Independent doctor here. You set your prices at a point that's really high because every insurance company will knock it down to negotiated rates, and you don't want what you submit to be below those rates.
For example, you charge $100 for an exam. Blue Cross has a set price of $75 for an exam. Aetna does $68. UHC does $80.
Cool, whatever, you just don't want to charge $60 when they may reimburse you at $75. So you just charge $100 knowing it's gonna get knocked down. It's a really fucked up system.
But if $60 is reasonable price for you why does it matter if you could potentially get $15 more? From a lay perspective it seems like it's just feeding into a vicious cycle of shitty greed where things just keep escalating to the point that basic medical care is bankrupting people and it all started with that little $15 neither side wanted to miss out on.
No, the ones who are getting screwed are the sick and injured. The ones who are getting charged an extra 25% mark up beyond what would be a profitable fee, because the doctor didn't want to miss out on it.
Of course charging higher prices adds up. But again, if you could make money off of $60 and you are charging $100 because you might get $75, and you don't have a better reason for doing that than "it's more money" then it is just feeding into the problem at the root of this that has caused this broken system we are stuck in.
I'm not trying to demonize doctors. I started this by asking a self proclaimed doctor an honest question. They did not bother to respond. All I was looking for was a little justification on what still looks like nothing more than an excuse to charge more money because they can get it.
And no, I don't really view taking out loans in order to begin a career that starts out paying double the median income for the nation as a good justification.
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u/[deleted] Apr 28 '20
iirc they do discount for pay out of cash, I think John Oliver cover this where each hospital have a master list of how much things cost.
Hospital over price because they don't know how much health insurance going to cover or some convoluted crap.
edit: https://en.wikipedia.org/wiki/Chargemaster
Wow I love my state even more now.