Wednesday, January 28, 2015

Medical Bills Going Down If You Pay Cash – Way Down

By Dike Drummond MD

Medical bills going down when you pay cash. Medical Bills Going Down as Docs and Hospitals Start to Discount for Cash. Discounts of up to 89% for common procedures being offered in southern California healthcare system.

If you have been in practice for even a short while you have patients who have lost their homes and even been bankrupted to pay medical bills, usually for emergencies or end of life care.

Now Doctors and Hospitals are starting to do what every other business has done since the beginning of time – giving a discount when you pony up cash. States are beginning to require pricing transparency and hospitals and physicians are starting to publish their “cash prices” for all to see.

We may be seeing a time when the uninsured person writing a check for their medical bills begins to get a much needed break. This new pricing trend is causing some interesting ripples as more and more people become aware of the sometimes dramatically lower prices for cash on the barrel head.

Here are two examples of MUCH LOWER medical bills when you pay with cash.

1) A recent article in the Los Angeles Times reported a CT scan of the abdomen costs about $2,400 for patients insured by Blue Shield of California, while the Los Alamitos (Calif.) Medical Center cash price is only $250. That is an 89% discount by my calculation.

2) Another local California hospital charges insured patients $415 for blood tests that cost only $95 in cash. This time it’s a mere 77% discount.

Now, there are some interesting rules to the cash discount game.

First – to get the discounted prices, patients would have to withhold insurance information from hospitals. If you tell them you have insurance, they will be bound to charge you the insurance company’s negotiated rate. Those are the up to 89% higher fees documented in the previous paragraph!

However, if you don’t tell them you have insurance and pay cash instead, the cash payments don’t apply to your annual out-of-pocket spending limits.

For an 89% discount, I am pretty sure there are times it would be worth it to keep your little secret. If you are healthy and only need an occasional visit to the doctor you now get to make the judgment call on cash discount vs. paying five times as much and applying it to your deductible.

Hospital executives say they don’t like to charge insured patients more, calling it a result of the country’s broken healthcare system.

“We end up being forced to charge a premium to health plans to make the books balance,” said John Bishop, the hospital’s finance chief of Long Beach (CA) Memorial Medical Center. “It’s a backdoor tax on employers and consumers.”

Let the Lawsuits Begin

In perhaps the most interesting reaction to cash discounts, a patient who was unaware of the discounted cash pricing last month filed a lawsuit against Blue Shield of California for unfair business practices, breach of good faith and misrepresentation over her medical bills after she was charged $2,336 for a CT scan that would have cost her $1,054 in cash.

Blue Shield said it “cannot promise or represent that there could not be providers who will charge someone less out-of-pocket cost for a service than she would pay if the Blue Shield contract rate applies.”

In my mind it is only fair that, when it comes to medical bills, the cash price gets a discount. I must admit the size of the discounts being offered certainly raises my eyebrows. However, it is just the latest in a long string of things that don’t make sense when it comes to healthcare pricing in America.
At least now, the people unfortunate enough to have only cash to pay their medical bills can finally get a break. Cash.

Obamacare program costs $50,000 in taxpayer money for every American who gets health insurance, says bombshell budget report

  •  Stunning figure comes from Congressional Budget Office report that revised cost estimates for  the next 10 years 
  •  Government will spend $1.993 TRILLION over a decade and take in $643 BILLION in new taxes, penalties and fees related to Obamacare
  • The $1.35 trillion net cost will result in 'between 24 million and 27 million' fewer Americans being uninsured – a $50,000 price tag per person at best 
  •  The law will still leave 'between 29 million and 31 million' nonelderly Americans without medical insurance 
  •  Numbers assume Obamacare insurance exchange enrollment will double between now and 2025

By David Martosko, Us Political Editor

Published: 16:38 EST, 26 January 2015 | Updated: 18:32 EST, 26 January 2015

It will cost the federal government – taxpayers, that is – $50,000 for every person who gets health insurance under the Obamacare law, the Congressional Budget Office revealed on Monday.

The number comes from figures buried in a 15-page section of the nonpartisan organization's new ten-year budget outlook.

The best-case scenario described by the CBO would result in 'between 24 million and 27 million' fewer Americans being uninsured in 2025, compared to the year before the Affordable Care Act took effect.

Pulling that off will cost Uncle Sam about $1.35 trillion – or $50,000 per head.

THE $2 TRILLION DOLLAR MAN: President Barack Obama was in India on Monday when the Congressional Budget Office reported the federal government's gross costs for a decade of Obamacare will be $1.993 trillion
PROMISES: Obama pledged in 2009 during a speech before a joint session of Congress that his health insurance proposal would cost $900 billion over ten years – a far cry short of current numbers
The numbers are daunting: It will take $1.993 trillion, a number that looks like $1,993,000,000,000, to provide insurance subsidies to poor and middle-class Americans, and to pay for a massive expansion of Medicaid and CHIP (Children's Health Insurance Program) costs.

Offsetting that massive outlay will be $643 billion in new taxes, penalties and fees related to the Obamacare law.

That revenue includes quickly escalating penalties – or 'taxes,' as the U.S. Supreme Court described them – on people who resist Washington's command to buy medical insurance.

It also includes income from a controversial medical device tax, which some Republicans predict will be eliminated in the next two years.

If they're right, Obamacare's per-person cost would be even higher.

President Barack Obama pledged to members of Congress in 2009, as his signature insurance overhaul law was being hotly debated, that 'the plan I'm proposing will cost around $900 billion over 10 years.'

It would be a significant discount if the White House could return to that number today.

PRICEY: The federal government will spend $50,000 for each person recruited to buy insurance or enroll in free Medicaid through the Obamacare exchanges

In that same speech, Obama claimed that there were 'more than 30 million American citizens who cannot get coverage.'

$900 billion spent on those people would equate to no more than $30,000 each – less than two-thirds of what the CBO now says the program will cost when the dust settles.

The CBO and the Joint Committee on Taxation, a group of members from both houses of Congress, prepared Monday's report on the overall direction of the federal budget.

They estimated that 'the net costs of the coverage provisions of the ACA [Affordable Care Act] will rise sharply as the effects of the act phase in from 2015 through 2017.'

Those costs will 'rise steadily through 2022' before leveling off for three years, the groups' economists determined. But even at that point, the Obamacare program will cost the government 'about $145 billion' each year.

That number doesn't include the insurance premiums and out-of-pocket health care costs paid by Americans – only the government's role in implementing the law and paying for its guarantees.

And the law will still leave 'between 29 million and 31 million' nonelderly Americans without medical insurance, says the CBO.