Why do the uninsured pay less than those with health insurance?

From this article about medical debt:

Can anyone explain how that is possible?

If they’re counting charity cases and people who skip out on their bill with the rest of the uninsured, that would bring down the average.

These figures are how much they paid , not how much they owed, right?

You can’t squeeze blood from a stone. I’m guessing a 10k bill would put most people who can’t afford insurance into bankruptcy.

Actually (And I’d really like to see a cite on the prevalence of this), the uninsured often pay more (or are at lest billed more) for the same services. Many insurers have negotiated rates with hospitals and Medicare (I think) for one will not pay the “overhead” cost of unpaid bills. So hospitals have to charge more to those who have no ability to negoitate it away – the uninsured.

In any case I know when my insurance company dicided my son’s surgery was not covered, and we went to pay the bill, the hospital said … Oh you’re paying it? well then the bill is this and sent us a higher bill.

Yes, this is a common practice for insurance companies. If they have a large amount of business with a given facility, they will negotiate a better price. Of course the hospital benefits from this, too - getting paid 80% of the ‘nominal fee’ within two months beats the average time for uninsured payments, or the 18-24 months that Medicare/Medicaid takes to pay.

It’s possible that the uninsured left prescriptions unfilled, didn’t attend Physical rehabilitation appointments, and so on. They may be more likely to “go without” needed follow-up care, and avoid certain costs altogether because they know they will get no help with them, and cannot afford them.

Someone with insurance, on the otherhand, may have the expectation that some or all of that stuff will be covered. They may pursue follow-up care more more diligently and end up incurring more of those kinds of costs for co-pays, things that aren’t covered, and so on.

Speaking only for myself, but it might be indicative of a larger trend: now that I am uninsured, I spend far less on medical costs than I would if I were insured. The reason is pretty simple. When I had insurance, I could go to the doctor for next to nothing, and get a prescription that cost me 10 bucks. Now, if I go to the doctor, it can cost me 300 or more a visit, and the medicine could cost me 50 bucks or more. Therefore, I only seek medical attention when I feel I absolutely must, instead of taking the more preventetive approach that insurance makes possible.

All fine points, but the amount of care received and the amount paid for aren’t directly related. A person could very well receive care for a catostrophic illness, pay until they were broke, then continue to receive care and declare bankrupcy on the remaining bill.

Honestly I’m surprised that uninsured people averaged such a high payout before they were broke. I’d expect it to be much lower, and I’d suspect that the fortune/inheritence/estate of people who thought they were well-off enough to just pay cash for their care and not bother with insurance are skewing the average away from the amount paid by your typical cant-afford-insurance wage-slave.

I worked in collections at a largish hospital last summer as a temp and yep, the uninsured get the full bill. Say, for example, a procedure costs $5,000. No insurance? You owe the full amount (and I note that I only saw the hospital bills, not anything from doctors, anesthesiologists, pathology, or ambulance companies). Insurance? Well, usually they had a “negotiated” rate that was anywhere from 30-70% of the bill that the uninsured would pay – so the uninsured got screwed two ways there.

Sucked. The collection practices were bordering on the unethical, as well.