The scam that is health care in america

My wife had a knee replacement last month
just got the first bill from one of the doctors

Total bill 2700
insurance paid 170
our payment 40

the balance written off because of an agreement between the insurance company and the doctor

That means the doctor was going to charge an uninsured person 1200% more than what they were willing to accept from an insured patient.

That should be illegal.
medical providers should be banned from charging uninsured patients any more than they are willing to accept from insured patients

We went over this on the old board.

The agree ment with insurance companies – the hospital/doctor KNOW they will get paid. No doubt about it.

Uninsured patient. Crap shoot. How many will pay? How long will it take them to pay? what are the extra costs for the hospital/Dr. to collect the outstanding bill? All those variables and more are figured into the extra costs from those who might not ever pay their bill.

Curious… that just seems off, period. I am used to seeing crazy medical bills, but that is before the negotiated insurance price. Yours is just odd.

Getting routine car service costs more…

Not exactly. The charge master isn’t trying to figure in the cost of the uninsured, it’s sort of a twisted result of our screwed up method of hospital billing. No provider would expect any uninsured to actually pay the chargemaster. In fact, I know a local healthcare system that automatically applies an “uninsured” discount to the chargemaster. Not the 80%ish percent seen in insured individuals, more 50-60%.

Gee it almost seems like we should make everyone be insured under a group we know will pay and that everyone pays into.

The bill references is probably not the total cost, most likely the physician service portion.

In other words, the surgeon (or maybe anesthesia) got paid $170 to do the surgery. The hospital is going to have a separate bill for the OR time and other services.

But that’s just a hunch.

$210 dollars is what a surgeon takes home for a knee replacement?

Again, this makes no sense.

And I am ignoring fully loaded rates and and the multiplier the hospital needs…

Surprise? Physicians may not be paid as well as one might think.

Might be the anesthesiologist too.

So people who might not be able to pay or will take a while are charged more than someone who has it, and this is supposed to make sense?

I doubt he is gettin separate bills; I guess we can pretend a surgeon gets less per hour than a mechanic at your dealership, but I am gonna have to pass on the fiction.

I can’t find the exact amount on the Medicare Physician fee schedule right now. It was probably anesthesia potential he a nurse anesthetist. People most definitely can and do get separate bills for separate services. Physicians are often independent of the hospital systems operate in.

yep,this bill was just for one doctor.

Ive seen an estimate of what the hospital will charge and what my end will be.

the total procedure will result in medical providers getting maybe 15% total of what they charged

this wasnt the surgeons fee. this is a different doctor. Im not even sure which one yet,the bill just has a generic name on it. it may be the anesesiologist

I will get separate bills from teh surgeon, the anesthesiologist, the hospital and a host of other providers

Makes more sense if not the surgeon, but I have seen similar costs for cash paying patients. Now any form of credit with the hospital… yeah… still better but much worse.