Checking out my United Healthcare paperwork, here are some of the latest scams from the American health care system.
The eye doctor billed $1,500, which the uninsured (sucker) would have had to pay. United Healthcare cut them back to $179, apparently the fair price. The eye doctor’s technician messed up the prescription by not using the automatic refractometer to get a basic sanity check before asking me all of the “1 versus 2” questions. I went back and United Healthcare was billed another $112, which they decided should have been $34. (Shout-out to Costco, which remade two pairs of glasses with the corrected prescription at no charge.)
I went to see a different specialist. The bill was $900 for what United Healthcare said should have been $219 worth of services.
I went to a physical therapist for a $934 look at my neck (tip: don’t sit at a computer for decades!) that was worth only $130.
How did we get to the point where stuff like this doesn’t faze Americans? We’ve become accustomed to the idea that health care providers try to rip off the uninsured, that absurd prices fly around in the system until they’re negotiated down by a computer or a person at a health insurance company (and, of course, we have to pay for that negotiation since the health insurer has no source of revenue other than us), but how did that happen?
Related:
- Gender Studies class goes to the eye doctor
- The $27,321 MRI (the fair price was $1,287 and the value was $0)
- “Some Hospitals Marking Up Treatments By as Much as 1,000 Percent: Study” (NBC 2015): “The hospital with the highest charges? North Okaloosa Medical Center, about an hour outside Pensacola, Florida. It charges uninsured and out-of-network patients 12.6 times what Medicare allows.” (the justification for this is that the hospitals also provide “uncompensated care”, e.g., for migrants who don’t qualify for Medicaid, and the best way to make up for these losses is to cheat the uninsured)
- CNN story about a hero to progressives (I personally see the providers and the government regulators as the villains; in my view insurers are doing the best they can inside a completely broken system):
“We’ve become accustomed to the idea that health care providers try to rip off the uninsured”
But with Medicare, expanded Medicaid, CHIP, and heavily-subsidized ACA, isn’t there nearly zero uninsured?
Mr. Google says 8 – 9 % of Americans are uninsured in 2024.
I recently had successful cataract removal surgery in one eye. I had to pay the full cost at $1500, since I hadn’t met my annual $3000 deductible.
For comparison, a contractor is installing a new 9×7 garage door at my home on Friday for $2100.
I recently received a bill for $3000 for a five minute out-of-town ambulance ride necessitated by a nosebleed caused by primary aldosteronism.
There are several noteworthy observations:
1- The medical system really really really does not want to treat primary aldosteronism properly. It could be all the diabetes doctors named Mohammed. It also could be the medical trials like ALLHAT that created standards of care based on a cohort of sedentary obese 70 years olds with high sodium diets (ace/arb+hctz recommended).
2- I was never actually billed $3000. Instead my bank notified me of a collection that had been filed on my credit report. This may be my get out of jail free card as it is patently illegal under state and federal law to bill directly to collections. It is also par for the course for medicine and may require lawyers to resolve either way.
3- To answer the question proposed “how did that happen?” It is impossible to fund an egalitarian sector like health care at 20-25% of gdp, without some degree of socialist thuggery. Tax receipts typically start to struggle above the 20-25% range, and the government has many additional priorities. The web of mandates, insurance scams, and thuggish billing practices is how we get socialism while maintaining the illusion of free markets.