Thursday, June 20, 2013
Why Medical Care in the US Is Expensive... and Random
While I'm not going to talk about all the factors that contribute to the high prices of American healthcare, I will talk about one of them: protection against insurance claims.
Hospitals and insurance companies find themselves in an adversarial relationship. The hospitals want to get paid as much as possible. Insurance companies want to pay as little as possible. While the reality is much more complex, in simple terms what happens is that many hospitals tend to overcharge for their services. They know that insurance companies will undermine their claims and attempt to pay less than what the claim is asking for. It's not really about morals or hospitals or insurance companies being evil, but about each party looking for their own interests.
However, the problem is that a lot of the times, it's the patient that has to end up paying these charges, especially if he or she doesn't have good insurance or is uninsured. For example, some hospitals have charged extra for closing the incision after surgery or even for extra blankets. A few hospitals have been discovered inflating their prices for items in your billing list.
If you find yourself with a bill that's much higher than you expected, feel free to try to negotiate with your hospital. If the bill is too high, you may even want to consider hiring a medical billing advocate. Although I will speak more about them in a future article, just know that a medical billing advocate is a person that will negociate with the hospital and the insurance company so that you pay the least possible. Obviously, such a person will want a cut or a per-hour fee in exchange for these services.
With this system, it's not a surprise that many people are going to Mexico or other countries to get affordable care. However, there are advantages and disadvantages when getting treatment in other countries as well, which is why I recommend people fully inform themselves about their conditions, procedures, post-procedure care, risks, costs and cultural differences when going to another country to get health care.
If you are one of the people considering going to Mexico for medical treatment, I suggest you get Monica Rix Paxson's The English Speaker's Guide to Medical Care in Mexico, which will tell you how to find a good doctor and hospital, what the approximate prices for procedures are, and what differences to expect when receiving treatment in Mexico.
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