Lately I've been doing a lot of research on Doctors and Cars.
In the last year I have bought two cars. One for my mother and one for myself.
I have also had to decide on which health insurance I wanted to buy from my work.
By far the choice of insurance was far harder and has far more unknowns.
I had a choice between three plans. Insurance that is. Well, I really only had a choice between two plans. One of the three had way to much risk and no savings in premiums over one of the other two. It was only in there because the company offered a plan to part time employees. The same cost but way higher deductibles than the cheapest plan for full time employees.
Now why is this worse than buying a car.
First let me tell you a bit about my old plan the company decided they no longer wanted to pay for.
The cost to the employee was only $200 a month with specific copays and very low deductibles and low or no coinsurance.
Prescriptions were also covered for $10 a month. New cost for the same drugs, $30 a month.
$10 copay for primary care doctors.
$25 for a specialist visit.
Urgent Care $50
Hospital ER $100
If you needed surgery you had a 10% copay up to your maximum deductible of $1000 per person.
There were also many things that were free. For example I was having allergy shots 1-2 times a week.
Now heres my issue with the new insurance.
Most of the time when you need a doctor you are sick or injured, you don't have time to shop around. Even if you could shop around doctors don't publish their rates. And if they did they have more prices than a car dealer.
They have a price for people who call in with no insurance. Usually the highest price they charge. Hospitals are almost as bad. They know in an emergency they have to treat you so they handle it a bit differently. They treat you, send you the bill and then give you a discount if you pay in 30 days or less. If not you pay retail on some payment plan.
What might be a $10,000 dollar bill they will tell you it is only $7000 if you pay now. If you have insurance it might only be $5000 ,but, if you have a really aggressive insurance company the bill might get knocked down to $2000.
Then you get bills from the doctors who worked on you separately. Once again the prices could be all over the map. You don't have time to shop or any real power to negotiate. Most doctors or hospitals will just tell you to take a hike if you don't like what they charge.
Now back to my insurance.
If I want to see a specialist I now have to pay the whole bill up to my $800 per person deductible and after that I have to pay 20% of the billed amount up to my $3000 max out of pocket.
Another issue I have is that all my 20% cost sharing is based on rates that the insurance company negotiated. It could be higher than the cheapest price that doctor has said they are willing to take from someone else.
At least when you walk into a car dealer they have their labor rates posted on a wall. You also have time to shop around for the best rate.
Next time you go to the doctor ask them for their price list.
Last week I went into my allergy doc to get my weekly shot. When I was done I asked them how much I owed them if anything. Remember, up until now the shots have been covered 100%. I knew this because it was on my insurance companies website.
My new coverage. Nothing, nada, could't find anything about allergy shots. Are they covered 100%, do I have a 20% copay? Do I pay 100% till I meet my deductible? If I pay do I pay more or less than my last insurance company paid? They paid $5 a shot. Or since I have a new company I don't know.
The receptionist didn't know either. She said she just sent it to the billing people. It's been almost two weeks and I still don't know. The billing department must be way behind. Either that or the insurance company is way behind.
Until I know I'm not going back.
I'm also avoiding specialists. Which wouldn't be so bad if I could get an appointment with my Primary Care Doctor in less than 2 weeks. Urgent Care is now more expensive to visit as well. Which is pretty screwed up since there are several Urgent Cares in the are that let you "join" for a fee and get discount prices. Cheaper prices than I get with insurance. My insurance company is just a middle man siphoning off 20% or more of what I pay. One other side to the equation, what's their incentive to get me the best price when they get a cost plus deal.
I don't blame any of this on the Affordable Care Act. The system has been broken for a very long time. And my plan used to be cheap and cover more because of a collective bargaining agreement. That's right, I belong to a union. The company has been dying to get out from under that health insurance plan for 5 years and finally decided to pay us more so they could. Yet this year they are on track to make multi billions in profit. The CEO will make about 80 million or more this year. I don't think he has to worry about medical bills coating him a new car or his 401k.
So you can hate car dealers all you want but at least there are multiple sources of what a car costs them and now even more sources that will negotiate the price of the care for you.
Costco and Sam's Club, TruCar.Com, Consumers Reports. If you pay too much for a car it's your fault.
Where are these services for Medical Expenses. Why can't I go to the doctor and show my Costco card and get the lowest price possible and then use my insurance to pay their share.
I'd say the system is broken and impossible to fix but it's not. It just requires a change in the way we do business.
My Mother who is 84 has probably the best insurance around. She goes to the doctor, any doctor and pays nothing. Zip, nada, zero.
She pays about $200 a month to a AARP medigap policy. That and her Medicare covers everything.
I know Doctors complain about how much medicare pays. They also complain about all the people they need to pay to keep track of their billing and all those different deals they make with insurance companies.
As I said before I belong to a union. We negotiate a contract every 7-10 years. Almost everyday we complain we are getting paid to little. That we deserve more. We can't come to work one day and just raise our prices.
Well Doc. you might think you have your own business, but you don't. You have expenses and overhead and you have to manage your office and employees but you really work for the insurance companies. Just like my boss tells me that there is now money to pay me more, so does yours. The insurance company.
Actually many doctors are realizing this. They are selling their practices to hospitals and large groups and becoming employees of those groups or retiring. The savings is in hiring fewer people to do the billing among other things.
And don't let Hospitals, Insurance companies tell you the lies they have been. They are getting bigger. A lot bigger. Building more buildings buying more practices and paying CEO's high salaries and bonuses while complain how tough life is.
The medical business is far worse than the auto industry.
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