<political-rant>
I had surgery to repair my broken ankle this sumer. I also have fairly good health insurance through my employer. So, when the pre-billing statements from the hospital, surgeon, and anasthesiologist started showing up, I didn’t panic, even though the total bill (>$15K) would have been pretty tough for me to pay out-of-pocket.
When all was said and done, and my insurance had been fully invoked, I ended up owing a little under $1500. Seems pretty good, right? 90% coverage is good enough for all but the most expensive medical issues, and even significantly more expensive bills might be manageable under some sort of payment structure.
However, of that more than $13,000 that was “covered,” my insurance company actually only paid about $4000. That’s because they drive down the cost of everything else via contracts held with the hospitals, along with a healthy dose of strong-arming of doctors and specialists. (”If you want us to cover any of your patients, you’re going to have to accept 30 cents on the dollar for this procedure.”)
While that doesn’t directly affect me, it does mean that prices have to be that much higher for everyone without insurance. Without the insurance companies to negotiate on their behalf, they’re stuck paying extra to cover the gap between the real cost of care and what the insurers will pay.
We need a comprehensive Federal health plan that covers everyone if we’re going to have any chance of getting a handle on the cost of health care. Leaving those with the least all on their own to try to negotiate for care is neither fair nor sustainable.
</political-rant>
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