Health Care Woes
I hate to sound like a liberal, but it does appear that our system of paying for health care is broken. Allow me to elaborate.
A few weeks ago, while we were enjoying a thoroughly intellectual week at the venerable Chautauqua Institution, my 11-year old crashed on his bike, taking a handlebar to the gut. It was an ugly contusion, not gushing blood or anything, but big and purpley and round, and he was laying on the ground on his side, wouldn't let anyone touch him. He couldn't sit up. By the time we got to him, he was in an ambulance with an IV, and shortly we found ourselves in the ER of the Westfield Community Hospital. There were concerns about internal bleeding or broken ribs, so they took CAT scan to be on the safe side, and also did a bunch of blood work. It seemed like overkill to me, but I'm not in the medical profession so I naturally deferred to their judgment.
Don't worry, he was fine, and the injury consisted mainly of a nasty bruise that has healed up nicely. Hubby and I were more concerned about the gigantic bill we were likely to receive, in light of the fact that we have a high-deductible health plan that pays out virtually nothing until we're out of pocket 5K.
Imagine our relief when we received the insurance statement revealing that the grand total of our responsibility would be $377.54. On closer inspection, we discovered the provider's charge was actually $2,489.95, but because of our health plan, they are only permitted to bill us the aforementioned $377.54. Note that our health plan is paying out nothing on this claim. All they did was negotiate this fantastically lower rate that evidently is acceptable to the provider.
What it boils down to is we get an 85% discount on health services, in exchange for paying our premiums, and the provider gets only about 15% of their bill paid. Not that I'm complaining about this benefit to us.
But it seems to me that something is a little out of whack when an uninsured person is going to be billed exhorbitant rates basically just because they don't have insurance. The health services provider is getting pennies on the dollar, while the insurance company is making out like a bandit. Remember, we paid all these premiums (from which we are benefitting, don't get me wrong) but the insurance company is paying out nothing. Seems to me the people who took care of my son deserve something more (but don't look at me, I paid my premiums.)
And on that subject, why is the hospital billing out at these huge rates when they are willing to accept so much less? It begins to look like the uninsured are actually subsidizing the insured, at least those of us with high deductible plans. So if two people come in with the same injury, one with insurance and one without, the insured one pays $377 and the uninsured one pays $2489, so the hospital is actually averaging around $1433 per person.
But maybe I shouldn't complain. We pay a lot of taxes, that certainly amount to subsidizing services for people who pay little or no taxes. I guess it just irks me that the insurance companies are raking in obscene profits. I'd rather the doctors and nurses (who are woefully underpaid, if you want my commentary) be compensated. I mean, it's not the insurance guy who's fixing your broken body, is it?
A few weeks ago, while we were enjoying a thoroughly intellectual week at the venerable Chautauqua Institution, my 11-year old crashed on his bike, taking a handlebar to the gut. It was an ugly contusion, not gushing blood or anything, but big and purpley and round, and he was laying on the ground on his side, wouldn't let anyone touch him. He couldn't sit up. By the time we got to him, he was in an ambulance with an IV, and shortly we found ourselves in the ER of the Westfield Community Hospital. There were concerns about internal bleeding or broken ribs, so they took CAT scan to be on the safe side, and also did a bunch of blood work. It seemed like overkill to me, but I'm not in the medical profession so I naturally deferred to their judgment.
Don't worry, he was fine, and the injury consisted mainly of a nasty bruise that has healed up nicely. Hubby and I were more concerned about the gigantic bill we were likely to receive, in light of the fact that we have a high-deductible health plan that pays out virtually nothing until we're out of pocket 5K.
Imagine our relief when we received the insurance statement revealing that the grand total of our responsibility would be $377.54. On closer inspection, we discovered the provider's charge was actually $2,489.95, but because of our health plan, they are only permitted to bill us the aforementioned $377.54. Note that our health plan is paying out nothing on this claim. All they did was negotiate this fantastically lower rate that evidently is acceptable to the provider.
What it boils down to is we get an 85% discount on health services, in exchange for paying our premiums, and the provider gets only about 15% of their bill paid. Not that I'm complaining about this benefit to us.
But it seems to me that something is a little out of whack when an uninsured person is going to be billed exhorbitant rates basically just because they don't have insurance. The health services provider is getting pennies on the dollar, while the insurance company is making out like a bandit. Remember, we paid all these premiums (from which we are benefitting, don't get me wrong) but the insurance company is paying out nothing. Seems to me the people who took care of my son deserve something more (but don't look at me, I paid my premiums.)
And on that subject, why is the hospital billing out at these huge rates when they are willing to accept so much less? It begins to look like the uninsured are actually subsidizing the insured, at least those of us with high deductible plans. So if two people come in with the same injury, one with insurance and one without, the insured one pays $377 and the uninsured one pays $2489, so the hospital is actually averaging around $1433 per person.
But maybe I shouldn't complain. We pay a lot of taxes, that certainly amount to subsidizing services for people who pay little or no taxes. I guess it just irks me that the insurance companies are raking in obscene profits. I'd rather the doctors and nurses (who are woefully underpaid, if you want my commentary) be compensated. I mean, it's not the insurance guy who's fixing your broken body, is it?
posted by calabresewoman | 1:45 PM
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