Dr.Who
Well-Known Member
Sara works mainly with benefits.
Benefit denied.
People should realize that most companies are essentially self-insured, and that the rates are set not by the evil insurance companies, who serves as administrators, but by the companies they work for, which have to finance their insurance primarily out of money paid in. Even the weak form of socialism which is corporate insurance has a bottom line in which money in has balance up with money out. There is no free lunch.
Nice to see someone gets it. the money in always has to balance the money out. And each layer of complexity is an added layer of inefficiency and profit taking.
When the patient pays the doctor there is one layer. Sometimes the doctor and the patient have inefficiencies - like when the patient bounces a check or the book keeper loses it, etc. and of course the doctor needs to make a profit or he won't be able to help any patients.
Unfortunately, often the patient will not be able to pay huge bills that come up unexpectedly. He then decides that he would like to add another layer of complexity by getting insurance. Now the insurance company adds inefficiencies and takes a profit. It is up to the patient to shop around to get the best deal and to compare what he would have paid to the doctor without insurance to what he is paying now.
But then the employer becomes the one who buys the insurance and the patient is more out of the loop. There is even more complexity and more profit taken - and not just by the employer. Now things are confusing enough that the patient doesn't have much chance to compare costs and he certainly can't shop around. He often does not even understand the bills he sees (or not) go between insurance company and doctor.
The the government decided that they need to be involved too - more complexity and more profit taken.
By now the patient has gotten so confused and out of the loop that he has forgotten that the purpose of insurance was to pay for things that were huge and unexpected. Now he buys vision, and dental, and routine exams, etc. And he gets to pay for all the added complexity and profit.
Some of them even forget that the money in always has to balance the money out. They want it all. And they think that just because they don't see a $500/month or $2000/month premium that they are not paying it.
Even if no money comes out of their pocket and Uncle Sam pays the premiums or doctors by taking money from rich guys too stupid to shelter their money or smart enough to pay the tax but get a back room deal at the same time they still pay for it one way or another. If not in premiums then in lower wages or higher prices.