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Cost of health-care insurance has no reason to keep rising

Published: Thu, December 19, 2013 @ 12:00 a.m.

Cost of health-care insurance has no reason to keep rising

222In 1983, Congress passed the Tax Equity and Responsibility Act. What this act did was to establish criteria for establishing charges for services in hospitals and doctors offices based on what was termed DRGs (Diagnostic Related Groups). Acceptance of this methodology was universal and charges for these DRGs were set. Hospital emergency care was a different matter.

The bigger problem lies in the definition of terms. The “cost of health care” and “health-care costs” are not synonymous. The first is the charges that a hospital makes for services rendered. The second is the cost of health-care insurance. It is the “cost of health-care insurance” that is generally thought of as, “hospital and medical care,” and it is, in fact, the health-care insurance that is on the rise.

Should your readers take the time to understand the last line of the referenced paragraph they might realize that it is actually the cost of health-care insurance that the article is reporting

Leonard J. Sainato, Warren


1questionreality(509 comments)posted 1 year, 7 months ago

One of the biggest problems of our system is entrepreneurial doctors (doc-in-a-box) who run their own businesses and make their own deals one-by-one with every insurance company.  That model has to die.  There is no way an ordinary consumer can cipher out the relationships before receiving medical care.

Today, at the urging of your insurance company, you arrange for a preventive colonoscopy because you are told it will be covered at 100%. Then, afterwards you find out the anesthesiologist is out-of-network and the doctor uses a non-preventive billing code because you told him you phart 5 times every day between 7AM and 8AM. The patient now gets stuck paying a portion of the bill. It is absurd!

All part of the absurd procedure based healthcare system we have endured to date(the DRGs the writer of this letter mentions).

Medical Mutual of Ohio gives Southwoods Anesthesia LLC a courtesy “in network” pricing since the Hospital is in network and Southwoods Anesthesiologist are the only group that provides service to their facility. In other words, Southwoods Anesthesia is "out-of-network" and you end up paying for their services.

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276Ytown(1318 comments)posted 1 year, 7 months ago

SeriouslyNow: Excellent point.

And to add: From other standpoint the cost of health insurance to pay for these services as Mr. Sainato points out in his article.

But, as the article says "Cost of health-care insurance has no reason to keep rising", you have to go back to the source of the cost...the provider of service. Although also rising, health insurance coverage protects us from loss against the expenses related to illness or injury and rises as costs at the source rise.

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3Jerryl(105 comments)posted 1 year, 7 months ago

Mr. Sainato refers to an article, "actually the cost of health-care insurance that the ARTICLE is reporting".

What article is he talking about? Does anyone know?

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4Sensible(118 comments)posted 1 year, 7 months ago


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5tnmartin(426 comments)posted 1 year, 7 months ago

and why should the cost of healthcare NOT rise?
Priced milk lately?
gasoline is about twice what it was before Obumble took over. Ask farmers about the cost of hay over the last few years. Seen the price of beef, or chicken?
Seen all the shyster lawyer ads on the TV? The ones that include "YOU may be eligible for significant compensation! Call the law offices of Dewey, Cheatem, and Howe for a free consultation!"?
doctors and clinic have to pay for the insurance against shyster lawyers and idiot juries in lawsuits that are at least questionable.. Doctors and nurses have to buy gas and food and heat their homes and offices too.
Where do people think the money comes from? A magic tree??
And, of course, the unconstitutional idiocy of Obamacare is making everything worse, generally MUCH worse. But hey, keep voting for the democraps. Some day, the whole nation will be as big a success as the Valley is now. Sorta like Bulgaria or Haiti.

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