Why I Hate Hospitals
I have a modest proposal to reshape the health insurance system. It takes away some of the burden from the insurance companies and places it on the individual but also gives the policyholder a saving’s edge. It is based on the idea that the real culprit in all of this are hospitals.
First, here is the plan and then I’ll go into why I believe this is better than the current modus operandi:
|Category||Age Category||Insurance Premium||Deductible||How it works|
|Doctor Visits, Simple Tests, Emergency Room visits||35-44
(Self-insurance in a Health Savings Account
|zero||Individual uses up to the value of his or her premium for all outpatient visits by paying out of the HSA approved checking account. Once the HSA is exhausted, the Major Medical policy kicks in. The individual is then obligated to spend up to deductible until it is used up and then only pays 20% up to one million for the year.
If during the course of the year, the person does not use any or all of the HSA money, he or she may apply it to the next year, thereby saving them the need to again put aside extra money each year. They are rewarded for being fortunate enough to stay healthy.
Insurance companies lose out but also gain with not having to deal with the paperwork on the majority of medical visits.
|Major Medical- Surgery, Expensive Tests, Procedures||35-49
|2000.00 (paid to an Insurance Company)
|Individual is obligated to pay up to the major medical deductible and 20% afterward for all bills up to one million dollar cap for the year. At cap, insurance company pays 100%.|
Hospital organizations must also be required to drastically lower billing amounts. It is outrageous and way out of line. They do a lot of unneeded extra testing and then charge an outrageous amount for little time spent taking the tests.
Not too long ago my doctor insisted that I take a CAT scan. Correction- two cat scans, because the area of the body being scanned required two passes. I spent a total of twenty minutes going through the doughnut . The insurance company was billed over six thousand dollars for these twenty minutes of service.
The dye that they made me drink to prep for the test cost five hundred dollars! The insurance company thought that this was fair. Each scan was billed at $2800. The insurance company responded to the bill with, â€œnot so fast! We have a network (translated, a wink and a nod) agreement where you accept our negotiated rate. This brought the price down to $1400 each. Big deal! After using up my $1000 deductible for the year, I was still stuck with paying over one thousand four hundred dollars for an outpatient visit that took less than a half hour.
I called the hospital and asked to get the price reduced. They said that at best they could do was to lower it by ten percent or ask to fill out a financial aid form. I wasn’t about to be insulted by filling out such a form, so I took the discount but then asked for the right to pay it off in three installments. The customer service agent told me that she would not allow it- either pay the full amount in twelve monthly installments, or take the discount. I told her that the hospital already received a more than thousand dollar check from the insurance company on my behalf. It was not as if they were relying only on my payment to make a profit on the deal. I asked to speak to a supervisor. She transferred me into the voice mail for a higher echelon person. He returned my call on the next business day and was equally hesitant to offer compromise. He finally told me he was doing me a great personal favor to allow me to pay the bill off in three installments while also taking the ten percent discount.
There should be only one price for a procedure regardless if a person has insurance or not or whether they are in the insurance network. Period. And the price should be regulated by an impartial group that is not beholden to the hospitals.
I recognize that some of the dollar figures listed above may need to be adjusted for practicality. Paramount, though, is that we need to put intelligence and incentive back into health care decision-making for all parties involved- the patient, doctors, insurance companies and hospitals. Otherwise, we mind as well close down the hospitals and let the healthiest survive to the next generation. It will cut down on the price of gas as there will be less people who own cars.