Uninsured's leave $49 billion in unpaid hospital bills

[The Voice]

Again it is the insurance companies as a whole that are the problem and why costs are going up. I work in an industry where I see patient financials. If you have a procedure done that is 1000 and the Insurance is only contracted to pay 46% based on the current fee schedule then of that 1000 the hospital/physician is only allowed to receive $640. Of that 640 the insurance company will usually pay 80% Which is $512.

So from a 1000 charge that a business is trying to collect they are only able to collect 51% in a timely manner (usually take 3 weeks from the time a bill drops till the time an insurance company sends in the payment. Then and only then can they bill the secondary insurance (if there is any) or the patient. if the claim is denied then through the appeal process the hospital or physicians office can bill the patient. However for those that have insurance but their treatments are not deemed medically necessary can foot the entire bill. So when you deny a cancer patient Chemo for the reason of "Not Medically Necessary" and the patient has to pay $35,000 out of pocket when they have insurance). How is that not broken?

The problem is the insurance companies and the way they adjudicate their claims. Think about it this way. You were in a car accident. You file a claim and have about 5000 worth of repairs that need to be done. However the Insurance company says that since your car still runs they aren't covering it and you have to pay the entire 5000 out of pocket.

Who in this thread said the current system isn't broken? Please show me the quote where someone said "I'm completely satisfied with the current system".

You can't just try to fix the insurance problem. There's many other problems with our medical system. You need to address the pharmaceuticals, hospitals, and medical equipment companies. They all have issues that drive up the price of medical bills.

 

[Coyote]

This is the fundamental reason for government services ... to provide services that do not make sense for private industry to provide, and there's simply no profit motive for the private industry to provide affordable care to high-risk customers. We can accept this in other insurance industries. If car insurance became too expensive you could just stop driving, but just stop living is not an acceptable option.

But in John Kasich Land, and in the heads of many Republicans who share his ideologies, it makes sense for private industry to provide any and all services. That whole caveat about "no profit motive"--which you're absolutely right about--just gets ignored, I guess. Otherwise, they'd have to regulate the hell out of private industry, and they don't want that, either. And I'll give my conservative friends here something I think we can agree on: a clear law is always more efficient and effective than endless regulation noodling.

Tony Judt makes a lot of good points on public services in his book Ill Fares the Land. If you look at the concept of a highway, for instance, there's no way a thing like that gets done by even a relatively small private industry or corporation. There's not enough incentive. Once it's built, of course, it becomes possible for a corporation to maintain it, but what would be their incentive to keep up-to-date the portions of the highway that go through rural counties, towns, etc.?

I totally agree, but if I'm remembering this right, one of the reasons our "safety net" is setup to keep people unemployed is to manage the labor pool supply and demand. If we required welfare recipients to work, the fear is they'd just put someone else making more money doing the same thing out of work.

I think there's some truth to that. In that scenario, you'd have one guy unemployed and one considered "working poor", depending on what the company hired at. But I wonder if it's as applicable today. In a time when our economy was more about manufacturing, I think there was a smaller range of differences between skill sets. You could replace a guy making $10/hr with a guy who'd make $4 or $5/hr and not lose much in terms of skill. We're so specialized these days, I don't know that the same thing could happen as often. I know it does still happen, of course, but re-training and new education seems crucial today.