Reply #8: Well, my experience is just the opposite. [View All]

[soupkitchen]

Why it is true that a cash payee won't get as many procedures recommended to them as a "covered" person, this is only a good thing if you don't need the procedure.
Recently I was billed by mistake for a procedure that was already paid for by my insurance. The insurance company paid $210.00. The hospital billed me for $350.00
And as far as I'm concerned the differnce between what insurance companies pay for procedures and what cash payees pay is one of the most flagrant examples of the inequities inherent in the health care system.
While certain cost advantages can be attributed to Insurance Companies creating greater efficencies, the reality is that hospitals price gouge cash payers. For a few reasons: One) is they can get the money great, and two) if they don't get paid they can claim greater losses.
In fact, I think the first simple step to putting some logic into this system is to put a "cap" on how much more than insurers cash payees can be charged. Remember a lot of medical procedures really can't be "cost quantified" What does an MRI cost? Well, that partially depends upon how many MRI's one get out of a machine, and that won't be determined for years and years. (Yes, I know the machine can be depreciated for tax purposes, but it can still be used after the depreciation expires.)
Anyway I don't think the $140.00 difference between what my insurance company paid and what I was being charged can in anyway be justified.
And is indicative of the greedy illogic of the system. But I also think it is an inequality that can addressed by legislative action. Sometimes the answer to things boils down to simple fairness.