Reply to post: Re: Pity they were caught

IT giant CSC coughs up $2m after helping New York City bill Medicaid for child therapy rather than insurance cos

Jellied Eel Silver badge

Re: Pity they were caught

Think of the US health insurance industry as a middleman that takes a very large cut out of any health transaction. For every $1m billed directly to MedicAid, claiming the same via insurance would have likely required an addition 10-20% for hospital administration, 40%-60% for insurance company fees and administration and anyone without the necessary insurance to be denied treatment.

I've never understood the US health industry.. Other than it's a massive cash cow for many of the players involved. I once saw a doc with a doc demonstrating the costs for a typical procedure. They whipped out various bits of plumbing and said stuff like tubes for intubation 'cost' $8,000.. And me thinking it's a bit of plastic tubing, and does it bollocks. Ok, so it needs to be tested/approved/sterilised but shouldn't cost that much. But I think rather than cost, it was really the maximum RRP the plumbing could be billed for.

Which also made some sense given overhead costs need to get paid, but things like B&B are also charged ending up with a parts & labour bill that'd make a BMW dealership green with envy. And then I saw something that suggested a 2-tier price list. So one bill if it was heading for an insurer, another much lower bill if the patient was going to pay themselves. But overall, margins seemed grossly inflated, inflating the cost of US medical care in general. And being a business, hospitals 'controlling costs' by squeezing staff pay & conditions. And if that results in malpractice claims, well, those can be against the physician's insurance, not the hospital. Assuming the physician can afford that insurance. If they can't, well, they can't practice. Which was the subject of another article pointing out a shortage of neurosurgeons due to the stonkingly high cost of insurance.

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