Tuesday, August 06, 2013

Nobody pays $384 for a physical therapy visit

The headline from a WaPo op-ed reads:

For a stiff neck, nearly $6,000 in physical therapy seemed too much

The author is a patient who had physical therapy prescribed for a simple musculoskeletal problem.

My insurance company sent me notification it was “seeking additional information about these charges,” which would mean a “delay in payment” for my PT treatments. My insurer had been billed $412 for my first appointment and $384 for the second. I can hardly blame the company for wanting to know the justification of such costs.
Now I understand why the front desk seemed so eager to have me use my maximum of 12 visits before the end of June: I was leaving nearly $5,000 worth of payments on the table. [bold mine-- Tony]
Notice the confusion of bills, payments and cost.
The author assumes that the insurance company gets no discount and will pay the full $384 billed for the physical therapy appointment and the thousands of dollars of visits. It's satisfying I suppose for health care consumers to read these bills and feel that they have found the real reason, the Holy Grail, of the health care cost crisis, -- $6,000 !!!! OMG!!!--so they fire off an op-ed finally enlightening all of us on the true nut of the issue.
Of course, it's way more complicated than $6,000 in bills. Every insurance company and payer, even cash payer, negotiates a discount to the amount billed. In fact, the amount billed, the $6,000 is a compete fiction. Stop talking about it. 
There's a discount. It might be $100 or $300 or $50.
For a nation ostensibly built on the notion of capitalism and finance I continue to be astounded at the lack of sophistication of the arguments regarding health care finance.
If the Washington Post can publish such an inane op-ed then there is no hope. We should be way beyond the griping about the $384 charged for a physical therapy visit. Nobody ever pays $384 for a physical therapy visit. The insurance company gets a discount. Medicare gets a discounts. Medicaid gets a BIG discount (if it's covered at all). Even cash customers negotiate a discount.

Maybe it's a problem that we really don't know how much is reimbursed for that visit. Fine. But nobody PAYS $384 for a physical therapy visit.

Let me say it again, nobody pays $384 for a physical therapy visit.

Nobody pays $384 for a physical therapy visit.

$384 was the CHARGE, not the payment, NOT the cost.

Get it?

Nobody pays $384 for a physical therapy visit.

Please, if you are an editor for the Washington Post, the USAToday, the Wall Street Journal, the New York Times, or a producer for any news network do NOT conflate charges with payments with costs. Don't embarrass yourselves by publishing op-eds and letters like this without explanation. You are morons.

Nobody pays $384 for a physical therapy visit.