I Have Insurance and Still Can’t Pay My Medical Bills

by Mary Schreiber Swenson, PhD | Feb 4, 2020 | Price transparency

“There is a Lack of Price Transparency in Healthcare” I have insurance and still can’t pay my medical bills.  This is in a large part because there is NO cost transparency in healthcare in the United States.

What Makes Healthcare Expensive? Let me explain:

  • My deductible is $7,900 for the year.

  • My copay is $20 per visit.  (And the copay DOES NOT count towards my deductible)

  • This means I have out-of-pocket costs of AT LEAST  $7,900 Before my insurance pays a single cent

On top of that:

  •  I am paying a monthly premium which averages around $883 a month

  • I am told what doctor I can use, in which network, and who I must see

  • Also, how I am to be treated and what medication I will be allowed

By the time I pay the $7,900 and the ($883 x 12 =) $10,586, I have paid $18,500. I also pay all dental out of pocket – another $379

Medical Bill or Mortgage at End of the Month?

Now, during that time, I am not afraid to go to the doctor because of needles and blood. I am afraid of the medical bill and the choices I will have to make at the end of the month – House Payment or Medical Bills. Even more bizarre, I am a customer of the insurance company. I buy the insurance service and without me, the insurer does not get paid! The insurance company is taking away my right to choose who I see for healthcare services. And I still write them a check every month Excessive Long Term Insurance Costs I am blindly paying into a system for years and years:

  • Let’s say I work 25 years and pay into That system – $18,868 x 25 years = $472,000 (That could have been my beach house, a very nice beach house).

  • Of course, we get sick and money is taken from That pool of $471,700, yet we continue to be so fearful.

Chance of Being Hospitalized in the USA. Did you know that spending a night in a hospital is a rare event? 92 % of the population did not spend one night in a hospital.  Only one percent spent eight or more nights?! According to a report released by the U.S. Census Bureau, the average American has 3.9 visits to doctors, nurses or other medical providers each year. When you buy a house, you are not told where to live, how to live and what repairperson you may see.

Control of Healthcare by People

  • We The People, need to take back control of our healthcare.

  • We The Customer, need to say, we are not satisfied with the quality of services.

  • We The People want more choices because we are fearful that we are going to be left sick and stranded even as we continue to pay. Yet, because we, the people, just don’t understand the healthcare And insurance systems, we don’t assert our rights

Steps to Give Consumers Control of Healthcare

So, what are the next steps? Start asking your doctor or hospital what the costs are for your treatment. I travel the globe, and in every country, they have a list of all services and procedures with a coordinating price list. Demand to know what your healthcare cost is. Ask how much do they, as the hospital, Get paid by the insurance company so you know how much you have to pay yourself. Only the six major insurance companies that dominate the USA dictate how much you pay and who you see.

The insurance company is telling the Hospitals how much they will pay them.

We fight for our freedom of speech. We fight for our right to bear arms. We speak up about inequality.

But We The People say nothing about our healthcare and who should take care of us when we are sick. Our politicians have direct control over what insurance companies can charge us. They have a duty to the people. The law gives the authority to the Director of Insurance (an elected position), and the government in general, to set the rates for how much we pay for our insurance

Consumer Control of Healthcare Costs

  1. What exactly do I want from my politician and my employer?

  2. I want transparent pricing on my healthcare costs, I want to know exactly how much I am paying for each of my healthcare procedures.

  3. As a patient, I do not want any cost-sharing.

  4. I do not want to pay a deductible or copay or coinsurance (which means you pay a percentage which generally applies to the hospital stay. A typical industry copay may require you to pay 30% of your hospital bill up to $100,000$ until you fulfill your out-of-pocket expenses.)

  5. I want an Open Network – where I can go to any provider or hospital

  6. I want choices: My choice, My body, and who I want to take care of my medical problems whether that is within my state or outside my state, or even outside of my country!

  7. We the people demand one unique policy that covers essential healthcare benefits. Why is there a need for a hodgepodge of different policies that pay different amounts? Insurance actually pays different amounts for the same treatment to different hospitals.

Your politicians can change this. Your employer can negotiate with politicians. Providers can negotiate with your hospital to get a better deal. You can actually shop your healthcare to get the best pricing. Proceed as if you are buying a car!!! Research by asking others and using the internet. Once you have control, you control your treatment. If you do not have control, your insurance company controls your treatment. Of all the different types of insurance, only health insurance dictates your life choices in this way Difficulty of Decreasing Healthcare Costs So, are you thinking that this is too difficult of a task? My answer is, please just do your part and ask the question – what is the price of my healthcare procedure? I demand to know because I cannot afford any surprise bills. There is no hospital or healthcare price transparency in the United States. That needs to be fixed! Remember, the most powerful entity in the United States is… We The People!

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