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Couple left with $200k bill after baby born in US
(www.bbc.co.uk)
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And that’s basically it!
Insurance companies make deals with hospitals along the lines of "We'll pay 1k for this procedure which should cost 300 bucks, or 40% of your standard rates, whichever is lower." So the standard rate becomes $2500.
Then the insurance company will require a 40% "copay" based on the standard rates, and the patient ends up paying the $1000 and the insurance company doesn't pay shit despite collecting hundreds a month in premiums.
If you tell them you don't have insurance they'll frequently discount the fee to the $300 it should cost.
And this is embraced because profit is capped to a percentage of payouts