Bureaucracy Fighter
Ask Jean Poole, a medical billing advocate, about her work helping people navigate the bewildering world of medical bills and insurance claims, and the stories pour out. There’s the client who was billed almost $11,000 for an 11-minute hand surgery. The cancer patient who was charged $9,550.40 for a round of chemotherapy he never received.
More astonishing findings in this broken system in the New York Times.
The system has gotten so complicated that it’s impossible to say it isn’t broken. You can’t even visit a doctor for a check-up without insurance getting involved.
I felt especially bad for the lady with a suitcase full of bills and no idea what she actually owed.
The article points out what many of us know: prices for medical services have little relation to their cost.
In our discussions with Milliman, an actuarial firm, they are showing medical trend at 7% and investment trend at 4%.
I told them that the 3% differential doesn’t concern me, as it makes no sense to try to continue reimbursing for over-inflated prices.
I am looking forward to our next meeting.
The numbers we received were accompanied by this encouraging text: “Based on our modeling of expected product results, it is possible to create a set of product features, premiums, and trend assumptions (I don’t like those last 2 words!) that produce acceptable financial results for both the insured and the insurer(s). This finding rests on the use of an alternative claim filing distribution that assumes changes in participants’ behavior due to the design of the product. The net effect is to reduce participant claims.”
Don Levit
In health care prices are meaningless because doctors and hospitals don’t compete on price. When providers don’t compete on price, it isn’t surprising that accurate billing also takes a back seat to other factors.
Isn’t an itemization of the bill what people request when they want a breakdown of the bill? I’ve heard of people that have asked for this.