@thegerg said:
If you're trying to argue that health insurance should be a right in the same way that owning guns is a right, you must recognize that's already the case. If you want a gun in the US you have the right to buy a gun, just like you have the right to buy insurance if you want insurance.
But our medical system is convoluted and broken AF. I'll give you an example (it's been a while so I may not be 100% on the individual bill amounts but the total will be pretty accurate):
I had an ER visit when I torn my ACL a couple years ago. I have decent health insurance through my employer and as such I have like a $250 deductible on ER visits so long as I go to a facility that's within my network. Easy, right?
Well, after that I got a bill from the facility. While the ER visit was covered under the $250 the use of the facility is a separate bill, plus I needed an x-ray which was also extra. I got a bill for like another $800 or so. So apparently, the insurance company has this concept of an "allowed amount", which is basically the insurance company saying "uh uh, you're not allowed to charge our guy that much. We think it should cost _____ amount instead" and the biller complies and changes the amount you get charged. So my "allowed amount" was closer to $550 and the insurance company covered 80% of that, so I was on the hook for another $110.
Whatever, not a big deal. So then a month later I got -another- bill that was for like another $600 but bizarrely said "out of network". Assuming this was a mistake, I called my insurance company. It turns out that while the ER visit and the facility I visited are covered, there's like this whole separate concept of a "Group of Emergency Room Doctors" or something like that. They are technically out of network even though the place I visited many times is. They charged me $600, but my insurance company comes back with the "allowed amount" that was much lower. However, the ER Doctors Group doesn't have to honor that because they aren't in network so they charge me the full amount. My insurance company says "ok, but we only cover 80% of what we -think- it should cost, not what it costs" so they covered 80% of their idea of the "allowed amount" even though what I was charged was much higher. Also, because this is out of network they don't reimburse the biller directly, but instead I have to cover the full amount and they send me a check for what little they would cover.
At the end of the day, it all ended up costing closer to $750 on a service that's supposed to have a $250 deductible. And that's because I can afford it. If I couldn't it would have been so much more, which is bonkers.
-Byshop
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