Not quite sure I undersand what you are trying to say. It is the insurance companies that set the rate they will pay. If the facility is in their "network" they agree to the negotiated price, or sometimes less. If the facility is not in the network and the person decided to get treatment there anyway, the insurance company will still only reimburse what they would pay an in-network facility. It is then up to the individual to pay the difference in price.

Health care in the US was never set up to provide health care to the individual. It was set up to provide a constant stream of income to the facilities, and later the physicians. This is the basis for the current US health insurance.

I do not provide my SSN to medical providers. I do provide the medical insurance card as that is sufficient.

I limit where I give my SSN. IRS & state taxes, credit applications (I initiate), DMV & other very limited circumstances are where I give my SSN.

Most of the time, alot of people ask for SSN but it is not necessary.

Ok.. to clarify..

Facilities and insurance companies need to negotiate and come into an agreement what is the negotiated price. If facilities cannot provide services for the insurance company, then the price would have to be negotiated higher, so that the two sides come to agreement.. if you will, supply vs. demand..

This is what I would refer to as vendor and purchaser contractor agreement ..

If there are higher cost pressures, the insurance company will have to pay a higher price for the facilities to provide services, otherwise facilities simply won't agree to providing services..

Hence, a market system for insurance companies and facilities..

+1

I leave that field blank at all health care providers. Only once have they pushed for it...we went round and round until I left and found another oral surgeon to remove my wisdom teeth.

The US already has the system in place you describe: making a profit of illness.

The insurance companies decide what they will pay. The facilities and physicians decide if they can provide the service for that price. The facility either agrees to be considered in-network or opts out. If the faiclity opt-out then it is up to the person insured to decide whether to use that facility and make up any difference in cost.

In Alberta.. its' called Alberta Blue Cross..

Theres' choice.. but the coverage is menial, and the premiums are hefty.. the cost economics doesn't make sense, but I have the coverage as a write off..

Going back on topic and being a foreigner living in the US since a few years I always try to avoid the US medical system.. I ended up spending some crazy money for such simple things that I decided to fly back to Europe if anything really bad would happen to me.

It's actually cheaper, for example, to fly to Italy (my home country) have a broken tooth re-built and come back than paying for the same operation in NY..
I have an european insurance with an US extension for any emergency, way cheaper than any US medical insurance, but if I need to stay in the hospital for more than a day I'd fly back to Italy in no-time anyway.. No surprises, no insurance policies or partial coverage.. If you're sick they'll take care of you, no matter who you are...

Canada is closer..

How much is it to get a tooth rebuilt in NY?

"health care" is not an oxymoron in Monaco
 

I was on vacation in France and Italy in June and had a lovely 2 weeks in Paris and on the Cote d'Azur. Then, I went to Ventimiglia, Italy...where this massive headache hits. I took some tylenol and stayed out of the sun for a day. Tuesday it is worse, so my friend brought me to her Italian doctor, who gave me some codeine/ibuprofen - basically tylenol 3 - for what she said was a migraine. No charge for doctor visit, $15 for prescription.

Wednesday, I was no better, but I headed back to Nice, and stopped in a pharmacy. The pharmacist sold me codeine with caffeine over the counter, no prescription. Thursday, 4th day of head ache, I was feeling better so I went to the beach near Cap D'ail, where I quickly sank...couldn't sit up, nauseous, short of breath and an ice pick in my eye...STABBING and throbbing...so, I dragged myself to the life guard who called the pompiers (firemen) and they carried me in a chair up the side of a cliff to an ambulance, a la Cleopatra, stopping along the way to let me take a photo of their biceps.....I was whisked off to Princess Grace Hospital in Monaco, where i was told IN FRENCH, I needed immediate laser surgery in my eye to relieve the pressure, but they couldn't do it til I stopped writhing in pain...Sooooo, they admitted me.

I am flipping out because: 1) I have 4 euros in my pocket 2) my id, passport and everything else I own is in the Cap D'ail youth hostel 3) minor detail is that I have type 1 insulin dependent diabetes and I didn't want them f*&%ing with my blood sugars. They shot me full of IV drugs all night to bring the pressure in my right eye down (it was almost 50!). Friday morning, they laser three holes in my iris...Instant Relief. Pressure is now 11 in both eyes. I was released later that afternoon, and just as I was leaving an administrator came for my info...literally 24 hours after I was admitted! It was so amazing NOT being asked "how are you going to pay for this" before "where do you hurt and what do you need?"

A month later I received a bill for 775 Euros...about $1200. I submitted it to my US health insurance with the diagnosis codes and THEY PAID THEIR 80%. Had I not been admitted, they probably would not have paid it. In the US, an emergency AND difficult, rescue off the beach, the ambulance ride, ER, after hours Opthamologist care, over night in a room, laser surgery and a follow up visit, would have cost a zillion bucks. My nurses let me take care of my own diabetes instead of trying to wrestle control away from me. The nurse even had samples of the prescriptions I needed, so I didn't even have to get that.

My mother just said she was grateful I was in Monaco, and not Morocco...and I concur...

Most countries will provide urgent/emergency care until the patient is physically well enough to be discharged. IIRC even the US system is obliged to provide free care to those about to drop dead without treatment.

So in your scenario, you'd be OK to stay in the local system with or without insurance if the situation was entirely hospital based (e.g. rushed to hospital with acute pain, never discharged).

However many terminal illnesses take some time to get you. And many are not diagnosed as in-patient, but as out-patient. So you'd be discharged or never admitted as "urgent/emergency". And hospitals / clinics are much better at turning away patients for follow up treatments.

Take cancer as an example. You'd not get diagnosed without appropriate local cover unless it was an emergency admission. Then getting follow-up radiation/chemo/surgery would probably also be impossible without appropriate local coverage.

You might argue "what the heck, why would I want chemo etc anyway" or "OK so what if no follow up treatment was possible, just the dying bit". If discharged from hospital, you still would likely need some end-of-life support (think morphine as well as nursing care).

To add to the US medical horror stories - here is mine. My father came to visit me with what he thought was good travel insurance.

Its the dead of winter in Boston, a Sunday, and he catches a cold. Its a cough, runny nose, no fever. Its pretty bad, and he is in his mid-70s, so I take him to an urgent care facility close by.

They take down his name and my address, and after a while the doctor sees him. Asks some questions, and my Dad says he has high blood pressure, and no Primary Care Physician in MA. The doctor immediately orders a slew of tests. My father says he is concerned about the cold, and is already aware of the other blood pressure related issues, and does not want to pay for these additional tests.

The doctor says he is required to take these tests. No one can tell my father what the cost of these tests are. At the end of taking the tests (5 hour wait), the doctor prescribes a bunch of things for the BP and related issues, and an antibiotic for the cold.

Total cost of care came to $2500 (not including the medicine) - non-negotiated rates. I got 3 different bills in the mail, 2 months after the date of the visit (one for physician services, one for lab work, one for hospital charges) - they were all on different letterheads. They were all "itemized" with strange terms which did not make sense to us non-medics. When I called up, no one in the hospital would talk to me, as I am not the patient. My father had to call from overseas, and the hospital admitted a billing mistake, and changed some of the charges.

The bottom line is it should not cost $2500 for a cold. Also, other than an emergency room or a urgent care facilities, there is no easy way for an outsider to see a doctor here in the US. There are no "walk-in" clinics, the only ones I could find were all for low income or no-insurance people run by churches or other charity organizations (Not what I was looking for).

Incidentally, my father has excellent insurance where he works, and it covers him worldwide - the only two exceptions are the US and Canada. Fortunately, his travel insurance picked up the tab.

I hate to interrupt what is sadly turning into a "bash America" thread, but the above statement has not been true for many years. In fact, there is a nickname for walk in clinics in the medical profession, "doc in a box." Google it and see.

Here in New York City, the huge pharmacy chain Duane Reade has opened walk in clinics in many of its pharmacies.

It's not a "bash America" thread. If anything, it's a "bash the US healthcare system" thread, and it would appear that most of the contributors are actually either US citizens, or (like myself) US-based, and thus speak from experience. There are many things to be admired about the United States, however IMO the corrupt medical system isn't one of them.

My Canada Experience....
 

I was in Montreal with a female friend who fell and injured her knee. We went to the nearest hospital in the French district. The doctor wanted CAN $200 cash. They x-rayed her, bandaged her up and said she was OK.

When she got back to the US she found out her kneecap was in fact broken.

The hospital was dingy, dark and rather scary with patients on gurneys in every hallway.

Wouldn't want to need medical care in Canada, thanks.

Call it whatever you like. I hope you agree that criticism should be based on facts. The message I responded to contained some information that was not correct.