our wacky health care system
Jun. 10th, 2019 08:02 pmI just got a medical bill in the mail. ![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
shalmestere had wanted to know whether her childhood immunizations were still protective or needed a refresher, so she had some blood tests. The list price for the five blood tests came to $1061.14, of which the insurance company paid $34.58, we owe $39.41, and the remaining $987.15 vanished in a puff of negotiated smoke.
Obviously, these blood tests don't actually cost $1051.14 to run, or the screening lab would go quickly bankrupt getting paid six cents on the dollar. I assume that if we didn't have insurance, we would have gotten a bill for the full $1061.14, but I'm quite sure that
(a) uninsured patients are a small fraction of the total, and
(b) even uninsured patients don't necessarily pay that much, because some of them simply can't.
Let's guess that at most 10% of patients actually pay the list price, and the rest pay roughly what we and our insurance company are paying. That averages out to the lab actually getting paid $172.70 for these tests, so the cost of running them must be less than that. Why not just charge everybody $175, regardless of what insurance they have (if any)?
(If 5% rather than 10% of patients pay the list price, the lab would be getting $123.35 per patient; again, why not just charge everybody $125 rather than making up this wacky number with no connection to reality, hoping to actually get it from a tiny fraction of patients?)
shalmestere had wanted to know whether her childhood immunizations were still protective or needed a refresher, so she had some blood tests. The list price for the five blood tests came to $1061.14, of which the insurance company paid $34.58, we owe $39.41, and the remaining $987.15 vanished in a puff of negotiated smoke.Obviously, these blood tests don't actually cost $1051.14 to run, or the screening lab would go quickly bankrupt getting paid six cents on the dollar. I assume that if we didn't have insurance, we would have gotten a bill for the full $1061.14, but I'm quite sure that
(a) uninsured patients are a small fraction of the total, and
(b) even uninsured patients don't necessarily pay that much, because some of them simply can't.
Let's guess that at most 10% of patients actually pay the list price, and the rest pay roughly what we and our insurance company are paying. That averages out to the lab actually getting paid $172.70 for these tests, so the cost of running them must be less than that. Why not just charge everybody $175, regardless of what insurance they have (if any)?
(If 5% rather than 10% of patients pay the list price, the lab would be getting $123.35 per patient; again, why not just charge everybody $125 rather than making up this wacky number with no connection to reality, hoping to actually get it from a tiny fraction of patients?)
