Have you ever been frustrated by high health care bills even when you have insurance? Isn’t your insurance company supposed to be helping LOWER your bills? Well, unfortunately, the answer is no. Health insurance works more like a discount card. Everything you buy is now 75% off. Too bad everything now costs a million dollars more than it did before your discount.
Widely perceived as fierce guardians of health care dollars, insurers, in many cases, aren’t. In fact, they often agree to pay high prices, then, one way or another, pass those high prices on to patients — all while raking in healthy profits.
The introduction of a third party payer system (that’s the technical term for when someone else uses your money to pay for your healthcare like your insurance company or the government if you have Medicare ) is finally reaching its logical conclusion. Anytime someone else uses your money to buy you something several things happen. First, the overall cost goes up. You have to pay for this person’s services and you have to pay for the product. Second, the person making the decisions might not be as diligent in shopping for the best deal because, after all, it’s not their money they are spending. It’s yours. Lastly, they care less about the quality of the product they buy for you because, again, it’s not for them. It’s for you.
The Affordable Care Act kept profit margins in check by requiring companies to use at least 80 percent of the premiums for medical care. That’s good in theory, but it actually contributes to rising health care costs. If the insurance company has accurately built high costs into the premium, it can make more money. Here’s how: Let’s say administrative expenses eat up about 17 percent of each premium dollar and around 3 percent is profit. Making a 3 percent profit is better if the company spends more.
It’s as if a mom told her son he could have 3 percent of a bowl of ice cream. A clever child would say, “Make it a bigger bowl.”
Read this account of one patient who thought this insurance was going to help pay his medical bills. They did but only after causing those bills to inflate 10-15x their true costs. Direct Primary Care brings true price transparency to primary care. We seek to lower the price of care because we serve you only.