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.