Remember that LA Times article from a couple months back where they revealed that the average American family pays about $20,000 for health care every year? And then ran the article with a picture of a Hyundai sedan, because they are charging $20,000 for a Hyundai sedan these days? Anyway, turns out that’s only true for Americans who have insurance. The LA Times has since learned that the rest of us — the Poors who are uninsured and the unemployed, basically — are not missing out on Hyundai sedans by paying for health care. This is because hospitals just go on ahead and charge people whatever they feel like, so uninsured people can get services for 10% of what they would cost insured people. DAMN YOU, POORS.
Unknown to most consumers, many hospitals and physicians offer steep discounts for cash-paying patients regardless of income. But there’s a catch: Typically you can get the lowest price only if you don’t use your health insurance…The difference in price can be stunning. Los Alamitos Medical Center, for instance, lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400. When The Times called for a cash price, the hospital said it was $250.
Of course, like most things in this country, this is caused by Poors who want Free Handouts, and is not at all related to the fee-for-service model upon which our health care system is based and its attendant insurance reimbursement scheme, which incentivizes specialists with higher compensation to perform expensive diagnostic and therapeutic procedures.
Hospital executives say they don’t like to charge insured patients more, but say that’s a result of the country’s broken healthcare system. At Long Beach Memorial Medical Center…the hospital’s chief financial officer said insured patients like her pay more to subsidize the uncompensated care given to the uninsured and low reimbursements for Medicaid patients.
You’ll be shocked to learn that insurance companies feel that this is totally fair and totally reasonable, charging different prices to different people without telling them what the prices are or why they are paying them.
[Jo Ann] Snyder, [a] salon manager, stumbled across the two-tier system accidentally. She has filed suit against her insurer, saying she hopes her case will lead to more disclosure of the price options, and ultimately lower treatment costs for patients.

The Long Beach woman said she sought treatment in 2009 for a pain in her abdomen. First her doctor ordered a CT scan of her abdomen and pelvis at Liberty Pacific Medical Imaging, an independent facility near Long Beach Memorial.

She got approval from Blue Shield, and she paid the negotiated rate of $660. Snyder underwent surgery on her colon, and her doctor ordered another CT scan in January 2010 because she felt lingering pain.

This time, her surgeon referred her to the hospital’s imaging center. Snyder said she assumed her bill would be about the same because it was the identical test. Instead, Blue Shield’s rate with Long Beach Memorial was $3,497 and the insurer told Snyder she owed $2,336, records show.

Incensed by having to pay nearly four times as much for the second scan, she started searching for an explanation. That’s when she discovered that the hospital’s cash price was less than half what she owed through her insurance.

In a complaint filed last month in Orange County Superior Court, Snyder accused Blue Shield of unfair business practices, breach of good faith and misrepresentation over her medical bills. The suit seeks class-action status on behalf of other Blue Shield customers.

A spokesman for Blue Shield said the case has no merit and the nonprofit insurer negotiates the most favorable rates it can.

Sadly, the L.A. Times article neglects to mention any hospitals that will accept chickens or vegetables.


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  • Hospital executives say they don’t like to charge insured patients more

    And Willie Sutton didn't like to rob banks.

    • Because that's where the money is, in both cases. Clearly no one wants more money, except for that greedy little bitch in the Capital One commercials with Jimmy Fallon….

    • Tundra Grifter

      Asked why he always worked alone, Will Sutton said "It's the people in the business. You just can't trust 'em."

  • randcoolcatdaddy

    This is good news for Dick Cheney's team of Satanic heart doctors!

  • freakishlywrong

    No snarky. I'm not sure if it's even worth having our stagnate jawbs anymore. I've not seen a raise in 12 years, sold my house because there are no more bonuses or stock options for the likes of us. All that's expected of us is to be the only class paying taxes, and in return expect to work until we die. It's pouring and dark. Sorry. Lighten up Freakish!

    • Look at the bright side of the situation: with all the stress of a job that one hates but can't leave because he will never get another one he won't have to work as long because he will die sooner than if he didn't have that stress.

      • WunkRocker

        See this is why, 1) I'm quitting my jerb soon. 2) Cashing in my "retirement." 3) starting a REAL business (meth lab).

    • It's OK, you're not alone. I'm at loggerheads with my bosses because I haven't seen a raise in almost ten years and my bonus has been cut in half. AND I'm paying more for my share of the insurance, simply because the 75 year old chairman refuses to a) die, b) go on Medicare, and/or c) see in-network doctors, which drives the cost pool up enormously

      Dude was charged (because he pays cash and then gets reimbursed by the insurance plan, his bookeeper tells me the prices) $17,000 for a simple basal carcinoma excision that my insurance plan covers and pays $4000 for. Same doctor's office, too, but one surgeon is in-network and the other is not.

      I'm less worried about me and how long I'll have to work (sort of figured 80 sounds about right) but more worried about my daughter just starting out and can I leave her enough money so she won't have to worry about the stuff that keeps people like you and me up at night.

      • Terry

        Have you considered making sure the Chairman eats lots and lots of bacon, then giving him a good scare? Conversely, you could bribe his cleaning lady to start waxing his bathtub.

        • He's a hypochondriac. Which only makes the whole health insurance thing worse. Dude sneezes and entire county hospitals are at Condition Yellow

    • BigSkullF*ckingDog

      Yes, but at least we get to die. They haven't figured out how to turn us into undead worker drones … yet. I've always been the glass half full type.

      • Clearly, you haven't paid for a funeral lately. My dad had to work two years past his death to pay for his coffin.

    • I would sell my house and return to apartment living (there are some cool ones in this one part of downtown) if it weren't for my dog and his need for a yard of some kind.
      He'll probably only be around a couple more years. It's getting pretty bad when you find yourself anticipating the cost-cutting measures of relocating after you no longer have a four-legged critter to accommodate for these decisions!
      Oh, and RIP upward-mobility scenario — mine must have peaked when I reached the point I could *afford* to purchase a house. I had no idea all the maintenance on yard etc. that I cannot afford to pay others to do. Yet, if I managed my time better I could "afford" to be this poor but at least could carve out some free time — time to devote then to, uh, rummage the attic some more for shit to sell on eBay, or offer to clean the neighbors' houses for some extra $$ — *that* kind of "free time"!

      • freakishlywrong

        I got lucky selling the house, and apartment living ♪ is the life for me♫. Considering I'm not handy, repairs, no matter what, were ALWAYS $1,000. I just couldn't do it anymore. There should be someplace with a dog run nearby? What is this "free time" you speak of?

        • Free time?


        • Guppy

          "Free time" is that time you use to buy consumer goods to entertain yourself, thereby keeping the economy viable.

        • someplace with a dog run nearby

          I am such a fuckin' craven lamester. Here I go using my mutt-hound as a scapegoat for obstructing my downward-mobility spiral when I can't wait most days to get home to his shaggy wagging tail. He is a reminder I am blessed; he, like most rescues, is one of a kind. There are good dog parks in the metro, another blessing — there's one in particular whose volunteers keep it supplied w/ fresh water & some maintenance. When I first adopted my flea-bitten crittur we lived just a block away from a fenced "Dog Corner" on Monument Avenue, it was *such* a social scene! Then it got razed so some poser could build a faux mansion that sticks out like a sore thumb among the elegant, antiquated homes dominating Monument. A 1%-er wasting space (driving by, it appears no one's *ever* home) that us 99%'ers could've continued making better use of!

        • fuflans

          right? the minute i bought a house – back in '97 – my minimum price point went from 'oh, it'll be $200-$300' to 'well, i'll budget $1000'.

          that being said, i can't afford to LEAVE. bought in '97, etc.

    • Baconzgood

      Someone needs a hug….

      • freakishlywrong

        Thanks all of you, I just got one. A Wonkhug.

    • HarryButtle

      Looks like somebody's got a case of the Mondays…

      Sorry. <snark off>

      You know, if I had a nickel for everybody I know in that very same situation…I would no longer be in that very same situation.

    • Just get fired like me. Then you can just spend all your time boozing and eating saltines which is surprisingly less stressful

  • Goonemeritus

    Perhaps we should consider some sort of mandate type legislation.

    • thatsitfortheother1

      You know who else had mandates?

      • EatsBabyDingos

        Marcus? Oh, that was just buttsects.

      • Jeff Gannon?

      • PubOption

        Larry (Wide Stance) Craig?

      • noodlesalad

        Lindsay and Walnuts?

    • fuflans

      now that's fine fine snark.

  • In the "developed" (read mostly white) world only in US Amercia is where you would see hospitals and insurance companies ass rape the poors (although out "here", hospitals and insurance companies ass rape the gubbiment.)

    US Amercia exceptionalism in action! Fuck yeah!

  • Studebaker Hawk

    I was under the impression that chickens and vegetables, as well as hamsters, gerbils, etc., are the main reasons many people go to the hospital in the first place.

    • thatsitfortheother1

      So my medical records weren't "lost" after all.

      • How many watts was the bulb again?

        • thatsitfortheother1

          I dated an ER nurse in my younger days. She told me you would not believe how many people trip and fall on a light bulb while getting ready for a shower, mostly on weekends and holidays.

          • BerkeleyBear

            Or a doorknob, according to some well informed perverts of my acquaintance.

    • Dashboard Buddha

      Paging Doctor Gere…Doctor Gere to the emergency room.

    • Guppy

      Chickens and vegetables? Too much of one and not enough of the other?

  • Douché

    That's it, I'm canceling my health insurance and buying a Hyundai!

  • memzilla

    This calls for a Rethuglican House bill to legalize selling your internal organs to pay for the health care you need, because Freedom, and Invisible Hand!

  • Goonemeritus

    Damn you poor’s I just can’t stay mad at you.

  • SorosBot

    Wish I knew that when I took my uninsured ass to the emergency room last year and ended up getting charged over $2000 for just sitting around and waiting then eventually talking to a doctor for a few minutes. Oh I filled out some paperwork too, guess that was worth a thousand,

    • You should have shopped around for a better deal on your sucking chest wound.

    • OneYieldRegular

      I once had the same emergency thing happen twice in one year. In the first case, here in the USA, I got myself to the hospital and paid just under $500 for talking to a doctor in the ER for 10 minutes. In the second case, in socialist France, an ambulance took me to the ER where I had a battery of tests, saw two doctors, and had all my lab work done on the spot, for a total of $85 (after the exchange rate and including the ambulance ride).

  • Doktor StrangeZoom

    GRRRRRRR!!!! Lucky Ducky!!

    • BarackMyWorld

      I'm glad every time this gets posted again.

    • Oblios_Cap

      My thoughts exactly. Lucky Poorz

  • niblick77

    "Los Alamitos Medical Center, for instance, lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400. When The Times called for a cash price, the hospital said it was $250." – There isn't a law against this?

    • Doktor StrangeZoom

      Yes. There is almost certainly a law against that sort of thing. It's privileged corporate information, and releasing it to newspapers is theft.

      • niblick77

        Well played!

    • thatsitfortheother1

      It's the invisible hand of the marketplace.

      Reaching into your invisible bank account.

    • Terry

      It's just the invisible hand of the free market at work.

    • Biel_ze_Bubba

      In NYC, the First Commandment is "Thou shall not pay retail," but still — US healthcare must be the brokenest "market" in the history of mankind.

      BTW, good luck finding an "in your network" doctor in NYC. Any doc or dentist worth his Park Avenue shingle takes no insurance whatsoever.

  • Chick-Fil-Atheist™

    Poors, you clearly don't understand the medical system, and you're pretty stupid about capitalism at the same time. How else are the insurers supposed to make money, if they can't charge a fucking truckload of little overhead for the same procedure?

  • noodlesalad

    The free market works! No health insurance for anyone! Dr. Galt's Miracle Tonic cures what ails ya.

  • Dudleydidwrong

    Each of the poorz need to go to a hospital with a lawyer to help negotiate the cost of whatever they need at these places. This would make more jobz for lawyers who are now panhandling on our streets and allow the chicken, turkey, hamster, and piglet farmers to have a better handle on how many they need to raise to keep the supply rolling. Lawyers would get 10% of the animals as pay. They're so needy!

    Is today "Take a lawyer to lunch" day? (Oops! It's on the legal calendar as "Eat a client for lunch" day. My bad.)

    • JohnyEdge

      I'm a lawyer. No lawyer would do it for less than 40%.

      A good lawyer wouldn't take less than 50%.

  • HempDogbane

    Get your x-rays at the vet ! Antibiotics too !

    • Vet (to patient): "Hm, your fetlock appears to have a stress fracture. We'll have to put you down."

      Patient: "But doc! I have to be at my job in ten minutes!"

      • Terry

        Those hansom cabs won't pull themselves.

    • Baconzgood

      That's where I get my sedatives for my….*looks about oddly*…horse? Yeaaah my horse. I got lots of horses.

  • It's true, tho, that hospitals are mandated to treat anyone who walks into the ER as appropriate, which means the costs are going to be picked up by you and me.

    Gee…that's kind of like "single payer health insurance," except we're the payer…

    • DahBoner

      ….mandated to treat anyone who walks into the ER " as appropriate"

      As in, stopping the bleeding.

      Preventative healthcare? Hell, no.

      • Or re-starting the heart. Nevermind he walks out of the ER and drops dead on the sidewalk.

  • Schmannnity

    Thank goodness insurance companies are exempt from antitrust and price fixing regulations. That's worked out great!

  • el_donaldo

    So universal coverage would reduce healthcare costs overall, and not only spur entrepreneurs, innovation, and vast new freedoms for the American worker, it would supercharge the moribund economy? You don't say.

    If only getting there were as easy as being sarcastic about it.

  • thatsitfortheother1

    My doctor didn't have change for a whole chicken, but I got back an egg salad sandwich.

  • EatsBabyDingos

    I've known this for years, except that hospitals charge "reasonable and customary" charges by whim. If you don't prepay the $250, and you are in the ER, you'll get the bill for $4500, which they will then sue you for and attach your wages. Sadly, I've represented some hospitals doing this (**cough cough, Inova/Fairfax Hospital**) in court, and I always thought it bordered on criminal.

    • BerkeleyBear

      It does, but it is that lovely border area lawyers and doctors have carved out for ourselves where rules just don't seem to apply quite the same way. Sort of like quantum physics, only with more human drama and suffering.

    • Biel_ze_Bubba

      It's hard to negotiate for the cash price with that damned plastic tube down your throat. I think that's why it's the first thing they do in the ER.

      "He's trying to negotiate … intubation, STAT!"

  • boobookitteh

    Fucked if you're not insured and fucked if you are.

    The Best Health Care System in The World ™.

    • BarackMyWorld


      *actual conservative talking point

      • freakishlywrong

        Dick Cheney got a new heart. DICK CHENEY GOT A NEW HEART. Dick could afford three hearts if he needed them. See, the Best system in the world!

        • calliecallie

          And we picked up the tab.

  • PubOption

    There was an investigation into hospital charges by one of the TV stations in Dallas, about 12 years ago. The hospitals there said that they could not (at least publicly) offer discounts for cash, because the insurance companies would pay no more than the lowest price anyone had paid for a particular service.

  • Pragmatist2

    It's OK. They only get 10% of the care.

  • DahBoner

    This whole problem could be solved if your mother wore a crown.


    • Marcus gets his kids free healthcare?

  • Baconzgood

    This is why we need tort reform.

  • chascates

    Even if I could take a chicken to the doctor I'd need about 3,000 to pay for the gall bladder operation I've needed for about 8 years now. I still owe $300 to my doctor's office of 6 months ago and 6 months worth of my prescriptions is as much as he'll give me until I come in for blood tests. I don't have anything to sell and get paid $100 a week (plus a house to live in) for working on the farm. If Cuba wasn't so far from Texas I'd consider swimming there and asking for medical help.

    • Biel_ze_Bubba

      First order of business is to get the hell out of Texas, before it kills you. The One-Star State is ranked somthing like 48th in the country when it comes to health care.

  • Barb

    My sister sent me a text message last month, asking me to give her money to buy the house next to hers. She was afraid that negros would want to buy it and move in. I told her that my daughter is going to have a neo natal intensive care bill that is going to have more zeros in it than a line of autograph seekers at a Sarah Palin appearance. I'm probably going to have to help with that bill.

    One month later, Nancy still isn't speaking to me. Priceless.

    • chascates

      Maybe your sister can start a raffle to buy that house. "Ten dollars to buy a house to keep our block white" or something like that. Should get plenty of publicity.

      • I had an ex-girlfriend who did that after we broke up, figuring she could make a mint off the rubes. I threatened to buy half the tickets and then burn the house for the insurance. She stopped.

        It was not a pleasant relationship.

      • Barb

        Good one, Chascares.

        Nancy lives in Mobile and she probably already thought about that idea.

    • Barb, she's merely following the words of that old hymn, "Nearer? MY GOD! To Thee"

    • freakishlywrong

      Don't take this the wrong way, Barb, but Nancy there sounds like a huge bitch. I'd use the C word, but, you know, sisters.

      • Barb

        Freakishly, you can call her a cunt and I won't mind.

    • Chichikovovich

      Why didn't you reply that if she didn't give you some money to help with the neo-natal intensive care you'd buy the house next to her and rent it to "Negros"?

      • Barb

        Lol Chich! There isn't a person alive who hasn't met me who doesn't know that I detest racist behavior. I can't believe she even tried that garbage with me.

        • Ooh, let me go one better: turn it into a day care center for homeless women to leave their kids while they return deposit bottles!

          • BerkeleyBear

            Still better – a home for white Christian teens to hide from their parents for the mandatory waiting period for abortions, then recover for a while. Just to let her know the inevitable decline of white dominance is coming.

    • Chichikovovich

      Oh, and on that subject, how are things going with the arrested labor? Everything calm, and as uncomplicated as such a situation can be, I hope.

      • Barb

        Morning Chic! Just got this at 7:41:
        I saw the ob-gyn today and I am 50% effaced so far, but no dilation. I've gained a total of 19 lbs all together. Now I'm off to have an u/s done to check how much Mina weighs. At 2 pm we see the cardiologist. Yay!
        Love, Chrissy

        Sent from my iPhone

        • Chichikovovich

          That's fabulous news. Please give her a big hug for us.

          • Barb

            I live in New Mexico, Chrissy lives in Delaware and Victoria lives in Florida. The baby race is on like Donkey Kong and I can't wait to see which last minute airline ticket I have to buy first.

    • comrad_darkness

      I would have said, Sis, if I had that much money I'd buy the place and give it to a black family, just because you asked me such stupid shit.

      You are reminding me that I used to unknowingly live in a black neighborhood. This probably sounds naive, but this did not come up until trying to sell the house. Sure all the neighbors were black but that didn't somehow click with me even after four years. All I knew was my neighbors were quiet people and it was a nice street.

      It was a very hot market, offers before the actual sale date. When the second buyer was trying to back out (after figuring out the black neighborhood thing, according to our realtor) we could have stuck them with the sale by not counter-offering. But we did counter and they backed out. Then it took months to sell. But there was no regret. I didn't want to stick our sweet neighbors with assholes.

      • Biel_ze_Bubba

        When I step out onto the street, it looks like a fucking United Nations convention (or a Benetton ad, without the weird clothing), and nobody thinks twice about it. The family next door is Jewish, the lady across the hall is black, the people downstairs are Chinese. Hard to believe that racist goobers live on the same planet, let alone in the same country.

        Some countries have mandatory military service; maybe the U.S. needs mandatory urban residency. A year or two of immersion could do wonders, for all but the most boneheaded of racist cretins.

  • If hospitals had to post prices for procedures patients might shop around for the cheapest deal instead of the best care. That would be terrible–much better to stick with the current system in which patients have no idea of how much something will cost and how good or bad their care will be.

    • Biel_ze_Bubba

      Shopping for price and service? Can't have that! That would be, like, a free market!
      You can't have that in Americ…..uhhhhh, wait a minute…

  • BarackMyWorld

    America needs Romneycare.

    • Amercia needs Rmoneycare

      • BarackMyWorld

        That too.

    • poorgradstudent

      Romneycare = take an aspirin and pray?

      • Biel_ze_Bubba

        For preventive medicine, hold it between your knees.

  • FakaktaSouth

    Oh good lord, what came first, the chicken or the ability to convince people that screwing them out of what they need purely for profit is the best, most fairest way to live? Medicare (and tits, I know) for all or GTFO.

    Yet another buncha bullshit that ain't gotta be so hard.

    • I bet screwing the chicken came first.

      • FakaktaSouth

        AND i am pretty sure fucking a chicken is the fastest way to need a doctor – see? the circle of life.

        • Hakuna matata means "Keep fucking that chicken"

  • elburritodeluxe

    Can you believe that NoBama thinks this system is broken? What a Socialist!

  • If the uninsured are charged more, maybe they'll stop freeloading and buy insurance. Problem solved!

  • SoBeach

    I went a few years without insurance. Any time I needed to see a doctor I told them up front I had no insurance and would pay cash. They would charge me EXACTLY what I pay as a co-pay today with my gold plated insurance plan.

    Only difference I see with insurance is I get hundreds of dollars a month taken out of my paycheck. When I see a doctor or get a test it still costs me the same out of pocket.

    The entire system, top to bottom, is a joke.

  • fuflans

    people people people we have the best health care system in the world and you all know it.

    • Chichikovovich

      All we need to make it 100% perfect, as God intended, is tort reform and selling of insurance across state lines.

      • comrad_darkness

        Yeah, because nothing would boost the bottom line of already overly influential deep pocketed insurance companies like not having those pesky state regulators telling them they have to actually provide some services after they collect premiums.

  • comrad_darkness

    Health insurance does cause some fascinating distortions such as full service providers holding onto what should be the very low margin end of the market (which should be always growing larger) because it's NOT low margin in this case.

  • joshleefolsom

    That's bogus, man!! All I ever hear is that same old bullshit about overcharging insurance to cover the cost of the poor — that's what their property tax exemption is supposed to cover!! Fuckin A, man, if they are overcharging me to cover an ill person with no money, then fucking charge them property taxes and put the system back in balance. They obviously consider the property tax exemption a windfall profit since they are not using it for the charitable purposes it is intended. THESE PRETZELS ARE MAKING ME THIRSTY!!

    • sullivanst

      Also, what they don't mention is that if you fail to actually ask for the superdiscount cash rate, they'll charge you the megascary "full price" rate that the insured see next to the negotiated rate to make them feel better about the assfucking they're about to take because it wasn't with the biggest dildo available.

  • sullivanst

    Sadly the ACA could incentivize insurers to negotiate higher rates, because of the implementation of the MLR cap (if you spend more on actual care, the 15% you're allowed to skim on non-medical expenses is a bigger amount).

    That's not to say I oppose the MLR cap, just wish it'd either been written differently or accompanied by other measures to offset the perverse incentive it creates. I suppose the theory is competition for enrollees on the Exchange will fix it, but I'm skeptical about that.

  • Tundra Grifter

    I believe it was Susan Orleans (she wrote the new book about Rin Tin Tin) who said during a recent NPR interview she took her sick chicken to the Vet.

    He said "Most people don't treat sick chickens. They eat them."

  • barto

    Actually, it's closer to $21K, and that DOESN'T include the administration and profit charges of the insurer (typically around 20% of the premium).

    Ain't this a great country?

  • Fox n Fiends

    Man those Death Panels are EXPENSIVE

  • ttommyunger

    I know the Insurance Industry employs thousands of people and spreads millions of lobbying/campaign dollars around; but eventually we are going to have to come to the realization that they contribute nothing to the health of our citizens and skim billions off the top for their own salaries, bonuses, maintenance and profit.

  • glamourdammerung

    Invisible Hand libel!


    i'm starting to think every company does this. its like haggling, re-imagined for a post-middle class kleptocracy.

  • Biel_ze_Bubba

    I dunno … is it possible to rob a GOP superPAC?

  • Keep fucking that chicken.

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