My latest explanation of benefits from my Anthem offers a great illustration of how the current health care “system” discriminates against the uninsured. For the EMG I had in October, the doctor initially billed $1377. The “amount allowed” was $461.15. That’s the fee the doctor will actually collect. I’m responsible for just 10 percent of this as coinsurance ($46.11) since, as one of the people who’s driving up healthcare costs, I’d already met my deductible just four months into the fiscal year.
In other words, an uninsured Sungold would have had to pay $1377, or nearly thirty times what I actually paid. The doctor would have collected three times what she actually received.
And that’s just the doctor’s fee. On top of that, the hospital charges for use of its space, equipment, and resources. Anthem’s negotiated facility fee was $491.01 (with 10 percent of that again falling on me), versus $1,096 for my hypothetical uninsured twin.
To recap: I actually paid just over $100. The unfortunate uninsured Sungold would have paid nearly $2500.
Whoever dubbed economics the dismal science must have been thinking of the economics of health care.
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