[fsstnotch]

Originally Posted by Dan40

There are basically 3 kinds of patients.
1.SELF PAY-- Those that have money to pay but choose not to be insured.
2.INSURED--Those covered by private insurance, individual or group coverage.
3.And those covered by a Government program or policy.

Lets say a surgery has to be done and the hospital/surgery center charges $20,000.00 for the surgery.
#1. is billed for $20,000.00 and must pay that.
#2. is also billed for $20,000.00 But he has 80/20 coverage, so he pays $4000.00. Does his insurance company pay the remaining $16,000.00? NO, they have a contract with the hospital where they agreed that surgery is worth $8000.00. so the patient pays 20% of RETAIL, $4000.00 and the insurance pays 80% of WHOLESALE, $6400.00.
#3. The Government has a schedule of benefits list and allows a certain sum for each treatment. The $20,000.00 Retail price means nothing to the Government. For the particular surgery they have a price of $2500.00. A person with 80/20 coverage [like Medicare] would pay $500.00 for this surgery if it was outpatient. Gov. would pay $2000. If the surgery was inpatient [patient was admitted and spent more than 24 hours in hospital] then the Government pays a flat rate for the admitting diagnosis. Patient pay a preset deductible only. No 80/20.

Does the system need overhaul? YES, YES, Does it need more Government NO, NO!!

Fix, not replace.

Your Cobra has bad plugs and wires. Replace the Cobra or get a tune up?

Yep, exactly! My wife had Knee surgery on halloween last year. Dr bills were around $25,000. We owe close to $4000. Her surgery was done by one of the best in the country, 1 week after diagnosis! That's the kind of healthcare I like!