Missing the point of Healthcare costs

We managed to get Health Insurance sorted out for my wife and daughter, without falling into the trap of me getting covered by an ACA policy, which would put me in jeopardy of violating the “public charge” agreement I accepted when applying for my green card. I’m self-insuring for another year aka uninsurance.

Today I took my daughter to the dentist, she needed two baby teeth pulled to make way for her adult teeth. The insurance didn’t verify when they put it in. So I paid by card. In a subsequent phone call we went through the process of how to claim the money back. The process involves mailing in an invoice, the insurer authorising it, contacting the dentist and having them re-submit for insurance payments, and then finally refunding us our payments.

Of course, I won’t pay for any of this back and forward. Insurance does. Insurance will pay the broker and admin who finally were able to spend a full hour helping us get the forms submitted without putting me in legal jeopardy.

The paediatric dentist will absorb the cost of trying to get the bill paid through insurance, then after discounting their charges for “cash”, taking a hit for payment by card, and then there is all the additional admin that the dentist and the insurer will have to put in. None of that is free, it’s all rolled into the cost of insurance. Repeat that thousands of times per day over a population of 300+ million…

Before this episode is finished, it will have cost more for the admin than the dental treatment. That’s madness. That’s just one small reason why we pay so much for medical insurance, and it’s invisible.

Author: Mark Cathcart

Formerly an Executive Director of Systems Engineering and a Senior Distinguished Engineer at Dell. Prior to that, an IBM Distinguished Engineer working for the Systems Group in NY and Austin. I'm currently "retired until further notice".

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