The High Cost of Health Insurance Games: Lose or Stop Playing… Are There Any Other Options?

June 16, 2016 by Redirect Health

When I moved to Arizona from Canada in 1995 I was told numerous times that, as a healthcare provider, waiving deductibles in any sort of routine way was illegal. Now as high deductible insurance becomes more prevalent, many providers are waiving deductibles in select cases because patients simply can’t afford to pay for the care.

A recent article in Modern Health highlights such a system. Ultimately, it seems that this is another way for this hospital to look good while concurrently contributing to the breakdown and rising costs of healthcare in the community. This is a practice that was made illegal in 1991 when done systematically. I would bet this hospital never does this with Medicare patients since the enforcement is much stricter and severe.

This problem is only part of the bigger picture and begs questions that never seems to be asked:

  • Are the charges in the hospital fairly priced and legitimate in the first place?
  • Or were the services inflated to 5 to 20 times the going rates outside the hospital?
  • And finally, were all the services really even necessary?

Our experience at Redirect Health shows us there are nearly always extra charges on hospital bills that can be removed if one knows how to find them and then asks for them to be removed.

The only way for the purchaser (employer) and user (employee) of healthcare to win at this game is to stop playing. For employers, the easiest and best way to leave the game is to self-insure. Once self-insured, employers can tap into reliable ways to help their employees obtain services at the right prices.

Many services and procedures captured by hospitals around the country can be performed at a clinics down the street for a small fraction of the cost. When we start doing this in mass, like we are helping employers do right here at Redirect Health, maybe then we will see prices come down to reasonable levels.