On a recent CBS Sunday Morning broadcast, it was revealed how much "Med-Flight" helicopters cost and how much patients are charged. Redundant? Read on!
The cost with some profit for the service provider averages about $12,000 according to the management representative of a certain med-flight service and that is typically what the insurance pays for ... if the patient has insurance. You see, the med-flight service actually send out invoices for around $50,000 because so few people can pay the $12,000 they have to "over-charge" everyone.
In a previous post we outlined an out patient hospital procedure that only resulted in the hospital being paid $1,200 ... $600 from the patient and $600 from the insurance carrier and the rest was written off ... right on the EOB (Explanation of Benefits). So, what is going on here?
It seems that those that say that it is always about "money or sex" when trying to root out corruption applies here. It seems to be money. Why would a hospital charge $12,000 but then accept $1,200 as full payment when an insurance company is involved? Let that simmer for a minute. Then scroll down.
It is about money. When asked about the procedure's cost, the Doctor quickly responded, $12,000. The relief is that with insurance, it only cost the insured patient $600. So who benefits from this arrangement? Let that simmer for a minute. The scroll down some more.
First, consider who does NOT benefit. The uninsured. Because the uninsured have to pay the $12,000 or seek some agency to pay it on their behalf ... or even finance it with the hospital accounts receivable office. So, who benefits? Well, who gets the "deal" on the $12,000 procedure? Not the patient really because the patient is paying $600 plus their monthly premium. The insurance company is the big winner here. They have provided no real service, while claiming to negotiate the costs down actually have driven costs up for all of us because our taxes fund payments for those without insurance who get to pay rates that in this case are higher by a multiple of 10 and the actual cost is hidden in the process so the insured have a false sense of gratitude because they are led to believe that their insurance really saved them.
I remember flashing down the interstate with a co-worker who was driving probably a little too fast. As we approached a merging lane a car suddenly appeared beside us and my co-worker jerked our car hard to the left lane and overshot it by putting the left 2 wheels on the grass. Then with a panicked stab on the brakes, we were spinning down the center of the two lanes with all 4 wheels locked (this was before anti-lock brakes). As our car came to a stop, we were cross ways in the middle of the two lanes with on-coming traffic, which included a tractor trailer, headed directly at my door (this was before air bags too, but I doubt that an airbag would have stopped that truck). My co-worker quickly backed into the median grass and the traffic whisked past us without a scratch to us or the car. So, then my co-worker asked for a "thank you" for saving my life.
That is the point of both of these stories. My co-worker put me in "harm's way" so why should I be grateful? The apparent collusion between providers, insurance companies and drug companies have contributed significantly to the rising costs of care and insurance ... why should we be thankful?
Why not just charge $1,200 and move on? Does it really matter who pays it? Should it really matter who pays it?