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I hate HATE HATE insurance companies. HATE THEM.
Partly because for the majority of my life I was without insurance and relied on the community and public health services for my medical care--$800 for 2 stitches, $400 to walk into an ER and be sent home an hour later without even seeing a Dr, etc.
These prices are set by insurance companies. They say "Hey, we'll pay you X for Y services" and the hospitals KNOW that the service costs Y+1500, say. But the only way BCBS will pay for the service is by cutting $1500 (or 10,000, or 50) off the price. Their reasoning is that the hospital/dr's office/clinic will get MORE customers through BCBS and in the end come out "on top"
only they (the hospitals) don't.
So they pass the extra 1500 for Y service onto people without insurance, or who are underinsured.
I can blame the hospitals, but at the same time, I can't. They have MRI machines that cost hundreds of thousands of dollars, they have MRI techs that cost dozens of dollars an hour to read the MRI's. They have to make up those costs and the insurance companies AREN'T paying a fair or competitive price for these services.
Now, I have insurance, and I still feel the pinch.
When I had back surgery (with insurance), I paid a $20 copay for a surgery that they billed the insurance over $10,000 for. WHen I was looking at the charges included, one of the charges was for nurse pay. The insurance company paid $15.00 an hour for OR and PACU nurses. Well, I know for a fact that a NEW GRAD operating room RN makes MINIMUM (at this hospital, at least) $25 an hour. PACU nurses generally have to have 2 years RN experience, so they'd be making in the $30+ wage.
But the insurance company only paid $15.00 an hour for those RN's.
As an RN, I feel this because hospitals can't afford to raise my pay because of insurance companies under-paying for services. Nursing Assistants make more than $15 an hour, yet BCBS feels that a seasoned, trained, educated, knowledgeable and safe RN is only worth $15 an hour. The other $10 or $20 an hour is "eaten" by the hospital. That money has to come from somewhere, and usually that money comes at the cost of new and updated supplies, pay raises, hiring new staff, continuing education, etc.
There is no reason that health care should be for-profit. No one should profit so grossly off the illness, injury, disease, and death of others.
E-V-E-R-Y Nurse I know, and 99% of the MD's I work with (as well as the tons of ancillary staff members) ALL believe that our lives would be SO MUCH BETTER as practitioners should insurance companies just GO AWAY and everyone given a universal health care of some type.
Our hands are SO TIED by insurance companies. So many things that we want to do for patients, and need to do for patients, but we can't because the insurance won't pay for it, the patient can't pay for it, the hospital can't pay for it. We (as professional practitioners) have come up with clever ways, though, of describing procedure X like it were procedure M so that way it's covered by insurance. Is it "fraud"? You bet. Is it necessary for a patient's health, wellbeing, and quality of life? You fucking double bet.
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