Ever hear of balance billing? It’s a game that health care providers and insurance companies play with their customers caught in the middle, and it’s getting a lot of attention in California. The idea is insurance companies reimburse only the amount that Medicare pays for a given service, which is sometimes about 60% of the actual cost, and the patients are billed for the difference. Combined with the free care that many hospitals provide to uninsured emergency room walk-ins, it’s no wonder health care providers want fully insured patients to be fully insured.
I make my living working at a company that depends upon the viability of hospitals. Carol worked at two suburban Boston hospitals that closed. Shut down and gone. So there’s a reason for hospital administrators to insist upon full reimbursement for services.
Until and unless there’s national health in the United States, it’s my expectation that at some point “fully insured” will mean having a sizable deductible. Everybody will pay something like the first $1000 annually for individual coverage and $2500 for a family. These amounts would be adjusted over a period of time until they’re doubled. The elderly, diabetics and pregnant women would go through that very quickly, of course, but many people would be paying for all of their routine care.
The problem is, of course, that some people won’t go to the doctor and they’ll end up in emergency rooms anyway. But by shifting the financial burden of primary care to consumers, the hope would be that premiums would drop enough that more people could be covered for cancer and heart attacks. And no more of that pre-existing condition nonsense. Health care as we know it in America would be gone, but I just don’t see how else the system can manage.
And let’s be honest with ourselves. Many health problems are caused by eating, drinking, smoking, and lack of exercise.
Yikes! First of all, I’d take that last statement further and say that MOST health problems today are caused by eating, drinking, smoking, drug abuse, and lack of exercise. Then you have mental illness, which is still controversial. What is really mental illness and what is not? What about “well child” care? Who should pay for that? What about vaccinations? Are all of them really necessary? Personally, I don’t trust the new Gardisil, and neither does Molly’s pediatrician. Cervical cancer is highly treatable and the least of her worries at 12 years old.
As a chronic migraine sufferer, I can easily rack up 2-3 visits to the ER every year if I can’t knock out the pain after a week. I got one so bad once I fainted at home and Molly ended up calling 911. They put me in overnight. Sometimes you do everything you are supposed to do, and it still doesn’t budge. For now, we have pretty good coverage through Tom’s company, but how long will that last? He has a heart rhythm problem (NOT chronic) that puts HIM in the ER at least once a year.