The average American sure doesn't benefit
Reshared post from +Jim Fawcette
Fallacy of Cutting Medicare to Save Money
Today's NYT.com has an article on how some doctors exploit out-of-network medical care to charge outrageous, unethical fees.
My take-away was different than the article's focus: I saw the great job Medicare does of controlling medical costs vs private insurance, and the concomitant fallacy the right-wing has that we can control medical costs by simply refusing to pay some of the bills (which is all cutting Medicare, as the Republicans want to do, amounts to) and transferring Medicare to private providers.
In this case, a Mr. Gonzalez was billed $60,000 for a relatively simple gall-bladder removal. If Gonzalez had been on Medicare, it would have paid the doctor only $958, while the average commercial price is $12,292. But, because he was out of his network, his insurer, United Healthcare, paid only $838 and stuck him with the balance. He ended up getting a community group to negotiate a lowered fee.
From a report on healthcare costs:
"Among the fees on the report’s list are a $6,205 outpatient office visit to a doctor in Massachusetts for which Medicare would have paid $152; a $12,000 bill for examining a tissue specimen in New York for which Medicare would have paid $128; and a $48,983 surgeon’s fee for a total hip replacement in New Jersey that Medicare would have reimbursed at $1,543. Many of the highest billers were in New York, Texas, Florida and New Jersey."
Fair Health, a non-profit that tracks health care costs:
http://www.fairhealth.orgArticle and graphic here:
http://www.nytimes.com/2013/02/01/health/insurance-industry-report-faults-high-fees-for-out-of-network-care.html?smid=pl-share
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but you see, poor people and minorities because
I discovered (the somewhat hard way) that dental insurance providers are just as bad. Ack. Luckily I had the funds to cover the balance due.
It's not just the insurers that are the problem. The bulk of health care dollars/overcharging is by doctors/hospital services. This is where the bulk of the reform needs to happen. Yes, prescription costs are high but they are no where near the costs charged by hospital services and doctors.