From: frissell@panix.com
Date: Fri, 31 Oct 1997 20:42:37 +0800
To: Tim May <cypherpunks@cyberpass.net
Subject: Re: Protocols for Insurance to Maintain Privacy
In-Reply-To: <7433f6e11aa46cf7b903a8251c3e35b5@squirrel>
Message-ID: <3.0.2.32.19971031064814.03c38e18@panix.com>
MIME-Version: 1.0
Content-Type: text/plain



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At 09:33 AM 10/30/97 -0700, Tim May wrote:

>Listed prices are the "sucker rates," kind of like the posted prices for
>out-of-towners, with locals getting a discount. And these pricing
>differences apply to the whole range of procedures. For example, an
>insurance company might have negotiated--over many years of intense
>negotiations--a fee of $100,000 for a liver transplant, but a "cash-paying
>customer" (a victim, a mark, a sucker) would pay the list price, e.g.,
>$300,000.
>
>Could I negotiate a lower room rate, and lower fees for a spectrum of
>possibly needed treatments? Probably. I haven't had to try, fortunately.
>(Nor am I knowledgeable about procedures. Nor am I patient negotiator, no
>pun intended.)

You can negotiate in advance.  Many doctors will cut their rates for surgery 
if you tell them you are uninsured.  We actually called around to a number of 
hospitals recently to see if they would discount a birth for cash up front 
and we were able to find hospitals willing to cut their rates.  A 50% cut 
seems the standard range.

>Just noting that cash is not always king. Especially to any medium-sized or
>larger hospital, where filling out the forms correctly is more important
>than getting paid in cash. (My dentist's receptionist is befuddled by my
>paying in cash. She clearly prefers to just enter the number of an
>insurance company.)

The magic words are "Hill-Burton Act."  Most hospitals have accepted Hill-
Burton Act funding and are required to admit people with or without 
insurance.  Some resist of course.  

>I have so far elected to self-insure, i.e., to just pay any medical bills I
>might have out of pocket. However, given this "sucker rate" and the
>increasing unwillingness of hospitals to take patients not in health care
>or insurance programs, I may have little choice but to sign up.

Me too.  In 20 years, however, you and I will be drafted into Medicare 
(against our wills) unless the system is substantially modified by then (the 
most likely outcome).

DCF
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