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Originally posted by: snidely333
Whenever I go to the Dr., my insurance company dictates how much the Dr. will get paid. My insurance company determines the cost of the healthcare. Dr. might bill me $400. Insurance pays them $42 and there is not further charge to me. I had some routine blood work done last month and due to a glitch, my insurance company denied the claim and the bill was $512. Insurance kicked in and paid $37 and that was that. Tell me again who determines healthcare costs?
Originally posted by: snidely333
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Originally posted by: pjstrohQuote
Originally posted by: alanleroyQuoteThey base the premiums on their estimated costs. If their estimated costs go up, the premiums go up. If the premiums go up, their profits go up. Where is the incentive to lower costs?
Originally posted by: billryan
80% of the premium must go to health care. The 20% is of premiums, not of the actual cost of health care. If health care cost go up, its eats up the premiums, leaving less for administration, not more. Are you experiencing a brain fart or something?
The insurance companies dont determine cost of medical care. The healthcare providers do and the price is loosely based on supply/demand which is why urban premiums tend to be less expensive than rural ones.
The 80/20 rule stops insurance companies from jacking up rates especially in areas where competition is lacking.
Whenever I go to the Dr., my insurance company dictates how much the Dr. will get paid. My insurance company determines the cost of the healthcare. Dr. might bill me $400. Insurance pays them $42 and there is not further charge to me. I had some routine blood work done last month and due to a glitch, my insurance company denied the claim and the bill was $512. Insurance kicked in and paid $37 and that was that. Tell me again who determines healthcare costs?
The healthcare providers. Granted its a negotiation - which is in of itself a travesty. The ability for your insurance company to negotiate price is comparable to your ability to get a good deal on a new car. Insurance companies have leverage but only to some extent.
A rural hospital is going to charge a lot more to fix a broken arm than an urban hospital - largely because they are the only game in town. And all the negotiating skills in the world wont fix that.