Thursday, October 15, 2009

How Much Will My Insurance Pay?

The problem with health insurance reform is does not appear to reform the practice that makes the entire system “NUTS!!” Imagine going into restaurant and having a wonderful meal. When the check comes, you tell the owner that he will submit his bill to your restaurant paying service. Somewhere between two and six months, your restaurant paying service will send the restaurant a check for 80% of what they feel the meal was worth. NUTS???? That’s how insurance operates. The government and insurance companies buy in volume and negotiate. That is a key part of their cost containment. However, this buffer between the customer and care provider takes away from the customer’s (patient’s) ability to negotiate because they don't know how much the bill is. Then they are not told how much the insurance company will pay. For health-care reform, to be successful, the f secret negotiations must stop, unless the procedure is covered 100%. 80% -- 20% or 50% -- 50% or co-pays or out-of-pocket maximums makes no sense when the real numbers are hidden. More importantly, providers cannot run a business without knowing in advance, how much they get paid for the services they perform. If you really want healthcare reform, we need to look at this current insurance practice and realize that secret contracts make the patient/client, a bystander in their own healthcare. Alan. Early bird discount for Controversies in Childbirth Conference expires Saturday

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