When you go shopping, does your subculture encourage you to haggle over the price of the object you want to purchase?

Or do you walk into the market, see the price on display, and readily pay the posted amount without asking for a discount?

In my local subculture, I walk into a doctor’s office or hospital and see no posted prices for services to be rendered.

Instead, I hand the receptionist my medical insurance card(s) and after services are completed, I hand my credit card or cash to cover the cost of copay.

Days, weeks or months later, I receive a bill for the services.

The bill most often details the amount of money the doctor/hospital negotiated with the medical insurance company to cover the rendered services.

For instance, a recent surgery on my right wrist was listed as costing ~$9000 but the insurance company only paid about ~$900 and I owed a small copay ($250, if I remember correctly, that I paid before the surgery).  [Followup office visits, usually $25 copay, were included for “free.”]

And now, I get to my mother in-law’s recent hospital stay that concluded in death.

Yesterday, a third-party payment company (which my wife jokingly calls an “ambulance chaser”) called to see if I planned to pursue payment from the nursing/assisted living home for the hospital bill.

Why would they do that?

Well, if my mother in-law’s insurance (Medicare plus supplemental) pays for the hospital bill, the negotiated amount will be substantially less than the hospital’s stated total (think “retail” (the hospital’s stated total) versus “wholesale” (the negotiated amount)).

However, if the third-party payment company (contracted by the hospital, if I understand their relationship to the medical community correctly, in this case) is giving given authorisation to pursue payment, they will try to extract the hospital’s stated total, taking for themselves, I’m sure, a flat fee or percentage, if successful in charging the nursing/assisted living company, where my mother in-law fell, for the full hospital bill.

In other words, should you find yourself having to pay for medical services, you will be charged the full amount.  Therefore, be advised that you have plenty of room to negotiate a lower amount, easily down to the amount that insurance companies will pay; that is, if you have any haggling skills in you at all, unless you’re a retail shopper unaccustomed to bargaining for a deal.

In that case, ignore what you just read, and I’m going into the medical business, accepting only patients like you who are willing to pay retail.

By the way, this partially explains why doctors don’t perform as many free/pro bono services for the community as they used to, because it falsely gives medical insurance companies the right to claim that doctor services can be valued at zero.

More as it develops…