Sorry but another healthcare costs rant acomin'...

Sorry for Predicting!

Seriously though, the reason it is a little funny is because there is a big grain of truth to it. There are many hands grabbing into a pot of potential cash trying to get as much of it as they can while trying to remain as concealed as possible and maintaining the tiniest bit of plausible deniability to be able to say "sorry, it's not MY fault." But it is. It definitely is the fault of all of them.

This is anathema to all the free market fundamentalists, but this is an area where we all would be better off taking the idea of making a profit out of the equation altogether.

It's also anathema to the "less government/less regulations" ideologues but it's also an area that would benefit from strict regulations on pricing and the requirement that all prices be public and agreed to up front, as well as regulations regarding providers owning and operating side ventures (like the facility you mentioned, or imaging facilities, or other profit-making ventures) that get business steered to them by the very doctors who own them.

and that plausible deniability ( which i have heard now twice...once from insurer and now from dr office ) - Its up to you to make sure that every aspect of your services are IN NETWORK- YET neither my DR NOR Insurer ( both of whom i had spoken with a few times PRIOR to surgery ) EVER mentioned this to me. So it stood to reason that if my Surgeon was IN NETWORK, the place he performed his surgery WOULD BE TOO!

I just had total knee replacement surgery. For the surgery and a 2 day hospital stay the bill was over $76000. And that doesn't include the surgeon's fees. My total out of pocket so far is somewhere around $2000.00. The insurance company (BCBS of Texas) has paid about $19k. I'm sweating bullets right now because Louisiana does not have a law against balance billing for out of network providers. I made damn sure everyone was in network well before my surgery date, but there is always that one forgotten detail...

This was my first exp with any sort of "major medical procedure" ever. I will know going fwd for sure, but I would expect, at the very least, that the Dr. should either remind/advise patient or give the patient some sort of notification that just because he is IN NETWORK doesnt mean the place where the surgery will be performed is. Something. Anything. This is totally misleading.