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Old 01-21-2013, 09:19 AM   #41
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I want an answer too.
And why do the medical providers agree to accept an insurance payment much lower than their original bill. Could it be that the bills were inflated in the first place?
This. So nobody else is paying, IMO. But even those "negotiated" prices are inflated to pay for those who cannot. Not saying this in anger, just sayin'.
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Old 01-21-2013, 09:45 AM   #42
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I don't think it makes sense to put the costs of providing service to people who cannot pay on the people who provide the service. Should we expect the tollbooth attendant to pay tolls for the cars that roll up to the booth without any cash in them?
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Old 01-21-2013, 09:54 AM   #43
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I don't think it makes sense to put the costs of providing service to people who cannot pay on the people who provide the service. Should we expect the tollbooth attendant to pay tolls for the cars that roll up to the booth without any cash in them?
Well in the longer term everybody else pays due to higher rates because of the increased cost of doing business.
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Old 01-21-2013, 09:56 AM   #44
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Yes.
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Old 01-21-2013, 10:19 AM   #45
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I don't think it makes sense to put the costs of providing service to people who cannot pay on the people who provide the service. Should we expect the tollbooth attendant to pay tolls for the cars that roll up to the booth without any cash in them?
The difference is, there is a law that says people can't be turned away for emergency treatment - so somebody has to pay.

The tollboth attendant can say - sorry, no admittance.

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Old 01-21-2013, 10:21 AM   #46
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I'm not sure I understand why that makes a difference, i.e., why the law should place an expectation on those who provide service to cover the cost of the service. I think, in that regard, the two scenarios are the same.
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Old 01-21-2013, 11:24 AM   #47
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Well if it's not the provider who pays directly (as a cost of doing business) then it would be the government. But single payer is a non-starter in the US and increasing the amount of government funded healthcare is incredibly difficult (e.g., fight over PPACA).

I guess now with essentially mandatory coverage (and insurance rebates for low-income folks), this scenario should happen less.
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Old 01-21-2013, 12:19 PM   #48
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The reason why hospitals and providers have to build in an allowance for unpaid accounts receivable is that many people present for health care as an emergency when there is no opportunity to check their financial ability to pay before beginning treatment. There are ethical issues why they cannot be turned away. The extra cost is built into hospital budgets and inflates your health care costs.
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Old 01-21-2013, 12:27 PM   #49
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There are ethical issues why they cannot be turned away.
Legal issues, as well.
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Old 01-21-2013, 12:39 PM   #50
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Please provide a snippet or summary of the link so members don't have to open it to find out what it is.
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Old 01-21-2013, 12:41 PM   #51
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Surely:
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Emergency Medical Treatment & Labor Act (EMTALA)
In 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay. Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented.
I didn't think it was an issue given that it was a government website.
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Old 01-21-2013, 12:52 PM   #52
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I didn't think it was an issue given that it was a government website.
Thank you. It is a courtesy to other members so they don't have to open a link and go to another site when a summary might do. Community rues also encourage this
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Old 01-21-2013, 12:55 PM   #53
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Make sense. Will do from now on.
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Old 01-21-2013, 01:02 PM   #54
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Thanks for the clarification. This makes more sense, and looks like the pricing I have seen as well. Not sure I'd call it a discount, though. More like a price dysfunction. Pity the person stuck with no insurance and a bit of money in the bank.
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Old 01-21-2013, 01:04 PM   #55
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This. So nobody else is paying, IMO. But even those "negotiated" prices are inflated to pay for those who cannot. Not saying this in anger, just sayin'.
Maybe this explains why a podiatrist told me that orthotics (which I did not get) would cost $600 if I had insurance, $300 if I did not.

That surprised me.

A similar situation occurred with my optometrist. For years I had VSP, and they still encourage me to buy an individual policy. When I heard their summary of costs to a VSP-insured client and how much that client had 'saved,' I realized that as a privately paying individual, I was already paying the lower rate. I was paying the same out of pocket that the VSP-insured client was paying out of pocket.

I finally figured they wanted me to purchase VSP so that they could bill VSP those higher rates. In effect, I would be purchasing insurance and getting the same prices on my optometric services, but they would be making more money because they would be able to bill VSP those higher rates.

So my out of pocket costs would have increased by the amount of the premiums, and I figured I wasn't going to save much on the other services I received.

What a system!
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Old 01-21-2013, 04:45 PM   #56
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When my doc left his practice to go teach, I tried to get another doc in the practice that wasn't taking new patients. I finally got in when I said I had BCBS. My dentist on the other hand suggested I drop my DI, he said I could pay a cash price, well below DI allowed fees. So far so good saved $1112 in the last 2 years.
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