Socialized Health Care in the USA

[LochnarITB]

I dunno, if I go to the dentist and tell them I'm out of insurance coverage for the year and will need to pay out of pocket, they'll right away, without asking whack anywhere from 20-50% off the price of whatever I'm having done. How that doesn't count as insurance fraud is beyond me, but it's pretty common.

What is really happening is that you are paying what they would have been paid by the insurance company. Insurance companies not only negotiate what the pricing will be, they also negotiate the portion of that amount that will be written off. Look at an EoB (explanation of benefits). You will see the price that the coded service or procedure bills at. You will then see the contracted write off and what was paid by the insurance company. This should then yield zero balance, or the copay amount, which is the patient responsibility. This makes the insurance company look like they are doing more for you than they are.

Problems for uninsured come when the provider does not do what your dentist does. They are billed at the initial price generated by the code and there is no write off and no insurance portion. They are stuck with the inflated price to be paid in full.