[xp84]

Using insane prices and then marking them down to reasonable levels "as an insurance discount" only has a few possible purposes and none of them are good:

1. Ripping off anyone without insurance who doesn't realize they may be able to negotiate it 2. Misrepresenting the true cost of healthcare for anyone who goes off the "original price" 3. Establishing that insurance companies have to push for deep, 90%+ discounts on everything, meaning nobody can offer sane pricing because the insurance company will say "But <HOSPITAL> gives us 95% off!"

I recently had a genetic test done. They told me that if my cost after insurance was more than $200 they'd notify me ahead of time so I could decide how to proceed, one option was a simple pay-cash option for $250. Turns out the "Amount billed" to insurance was $ 25,000, which was then "discounted" by about $ 24,600 and they were paid $400 or something. So, this is a service the lab is happy to provide for $250 -- and they make money at that price, yet in some fantasy universe, $ 25,000 is in play. This is why people want to burn the US health system to the ground.

[lannisterstark]

Curious question, if the amount 'billed' to your insurance was as you say, 25000, and if a patient went there and they were told without insurance they'd get charged say, $300 (slightly higher than with-insurance price), does it matter to that end user, or the users with insurance that the insurance is being charged $25 grand?

Ultimately the end user is paying $250/300. Eg, my counselor example.

[brewdad]

The problem comes when insurance denies the claim for whatever reason. Now, the provider is going to try to bill you the $25,000. It's up to you to either get your insurance to cover the procedure properly or to negotiate it back down to something close to the $300 price. They won't just offer it to you after processing through insurance.

[tehwebguy]

Exactly, they don’t wanna pay it either. Plus, the negotiated rates have nothing to do with whether or not a patient bill will be “approved”.

[BHSPitMonkey]

The inflated procedure costs help shape the premiums we all pay for (either directly, or through our employers, or though the overhead costs of business with employees where we shop and do business). It's just a sneaky way to extract as much value from society as they can get away with.