An average day in the U.S. health care system. Here’s a Quest Diagnostics bill for some blood tests:
The good news is that the patient paid only $103 for the tests ($83 via insurance; $20.67 via an efficient paper bill mailed in USPS) that are worth $1,559. The rain on this parade is that there is no world in which these tests are worth 15X what Quest gladly accepted as payment under United Healthcare’s negotiated rate. The only time that $1,559 would have kicked in is if Quest were pursuing a patient whose insurance fell through the cracks somehow.
I still can’t figure out how it is legal for Quest or any other health care provider to pursue an uninsured patient for 15X the fair price for its services (where “fair” = what 98% of customers pay).
Related:
- San Francisco’s city-owned, Mark Zuckerberg-financed hospital ripping off patients with bills that are 6X the fair price: New York Post
I can’t figure out how it is legal for A Mother’s Love Mega Healthcare, Inc. to deny all subsequent claims if I mention the word “back”. Or how it is legal for corporate bean-counters to practice medicine. But then, I’ve very ignorant of health-care laws and de facto practices, maybe I ought to ask my Ivy League trained lawyer friend in Florida. Oh wait, he only represents the under served physician-class; his assistant is adamant that his schedule is very booked, no time for college chums.
P.S.
What about the legality of my $2000 a month ObamaCare premiums (if I could afford them).
I have done blood tests in 3rd world countries for $10 total. No insurance. It’s like buying something at the grocery store in the US, except the price you see is the price you pay. Full panel.
In countries like those there is basically an anarcho-capitalist system. In practice it should be illegal but nothing is enforced so everything is permitted.
They send a gentleman to your house. He ensures you watch him breaking the seal in front of him so you know it’s a new needle. Then they go back and you get a full copy by email in a few days
Anon: If you check the above you’ll see that quite a few of the tests are price at only $10-20 and some of these were panels. So thefair/real price of running the fancy machine isn’t that different here. The difference is that an American has to travel to the blood draw and also there is an ever-present risk of being billed 15X the fair price in case of an insurance mixup.
I’d rather pay $1559 for a blood test than live in a 3rd world shithole, thank you, all things considered. Why are they all streaming into America, with such cheap, wonderous healthcare available in the old country. Best.
@Guy, people do frequently go back for dental (don’t know about other medical but possible). Turns out to be cheaper including airfare cost, and probably better care too.
I am not clear on who if anyone pays the rack rate for medical costs. I am also not clear on whether courts enforce these sorts of claims if they do end up in court. I once had a claim from one of the big testing companies with similarly inflated prices- I don’t remember why insurance was not involved. I disputed the claim and offered to pay the right price, which was about $50. My recollection is that after a bit of back and forth the company disappeared and never bothered to collect the $50. I think if you dispute the claim – i.e. send a registered letter saying “I dispute the claim” & give some reason- the companies typically disappear. My guess is if you don’t dispute the claim then the claimant or more likely the collection company the undisputed claim is sold to is entitled to initiate a summary proceeding (i.e. the fairness of the numbers is not open to question – just whether you were given notice and failed to dispute the claim) and the entry of a default judgment. The judgment can then be enforced through the garnishment of wages, a lien on property, etc. I think there is also another issue, which is often the patient is not contracting with the testing service but rather with a physician or hospital that in turn contracts with the testing service. That would seem to raise possible defenses.
I don’t know what the high price is. I don’t think anybody pays it. (In my case, it was a $155,000 scan the insurance paid $8500 for.
I do wonder about stories that people are bankrupted by medical expenses. Surely any jury would be able to see that most medial billing is bogus.
I did not have health insurance for a stretch of several years and it was cheaper to pay negotiated prices out of the pocket then buying so – called insurance, including for minor surgeries and minor hospital stays. Same for dentists, until my dentist got smart (built the practice) and started charging top rates, influenced by crappy dental insurance “negotiators”. Now he asks for insurance, which pays him more then I used to negotiate. I am stack with him because he is doing comparatively great job, comparatively to bums from top tier dental schools that I had a misfortune to patron before of course. He is not fully realizing this, otherwise he would charge even more.