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November 29, 2007

Whats wrong with our healthcare/insurance system

Going to go off topic here on a bit of a personal rant.  At StillSecure we try to provide all of our employees with a benefits package that is world class.  Part of that is providing health care coverage to our employees. This is something I and the rest of our executive team believe strongly in.  If you work here, you should have peace of mind regarding paying for any health care you or your family may require. Over the years the health insurance premiums have gone up year over year.  It became such an expense that some time back we started to pick up a the majority of the insurance premiums (like over 75%) but had to ask our employees to help cover the burden.  Since than the premiums continue to go up by better than 10% a year, sometimes 15 to 20%.  For a company with 100 employees this is not a trivial sum.  This past year we switched providers again to try and keep these costs down.  I just don't understand why these costs keep spiraling out of control and don't tell me it is because of malpractice cases, that is just drivel.

Well this fall I learned first hand why the system is so expensive and who is really milking it. Bonnie had to go for some minor surgery back in September. She went in the morning to the ambulatory surgery center.  Her surgery was only about 30 minutes, but after spending a few hours in recovery from the anesthesia, her doctor recommended she stay overnight at the hospital and go home in the morning.  No problem, the next morning she came home and made a complete recovery in a short time.  Then the bills started coming!

First was the surgeon.  This is the guy who did a lot of the work and boy did he get the short end of the stick.  It seemed because we had switched insurance carriers in July, we had not met our deductible yet.  So we had to pay the first 500 dollars of his bill ourselves.  The insurance carrier paid him a whopping 167 dollars over the 500 dollar deductible!   For performing this surgery the surgeon received the grand sum of 667 dollars!  Hardly seems worth it when you consider what he had to do. Next came the anesthesia bill.  With the deductible met, we only had to pay 10 or 20% of this bill, but the insurance carrier paid them just about as much as the surgeon!  Now for the best part.  It seems our new lower priced insurance covers only 90% of hospital bills.  We get a bill for like 700 dollars from the hospital.  I look at the amount the hospital billed in total and it is for 17k!  That is right 17 thousand dollars.  700 is not 10% of that, but I thought after billing this outrageous amount, taking another 700 dollars from me was wrong. I called the hospital.  They then explained to me how they arrived at 17k and also informed me that the insurance company only paid them about 4k.  I asked how this was possible.  They said they knew what the insurance company would actually pay, that is why they bill what they do.  In essence by billing this crazy number they ensure that they will receive a fair amount from the insurance carrier.  Of course they still made me pay my share.

What is wrong with this picture?  The whole system is a scam with everyone playing their share.  With the doctors and nurses doing the actual work getting the short end of the stick I am sure.  Until we get this system back in balance we are doomed to run away health care costs and increased burden on our system.  BTW, Dr. Stanley Feld has a great blog on this very subject. Read it if you get a chance.


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