I’ve been thinking about healthcare. Not about the quality of care, but about the parts of the process. There are health providers, patients, and that part in the middle, the insurance companies. One of these parts is not like the others…
Two of these parts are critical to the process. It wouldn’t happen without them. The other part is how we finance the process over the course of our lives. I wonder how many people are employed in the health insurance industry. Is it possible that the financing portion of the process uses up a disproportionate share of the resources involved?
Here is how it works. I go to the clinic for some work. We get a bill for $300. The bill goes to the insurance company. The insurance company marks the bill down to a prearranged fee of $250 for that particular service and pays the clinic. We get a notice that the bill has been paid. It’s all good. I got what I needed. The clinic got paid. The Insurance Company kept the clinic from overcharging us by $50. And we got to finance any healthcare we need for our entire lives by paying insurance premiums, on average, of an amount equal to the amount of any medical costs, plus all the operating costs of the insurance company, plus a profit margin to the insurance company owners.
What do you suppose the insurance company portion adds up to? Judy asked the doctor at the clinic what he would have charged to do what he did if we hadn’t had insurance. (Remember he charged $300 and it got marked down by the insurance company to $250.) His answer? $100. $100. If we had walked in the door and said we didn’t have insurance we wanted to pay cash, the fee would have been $100. That means for $100 of service, the doctor charged the insurance company $250, and the insurance company charged us way more than $250 in premiums.
Isn’t there a cost-of-health-care crisis going on right now? Of course, unencumbered by knowledge as I am, I’m not part of any discussion about it, but we wouldn’t want that to hold me back from asking the question. Is it possible that, without compromising any quality of service, there is some other way to finance our health care; some way that would not double or triple the actual cost?
