Robbing the middle class.

• Author: Eck, Alieta
• Position: Medicine & Health

"The No. 1 recommendation would be for patients with high deductibles to hide any connection with an insurance company and negotiate the best cash prices for services."

AS THE CONTROVERSY raged between those Republicans who wanted full repeal and those who wanted to retain what might be "good" about ObamaCare, we were not asking the right questions. While they were arguing whether or not to keep the ObamaCare subsidies (or the equivalent as "tax credits"), was anyone asking what it is we are subsidizing? Why has medical care in the U.S. gotten so expensive? Why did the cost of a hospital stay go from an average of $17,000 in 2000 to close to $40,000 today, while the average length of stay declined? Why do U.S. hospital stays cost three times more than in other industrialized countries?

The dirty little secret is that having insurance might be a guarantee that the insured pays more and, because deductibles have risen dramatically along with premiums, a family needs to pay thousands of dollars out-of-pocket before insurance kicks in--but how does this work?

Most insurance companies have networks of "preferred providers." One would assume that a "preferred provider" is a doctor or a lab that gives better rates, but the opposite is the case. As an example, one patient spent a day in the emergency room where the total bill came to $12,000. The "preferred provider" rate brought the bill down to $10,000, which happened to be that patient's deductible. Upon further scrutiny, the breakdown of the bill showed a lab fee of $3,500--labs that would have cost less than $100 cash on the outside.

When the hospital patient advocate was queried, the answer came back, "Your insurance company negotiated $10,000 and, since you have not met your deductible, you are bound it pay it. Paying the cash price is not an option." She acknowledged that this seemed unfair, but would not budge.

Another patient discovered that his insurance had lapsed and was given a cash price of $75 for an office visit. Once insurance was restored, the submitted fee was $275. Since he had not met his deductible, he was expected to pay the higher fee.

Since 92% of people will not incur more than $5,000 per year in medical expenses, the middle class has been fleeced under ObamaCare in so many ways. Many patients have received subsidies, but this just means that taxpayers are forced to pay part of their premiums, and the patients remain stuck with those deductibles and the higher negotiated...