Insurance companies set the prices and institutions are legally beholden to that.
If you are self pay, (ie have no contract with any insurance company) your bills are half of what a covered patient is charged. Hospitals/Clinics have to charge insured Pts insurance prices. Or they will be blacklisted.
While your paying double with insurance. Your coverage will claim its covering half before decuct. In reality, this is a lie.
You pay what self pay patients pay.
Then, ins will tell you they negatiated a better price on your behalf, so they didn't even have to pay the other half. Isn't that nice?
In reality, they set the inflated price to scare you into keeping insurance and to pretend like they're doing something for you.. its a scam.
All while your here paying off impossible deductibles, copays, and for the insurance itself. They are extorting money off you with 0 benefit.
God forbid you have emergency outside of network and get stuck with a surgery bill thats double the price it should be!
Insurance is only okay-ish for people who need a ton of medications, (just get part D plans that only cover meds)
Or people with preexisting conditions who's medical bills exceed deductibles, but they often deny coverage for people like this! So what's the point? Or emergencies, and thats if your in network and you'd still be paying 5k deduct and the price will be doubled for everything.
Self pay prices would drastically drop if this weren't the case. Its legalized price gouging.
I am anti vax, so I haven't had a vaccine in years. But when I signed up with the VA my records show I had several vaccines. So my dr clinic has falsified my records.
What am I missing here? The only way you can self pay is if you don't have insurance. By giving people the money they still have to purchase insurance if they think they need it. Other than possibly creating some competition, which I doubt because they collude in not having differences in pricing, how is it any different. A person still pays a crazy price for the insurance. How would the government figure out what a person should receive in payment? What would you suggest to make something like this work?
Well there needs to be anti trust lawsuits against insurances because they're definitely racketeering.
Maybe allow insured patients the right to opt out of insurance pricing, they can self pay if so choose. That way ins can't price gouge, pricing becomes transparent and competitive again.(and if you have an emergency your not stuck with some over inflated bill)
I definitely dont think throwing more tax money at the issue would help. Obamacare made this issue way worse.
The only thing it was good for is encouraging insurances to cover pts with preexisting. That can stay.
FYI the government already regulates medical pricing and it is usually what self pay is priced at. You can view the "real" cost of procedures at "CMS.gov Fee Schedual" if you have the codes for the proceedures, which you can google and have access to on your bills. (Ex; 99213 is a typical, basline Dr visit / checkup) ((remember in a hospital - not a clinic. Fees are doubled because there is a hospital fee and Dr fee))
Trumps first term made pricing transparent but its still not enough. Insurance convolutes everything on purpose so people dont really understand, even with pricing transparency as it stands currently.
We should have the right to opt out. That would take some of the power out of the hands of the insurance companies and give to us. Racketeering is another avenue that must be looked at because they are colluding to set prices between each other. They must be reined in. You are right. The ACA only amplified the problems and throwing more money at it only benefits the insurance companies. That is why simply extending the subsides is not a solution.
Insurance companies set the prices and institutions are legally beholden to that.
If you are self pay, (ie have no contract with any insurance company) your bills are half of what a covered patient is charged. Hospitals/Clinics have to charge insured Pts insurance prices. Or they will be blacklisted.
While your paying double with insurance. Your coverage will claim its covering half before decuct. In reality, this is a lie.
You pay what self pay patients pay.
Then, ins will tell you they negatiated a better price on your behalf, so they didn't even have to pay the other half. Isn't that nice?
In reality, they set the inflated price to scare you into keeping insurance and to pretend like they're doing something for you.. its a scam.
All while your here paying off impossible deductibles, copays, and for the insurance itself. They are extorting money off you with 0 benefit.
God forbid you have emergency outside of network and get stuck with a surgery bill thats double the price it should be!
Insurance is only okay-ish for people who need a ton of medications, (just get part D plans that only cover meds)
Or people with preexisting conditions who's medical bills exceed deductibles, but they often deny coverage for people like this! So what's the point? Or emergencies, and thats if your in network and you'd still be paying 5k deduct and the price will be doubled for everything.
Self pay prices would drastically drop if this weren't the case. Its legalized price gouging.
I am anti vax, so I haven't had a vaccine in years. But when I signed up with the VA my records show I had several vaccines. So my dr clinic has falsified my records.
What am I missing here? The only way you can self pay is if you don't have insurance. By giving people the money they still have to purchase insurance if they think they need it. Other than possibly creating some competition, which I doubt because they collude in not having differences in pricing, how is it any different. A person still pays a crazy price for the insurance. How would the government figure out what a person should receive in payment? What would you suggest to make something like this work?
Well there needs to be anti trust lawsuits against insurances because they're definitely racketeering.
Maybe allow insured patients the right to opt out of insurance pricing, they can self pay if so choose. That way ins can't price gouge, pricing becomes transparent and competitive again.(and if you have an emergency your not stuck with some over inflated bill)
I definitely dont think throwing more tax money at the issue would help. Obamacare made this issue way worse.
The only thing it was good for is encouraging insurances to cover pts with preexisting. That can stay.
FYI the government already regulates medical pricing and it is usually what self pay is priced at. You can view the "real" cost of procedures at "CMS.gov Fee Schedual" if you have the codes for the proceedures, which you can google and have access to on your bills. (Ex; 99213 is a typical, basline Dr visit / checkup) ((remember in a hospital - not a clinic. Fees are doubled because there is a hospital fee and Dr fee))
Trumps first term made pricing transparent but its still not enough. Insurance convolutes everything on purpose so people dont really understand, even with pricing transparency as it stands currently.
Thank you for your reply. That helps.
We should have the right to opt out. That would take some of the power out of the hands of the insurance companies and give to us. Racketeering is another avenue that must be looked at because they are colluding to set prices between each other. They must be reined in. You are right. The ACA only amplified the problems and throwing more money at it only benefits the insurance companies. That is why simply extending the subsides is not a solution.
Thank you! I had no idea!