Hospital Cover Charges & Whorehouse Financing – A true story based on fabricated facts…………
A self-funded health plan that moved away from managed care networks two decades ago knows the secrets of health care finance in this country.
They know secretive managed care contracts (PPO’s) negotiated without their approval or input by faceless third party intermediaries driven by their own self vested interests are not looking out for them. They know pricing is based on arbitrary numbers having no relationship whatsoever to cost and can be as much as 500% or more than what government plans pay. An emergency room visit can be as high as $35,000 for a brief stay before being sent home. An outpatient hospital surgical visit, morning check in and afternoon checkout can run $100,000.
They know greed drives profits in American health care finance.
In this true story based on fabricated facts there is a lesson to be learned; You can’t always get what you want.
This plan sponsor knows M.D. Anderson – Houston is one of the highest priced hospitals on the planet. They know M.D. Anderson – Houston is not the only hospital of its kind, that there are others as good or better and less expensive.
They know hospitals don’t deliver care, doctors do that. Hospitals are simply brick & mortar locations, an address you go to in order to meet the doctor who does all the work with the help of his support team.
Hospital charges are simply cover charges.
It’s kind of like going to a whore house. The house has an address, has walls and a roof, and gets it’s cut while others do the work. This plan sponsor doesn’t cover whore house visits nor do they cover M.D. Anderson – Houston visits either. It’s a moral issue to them.
One bright and sunny day an employee demanded the plan pay for her upcoming visit at M.D. Anderson – Houston. “My doctor says that’s where I need to go to get cured! If you don’t pay for my visit there I will die!!!”
“We have good news for you!” said the HR Director. “We can send you to M.D. Anderson – San Antonio and we will pay 100% of the cost! It’s half the cost, that’s why we can waive all your financial responsibility’ !”
This did not go well with the employee. Emotional, distraught, scared, she wanted to live and the only hospital on the planet that could save her life was at an address in Houston she thought. M.D. Anderson – Houston, with walls and a roof, is the only place one can go to get cured! All other hospitals are inferior, places where people go to die.
“How dare you put a price on saving a life! That’s immoral!” screamed the employee.
“Well……… here’s what we can do for you!” purred the HR lady. “What you’re really asking is for all your fellow workers to pitch in and pay for your visit at the highest priced hospital on the planet. So what better way to do that than to pass around a hat like they do in church every Sunday? Here’s the hat…………you can start here in the administration building. Good Luck!”
“But no one will contribute! stammered the employee. “You must force them to pay for my expenses at the most expensive hospital on the planet!”
“Nope, can’t do that. It would be immoral. That would be like you taking a job at the local whore house to have your customers contribute to your medical costs” said the HR lady.
“What’s the address?” said the employee. And out she went.
