Many of us get claim summaries in the mail, barely looking at them before throwing them away. But they reveal the deep inequities and flaws in our system. This is one I recently received for my wife. You must look beyond the summary- insane as it is- to see the real problems. 🧵 
$31,000 billed- for a single medication?! How is that reasonable? But insurance only paid 13 cents on the dollar. So what if you didn’t have insurance? Well you’d be billed the entire amount, which both insurer and healthcare institution tacitly agree is 87% too much...
You don’t have $31,000? Well a collections agency can buy your “debt” from the healthcare institution- who may end up with almost as much as insurance would’ve paid them anyway. The debt collector agrees to settle with you for half of what you “owe” ($15k), and keeps the margin.
You spend the next 10 years stressing over installment payments that are 2-3 x more than the insurance company would’ve paid for the same medical treatment. All because you don’t have “insurance,” through your job. Healthcare institution wins, debt collector wins, you lose.
And here’s the kicker- there’s taxpayer susbsidies for employer sponsored insurance. So even if you don’t get insurance through an employer, you’re paying to offset someone else’s insurance who may be getting offered the same medical care at a MUCH lower rate than you.
Employer sponsored insurance is great- if you have it. It’s one of the largest taxpayer funded subsidies offered by the government. However, people who are poorer, and those who are persons of color, are less likely to have employer sponsored insurance- a persistent inequity.
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