$12,712 for $675 cataract surgery, $20,120 for $584 knee operation, $72,000 for $1,629 spinal fusion

[tj2001]

http://www.nytimes.com/2009/08/12/health/policy/12insure.html?hp

August 12, 2009
High Fees Common in Medical Care, Survey Finds
By GINA KOLATA

A patient in Illinois was charged $12,712 for cataract surgery. Medicare pays $675 for the same procedure. In California, a patient was charged $20,120 for a knee operation that Medicare pays $584 for. And a New Jersey patient was charged $72,000 for a spinal fusion procedure that Medicare covers for $1,629.

The charges are among a long list of high fees cited in a survey released online Tuesday by America’s Health Insurance Plans, which represents 1,300 health insurance companies. The group said it had used Medicare payments for comparison because Medicare was so familiar and payments are, on average, about 80 percent of what private insurers pay.

The survey, insurers and some economists say, shows the sort of irrational pricing of medical care that is an integral part of the nation’s health care problems and that is largely being ignored, some say, in the current debate.

“It’s the wild, wild West when it comes to prices of anything in the U.S. health care system, whether for a doctor visit or for hospital charges,” said Jonathan S. Skinner, a health economist at Dartmouth.

The situation is so irrational, said Uwe E. Reinhardt, a health economist at Princeton, that it simply cannot go on.

[izquierdista]

1. Even when you pay in cash

And get a receipt stamped "paid", you can get some bullshit bill in the mail demanding more dough.

[RUMMYisFROSTED]

2. Best in the world.

[Joe the Liberal]

4. Sure is....

if you can afford it.

[RUMMYisFROSTED]

7. Or imagine it.

[Joe the Liberal]

8. Lol yup. n/t

:rofl:

[RUMMYisFROSTED]

3. Best in the world.

[KatyaR]

5. delete

n/t

[GodlyDemocrat]

6. This is why many doctors don't accept Medicare, including my own specialists

[Dr.Phool]

11. The reason doctors don't accept Medicare is because

Bush and the repukes slashed reimbursement rates by 30% a couple of years ago. 10% each year over a 3 year period. My doctor bitched about it continually.

And if you pay for your own procedures, you'll pay about four times what a insurance company will pay.

[Blaukraut]

17. hopefully this will be addressed in the bill

The fact that doctors and hospitals don't accept certain insurance like medicare is not going to be helpful to healthcare reform. Say there will be an insurance co-op or public option: who is to say that doctors will even accept them?

[jody]

9. Medicare/medicaid pay so little to internal medicine/family practice MDs there's a shortage. n/t

[CurtEastPoint]

10. Not on Medicare (yet) and my back surgery was $12K; Cigna paid them $2K

It is all a f'ing shell game.

[girl gone mad]

12. Why isn't this being addressed in any of the bills?

The uninsured and under-insured should not be paying 6x or 12x as much as the insured for the same care, especially when you consider the fact that paying out of pocket is less of a hassle for all interested parties.

[sybylla]

13. Fall on bicycle, ambulance ride to hospital, xray, three stitches, $5300

With the insurance company "discounts" applied.

This happened to my college age son in June.

No wonder our healthcare system is in trouble.

[TexasObserver]

14. Regulation of costs is the ONLY way to stop the health care madness.

As long as the health care industry has no regulation on the charges it can assess, our health care system will be mainly a way for those at the top to make obscene profits at the expense of those who pay for the system.

[Kansas Wyatt]

15. What is the motive for the Medical Industry irrationally jacking up charges?

Is it so they can write it all off as a loss, to offset their real income, in which they would give themselves a TAX cut?

Are they allowed to write off what Medicare and the Insurance Industry does not pay as well?

[supernova]

16. Honesty in billing would be a huge savings

Hospitals should stop billing things to people willy nilly and just be honest about what stuff actually costs, regardless of who the payer is. It is really horrifying that I have to pay 4 or 5 times what an insurer does for the same procedure.

Having said that, if Medicare for all is the way we go, then yes, M reimbursment rates need to be upped to comperable, but not the same as what a private insurer would pay (maybe 80%?) Docs clinics need to be assured that they will get paid, more or less appropriately.

[4_TN_TITANS]

18. I guess I don't get it....

Why would insurance companies fund a study that demonstrates what a much better deal the government gets? Are they claiming that what Medicare pays is that far removed from actual costs?

[SOS]

19. On Medicare? No problem

Uninsured? Pay the full amount or get in line at bankruptcy court.

Best system in the world!