Thank Goodness for good Health Insurance

...any why our health care system is so screwy....

I just got the "Explanation of Benefits" from our health care provider today for the coverage of my Appendicitis episode. The first sentence of reads: It's not a bill.

In other words, it breaks down the billed charges, and the amount that our health care plan covered, as well as any balance that we owe.

I've said it before: one of the great benefits of marrying Dick (and there are so many!) is, well, great benefits. Before we married, I had my insurance through Kaiser. I can't complain, as I had my fair share of emergency room visits, test, etc., with them, and I always received top notch care. It wasn't cheap, by any means, but well worth the monthly premiums to know that I was covered.

Dick's health care benefits through work are outstanding. We're very grateful for that. It is one of the things that crossed my mind when I was staying in the hospital earlier this month.

So, how much does an Emergency Room visit, an Appendectomy and one night in the hospital cost?

$33,500.00.
Holy crap.

Now, here's the thing. Everything is broken down in this "Explanation of Benefits".
The cost that I just listed is the "Charges billed by provider".

The next column in the form is called "Provider's fee adjustment" which is: Difference between "charges bill by provider" and the amount providers have agreed to accept as full payment.

The difference? Anywhere between 10% and 50%. (the big ticket items were generally around 10%)

Then, there's the "Total amount eligible for benefits", "Total benefit paid by your plan" and "Amount you're responsible for".

Happily, the amount listed for us in the last column was "$0".
But, that didn't stop me from gawking at the rest of the statement.

This is why our health care system is so messed up: someone without health insurance would've been billed $33,500.00. If someone has (certain types of) insurance, the insurance company is only billed 10-50% of that amount.

There's something seriously wrong with this system.
As someone who has had many friends without medical insurance, it makes me sick to think that the people who can't afford medical insurance would be the ones who are gouged beyond reason. I've taken friends to the emergency room a couple of times who held off until the bitter end because they knew they wouldn't be able to afford it. In the end, the bill would come, and they'd be in debt for months or years trying to pay it off.

I know I'm really lucky to have married someone with great medical benefits, but that's just it, isnt' it?

I'm just lucky.