Originally Posted by Indy Can you answer a question for me as an "insider"? Why don't the insurance companies pay the doctor's claim in full? Why do they always only reimburse around 60% or so? That sounds very shady to me and causes an artificially inflated health care cost to the average consumer thus forcing more and more people to buy insurance when they would normally have been able to pay for it out of their own pocket. I'm not attacking, I really want to know their excuse for it.

It should be noted that while just over half of the uninsured have incomes < 200% of the federal poverty level, 27% have incomes of 300% or more than the federal poverty level. There is more to the story concerning the high incidence of uninsured persons than incomes and health policy costs.

Some information on the profile of the uninsured can be found at:

Overview of the Uninsured in the United States: An analysis of the 2005 Current Population Survey: Issue Brief
http://www.cdc.gov/nchs/data/nhis/ea...nsur200712.pdf
SCI: About Coverage: Why Are People Uninsured?

With respect to the opening message in this thread, I would suggest that addressing health care inflation will be a critical issue in leading to expanded health coverage. To do that, reforms that allow the health care system to operate in a more competitive, market-oriented fashion will be necessary. Such reforms could include, but not be limited to:

- permitting drug re-importation; in finance, arbitrage eliminates pricing disparities for identical investments e.g., the price of gold selling in let's say New York vs. London. In an arbitrage situation e.g., Gold is selling at $900 per ounce in London and $895 in New York, traders would buy gold in New York (pushing the price higher there) and sell gold in London (pushing the price lower there) until the price disparity disappears. There is no compelling reason why the force of law should be used as an instrument to bar what amounts to prescription drug arbitrage that would, if permitted to take place, reduce or eliminate price disparities.

- remove barriers that make it difficult for hospitals and other health providers to address a growing chronic shortage in physicians (specialists and general practioners) and nurses. That would mean liberalizing immigration laws so that hospitals could bring in sufficient numbers skilled professionals from overseas. It would also mean improving the U.S. education system so that more Americans would study science and move into medicine where income growth is robust.

- abolishing the ability of states to adopt anti-competitive laws that make it difficult for out-of-state or international insurers to compete for customers.

- permitting insurance companies maximum flexibility (fewer mandates) to innovate in designing policies that better meet customer needs, allowing them to pool individuals to diversify risk, etc.

- extending identical tax treatment to health purchasers regardless of whether those purchasers are corporations or individuals.

Originally Posted by rivrrat Because the insurance companies know that docs artificially inflate their prices for the insured folks to make up for the slack-asses who mooch off of the rest of us. Who do you think pays for the people who don't pay? If you have insurance, the price for your visits, treatments, procedures, etc, automatically goes UP. I can tell you that from the experiences of working both in the medical field and for a major insurance company.