I submitted real data from a real bill. If you choose to believe that the companies for some reason put fake numbers on the bill then could you explain the mechanism by which they lower the cost? And if they actually charge less, why are they billing more? It doesn't make sense, does it?
You keep focusing on the asking price. I'm interested in the amount paid. They are not the same thing.
The amount paid apparently is, on average, 39% of the asking price. You seem to accept that. And, yes, that average would include those who pay nothing, as you say, so presumably there are some paying at or near the asking price. I don't have any knowledge of anyone actually doing that and apparently neither do you but it's reasonable to assume that some do. Probably the rich self-insured do. And people getting cosmetic surgery do. But this discussion is not about them.
By what mechanism do providers lower the cost? The patient either asks them to accept some lower amount or simply pays some lower amount (or nothing) and no more and the provider decides not to force the issue or is unsuccessful in doing so. Providers aren't likely to take the initiative to offer to negotiate. In the price-setting process, they have the first play--the billed price. It's up to the patient to start a dialog to lower it.
Why do they bill more? Why do sellers of Oriental rugs have constant half price sales? To make you think you're getting a bargain when you pay the 50% off price. That's one reason. Probably, though, the key reason is that they have inflated their prices for the purpose of negotiation with the insurance companies. If they don't bill others at those prices, they are acknowledging that they have done so and must keep up appearances. Also, the stature of professionals is measured by the prices they command. No one wants to look like a cut rate doctor. Patients would assume they aren't competent. They have to keep their prices up with Dr. Jones.
Frankly that proves my point.
You keep claiming proven points. I don't claim to have proven mine. Neither of us is an insider with profound knowledge of how this works. I am offering, though, reasonable explanations according to my instincts that counter your allegedly proven points trying to make you understand that they only appear proven to true believers. Until you have some evidence, you're just calling your inferences "facts." |
