Concerning Health Care costs is this statement true?

This is part of a response I got from another question I asked about health care costs. Do you believe this statement is true?

"The insurers negotiate special rates with providers that are much less than their regular rates."

set a base rate for services and it is usually less than what the provider pays. But this statement makes it sound like private insurers are the ones saving us money. I doubt that is true.

force providers (mostly hospitals and clinics) to accept the least payments possible. The providers adjust delivery of care to operate within the constraints they are made to accept. In response to a class action lawsuit filed several years ago over the inherent unfairness of the multitiered payment system, most hospitals now offer discounts to self pay patients. If you can pay your entire hospital bill within thirty days, the discount is as high as 20%. This is not about saving money for the insurance companies customers. It's about increasing profits for the insurers.

And I have a stack of insurance statements to back me up.

These agreements save the insurers billions.

I don't do insurance. If the patients want to use theirs, fine, pay the office, then they can file the paperwork. (Or, they can hire a claims specialist to work at my office.) After all, its their insurance not mine.

What I am trying to do is both understand the complexity of the cost of health care and who or what moderates or extends those costs and understand how people perceive the 'health care industry'. So far almost all I see are contradictions on the perception side and no understanding of the root cost of health care on the business side. I'll just keep on asking questions until it makes sense.

Your response is an out-lier (no idea how to spell that and the checker is of no help) of course but its the most interesting response I have seen yet (with one possible exception). I suspect that if your (I presume you are a practicing physician) approach, if it were to be the norm, would drive down the cost of health care in this country and concurrently be very likely to bring the matter of a broken health care system to quick end.

I live moderately. Spend about a week a month doing clinic work. My private practice is high-end expensive. My wealthy patients subsidize care given to the less fortunate.

I feel far more rewarded working like this.

I'm in the health care field, not the health 'I don't care' business.

Cheers.

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into some of the factors driving costs upwards.

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?yrail

that require equal pricing of health care services. A few years back the Wall Street Journal did a front page series comparing pricing of health care services. Needless to say, it is not equal.

Too bad we have spineless bought and paid for attorney generals who are unwilling to enforce those laws. Fucking bastards. Every damn one of them should be removed from office and thrown in jail.

The doctor charges a fee.

On your bill it will say something like "adjustment". That's the amount the insurance company will pay the doctor.

So you'' get something like this.

5/29/09 labwork $ 345

insurance adjustment $ 210

fee charged $ 135

insurance paid $ 109

patient pays $ 26

If a doctor thinks the insurance adjustments are not reasonable, then he doesn't accept that insurance. Many doctors are not accepting Blue Cross / Blue Shield for that reason.

cost in order to profit from their gambling on the people's illness and or injury. Some of this profit is needed to bribe the politicians to keep the doctors, nurses and others advocating national universal health care from even having a seat at the table.

The insurance corporations may on the short end negotiate lower prices for the insured but the prices are primarily high because 40+ million Americans are uninsured and I believe 50+ million are under-insured, so any cost cutting to the insured is an illusion. Too many people can't afford to pay the middle man, and people having nothing to do with actual health care rake in millions if not billions. I believe the for profit "health" insurance model to be a major contributor to the high foreclosure rate.

I believe one misconception many people have regarding for profit health insurance is that it profits from people's health, I see the opposite effect, they profit from illness and injury.

Supply and demand, virtually everybody gets sick or injured at some point their life, this is the inevitable demand that insurance corporations need to sell their product if nobody got sick or injured there would be no demand, their business would dry up. When demand outstrips supply; premiums escalate through the roof far outstripping inflation, I believe this is what the nation has and will be more acutely experiencing as the population ages.

I also believe for a corporation; having nothing to do with health care to profit from the American Peoples' injury and illness to be as immoral and carcinogenic to society as for profit prisons making money by imprisoning the people.

My conclusion is that if the American People were universally covered by the government and health care were treated as a national asset instead of legalized corporate sponsored gambling, the prices would drop.

Its all sort of a bullshit statement. If you aren't insured, you get charged arbitrarily high magic rates. Most insured cannot pay them, so the health care facility gets a big whopping tax write-off for the amount they forgive, and they send the smaller portion to collection and still get paid. The write-off they get may potentially amount to more savings in taxes than they would of gotten paid in the first place if the person was insured.

So, what I am trying to say, is that there is no true baseline "regular" rates. Hence, no money really being saved with these negotiators (and single-payer negotiates too). The norm is the lower "special rates" (which are high and profitable in the first place). The "regular rates" are probably irregularly ever paid in full and they serve other purposes.