Why can doctors accept lower insurance payments but charge full price if you don't have it?

Question

For example my wife goes to a shrink and they carge $190.00 but the insurance knocks it down to $75.00 (of which we pay half). We are now looking to lose our insurance but the doctor won't budge on the $190.00 payment. If we had insurance they would only get $75.00 for the visit, why not accept it now and get all the money at the end of the appointment instead of half and waiting for the insurance company to pay the other half (which I imagine is going to take a while.
It just seems to discriminate against people without insurance.

Answer 1

You just answered your own question.
I got ill last year and was in the hospital for 21 days. My stay started on October 17 and ended on November 7; my insurance did not kick in until November 1. (Sucks for me) Anyway, I was billed full price for everything done to me until November 1 totalling over $250,000. Yes I was very very sick and almost died. When my insurance kicked in for the last week the rates were severly discounted. Funny how the insurance company that can afford to pay full price gets a break and me, half dead, and unable to work gets smacked with the full retail mark-up!

God bless the USA.


PS, thanks to all the wise minded people who voted all the morons out of office last week!

Answer 2

The doctor charges $190. He accepts less because he has agreed to be part of a network which in turn will give him more clients. Most insurance companies have a 48hr to one week turn around on claims, so he's not waiting for his money for very long.

While the system doesn't seem fair now, it was fair when you had insurance. I would suggest you do everything you can to get another group insurance because its unlikely that an individual program would cover your wife because of her prexisting condition. If that isn't likely then check out medical schools that charge on a sliding scale. You can probably also take your cobra continuation from the job, or check out a state health pool in your state.

Answer 3

You are quite correct that our system of medical care is discrimination. It is capitalism. That always involves discrimination. I myself have always been discriminated against because of my desire to have a Dodge Viper. I of course meant that to be funny but it points up a real problem that we have. We have a fine system of health care. Doctors come from all over the world to study here. We got it by capitalism. But this is a system that always gives the most benefit to those who have the most money. So the big question is not the insurance, or the doctor but the medical system itself. I would love to see a workable idea on how to fix our health care system. But remember it has to

1. Maintain an incentive for very good people to do the skull work to become providers

2. Provide the money for the highly expensive overhead of health care. From blood pressure cuffs to PET scanners.

3. Give health care to everyone

4. Create enough profit to encourage investors to put money into drug companies and medical equipment houses that we need to do research.

Now I have been a member and a user of the health care industry all my life and I do not know of a plan that meets all of the above. If someone else does I will be happy to get on their bandwagon.

Answer 4

Somewhere along the road doctors became more about money then helping people. They have forgotton why they decided to be a doctor and have become money hungry. If only I had the talent to help others. I would do whatever it took. Sure, they have to live too but not at the expense of others. To me, living in a house with an inside swimming pool would not make me happy if my patients were struggling to feed their children. God gave doctors a gift and though not all do, some take it for granted. Our gifts should be used to help others. Like for me, I am no expert but I love coming onto yahoo answers to offer people free advice. It's great when someone askes a question that I can relate to. I had a friend of mine ask me why I don't write an advice column and I told him that I don't know how to do that and besides I do it because I enjoy it. He told me that I could make money doing what I enjoy. My response was, I don't need to make money. I'm happy with my points, LOL. Anyway, after all of my children are in school I want to go to school myself to become a counselor. I don't know what it will take yet but I intend to do this for children who need someone to talk to because I had a hard childhood. Very abusive. If the parents can't afford a lot of money I won't turn my back on the child. My son is going through a rough time right now because his father has gone back to prison and his counselor wants $65 a session. (Just so you are aware I am not married to his father anymore. I remarried a long time ago.) Never has he offered to see my child free of charge or at a discount. We can't afford it so my son no longer goes. How is that caring?

Answer 5

I just found out that auto dealers do the same thing! I had some work done, and the extended warranty applied. When the bill came out to $400 less than I was quoted, I was told that there are "different" prenegotiated rates for warranty work!

It's called "volume discounting". It's not fair, but it's the way the world works. If you spend $150,000 on medical (or auto) bills a year, the provider gives you a hefty discount.

Answer 6

I agree it does discriminate against those without insurance. Just keep in mind that you are paying for all of those people who dont have insurance and dont pay their bills, nice thought isnt it? Also, the insurance co. can negotiate those prices with a provider because of their bargaining power due to the size and amount of payments they provide medical providers.

Answer 7

With insurance they are at least guaranteed to get some of their money. For example your 75 dollars of which you pay half. They are at least guaranteed to get half of that. Without insurance there is no guarantee they are going to say any of their money. Plus with insurance they also have the guarantee of more patients (i.e. the insurance company sends more people their way). Plus with insurance I'm sure the doctors and insurance people have deals going.