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Medical price-gouging hurts the uninsured

50 million Americans have no health insurance and are getting price-gouged by hospitals. One of the medical journals did a study that compares the prices for service paid by the insured vs. the uninsured. Those with coverage might get a bill that's $5,000 for a certain service. Typically they'll also have 20 percent co-pay, so that's an additional $1,000, for a combined $6,000 price tag. However, if you don't have coverage you will be billed $12,500 for the same procedure -- that's more than twice the price! What happens is that the big insurance companies cut deals with hospitals to reduce the amount they have to pay. Then they pass some of those saving on to their customers. But people without insurance don't have the same negotiating power and get stuck with the bill that's twice as large.

It's nuts that our system is upside down and backwards, especially if the goal is to move toward consumer-driven healthcare based on quality of service and price. Clark thinks there's no excuse not to have price lists at your medical provider. Medicine suffers from lack of financial transparency -- you can't comparison shop because you don’t know the price of any of the services you're going to receive. One insurance company is tackling this problem by ranking hospitals and doctors with green, yellow and red colors to tell you how much out-of-pocket expense you'll have. But we really need to be able to shop for medical care by price. Medical care accounts for 15 percent of our total national wealth each year. Of course, people are getting better health care, but Clark still has the feeling that we're squandering that 15 percent. After all, we spend more on health costs per person than any other country, yet we have shorter life-spans and are not as healthy as citizens in other nations. We're spending so much, but getting so little back. The reason is because medicine is largely not run like a business; Dentistry and Lasik eye surgery are two areas of the medical profession that are run like a business. The experiences in those offices are great because the services are driven by modern technology and the marketplace sets the price. They're great with customer service too, providing prompt appointments because they have to compete in a real marketplace.

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What others are saying

  • Medical costs
    This has got to be the very rare extreem. A write off that big I've only seen with welfare, which pays about 10%, and Medicare, about 35% and the hospital or practitioner is only taking that payment as a courtesy. Many providers can't afford to take those rates and stay in business, so they don't. If congess decides to cut Medicare rates another 10% the elderly are going to be lucky to find doctors that accept that at all. (Besides the fact that dealing with Medicare is almost impossible, little customer service-what's that...- and less accountability.) The average insurance discount is about 20%. Some more, some alot less. Maybe everyone else is paying for difference.

    Why can't you comparison shop? I've done it. I manage a doctor's office and alot of people inquire about costs. Every office has a set fee schedule but people have to call ahead and ask, not just wait until they get the bill.

    I would like to understand better why medicine isn't run like a business. Are you referring to hospitals and offices?

    Doctors are not God and there is a point between rediculous frivolous lawsuits and real negligence. Malpractice insurance is astronomical, often pushing some doctors out of state to practice. Obstetricians can be sued until a child turns 18 for 'wrongful life.' You can't get much more accountable than that.

    All doctors do naot make alot of money. This is a complete myth, so to say that that is the only reason they pracice is not true. Most doctors, and I've worked with alot, truly care about their patients and work hard to give them the best care.

    Why would anyone expect to receive a product or service without paying up front? That just astounds me. I'd like to tell the lady at the grocery store, 'I'll send you a check later,' but that just doesn't work. Can you go pick out a car and take it home without paying? The reality is, alot of people don't and won't pay their bill if you don't get it up front. Yes, I said alot.

    How many providers are nice enough to accept welfare, which pays about 10% on the dollar or medicare which pays about 35%. They sure do that for the love of the almighty buck.
  • MEDICAL COSTS
    REMEMBER ALL DOCTORS,HOSPITALS, AND PHARMACISTS ARE NOT EQUAL. INSURANCE COMPANIES (PBM HMO, ETC) DICTATE WAY TOO MUCH. PHARMACISTS ARE REQUIRED BY LAW TO COUNSEL PATIENTS ON MEDICATION, BUT INSURANCE COMPANIES REFUSE TO COMPENSATE FOR THAT. MEDICINE HAS BECOME TOO MUCH OF AN ASSEMBLY LINE PROCESS. HURRY HURRY AND CHEAP CHEAP
  • medical costs & care
    Face it folks, medicine is NOT focused on the patient and making him/her better. It is focused on making money for the medical profession and the few select people it allows into medical school. When one has a good insurance policy, you will be sent to see every possible dr out there. The key to better health care in country is to make that profession more accountable for the "treatment" it provides. When doctors make mistakes which result in death, they should be held criminally responsible. Doctors ought to know about the side effects and possible interactions of the drugs they prescribe. When a dr harms a person because he didn't know about interactions or side effects, they need to go to jail as much as the person who didn't know the gun was loaded. How did drs ever get into a position where they are paid, no matter how wrong the treatment. And if they don't do it right, they don't get paid. Why don't insurance companies review the treatment given before paying the dr IF the patient raises the issue? As it is, one must either have insurance or pay cash before one even sees a dr. Why are they so afraid they won't be paid? Yes, drs & hospitals need to stand behind their work and for more than 90 days. The harm from DES stents often doesn't appear for more than 3 years after implantation. Doctors are not gods, they are human beings and humans make mistakes. Publicly rating drs & hosp might help.
    The best thing would be for the medical profession to realize that it's duty is to the patient--and not to the drug/device community Do unto others as you want others to do unto you.

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This week's poll
NYC health inspectors have been handing out violations to chain restaurants that don't post calorie counts on their menus. What's your take on this?
I believe in what the inspectors are doing. Long live the food police.
This isn't a legitimate function of gov't-paid employees.
I couldn't care less. I'd be eating at home to save money!
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