So we all know health insurance is a rip-off and one of the most disgusting government-backed thefts in history. But did you realize it's also the biggest rip-off in the ENTIRE UNIVERSE?? It's true.
Bigger than the Iraq war. Bigger than the biggest bailout. Bigger than the incident involving J'krl and the gorf-pod heist on Striveti 9. Indeed the biggest rip-off in the entire universe.
I only say this because of my last doctor appointment.
I recently visited a specialist for a fairly everyday complaint. Nothing life-threatening, but potentially more than I wanted to waste my time on a generalist for -- basically feeling some blockage in my nasal passages. (I typically find generalists a waste of time anyway.)
So I go to my appointment, she does some investigation with a non-disposable probe, squirts some stuff up there and sends me away with a prescription.
Here's what I paid:
- $30 copay paid up-front
- $273 billed later from the doctor
- $92 for a prescription paid to the pharmacy
- Amount the insurance company paid to the doctor: $119
But wait! I paid something else here. I almost forgot because it's hidden on my paycheck. I pay about $100/month for health insurance (told you I had good insurance). So if you wanted, you could add in $1,200 to the total cost of my visit because I almost never go to the doctor. But let's be generous and assume I go to the doctor once a month so we'll just put that $100 into the mix.
- Amount paid to the insurance company by me: $100
So the supposed "cost" of my visit was $522 (30+273+119+100). Wait. What? I was there less than 15 minutes. And that doesn't count a $92 prescription.
I supposedly have great insurance and I have money. I can afford this. I'm not going to go bankrupt. But I wasn't told my $30 copay was going to balloon into a bill for more than $400 (not including insurance premiums and prescriptions). This is the only service in the entire universe that I HAVE to buy and have no idea what it costs until afterward.
If I do some really rough math here, I think we can see another insidious side to the insurance/medical industry that is rarely discussed. Let's make some assumptions:
- My doctor makes 311,000 per year
- I was there a half hour (I wasn't, but let's be generous)
- The substances she used on site have a real cost of $50 (totally making this up, but my guess is the actual cost was closer to 50 cents, so I feel I'm being generous here).
So what's my doctor's hourly rate? Well, $311,000 / 52 weeks a year is $5980/week. That's around $149/hour.
I had a half hour with her (not really) so let's say my real cost was somewhere around $75 for her time. Throw in some overhead and profit for the company of 20% and that price to me should be somewhere around $90. Add in my $50 for the medicine used and we get $140. I paid $100 to the insurance company and $30 in a co-pay. I don't think it's a coincidence that without those hard costs I wouldn't receive treatment.
So in other words, the doctor got her money no matter what. They checked my insurance and knew they'd be getting $119 + $30 guaranteed if they even glanced at me. That is, as I've shown, their ENTIRE COST plus PROFIT. But, yet, they get to come back and get another $273 paid directly.
The insurance company, of course, will be OK because they're getting contributions not only from other employees, me the rest of the year and (what I didn't mention earlier) my employer actually pays the bulk of my health care insurance premiums. I don't know how much they're contributing, but I'm sure it's more than $100/month.
So in other words it would have been cheaper for me and my company to pay the true costs of this visit out-of-pocket and skip the trip through the insurance world. Basically everyone along the pipeline is gouging and I'm still paying more out of my own wallet than the true cost.
I would imagine that for short visits to family doctors the actual cost is less than the $30 copay most of us are coughing up. And I bet if you analyzed most standard doctor visits, the actual cost is VERY close to what the patient pays out of pocket in co-pays, deductibles and uncovered doctor fees. And I would guarantee you that if you figured in the cost of the premiums paid by companies and patients, there's no question that insurance companies aren't really paying a single dime in health care costs for standard care.
I suspect what's going on is the doctors and insurance companies are very aware of the true costs of each of these items and pegs the amount paid directly by people AT THAT AMOUNT. That way they never lose a cent. Everything else is gravy for them. Very. Fat. Profits.
So you're paying (up-front and in premiums), your company is paying, but the insurance company is not paying. Sure they write checks so it looks like they're paying, but the checks are written for less than you paid in. So you might as well just pay them to hold your money for you and give you a portion of it back now and then. If they feel like it.
And that's why it's the biggest rip-off in the entire universe.