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Today's single payer post, Cigna edition

DCblogger's picture

Health care’s new math

When does 20% of $753.95 equal $641.60? When $753.95 equals $2,808.

Health systems have contracts with insurers about what the insurer will pay for a given procedure. While the specifics are confidential, Cigna’s contract with Sentara allowed for a “case rate” to be applied. In Dockter’s case, that meant the epidural injection she received was part of a group of outpatient surgeries that were all covered at the case rate of $2,808.

Just one of many examples of the sleazy behavior of our health neglect system. I am trying to document as many as I can.

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wasabi's picture
Submitted by wasabi on

My husband works for a small technical company with about 40 employees. They provide health insurance witha 20% copay, $1000 individual deductible, $5000 family deductible. Every year it goes up. Last year the insurance company increased the premium by 25%. Their reason was because they had to pay out 45% of the total amount paid by his company. A 55% (minus overhead) was just too little for them to accept in profit.

DCblogger's picture
Submitted by DCblogger on

single payer would do so much to help small companies and it would relieve big companies of their biggest overhead cost. I really do believe if we all keep hammering away at this we can win. so these little posts are my tiny contribution to this fight.

BDBlue's picture
Submitted by BDBlue on

Hasn't revolted over the healthcare situation in this country. The auto industry has a lot of problems, but if it could get out from under its healthcare costs, that would be huge. Time and time again we force American companies to compete with foreign competition that doesn't have to pay for healthcare. I don't mean those developing countries that don't have healthcare. I mean why are we deliberately putting ourselves at a disadvantage to Germany and Canada? Once again, people claiming to be good businessmen put bullshit ideology in front of what would actually be good for their business.

Fortunately, it does seem like some companies and executives are coming around. I guess all they needed was to be robbed blind by insurance companies and drug companies instead of merely mugged.

DCblogger's picture
Submitted by DCblogger on

my theory is class warfare. the people who control auto companies can't stand the idea that they would have to pay for health care of ordinary people, so they resist, even though single payer is in the interests of their shareholders.

Shane-O's picture
Submitted by Shane-O on

Perhaps, when it comes to big business - other than health "neglect" companies (I like that one!) - that the people who control the companies have to choose which politicians to support?

Unfortunately for them, the pro-big business politicians aren't the ones who would work for a single-payer system.

Equally, the politicians that generally are seen to "hurt" the interests of big business (via regulation, i.e. in the case of auto corporations, emissions standards) are the ones who would support a single-payer system.

It seems to me that these people are simply operating out of their own personal interests - and they can't keep the current capitalist system that shifts nearly all the business risk from the corporations to individuals, while at the same time achieving universal health care.

I believe if the corporations could have both, they would.

And thank you for linking to that article - good info there...

The Bill of Rights is a born rebel. It reeks with sedition. In every clause it shakes its fist in the face of constituted authority. . . . it is the one guaranty of human freedom to the American people. - Frank Irving Cobb

gizzardboy's picture
Submitted by gizzardboy on

When the bill is $750 and the insurance company says, "No, lets round that up to $2,800.", I think something stinks. I wouldn't be suprised if there was a side deal involved where everybody wins except the "insured". But then maybe I'm just too suspicious......

cenobite's picture
Submitted by cenobite on

It's another way of controlling the workforce. If you have to have health insurance, and only a corporation can buy it for you, then it's harder for you to leave your current job to work at a new one, especially if it's a start up or nonprofit of some kind.