[cure]

It's worse.

If you have insurance, the price tag will be X, and they will pay for some part (most?) of it.

If you don't have insurance, the price tag can easily be 100X and it's your responsibility.

If you have insurance, but you happened to pick up that can of pepsi from the left aisle (out of network) instead of the right aisle (in network), they won't cover it, and you're stuck with the 100X price. You won't know that before you buy the can of pepsi, of course.

If you try to ask your insurance if they cover the specific can of pepsi from the left aisle, they may or may not tell you. They may or may not give you the right answer, and if they tell you it's covered but then refuse to cover it, it's your problem (and again, the price will be 100X).

[zaroth]

It should be illegal to charge two different people two different prices for the same procedure at the same facility.

The whole model of negotiated rates, rebates, etc. needs to go.

I also think the concept of networks is bizarre on the face of it. A certified medical provider should be covered to perform procedures in their area of expertise. Period.

Personally I like the idea of anyone who wants to be able to buy into Medicare A & B. And if you don’t have Medicare then you can always pay the Medicare rate of the procedure at 100% (versus having Medicare where your copay is 20%).

If insurance companies can’t compete with that then great.

[davidjnelson]

I agree with you. I wonder what it would take to get rid of those discounts in terms of legislature and how individual voters could work together to fix it. The current system is ridiculous. A $17 procedure should not be billed at $1,200 "because they can".

[dmix]

So the solution is more layers of administration over the prices of the pseudo marketplace?

[zaroth]

How is that a fair representation of what I proposed?

I think part of the problem is absolutely opaque, discriminatory, and predatory pricing.

I went to get a basic blood count last month. I gave the lab my insurance card, but they must have copied a number wrong, because when I got the bill they had me down as self insured, and had a bill which said;

  Lab Services     :  $1,541.00
  Patient Adjust   : -$  385.25
  Total Due        :  $1,155.75

I called back and gave them my insurance card and they said ignore the bill a new one will come in the mail.

Last week I got the new bill:

  Lab Services     :  $   17.12
  Insurance Pay    :  $   12.12
  Total Due        :  $    5.00

Yes, I absolutely think it should be illegal to try to bilk a cash carrying customer over $1,000 for a $17 blood count test.

[hopler]

You missed the part where you chose an in-network can (hospital) that is filled with out-of-network soda (doctors).