I just received a $10,000 bill for urgent medical treatment I had last year for subdural hematomas caused by several concussions over my life span. The insurance company, Blue Shield of California, is claiming it is out of network and it has a $12,000 out of network deductible. It was out of state, and it was emergency. I had to be flown by a helicopter from Elko to the University of Utah Neurological Intensive care unit. The premium I pay is $1,200 a month, and you would think this would protect me. There are more bills, but this one is the largest, adding up to $50,000 counting out-of-network expenses. I now am trying to appeal this because without emergency surgery I surely would have died the day of the flight.
There is always a fine balance between socialism and the free market. Health insurance for profit is an abysmal failure. Medicare on the other hand has set prices, and out-of-network costs would have been covered for the most part. Recent figure set the overhead of private insurance is around 30 percent, and that does not count the obscene income for executives of the insurance companies. The hospitals have “coders” who try to increase their profit by “up-coding” the claims and increasing their payout. A recent study found that private insurance companies are charged two to five times as much as Medicare payouts for the same services.
For the 150 million people insured privately they would still be vulnerable to these out-of-network emergency services. Before the Republicans tell you we can’t afford this, take these facts into account. Besides, the increased pool of healthy people would decrease the costs to the government even more. The whole scam here is to keep people in the dark about the true cost of their private insurance and outlandish drug prices so that these companies can maintain their greedy grip on the medical system. Even Trump bemoaned the out-of-network costs and drug prices! Insurance is great unless you really need it. The medical system makes defense contracts look reasonable for a $500 hammer.