In healthcare, only the uninsured pay list price. They actually pay the crazy amounts that show up on their healthcare bills. Other payers, like insurance companies, pay a steeply discounted amount. Sometimes 70% off.
Pretty outrageous eh?
It's not new though. That's how it worked when I was a country doc in the early 90s and it was old and outrageous then. Now it's getting more attention; but it's not new. The weird thing is that this 'secret' has been in plain view for decades.
That's not the end of the story though. At least when I was in practice, we couldn't do a cash discount. The insurance price was based on list, and if we lowered list the insurance payments would fall. Indeed, our 'customary' charge rating would also fall, and in the bizarro world of healthcare finance what insurers were willing to pay us depended in part on our past charges.
Back then we wrote off many cash charges, but times have changed. For one thing, the Bush GOP made it much harder for regular folk to declare bankruptcy and escape healthcare debt.
So now that this story is getting traction, I wonder if Americans are ready to learn about how Evaluation and Management CPT codes (E&M Coding) destroyed primary care. Hint: "What gets measured gets done" doesn't mean "what is good gets done".
Many Americans still think we have a great healthcare system. It's probably not our only mass delusion.
