|
DesideriScuri -> RE: A question for Canadians, Brits and any other citizen of a country with nationalize health care (10/6/2013 7:30:27 AM)
|
quote:
ORIGINAL: dom2ownboi
The billable cost issue is irrelevant to most consumers. On the NHS you simply don't pay for anything except for prescription costs. If you choose to go private you get a bill and pay it, or your insurance does. The billable rate is I believe a non-issue. From what I understand billable rates are merely a way for insurance companies in the US to overcharge and then negotiate the actual payment made, which means their charges are a complete rip-off in my opinion.
In the UK there are NHS hospitals and private hospitals. As far as I know most NHS hospitals will do private work, billing either the patient or his insurance, and most private hospitals will do NHS work and bill the government or local health authority.
quote:
ORIGINAL: DesideriScuri
quote:
ORIGINAL: Politesub53
Zeppo, I am not sure if this is still the case but here is what I know. Many years ago I needed surgery to correct a deviation in my nose, or some such thing, as it was affecting my breathing, not drastically but enough to need looking at. There was a wait to see the NHS surgeon, so I mentioned to him I was in BUPA via the union I was in..... He put me on to a BUPA hospital and I was seen within two weeks, by the same surgeon. I had to pay for surgery up front and got reimbursed at a later date.
Do you have any idea what the difference in reimbursement rates (or billable costs) was between BUPA and NHS?
And, am I reading right that there are "NHS-only" hospitals and private insurance hospitals?
They do matter. And, they do matter for exactly the "rip off" reason you gave.
Let me put it to you this way: We completely agree that billable costs are a ripoff and that, pretty much, no one pays them. Insurance companies negotiate with providers over reimbursement rates, but the "billable costs" are still important. My ex-wife's company is self-insured, so they pay the reimbursements. The only time the insurance company pays is when the yearly stop loss limit (set individually, not aggregate on the entire employee pool) is met. At that point, the insurance company takes over the payment of further costs for that employee. So, the only actual benefits her company is getting is that they pay the "negotiated costs" and any time there is someone that goes over the stop loss. All premiums pay for, then, is the right to those negotiated costs and the stop loss.
Hospitals get to use the amount of charity care they give in maintaining their tax-exempt status.
Insurance companies get to use the amount of "savings" their negotiated prices provide as a sales tool. The higher the costs, the greater dollar amount they can show at any % of savings. Insurance companies that also own the hospital/provider have little incentive to not abuse that system.
|
|
|
|
