re: #50 Floral Giraffe

I do not pretend to know what the solution is.
I do agree that our present form of medical PAYMENTS needs to be fixed.
When my appendix ruptured, I spent 5 days in the hospital.
Because the paperwork got messed up, I saw the “actual” bills, over $40,000. When the paperwork got sorted out, the insurance company paid (IIRC) $14,000.

Now, conceivably $14,000 over time, would be something I might have managed to pay. $40,000 plus? NO WAY.

Insurance companies work out various rates of reimbursement with various providers. You can be sure that what the insurance paid, plus whatever your co-pay was, was sufficient reimbursement for the services you received.

If I recall my college days, when I wored as a Medicaid claims processor, Medicaid paid providers based on a percentage of the provider’s PREVIOUS YEAR’s usual and customary rates (UCR)

So, providers would jack up their stated rates to affect the UCR, in order to get a higher reimbursement next year.

Their stated rates were rarely what they ever actually got in reimbursement from insurance companies, Medicare or Medicaid.

Even folks with no insurance - if you talk to the provider, many will give you a different rate than what their stated rated is. It will still be a lot, but not nearly as much as what their stated rate is.