What Pecentage Increase Does It Take to Steal a Sales Rep From Your Competition?
Fire the Jerk and Take A Nice Trip - My Wishes for HR Pros in 2008.....

When Sticker Price in Medical Insurance Reminds You Of Buying a GM Car...

Bought a new car recently?  If so, you know sticker price is for suckers... Do two things - wait for the juicy rebates always offered by Detroit automakers, then head to the lot and try to dicker the sales people down even further.  That's right, the marketing machine of US automakers has conditioned us not to move until there's a $5K rebate involved off the top. 

Health care is similar in some ways, but different in some critical aspects.  First up, there's a sticker price Used_cars_moviecover that hospital facilities quote to the general public related to what different procedures cost. Think of that as their "sticker price".  Here's the big difference - rebates aren't available to everyone, just to the folks with quality health care plans.  The Blue Cross networks (as well as other big insurance providers) are able to extract HUGE discounts from doctors and facilities alike through the power of their network.  If doctors/hospitals want BCBS patients, they've got to be a part of the network, and to be part of the network they've got to agree to the fee schedule touted by BCBS. 

That's where the discounts/rebates come into play.  The rebates can be huge when compared to the sticker prices touted by hospitals.  Here's a new record in my world I just came across.  Employee goes in for a procedure, with the company billed 19K for the entire bill.  Sticker price from the hospital before BCBS got ahold of the claim and went all Tony Soprano on it?  $152K.  That's right - the sticker price was over 7 times the actual cost ultimately allowed by BCBS.

Which makes me think two things.  First, I'm glad we have a good provider that can extract deep discounts off of sticker price.  Second, the common guy out there who's not covered by a plan like ours and is trying to go without insurance is a car wreck away from a lifetime of bills he can't pay and a probable personal bankruptcy.

There's something wrong with health care when sticker price on medical procedures makes buying a car look like a "one price, no haggle" experience...



In Minnesota hospital were doing this, and actually billing people without insurance that amount, then they could write off any uncollected amounts as "charity" care. Obviously, the inflated price was not there real price, since 95% of their payments were discounted. The state attorney general extracted a settlement from the hospitals that they would only bill un-insured patients the average of what their payments were from health insurance companies. All states should have that same rule.

Verify your Comment

Previewing your Comment

This is only a preview. Your comment has not yet been posted.

Your comment could not be posted. Error type:
Your comment has been posted. Post another comment

The letters and numbers you entered did not match the image. Please try again.

As a final step before posting your comment, enter the letters and numbers you see in the image below. This prevents automated programs from posting comments.

Having trouble reading this image? View an alternate.


Post a comment

Your Information

(Name and email address are required. Email address will not be displayed with the comment.)