Do You Have Enough Health Insurance? Maybe Not

Good short and to the point explanation on how the systems work...BD

Jim Lawson, 61, was working for an oil company in northern California when he became ill from a staph infection in his arm. Unfortunately for Jim, the infection entered his blood stream and caused multi-organ failure. Jim was hospitalized, most of the time in intensive care, at the California Pacific Medical Center. He quickly exhausted his health insurance policy limit of $1.5 million. When he made a miraculous recovery several months later and returned home, he received a bill from the hospital for $1.2 million.

The second reason for hospital over-billing is that it bills those least able to pay (under-insured or uninsured) the most, and here is why. Insurance companies and HMO's negotiate charges with the hospital. The insurance carrier may negotiate a charge of $2,000 for a particular procedure but the hospital charges the uninsured $8,000 for that same procedure. Again, I have confirmed this fact with one of my local hospitals. And by the way, when the uninsured patient cannot pay...the hospital uses that fact to justify increasing their charges even more in order to "make up for" those unpaid bills. Finally, if the hospital is a non-profit hospital (don't get me started...) it will say that the fact it did not get paid for those services...is an example of its charitable work!