Soak the Senile
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Steve Lopez in the L.A. Times has a column on one of the craziest but least talked-about aspects of health care finance: arbitrarily high list price billing.

Gary Larson has a $5,000 deductible insurance plan, but has found that his medical bills are cheaper if he claims he's uninsured and pays cash. Using that strategy, an MRI scan of his shoulder cost him $350. His brother-in-law went to a nearby clinic for an MRI scan of his shoulder, was billed $13,000, and had to come up with $2,500. 

Kaiser member Robert Merrilees had a colonoscopy at an affiliated surgery center, which charged $7,500. His co-pay was $15, Kaiser picked up $470, the rest of the bill "just went away." Merrillees was left scratching his head over the crazy math in medical billing.

My family got a bill from a hospital once for $34,000. So, we sent it to the insurance company, and they paid $2,000 and we paid $200 and that was the end of it. But in the meantime, the bill itself set off heart palpitations, feelings of numbness, and other symptoms.

Maybe the hospital's strategy was that one out of hundred patients will be senile enough to pay the original bill in full. 

I must say that I haven't kept up with all the health care debates over the years, but, if memory serves, this subject didn't seem to come up much. I have no idea if Obamacare will even try to fix this or not. Most things that interest me seem orthogonal to what interests everybody else.

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