Health care issue

The crux of the health care issue is government involvement. This past week the insurance industry warned that government involvement would “dismantle employer coverage (that) Americans have relied on for a half century and overtake the system.” Two of the largest health care industry bodies have sent joint letters to Congress, stating they don’t believe that a government plan can “compete fairly” with private insurers within the health care market. America’s Health Insurance Plans and Blue Cross Blue Shield Association are the two companies taking the helm at criticisms of the government health plan.

The biggest challenge with health care programs

America’s Health Insurance and Blue Cross Blue Shield are the biggest critics of a government intervention regarding health care programs. AHIP’s chief Karen Ignagni and Blue Cross’ chief Scott Serota wrote in a dually-penned letter stating, “A government-run plan no matter how it is initially structured would dismantle employer-based coverage, significantly increase costs for those who remain in private coverage, and add additional liabilities to the federal budget.” They claimed that it is “impossible” to structure a government plan that can operate on the same level as a private plan. In the end, the government plan would use its advantages to “take over the health insurance market.” Their belief is that this plan would disable independent companies who are trying to better serve the health care system.

That seems to be the biggest challenge with government-created health care. How can the government create effective coverage plans without monopolizing the market? How can it provide health care programs while still encouraging free enterprise? How can their plan be effectively blended into the health care market alongside private health care programs?

The public opinion

Financial motivators are another reason the public is welcoming government-instated health care programs. With the high costs of health care, including medications and out-of-pocket expenses, the public has been struggling to meet the costs. Short term loans and family aid both supplement the high expense of medical care. Claire Danish of St. Croix, Minnesota stated, “We are doing what we can to handle our medical payments, but now with physical therapy bills coming out of our pockets, we don’t stand a chance at staying on track financially.”

Recent studies have shown that most people are in support of government intervention regarding health care. Although the program would compete with private companies in offering coverage, the public reaction is predominantly positive. Health care analyst Anne Summersdale stated, “Considering the number of people without health insurance, there is a huge pool of consumers who are ready and waiting for some government intervention…and the people who are covered have been disappointed by their own providers. They are also looking for government action.”

The cost of health care is rising

Like everything else in the economy, the cost of health care is rising. More and more people are going to have to face out-of-pocket health care expenses with the help of short term loans, family help and dipping into savings. Without some type of change, government-created or not, people will be at a standstill regarding their health care coverage.

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Although many people are not aware of it, the medical industry is one of the few American industries where negotiating the price is not only acceptable, but common. The reason many uninsured or underinsured people are quoted higher prices than insured individuals is because the price for many services has already been negotiated down by the insurance companies and HMOs. However, this practice is not limited to major institutions. Individuals can — and do — negotiate the price for particular services on a regular basis and this can result in significant savings.

Negotiating can save you up to 60 percent

According to Consumer Reports, only about thirty percent of Americans even try to negotiate with medical care providers; however, of those who try, 93 percent are successful at least once. The average savings are between thirty and sixty percent of the original amount owed, though there are many stories of people saving as much as ninety percent through effective negotiation. There are no guarantees that negotiation will get you a discount, but experience shows that most people who make the effort are successful to some extent.

Step One: Negotiate in advance

The first step to negotiating medical expenses is to negotiate terms in advance for planned medical visits and examinations. Due to problems with delayed payment, many medical service providers offer “prompt pay” discounts that can reduce your medical bill by as much as ten to twenty percent. These discounts are usually reserved for those who are able to pay for planned medical services at the time of the visit. However, many providers will also offer a prompt pay discount to those who are able to make large, although partial, payments on the spot.

Step Two: Talk to the CFO

The next step is to speak with the provider’s Chief Financial Officer (CFO) after you have received your bills. More often than not, just asking the CFO for a discount will get results. However, to do this effectively you have to know what is reasonable from the provider’s point of view. For this reason, you should know the average cost in your area for the services provided and you should ask for a price in that range. You can find out what the normal charge for various services is by looking at websites like Healthcarebluebook.com and many insurance company sites.

Step Three: Discuss payment options with the billing department

If you get a discount from the provider’s CFO, you probably will not be able to negotiate further discounts from the billing department. However, you may be able to negotiate an interest-free payment plan. The interest that accrues on medical expenses paid over time can be significant. Negotiating a payment plan that does not include interest will greatly reduce the amount you ultimately pay.

You have nothing to lose and much to gain

Contrary to the impressions of many people, most medical service providers are willing to negotiate and rarely expect everyone to pay every cent originally charged. In fact, many providers specifically budget for a lower repayment than they initially bill. For the consumer, there really is nothing to lose by trying to negotiate discounts and reasonable repayment terms. The worst case scenario is that the provider will refuse to grant a discount. But negotiating is worth the effort. As Consumer Reports has documented, 93 percent of those who try do in fact get a discount.