[snip] >>It could be argued that it's not so much that the insurance companies are so

actually, anything is negotiable. i did few times & most clinics give cash
discount (not much 10-20%)

regards,

Pam's Ode to Spammers & Telemarketers

May all spammers & telemarketers die an agonizing death; have no
burial places; their souls be chased by demons in Gehenna from one
room to another for 1000 years while listening to Bartok microcosmos +
Scriabin playing together.

Because if they don't give a bulk purchaser a discount, the
competition will.  It's no different than any other commodity.

The individual isn't the customer.  You gave up that right when you
wanted something for nothing.  ...and you're wrong. You can bargain
with medical groups.  Come with a fresh stack of Franklins and tell
them you'll pay up front.

That's a risk he's knowingly taking by not being insured.

That may be true for televisions and groceries, but I don't see how a
bulkdiscount factor should affect health care.
It could be argued that it's not so much that the insurance companies are so
powerful but that the individual alone has practically no barganing power.

The unemployed and  the really poor are covered by charity care, which is
often if not usually paid by the state.  It's the guy who worked all his
life and then is laid off and can't find another job for a while (a common
occurence nowadays) who can end  up being ruined by a $20,000 hospital
bill--and that's a modest hospital bill today.

It's never going to be equalized. Insurance companies "buy" a lot more
healthcare than any individual so there's a natural bulk discount factor.
There's also the fact that insurance companies have deep pockets so the
hospital likely will actually *get* paid. On the other hand, providing
hospital service to an uninsured individual is like a very high risk
unsecured loan. This is especially true given the dismal savings rate of
Americans and that "uninsured" likely correlates very highly with
"unemployed." So some of that extra can be thought of as interest for this
high risk unsecured "loan." It makes sense to price higher since it's much
risker to sell medical service to an uninsured individual and to provide
more incentive to be insured.

Whether or not it justifies 4.64-1 ratio is another matter, but it's not a
given that they should be equal.

It may not have been "a couple of bucks."  If your insurance company
raises your rates by 50%, for example (which is not uncommon), a small
business may just not be able to afford it.   Ideally, you'd have time
to shop around, but it's not an ideal world--you have to meet your
expenses and pay your salaries and keep your customers happy if you
expect to stay in business.  In my state, I couldn't find ANY
affordable insurance at all so had to  just risk it for a while.  But
the main point was that the uninsured should not have to to pay higher
hospital rates.  There's charity care if you're practically destitute,
but a lot of middle-class people who lost their jobs recently have no
choice but to go uninsured.

No it is certainly *not* understandable.  One does not shoot
themselves over a couple of bucks (difference between policies).  If
it were that important they should have been shopping *long* before.

But understandable.  The price of health insurance has become so
outrageous that some businesses just can't afford it.

Double, since they likely also won't have any coverage for existing
conditions when (if) they get it back.

That was goddam stupid.

http://www.usatoday.com/money/industries/health/2004-02-24-hospital-bills_x.htm
Hospitals sock uninsured with much bigger bills
By Julie Appleby, USA TODAY
Ed and Dianna Jellison let their business' health insurance lapse
while they shopped for a better price. But then Ed fell ill, spending
17 days in a Florida hospital as a viral infection ravaged his body.

Now the couple are fighting a $116,000 hospital bill, one they say
could be as low as $25,000 if an insurance company were paying it.

The tough truth for patients like the Jellisons — who earn too much to
qualify for charity care — is that they are often charged the highest
prices for hospital services.

Few know that. And they're stunned when they learn.

"If they accept $25,000 from an insurance company on a routine basis,
and what they're charging us for the same thing is $116,000, that's
not fair, and it's not right," says Dianne, who closed the couple's
roofing business and took a part-time job in a warehouse because Ed's
illness left him disabled.

http://www.usatoday.com/money/industries/health/2004-04-13-rising-hospital-costs
_x.htm

"Rapidly rising hospital charges have placed hospitals in the
spotlight. Critics say hospitals are unfairly using their growing
clout in many markets and charging far more than it costs to provide
services. Spending on hospital care is the fastest-growing segment of
the nation's health care tab."

"Because most hospitals rely on government health payments for about
50% of their revenue, and private insurers who negotiate discounts for
much of the rest, raising charges is one way hospitals can try to
bring in additional money from individuals and insurers not covered by
the discounts"

http://moneycentral.msn.com/content/Insurance/Insureyourhealth/P74840.asp
Profit-hungry hospitals are overcharging consumers an estimated $10
billion a year. Some deliberately work to keep bills indecipherable.
Here's how to fight back.

By Bankrate.com

American hospitals are fleecing patients out of billions of dollars
annually, and experts say that while some of the overcharges are
honest errors, many are deliberate.