Comic Strips

Found the European (or just someone young who doesn't know much about typical insurance shell-gaming).

You have no copay, but most insurance plans include any non-preventative visit in the deductable. That means you are responsible for 100% of the bill until your $1500/yr deductible (in as low deductible-plan, a LOT higher in most plans) is reached. To look like they're actually doing something, they treat the negotiated rate from the doctor's MSRP as a "discount" (the doctor says $300, the insurance negotiates you to $200). The really ugly irony of that, is that if you were uninsured, many offices would have given you an NP for $70, and some have an "uninsured rate" of like $150.

Nope, in network, that's just how their insurance worked.

This isn't necessarily true. I've seen and heard of multiple doctors who had a lower price for those without insurance.

The only time you’re better off without insurance is if you never use it.

This is absolutely not true. I have a high-risk, high-expense family member on my plan. Most years, we reach her deductible at the very end of the year and we're ultimately paying all that money for "a rate plan". Of the years we crossed the deductible and the insurance covered much of anything, it was still less than the $12,000 we shelled out that year in all but one case. In that one case, we saved about $5000, still a bit less than the overall money they've made off us. Literal cancer wasn't enough to make health insurance a good investment.

We still need it for three reasons. First, "what if you end up needing $100,000 or more in medical procedures". Second "the doctor won't be able to see you for 6 months unless you're insured" (though this sometimes goes the other way). And finally, it's a lot less of a financial drain through my employer as a pre-tax expense. Napkin math makes it $3-4000/yr saved in taxes.

They’re also negotiating the price down. Without insurance you’re pretty much bare assed to the healthcare industry, who can and will charge you whatever they want

This might surprise you, but many offices have "uninsured rates" because hitting someone with a $2000 bill for 5 minutes of time is a great way to have someone in collections for years and not actually see the money. They often do that alongside inferior service like an NP instead of a Doctor, but I've never found an office or hospital group who didn't do something for uninsured folks. And you're missing that they charge these things for insured folks much of the time to leverage their negotiated rates with hospitals.

The insurance company will require them to verify the hours billed, they’ll reject charges for shit they shouldn’t be billing for, and negotiate down the price of stuff they can bill for.

Oh, you're not talking about usual hospital bullshit? You're talking about fraud? Yeah. You call them on it once and that disappears from an entire bill. Most hospitals around here don't do it anymore because there's too much attention on them. TBH, the same hospitals you're talking about are are often getting away with coding fraud, which is still reaching the patient's wallet.

The difference even for simple visits can but several thousand dollars. For more serious visits the sky is the limit.

The "sky is the limit" is basically the only time insurance is cheaper than not being insured. And why the government really needs to become a singlepayer for healthcare costs.

Nope, when I ditched my insurance from that company and had to go to my regular doctor, it was $65 up front and I didn't see another bill. It was the most bullshit thing I've experienced.