FinallyRetired
Thinks s/he gets paid by the post
- Joined
- Aug 1, 2002
- Messages
- 1,322
After receiving several medical bills from doctors and hospitals, I've been shocked not by the high billed charges (which I've grown desensitized to), but by the huge disparity between the billed amount versus the Medicare allowable amount. Actually, I use military Tricare, but by law it's tied to Medicare allowable amounts, so it's the same thing.
For example a $10,000 billed charge for a major surgery might result in a Medicare allowable charge of only $2,000, of which Medicare pays 80%, or $1600, and I pay $400.
I have mixed feelings about this, and several possible explanations, and I have no idea which is correct:
1. If the procedure really costs $10,000, the doctor is being tremendously underpaid by Medicare, and I'm surprised any of them accept Medicare. It's only a matter of time before they drop Medicare patients, since no business can sustain such losses.
2. If the procedure really costs $2,000, the doctor is tremendously overcharging the patient, and Medicare is looking out for the patient by adjusting billing charges (and, yet, Medicare is said to be going bankrupt).
3. The true cost is somewhere between 1 and 2. We have a multiple tier system in this country: (a) those on Medicare, (b) those who are wealthy or have good private insurance, and (c) everyone else. Doctors/hospitals accept payment based on the tier of coverage, making up with tier (b) for losses for tiers (a) and (c).
I suspect the answer is 3. Am I correct, or is there something else going on?
For example a $10,000 billed charge for a major surgery might result in a Medicare allowable charge of only $2,000, of which Medicare pays 80%, or $1600, and I pay $400.
I have mixed feelings about this, and several possible explanations, and I have no idea which is correct:
1. If the procedure really costs $10,000, the doctor is being tremendously underpaid by Medicare, and I'm surprised any of them accept Medicare. It's only a matter of time before they drop Medicare patients, since no business can sustain such losses.
2. If the procedure really costs $2,000, the doctor is tremendously overcharging the patient, and Medicare is looking out for the patient by adjusting billing charges (and, yet, Medicare is said to be going bankrupt).
3. The true cost is somewhere between 1 and 2. We have a multiple tier system in this country: (a) those on Medicare, (b) those who are wealthy or have good private insurance, and (c) everyone else. Doctors/hospitals accept payment based on the tier of coverage, making up with tier (b) for losses for tiers (a) and (c).
I suspect the answer is 3. Am I correct, or is there something else going on?