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.