife Is a medical biller for a Ped's office. Long ago insurance companies decided they would only pay 40-60% of the cost of a procedure and or a visit, then some Docs just increased the price of the visit to get the amount they would of originally charged. Then the cycle began, insurance companies payed less, docs charged more and got less. Every month her AR for one practice is 45%-55% of what was billed and most of the time insurance companies just deny a claim hoping it will be missed or it will be denied over 90 days then provider can't collect. And that practice has not over inflated its pricing but has had to decide not to see certain children with certain insurance because they were going out of business from not getting paid at all. It is super jacked up, this is one place I think the government should regulate the insurance companies some how. I know intervention rarely works.

[BrianL]

My wife Is a medical biller for a Ped's office. Long ago insurance companies decided they would only pay 40-60% of the cost of a procedure and or a visit, then some Docs just increased the price of the visit to get the amount they would of originally charged. Then the cycle began, insurance companies payed less, docs charged more and got less. Every month her AR for one practice is 45%-55% of what was billed and most of the time insurance companies just deny a claim hoping it will be missed or it will be denied over 90 days then provider can't collect. And that practice has not over inflated its pricing but has had to decide not to see certain children with certain insurance because they were going out of business from not getting paid at all. It is super jacked up, this is one place I think the government should regulate the insurance companies some how. I know intervention rarely works.

They would have to regulate both sides. Overbilling and underpaying is the game and the patients get caught in the middle. There needs to be standardized upfront pricing.

[John Paul]

Totally agree, patients get the shaft for sure, but if pricing is standardized you would have to standardize Insurance reimbursements. If you didn't the care you would get would be substandard because Docs would have to see 2 to 3 times the amount of patients in a day to keep the practice going.

[gingib]

I’m working on a 500k bill at Texas Children’s

Worth every penny though

No insurance?