So You Think Your Insured ?

[LKTraz]

Oh wow....I SOOOOOOOOO want health care like the top notch care you get in Cuba. The whole world is trying to flock there to get cured!

Hahahahahahahahahahahaha! [u]Michael Moore [/u]as the source of anything more than the laughter of disbelief? Give me a break.

Do we have a problem with health insurance? Yes.
Are any of the plans to fix it currently on the table the answer? No.

Rate caps on procedures and frivolous lawsuits would go a much longer way toward fixing the problem. Much of the reason procedures cost so much stems from the inception of "UCR" payments.

In this system if a provider charges say $100 for a particular service the insurance will only pay the UCR (Usual and customary fee). This payment says that the rate for the service should only be 80% of the actual fee and they will pay 80% of that 80%. Sound complex? Yup.

So let's see:

$100 x 80% = $80
$80 x 80% = $64

Now since the provider only actually get 64% of what they feel they should charge they simply inflate the shit out of their charges in order to get what they really wanted for their service.

Add to this that we are a very litigious society the costs for malpractice insurance are at a confiscatory rate which makes doctors and hospitals up those rates even more so as to subsidize those inflated insurance charges.

Also, in consideration of the possibility of lawsuits being filed providers will order every test under the sun so as to avoid the possibility that someone will sue because they "missed something" because they failed to do such and such test.

This makes what should have been a $100 charge skyrocket to $5,000 or more.