Asking For The Right Information For The Wrong Crowd:

"The Medical-Bill Mystery" dated March 13, 2006 in the Wall Street Journal, pointed out that the need to know costs upfront for healthcare services is more important now than ever before because people have a reason to watch what they spend. This push may be driven by consumerism, but it only helps insurance companies and not the insured consumers as noted in the article.

A health insurance written under the health savings accounts requires an individual to first pay $1,050 before an insurance company begins paying any part of the medical bill. If a consumer, by shopping around for the lowest price, is able to meet all of the medical needs within the first $1,050 then the insurance company saves money by not paying on behalf of the insured. However, if the same consumer's medical needs would have cost $1,350 at a healthcare facility that commanded premium for convenience, higher customer services or other features, then the insurance company will have to pay part or all of the cost over $1,050 - approximately $300. The payment by the insurance company to the service providers is a cost to the insurance company; hence less profit is reaped by the company.

Insurance companies are in a constant tug-of-war with the insured patient. An insured customer desires the best services with minimal cost considerations (after all that is one of the reasons a person buys insurance; not necessarily to save the money, but to have access to quality services in case of illness) and the goal of an insurance company is to pay the least amount for the fewest number of services without jeopardizing or risking the health of a patient. Pushing the idea of price shopping and consumerism for the insured patients can only lead to more profits for the insurance companies and no added benefits or savings to the patients as more services will fall within the higher deductibles amount that a patient is paying first. Pushing the patients to choose service providers based on cost raises the bar of the insurance companies before they become responsible to pay for the patient's healthcare needs. One must plan to jump over the high jump bar to win the prize; however, in a price-reporting push, insurance companies wish not to have patient jump over the bar to increase their prize profits.

Lalit Goel

http://www.saagii.com
http://www.saagii@yahoo.com
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