Our health insurer just sent an Explanation of Benefits. I went to see a doctor and she billed the absurd $528 that would have been charged to the unfortunate uninsured victim. The insurance company knocked this down to $123.75 so they paid $43.75 and I paid the $80 copayment (on top of the $30,000 per year that we pay in premium).
Except for catastrophes, it seems that nobody would need health insurance if health insurance didn’t exist and providers had to charge a retail price that had some basis in market reality. The person who can afford the $80 co-pay can also afford $123.75.
- “A $20,243 bike crash: Zuckerberg hospital’s aggressive tactics leave patients with big bills” (Vox): Paramedics took her to the emergency room at Zuckerberg San Francisco General Hospital, where doctors X-rayed her arm and took a CT scan of her brain and spine. She left with her arm in a splint, on pain medication, and with a recommendation to follow up with an orthopedist. … A few months later, Dang got a bill for $24,074.50. Premera Blue Cross, her health insurer, would only cover $3,830.79 of that — an amount that it thought was fair for the services provided. That left Dang with $20,243.71 to pay, which the hospital threatened to send to collections in mid-December.