Q&A – The Cost Of Medical Care With And Without Insurance

Today’s entry - My son was admitted to a hospital ER in January with a broken arm. The hospital had trouble entering our insurance info. Afterwards, we received an adjusted bill for $1,950. I called the billing office to submit our insurance info. Our next bill was a real shocker. With insurance, the adjusted bill soared to over $30,000 and we pay 30% coinsurance, so we are now facing a new bill over $8,000 just for the ER visit. That’s not counting all the other providers who were involved. When I called, the billing department refused to budge on the amount. They even suggested I ask my insurance company why they couldn’t secure a better price. So now the consumer is expected to sit in on annual negotiations between the hospitals and insurers? 

Anyway, just wanted to give you an idea about the total lack of transparency in the health care industry. It’s enough to turn a Reagan Republican into a Bernie Bro.

Bottom Line: This is a sad and extreme example of what happens daily across the country generally without people ever realizing it. It’s rare for someone to have the “cash” price of the medical care prior to receiving the insurance adjusted rate. 

This note was a follow-up to my story from last Thursday in which I illustrated that health insurance doesn’t equal healthcare. Healthcare costs have increased above the rate of inflation every year since the end of the 1960s and the insurance first model is largely to blame. Without transparency you have a constant fight between the insurance company and medical service providers with you left holding the tab for your portion of whatever your obligation is once they’re done. We would never stand for it in any other aspect of our lives, but we have been conditioned for decades to accept it. 

Once again, the greatest failure of the Affordable Care Act was taking the single greatest obstacle to more affordable healthcare, health insurance, and mandating it. This is also why I strongly suggest you ask what the cost of healthcare is going to be in non-emergency situations prior to obtaining the care and signing the piece of paper that says you will pay whatever the price is once your insurance company has settled up with your medical service provider. 

You’d be amazed at what the difference can be when insurance isn’t where the conversation begins. Consumer price transparency is the solution, the more we do on our end to be better consumers, even with health insurance, the more likely we are to begin making progress. Waiting on Washington for “fixes” has not been an effective strategy. 

Submit your question using one of these methods. 

Email: brianmudd@iheartmedia.com

Twitter: @brianmuddradio

Facebook: Brian Mudd https://www.facebook.com/brian.mudd1

Photo by: Joe Raedle/Getty Images

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