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.

1 comment:

Mike Simmons said...

"Maybe it's a problem that we really don't know how much is reimbursed for that visit."


Third party payment with no price transparency IS THE PROBLEM. Thanks goodness for the ACA...

July 2009, Obama's Remarks on Health Care

"This is not just about the 47 million Americans who have no health insurance."


On June 28, 2012, the same day the Supreme Court issued its ruling, President Barack Obama delivered a speech in which he said 30 million Americans presently without health coverage will now have the opportunity to obtain affordable health plans.

“If you’re one of the 30 million Americans who don’t yet have health insurance, starting in 2014, this law will offer you an array of quality, affordable, private health insurance plans to choose from,” said Obama.

Listen to the video clip at the link below starting at 2:30:


So, according to Obama's own words, 17 million Americans have health insurance now that didn't then.

What progress! Even before the ObamaCare is implemented, and without further Congressional action, 17 million uninsured Americans somehow picked up health care coverage.

It gets better.

The CBO projects that under Obamacare over the next decade, the number of uninsured will never fall below 30 million (see the link below).


So, exactly what is the purpose of ObamaCare other than wrecking the health care system for the 85-90% of Americans who were satisifed with the system as it was, in what the CBO projects will be a failed attempt to provide health insurance (not health care) to the other 10-15%?

Maybe this: