[quote="Iheartcoffee, post:14, topic:45686"]
I believe that a lot of the reasons for our high health care costs can be attributed to the fact that health insurance companies have become "cover everything" companies rather than "cover the big stuff" companies. Just look at how our society has arrived at this idea that health insurance must cover contraceptives!
Doctor's offices have a LOT of overhead, and the insurance companies don't reduce overhead. In fact, most offices have to have at least several people dedicated to filing claims, handling benefits, etc. Couple this with the fact that insurance companies routinely do not cover things as well as they originally stated. A person can verify benefits prior to a procedure, but it doesn't guarantee the insurance company will actually pay for the claim. Many physician's offices have to write off those discrepancies and they only bill the patient for the difference if the cannot afford the write-off. This results in raising prices. If the insurance company typically gives an office 75% of what they ask for, then the office will have raise prices to be able to make more to cover that 25% loss they had on earlier claims. The cycle continues and prices go up.
If high-deductible plans gain in popularity we stand to probably reduce the insurance problems because patients will pay out of pocket or from a health savings account for the day-to-day stuff and will only receive coverage in the event of high medical costs. It brings insurance back to what it was originally intended to do - which is cover a person in a time of crisis. We don't file a homeowners claim to buy air filters, light bulbs, and faucet covers in the winter. However, we can file claims if the AC unit is demolished in a storm, the lamp starts a fire, or cold pipes burst and flood the house. We expect people to pay for the basics around the house and to even set aside money for preventative maintenance and basic care. If we apply these rules to our homes, why not our bodies as well?
Excellent post! :thumbsup:
I can tell you that from my own direct experience, doctor's offices try to cover their costs, and when they have agreements with insurance companies, the write-offs come out of some other aspect of their practice. I used to bill Medicaid for the OB-GYN I worked for. We worked very hard to find the ICDM code that would get the most money out of the state. It wasn't fraud, but it was a game we played. We had to find the right way to bill the state or we'd get little to nothing for seeing a Medicaid patient. If we used the simplest of codes, we got almost nothing back, so it was like charity work for the doctor. The more detailed the code, the more the state would pay. The rest of the cost would be "written off," in other words, passed on to his other patients. I used to be pretty good at this kind of billing - found a few codes that unlocked the payments and got the doctor almost all of his normal fees.
I found out years ago that the reason we are so tied in to group health insurance through our employers was from government intrusion via wage freezes during the Depression. Tying health insurance to a job was a way to lure employees without raising salaries. Thus, another reaction to over-reaching government causes long-term negative consequences. Doesn't it always happen and when will people realize that a supreme government run by humans is NOT BENIGN...
When I was growing up, there was no such thing as all-inclusive coverage - Blue Cross/Blue Shield was for the big things, everything else, we simply paid for. And costs were reasonable. Then came Teddy Kennedy and his HMO legislation. That's when everything went berserk. People would come into the doctor's office for a case of sniffles, or any other complaint, because they only paid a small fee if anything. The doctors then tried to raise their fees to cover the extra cost but were told that they had to accept what the HMO would reimburse them. Some docs went out of business at that point.