We view our own health care providers as benevolent and altruistic. Unfortunately, many of them work for blood sucking evil accounting offices whose sole focus is to bleed you to death financially:
Too often after a hospital procedure or visit to an emergency room patients get hit with unexpected bills from out-of-network doctors they had no role in choosing. These include assistant surgeons, emergency room doctors and anesthesiologists.
We just ran into balance billing. The local monopoly accepted a usual and customary reduced payment from a third party group payer. But then turned around and billed us for the entire remaining amount.
This is known as highway robbery by those altruistic health care practitioners.
How this works: Let’s say you have a “list price” $15,000 bill for health care. Chances are good that an in-network service charge for this would be as low as $5,000 and that is what the health care monopoly accepts in payment. But, in many places the health care monopolist bills the patient for the amount that was discounted. Stated another way, the third party pays $5,000 for the customary discounted price, and the health care provider then bills the patient for $10,000.
For this reason, the business side of health care is appropriately referred to as evil, mean, cruel – and run by literal blood suckers.
Imagine if you walked in to a grocery store and you paid different prices based upon which credit card you used to pay your bill. That’s what industrial health care does: prices vary not based on the service but on which “buying club” you belong to and how you choose to pay.
Health care is corrupt to its core. They do this because they can. They do not provide prices in advance and in an urgent scenario, you have no choice to but accept their blank bill upon entry.
Consider ACA policies. Much to the surprise of those with employer provided group insurance, ACA policies are not anything like your ESI. Where I live an “ACA Silver” plan with a $7,000 deductible costs $24,000/year. For the most part, you will spend over $30,000/year before you receive “benefits”.
Furthermore, check the fine print – almost all of the ACA policies in my area exclude coverage for hospitalization or surgery “out of network”. We are used to seeing limitations such as “50% coverage for out of network” – but most ACA policies decline all coverage for serious problems out of network.
Literally, while traveling in the U.S., if something were to happen requiring surgery or hospitalization, you have no insurance coverage. None. The Affordable Care Act created – a market of no insurance coverage.
What about “ACA subsidies”? If your household pre-tax income is above about $68,000 per year, you are not eligible for subsidies. When arrogant Jonathan Gruber wrote these policies into the ACA, he set up the subsidy cut off level to be determined as a function of the local poverty income level. The cut off level has no connection to insurance prices. Consequently, there are situations such as in Laramie WY where a Silver plan for an older couple costs $49,000/year with a $5,000 deductible – but if they make $69,000/year in pre-tax income, they are not eligible for any subsidies. Simple math – if your pre-tax income is $69k/year, after Federal and state taxes, property taxes – you basically have no money left for food and shelter. That’s how the ACA proponents defined “Affordable”?