Quote:
Originally Posted by SpiritWarrior
The best goes to the ones who can pay mas $$$.
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That's not accurate. The best health care goes to those with the best group plans. And, good group plans are based on having a huge employee base for what is essentially "collective bargaining" with the insurance companies. So, a government employee, such as my wife, has excellent, second-to-none health insurance not because her salary is huge and she pays big bucks, but rather because the fact that the government is a HUGE employer it can negotiate for GREAT benefits for all its employees.
So, it's not a $$$ game. It's a group bargaining game. And someone with good insurance is billed less for health care than someone with no insurance. Because the insurer negotiates for reduced rates at the outset.
So, let's take a "for instance" using some base numbers. My insurance covers, generally, 80% for covered procedures. So, let's say I have a hip replacement -- that would cost, ie., the doctor would bill, $40,000 roughly. O.K., so I pay 20% of that, or $8,000? NO. Because the first thing my insurer does is take a pen to that bill and insert their negotiated allowance for that procedure. Normally I see about a 50% reduction right off the bat. So that $40,000 immediately gets knocked down to $20,000 or less. This leaves me paying less than $4,000, and the insurer paying $16,000, and the doctor accepting $20,000 as fair payment.
The person who is uninsured? They get a collection agency calling them looking for a total of $40,000, which is now incurring interest over time.
The other way in which group negotiation results in lower costs is in the premiums. For attorneys in my law firm, getting the highest/best insurance for a family of 4 would cost over $1500/month. But, my wife's employer has over 100x the number of employees and can negotiate lower costs. So, we use her insurance, and our cost for our family of 4 is less than $300/month. Equal or better coverage.