[ucodegen]

It’s not a fallacy, it’s real. I just checked my summary of charges for 2008. My total charges were $3,884. My insurance (Aetna) paid $1,972.91, and I paid $170. Providers (for this year, coincidentally, it was 100% Scripps Clinic) took a discount of $1,741.90 or 44.8%. For 2009, the numbers are similar (total of $2827, insurance paid $1606, i paid $90, net discount of $1131 or 40%).

You also did not include what you are paying per month for the insurance. What were the charges for? Your total is a lot higher than what I spent when I had ‘complications’.. you have kids?.. just trying to figure out how you incurred $3,884.

Those are mostly incurred regardless of cash payers or third party payers. (There would be some savings obviously if they didnt have to process all the insurance/medicare stuff.)

The insurance involves more than ‘some’ of the overhead. This is why several doctors are going cash pay.

If it was anywhere near 1, we wouldn’t need reform.

And people are falling for the same argument that was applied to no-fault auto insurance… if everybody was insured the costs would be lower. This proved to be untrue and the insurance commissioner position was created in California to try to address that.

[ucodegen]

It’s not a fallacy, it’s real. I just checked my summary of charges for 2008. My total charges were $3,884. My insurance (Aetna) paid $1,972.91, and I paid $170. Providers (for this year, coincidentally, it was 100% Scripps Clinic) took a discount of $1,741.90 or 44.8%. For 2009, the numbers are similar (total of $2827, insurance paid $1606, i paid $90, net discount of $1131 or 40%).

You also did not include what you are paying per month for the insurance. What were the charges for? Your total is a lot higher than what I spent when I had ‘complications’.. you have kids?.. just trying to figure out how you incurred $3,884.

Those are mostly incurred regardless of cash payers or third party payers. (There would be some savings obviously if they didnt have to process all the insurance/medicare stuff.)

The insurance involves more than ‘some’ of the overhead. This is why several doctors are going cash pay.

If it was anywhere near 1, we wouldn’t need reform.

And people are falling for the same argument that was applied to no-fault auto insurance… if everybody was insured the costs would be lower. This proved to be untrue and the insurance commissioner position was created in California to try to address that.

[ucodegen]

It’s not a fallacy, it’s real. I just checked my summary of charges for 2008. My total charges were $3,884. My insurance (Aetna) paid $1,972.91, and I paid $170. Providers (for this year, coincidentally, it was 100% Scripps Clinic) took a discount of $1,741.90 or 44.8%. For 2009, the numbers are similar (total of $2827, insurance paid $1606, i paid $90, net discount of $1131 or 40%).

You also did not include what you are paying per month for the insurance. What were the charges for? Your total is a lot higher than what I spent when I had ‘complications’.. you have kids?.. just trying to figure out how you incurred $3,884.

Those are mostly incurred regardless of cash payers or third party payers. (There would be some savings obviously if they didnt have to process all the insurance/medicare stuff.)

The insurance involves more than ‘some’ of the overhead. This is why several doctors are going cash pay.

If it was anywhere near 1, we wouldn’t need reform.

And people are falling for the same argument that was applied to no-fault auto insurance… if everybody was insured the costs would be lower. This proved to be untrue and the insurance commissioner position was created in California to try to address that.

[ucodegen]

MRIs are a limited resource.. with a limited number of machines. It is very hard for insurance to negotiate these down.

For HMO/PPOs it depends on whether you get to choose your own doctor or use a plan doctor on how much potential discount through the plan. Service may also suffer w/ the plan doctors.

In doing self-pay vs comparison of what I would normally pay for with insurance (including the monthly payment), self-pay easily wins. What ever savings there may be in negotiated fees for some services, easily gets eaten up in the insurance company’s overhead. I included what I would pay for dental. I have had to have considerable dental work (lost track of the number of crowns), to the point that I would have gotten close to busting the lifetime cap on some dental insurance plans. BTW before you jump in on it, the reason why I had to have so much dental work was because of a dentist, not because the lack of one.

The degree of discount on rates is largely a fallacy. An easy way to check would be to figure out how much is being paid in for a GP’s office using self-pay rates and then calculate out what the effective earnings would be (subtracting office overhead, support personnel wages and insurance, malpractice insurance). The numbers end up not working out for a large discount. I even ran this for my GP.

Why would GPs and groups like Scripts give discounts to cash payers? Maybe because they don’t have to carry overhead to manage the insurance on these. I don’t think ‘charity’ fits here, certainly when you are dealing with a client who can whip out the checkbook and cover a $3000 bill without breaking a sweat.

http://www.cbsnews.com/stories/2004/04/05/health/main610269.shtml

Paragraph 4-7 is interesting here, read all:
http://www.articlesbase.com/insurance-articles/cash-discounts-if-you-want-to-pay-less-at-the-doctor-ask-about-cash-discounts-624181.html

http://www.nctimes.com/business/article_392491ef-109a-5af6-b058-69172350df03.html

There is a field within an insurance company’s 10K/Q that you may want to look at. I don’t remember the exact name is, but it equates to the ratio of claims paid out vs premiums paid in. Usually this number is less than one. During the time between the premium being paid in and the claim being paid out, the insurance co has use of that money for investing.

[ucodegen]

MRIs are a limited resource.. with a limited number of machines. It is very hard for insurance to negotiate these down.

For HMO/PPOs it depends on whether you get to choose your own doctor or use a plan doctor on how much potential discount through the plan. Service may also suffer w/ the plan doctors.

In doing self-pay vs comparison of what I would normally pay for with insurance (including the monthly payment), self-pay easily wins. What ever savings there may be in negotiated fees for some services, easily gets eaten up in the insurance company’s overhead. I included what I would pay for dental. I have had to have considerable dental work (lost track of the number of crowns), to the point that I would have gotten close to busting the lifetime cap on some dental insurance plans. BTW before you jump in on it, the reason why I had to have so much dental work was because of a dentist, not because the lack of one.

The degree of discount on rates is largely a fallacy. An easy way to check would be to figure out how much is being paid in for a GP’s office using self-pay rates and then calculate out what the effective earnings would be (subtracting office overhead, support personnel wages and insurance, malpractice insurance). The numbers end up not working out for a large discount. I even ran this for my GP.

Why would GPs and groups like Scripts give discounts to cash payers? Maybe because they don’t have to carry overhead to manage the insurance on these. I don’t think ‘charity’ fits here, certainly when you are dealing with a client who can whip out the checkbook and cover a $3000 bill without breaking a sweat.

http://www.cbsnews.com/stories/2004/04/05/health/main610269.shtml

Paragraph 4-7 is interesting here, read all:
http://www.articlesbase.com/insurance-articles/cash-discounts-if-you-want-to-pay-less-at-the-doctor-ask-about-cash-discounts-624181.html

http://www.nctimes.com/business/article_392491ef-109a-5af6-b058-69172350df03.html

There is a field within an insurance company’s 10K/Q that you may want to look at. I don’t remember the exact name is, but it equates to the ratio of claims paid out vs premiums paid in. Usually this number is less than one. During the time between the premium being paid in and the claim being paid out, the insurance co has use of that money for investing.

[ucodegen]

MRIs are a limited resource.. with a limited number of machines. It is very hard for insurance to negotiate these down.

For HMO/PPOs it depends on whether you get to choose your own doctor or use a plan doctor on how much potential discount through the plan. Service may also suffer w/ the plan doctors.

In doing self-pay vs comparison of what I would normally pay for with insurance (including the monthly payment), self-pay easily wins. What ever savings there may be in negotiated fees for some services, easily gets eaten up in the insurance company’s overhead. I included what I would pay for dental. I have had to have considerable dental work (lost track of the number of crowns), to the point that I would have gotten close to busting the lifetime cap on some dental insurance plans. BTW before you jump in on it, the reason why I had to have so much dental work was because of a dentist, not because the lack of one.

The degree of discount on rates is largely a fallacy. An easy way to check would be to figure out how much is being paid in for a GP’s office using self-pay rates and then calculate out what the effective earnings would be (subtracting office overhead, support personnel wages and insurance, malpractice insurance). The numbers end up not working out for a large discount. I even ran this for my GP.

Why would GPs and groups like Scripts give discounts to cash payers? Maybe because they don’t have to carry overhead to manage the insurance on these. I don’t think ‘charity’ fits here, certainly when you are dealing with a client who can whip out the checkbook and cover a $3000 bill without breaking a sweat.

http://www.cbsnews.com/stories/2004/04/05/health/main610269.shtml

Paragraph 4-7 is interesting here, read all:
http://www.articlesbase.com/insurance-articles/cash-discounts-if-you-want-to-pay-less-at-the-doctor-ask-about-cash-discounts-624181.html

http://www.nctimes.com/business/article_392491ef-109a-5af6-b058-69172350df03.html

There is a field within an insurance company’s 10K/Q that you may want to look at. I don’t remember the exact name is, but it equates to the ratio of claims paid out vs premiums paid in. Usually this number is less than one. During the time between the premium being paid in and the claim being paid out, the insurance co has use of that money for investing.

[ucodegen]

MRIs are a limited resource.. with a limited number of machines. It is very hard for insurance to negotiate these down.

For HMO/PPOs it depends on whether you get to choose your own doctor or use a plan doctor on how much potential discount through the plan. Service may also suffer w/ the plan doctors.

In doing self-pay vs comparison of what I would normally pay for with insurance (including the monthly payment), self-pay easily wins. What ever savings there may be in negotiated fees for some services, easily gets eaten up in the insurance company’s overhead. I included what I would pay for dental. I have had to have considerable dental work (lost track of the number of crowns), to the point that I would have gotten close to busting the lifetime cap on some dental insurance plans. BTW before you jump in on it, the reason why I had to have so much dental work was because of a dentist, not because the lack of one.

The degree of discount on rates is largely a fallacy. An easy way to check would be to figure out how much is being paid in for a GP’s office using self-pay rates and then calculate out what the effective earnings would be (subtracting office overhead, support personnel wages and insurance, malpractice insurance). The numbers end up not working out for a large discount. I even ran this for my GP.

Why would GPs and groups like Scripts give discounts to cash payers? Maybe because they don’t have to carry overhead to manage the insurance on these. I don’t think ‘charity’ fits here, certainly when you are dealing with a client who can whip out the checkbook and cover a $3000 bill without breaking a sweat.

http://www.cbsnews.com/stories/2004/04/05/health/main610269.shtml

Paragraph 4-7 is interesting here, read all:
http://www.articlesbase.com/insurance-articles/cash-discounts-if-you-want-to-pay-less-at-the-doctor-ask-about-cash-discounts-624181.html

http://www.nctimes.com/business/article_392491ef-109a-5af6-b058-69172350df03.html

There is a field within an insurance company’s 10K/Q that you may want to look at. I don’t remember the exact name is, but it equates to the ratio of claims paid out vs premiums paid in. Usually this number is less than one. During the time between the premium being paid in and the claim being paid out, the insurance co has use of that money for investing.

[ucodegen]

MRIs are a limited resource.. with a limited number of machines. It is very hard for insurance to negotiate these down.

For HMO/PPOs it depends on whether you get to choose your own doctor or use a plan doctor on how much potential discount through the plan. Service may also suffer w/ the plan doctors.

In doing self-pay vs comparison of what I would normally pay for with insurance (including the monthly payment), self-pay easily wins. What ever savings there may be in negotiated fees for some services, easily gets eaten up in the insurance company’s overhead. I included what I would pay for dental. I have had to have considerable dental work (lost track of the number of crowns), to the point that I would have gotten close to busting the lifetime cap on some dental insurance plans. BTW before you jump in on it, the reason why I had to have so much dental work was because of a dentist, not because the lack of one.

The degree of discount on rates is largely a fallacy. An easy way to check would be to figure out how much is being paid in for a GP’s office using self-pay rates and then calculate out what the effective earnings would be (subtracting office overhead, support personnel wages and insurance, malpractice insurance). The numbers end up not working out for a large discount. I even ran this for my GP.

Why would GPs and groups like Scripts give discounts to cash payers? Maybe because they don’t have to carry overhead to manage the insurance on these. I don’t think ‘charity’ fits here, certainly when you are dealing with a client who can whip out the checkbook and cover a $3000 bill without breaking a sweat.

http://www.cbsnews.com/stories/2004/04/05/health/main610269.shtml

Paragraph 4-7 is interesting here, read all:
http://www.articlesbase.com/insurance-articles/cash-discounts-if-you-want-to-pay-less-at-the-doctor-ask-about-cash-discounts-624181.html

http://www.nctimes.com/business/article_392491ef-109a-5af6-b058-69172350df03.html

There is a field within an insurance company’s 10K/Q that you may want to look at. I don’t remember the exact name is, but it equates to the ratio of claims paid out vs premiums paid in. Usually this number is less than one. During the time between the premium being paid in and the claim being paid out, the insurance co has use of that money for investing.

[ucodegen]

Right, their preference is to get cash in hand ASAP. I’m guessing that 30% discount is probably just about the same (or an even smaller discount) than insurance companies and medicare have already negotiated.

No its not. I talked to them about it. Go through insurance, charge is full price, period. In addition, 30% is not equivalent to the time-value-of-money for the reimbursement period in question. Besides, why present one amount as the cost when using insurance cost while the real cost for using insurance is done under the table? Does not make sense.

This same thing has happened with auto insurance… driving up repair costs. People only see the large bills, not the steady drip-drip-drip coming from their pockets. This is also why house prices are framed in terms of monthly payment.. not total price when talking about affordability.

I assume you have seen the TV commercials out for auto repair insurance.. showing that if you have a big repair, ie ECU (Engine Control Unit), you have to pay a lot of money and with their insurance, you have to pay nothing.. what they fail to mention is that with insurance, you have been paying every month for that ECU, whether or not you really end up needing to use the coverage. Insurance companies end up making money off of holding your money for a period of time and by making sure that the total amount they pay off in claims is less than the total amount the receive in premiums for a given time period. After all, insurance is a business, run for profit.

But that’s really not what the reform question is about. The more important question is whether they would rather deal with the federal government or private insurance. Since they already deal with medicare, almost flawlessly, the only significant question is reimbursment rate.

Actually it is what the reform question is about, and medicare reimbursement is not in any way flawless. In fact, the entire Medicare insurance system is nearly bankrupt and the paperwork can be a nightmare(from the doctors point of view). The discussion is actually 3 way; self-pay, private insurance or public(gov) insurance. Insurance companies want to frame it in terms of private vs. gov insurance with the gov insurance ‘taking away your rights’. They don’t want people to look at self-pay because people will realize that the insurance companies are basically ripping people off.

[ucodegen]

Right, their preference is to get cash in hand ASAP. I’m guessing that 30% discount is probably just about the same (or an even smaller discount) than insurance companies and medicare have already negotiated.

No its not. I talked to them about it. Go through insurance, charge is full price, period. In addition, 30% is not equivalent to the time-value-of-money for the reimbursement period in question. Besides, why present one amount as the cost when using insurance cost while the real cost for using insurance is done under the table? Does not make sense.

This same thing has happened with auto insurance… driving up repair costs. People only see the large bills, not the steady drip-drip-drip coming from their pockets. This is also why house prices are framed in terms of monthly payment.. not total price when talking about affordability.

I assume you have seen the TV commercials out for auto repair insurance.. showing that if you have a big repair, ie ECU (Engine Control Unit), you have to pay a lot of money and with their insurance, you have to pay nothing.. what they fail to mention is that with insurance, you have been paying every month for that ECU, whether or not you really end up needing to use the coverage. Insurance companies end up making money off of holding your money for a period of time and by making sure that the total amount they pay off in claims is less than the total amount the receive in premiums for a given time period. After all, insurance is a business, run for profit.

But that’s really not what the reform question is about. The more important question is whether they would rather deal with the federal government or private insurance. Since they already deal with medicare, almost flawlessly, the only significant question is reimbursment rate.

Actually it is what the reform question is about, and medicare reimbursement is not in any way flawless. In fact, the entire Medicare insurance system is nearly bankrupt and the paperwork can be a nightmare(from the doctors point of view). The discussion is actually 3 way; self-pay, private insurance or public(gov) insurance. Insurance companies want to frame it in terms of private vs. gov insurance with the gov insurance ‘taking away your rights’. They don’t want people to look at self-pay because people will realize that the insurance companies are basically ripping people off.

[ucodegen]

Right, their preference is to get cash in hand ASAP. I’m guessing that 30% discount is probably just about the same (or an even smaller discount) than insurance companies and medicare have already negotiated.

No its not. I talked to them about it. Go through insurance, charge is full price, period. In addition, 30% is not equivalent to the time-value-of-money for the reimbursement period in question. Besides, why present one amount as the cost when using insurance cost while the real cost for using insurance is done under the table? Does not make sense.

This same thing has happened with auto insurance… driving up repair costs. People only see the large bills, not the steady drip-drip-drip coming from their pockets. This is also why house prices are framed in terms of monthly payment.. not total price when talking about affordability.

I assume you have seen the TV commercials out for auto repair insurance.. showing that if you have a big repair, ie ECU (Engine Control Unit), you have to pay a lot of money and with their insurance, you have to pay nothing.. what they fail to mention is that with insurance, you have been paying every month for that ECU, whether or not you really end up needing to use the coverage. Insurance companies end up making money off of holding your money for a period of time and by making sure that the total amount they pay off in claims is less than the total amount the receive in premiums for a given time period. After all, insurance is a business, run for profit.

But that’s really not what the reform question is about. The more important question is whether they would rather deal with the federal government or private insurance. Since they already deal with medicare, almost flawlessly, the only significant question is reimbursment rate.

Actually it is what the reform question is about, and medicare reimbursement is not in any way flawless. In fact, the entire Medicare insurance system is nearly bankrupt and the paperwork can be a nightmare(from the doctors point of view). The discussion is actually 3 way; self-pay, private insurance or public(gov) insurance. Insurance companies want to frame it in terms of private vs. gov insurance with the gov insurance ‘taking away your rights’. They don’t want people to look at self-pay because people will realize that the insurance companies are basically ripping people off.

[ucodegen]

Right, their preference is to get cash in hand ASAP. I’m guessing that 30% discount is probably just about the same (or an even smaller discount) than insurance companies and medicare have already negotiated.

No its not. I talked to them about it. Go through insurance, charge is full price, period. In addition, 30% is not equivalent to the time-value-of-money for the reimbursement period in question. Besides, why present one amount as the cost when using insurance cost while the real cost for using insurance is done under the table? Does not make sense.

This same thing has happened with auto insurance… driving up repair costs. People only see the large bills, not the steady drip-drip-drip coming from their pockets. This is also why house prices are framed in terms of monthly payment.. not total price when talking about affordability.

I assume you have seen the TV commercials out for auto repair insurance.. showing that if you have a big repair, ie ECU (Engine Control Unit), you have to pay a lot of money and with their insurance, you have to pay nothing.. what they fail to mention is that with insurance, you have been paying every month for that ECU, whether or not you really end up needing to use the coverage. Insurance companies end up making money off of holding your money for a period of time and by making sure that the total amount they pay off in claims is less than the total amount the receive in premiums for a given time period. After all, insurance is a business, run for profit.

But that’s really not what the reform question is about. The more important question is whether they would rather deal with the federal government or private insurance. Since they already deal with medicare, almost flawlessly, the only significant question is reimbursment rate.

Actually it is what the reform question is about, and medicare reimbursement is not in any way flawless. In fact, the entire Medicare insurance system is nearly bankrupt and the paperwork can be a nightmare(from the doctors point of view). The discussion is actually 3 way; self-pay, private insurance or public(gov) insurance. Insurance companies want to frame it in terms of private vs. gov insurance with the gov insurance ‘taking away your rights’. They don’t want people to look at self-pay because people will realize that the insurance companies are basically ripping people off.

[ucodegen]

Right, their preference is to get cash in hand ASAP. I’m guessing that 30% discount is probably just about the same (or an even smaller discount) than insurance companies and medicare have already negotiated.

No its not. I talked to them about it. Go through insurance, charge is full price, period. In addition, 30% is not equivalent to the time-value-of-money for the reimbursement period in question. Besides, why present one amount as the cost when using insurance cost while the real cost for using insurance is done under the table? Does not make sense.

This same thing has happened with auto insurance… driving up repair costs. People only see the large bills, not the steady drip-drip-drip coming from their pockets. This is also why house prices are framed in terms of monthly payment.. not total price when talking about affordability.

I assume you have seen the TV commercials out for auto repair insurance.. showing that if you have a big repair, ie ECU (Engine Control Unit), you have to pay a lot of money and with their insurance, you have to pay nothing.. what they fail to mention is that with insurance, you have been paying every month for that ECU, whether or not you really end up needing to use the coverage. Insurance companies end up making money off of holding your money for a period of time and by making sure that the total amount they pay off in claims is less than the total amount the receive in premiums for a given time period. After all, insurance is a business, run for profit.

But that’s really not what the reform question is about. The more important question is whether they would rather deal with the federal government or private insurance. Since they already deal with medicare, almost flawlessly, the only significant question is reimbursment rate.

Actually it is what the reform question is about, and medicare reimbursement is not in any way flawless. In fact, the entire Medicare insurance system is nearly bankrupt and the paperwork can be a nightmare(from the doctors point of view). The discussion is actually 3 way; self-pay, private insurance or public(gov) insurance. Insurance companies want to frame it in terms of private vs. gov insurance with the gov insurance ‘taking away your rights’. They don’t want people to look at self-pay because people will realize that the insurance companies are basically ripping people off.

[ucodegen]

Recent polling shows that most physicians support reform, and a public option (or even stronger) in a wider margin than the general public.

http://www.npr.org/templates/story/story…

..

If you can identify bias in the polling data, I invite you to do so.

How about the fact that when you go to Scripts Hospital for an MRI, you will get a discount of aproximately 30% if you pay direct with your own cash/check than if they have to deal with your insurance. Considering they are giving up somewhere around $300 just not to have to deal with insurance makes the preference quite clear.

[ucodegen]

Recent polling shows that most physicians support reform, and a public option (or even stronger) in a wider margin than the general public.

http://www.npr.org/templates/story/story…

..

If you can identify bias in the polling data, I invite you to do so.

How about the fact that when you go to Scripts Hospital for an MRI, you will get a discount of aproximately 30% if you pay direct with your own cash/check than if they have to deal with your insurance. Considering they are giving up somewhere around $300 just not to have to deal with insurance makes the preference quite clear.

[Author]

Posts