Wednesday, January 09, 2008

Gouging the Uninsured

Every time I get a medical bill, I am shocked at the difference between the price of medical services and the cost of medical services.

I paid a bill this morning for a medical procedure and, according to the bill, the price of the procedure was $1,300. However, because I am insured, there was a $862 "adjustment," reducing the cost of the procedure to only $438.

This "adjustment" was not a payment by the insurance company, but reflected a price agreement negotiated between the insurance company and the doctors. The insurance company has said to the doctors, "You can quote whatever price you want, but we're only going to pay $438 for that procedure." And the doctors agreed.

What is most shocking is not just that doctors routinely bill prices that are 66% more than what they are really willing to accept as payment, but the implications of what this means for the 40% of our population that are uninsured. If you're uninsured, no one has negotiated a lower price for you, and no one will, and you're probably in no position to bargain, being in an emergency room with a serious medical problem and a poor credit history.

So if you're uninsured, you get gouged.

Remember that the next time you hear about some astronomically large medical bill that was run up by an uninsured person, or when you hear about the high cost of medical care, because what you may be hearing about is inflated prices.

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