Saturday, August 4, 2012


I finally got the lab test codes from my doctor - I think even he is amazed at how hard it was to find out the cost of the tests he ordered.  The cost for 3 blood tests comes to about $400.00.  That is nearly 2 weeks take home pay for me - ironically due to the high cost of my medical insurance.

So - knowing most tab tests are done by machines and not even by real trained people with jobs - why so much? One blood draw, program the machine and send the results. I don't think lab tests cost this much when done through a regular insurance plan, why so much for one where I am paying out of pocket before my deductible is paid?  A doctor asked and answered this question:

I can think of at least two reasons an insurance company might price services so outrageously high on certain policies. First, that would punish anyone who buys inexpensive insurance with a high deductible (both of these patients did). Second, they keep you from finding out how much (little) medical service really cost. Patients with high deductibles pay for most of their own medical care. The insurance companies make sure that these patients see a much higher price than the “real” price that they could pay. Just as with generic prescription drugs, insurance companies, not providers determine the price of everything. They can hide their real costs, and punish you for not buying a more expensive plan.

I have to admit I didn't realize that the insurance companies were quite so devious.

I did know that they spend a lot of money touting tort reform as an answer to high medical costs when legal costs are actually only 2% (mostly for their own lawyers.).  But I didn't know that the highest cost for insurance companies - 56% of their expenses - is for product design, underwriting and marketing. 

So the design and marketing of my high deductible plan is the reason my out of pocket/pre-deductible blood tests are so outrageous.

Wow. That is twisted.


knittergran said...

The insurance industry is evil. I wish we would go to single payer.

Jenn @ Juggling Life said...

That's why the cap on 20% spent on overhead is the ticking time bomb in the Affordable Care Act.


Tricia said...

Coming from a single payer system I can not tell you how much easier it is for patients. If the average American was able to experience single payer system they would never go back to this private insurance system.
There are lots of variations on it too as any of the developed countries demonstrate.
Here is my question How come right to lifers don't get upset that those without medical don't have a "right to life".

shrink on the couch said...

Now, I should know this and maybe if I did it wouldn't apply anyway as I am on the mental health side of the equation.

What I should know is whether it is the insurance company who, in fact, sets the rate.

In my case, I am the one who sets the fee for people who come in with or without insurance. I submit my fee to the insurance company (for those who are insured) and the insurance company then gives the patient a "contract discount" (or some such name). Discount from whatever it is I normally charge.

Now, the place where I'm confused is the part about people with high deductable plans. It is my understanding I am supposed to charge them the contracted rate (the discount, what the insurance company actually pays me) until their deductable is met. So in my case the insurance company isn't setting the original fee, I am. The insurance company does set the contract rate. (I do adjust my fee up to get paid by them as much as they'll give out). so what I'm saying is, you might check with your insurance company... see if it's correct that you pay the (outrageous) doctor set fee ($400) or the insurance company's rate.

I love Jenn@Juggling's answer! Boom is right. Just a week ago I received a check from BCBS - nearly $700 refund. Thank you ACA!! Thank you Obama!! Thank you Hillary for all the abuse you took all those years!!