Medical costs could be more reasonable and affordable if we were actually charged what providers charge insurance companies. We could then remove the middle man (medical insurance) and directly pay the providers. Many people don't know what they are billed and what your insurance actually pays. Many times this is closer to 75% less. Check your EOBs.
When insurance companies go around complaining that they are paying out too much for those with "pre-existing conditions", listen to the actual numbers (if they provide them). It is usually the billed amount, not the allowed amount (what is actually paid) being quoted. I say this as a person with several "pre-existing conditions", yet my insurance makes a very nice monthly profit from me. Its not as much as they were making before the regulations and they charged me $1500/month. Apparently thats the profit loss they are complaining about and want to bring back.
This is an example of one industry scratching the back of another and we the people pay for it all. Insurance companies complain that medical costs and therefore their expenses are too high, yet they make reduced cost deals with medical providers. Those they have come to terms with are a part of their "network" and others (higher cost terms or no terms) are "out of network". When a clinic lets you know your insurance no longer has a contract there it simply means, the clinic wanted a higher percentage than your insurance company was willing to pay. It has nothing at all to actually do with the ACA, just 'backroom business'.
Providers are willing to agree to this deal because the insurance company pushes so much business their way. Larger companies make lower agreed upon payments but offer more business, smaller companies are usually outpriced because they cant get the rate as low as they want since they dont offer the patient flow larger companies do.
All in all, the ACA ate into profits (insurance companies arent actually losing money, they are upset about a reduction in their profit margin) by not allowing the upcharge for, reduction to or refusal of services provided to people that are actually sick and/or disabled. Yes, more people signing up may have helped but I didnt think greedy insurance companies would become less greedy because insurance is mandatory.
They only see it one way... how can they get back to the rates we used to charge? So they raise rates and tell us one side is causing the higher rates of the other. They make a profit on us ALL, except maybe those that are running into extreme care needs.
Personally, I figure I wont have coverage next year. If the insurance companies get what they want I will be back to $1500 a month for my pre-existing conditions. ($18,000 a year). Dont even get me started on the greed from "big pharma".
#IAmTeamWen
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