The money can be used to pay for deductibles or any other listed medical care. The advantage is it's medical care based on capitalism. The ‘customer’ makes the call ...
You miss a point, (and I am not standing up for doctors), but what is billed to the insurance companies, Medicare, Tricare and the rest, are not what is paid. Every one of them have a pricing list based on procedures, (ICD), which they use to deny payment or underpay claims.
I have dealt with this issue for years, overseas, where you need to file your own claims because the doctors/hospitals have no idea how to document a claim the way the insurance company’s claim processors want it. (I did the preparation of my own and other retiree’s claims).
I have seen the claim processor decide that cataract surgery, in an out patient facility was a fifteen minute routine office visit. That one took over four months to get it paid correctly and they still wanted to deny payment for the replacement lens because the surgeon ordered it but the patient paid for it when it was delivered for the surgical procedure.
Medicare already sets prices. Problem is every doc you see can run the exact same test even if it’s not in their Baliwick. I see 4 Specialist with a Primary, each specialist wants to run their own test, then the Primary his set. Some over lap, Medicare has started to clamp down on this. So I have to remind the Primary NOT to step on the Specialist toes. Many of the Test my ENDO runs are run by the Primary, I try and see him 2 weeks before and have the restults sent to the Primary where they may sit in some office workers In box for weeks before they are put on the computer.
Since I’m married to a 40 yr Electronic/Computer Prof who has a daughter who owns her own It business I refuse to use Portals that can BE HACKED. I may not be a nerd that they are, but I fully understand Everything is Hack-able.
Computer systems are NOT compatible with in the same health system even. 1 Methodist dr computer system does not mesh with the system of another. And when you use 2 or 3 different ones, NONE of them talk to each other. Lab reports have to be Faxed over to sit in someone’s in box until they are put on their computer.
Then you add in Tricare Life (Ret. Military over 65) another Governemnt DoD controlled healthcare plan which is Secondary to Medicare, you get told you can’t use discounts, coupons, etc. Because all medications and the 20% they cover is DoD neogatied prices. So you have to keep up with both Medicare and DoD regs that change yearly. Nor do they have the same advantages of vision, hearing aids, or eye glasses that many of the private plans offer. Unless you are the Service Memeber who was Injured on Duty. You have NO RIGHTS OF APPEAL either when they eliminate the 1 med you can take. Hubby’s hearing aids and dentures were Service Connected, MINE as a Spouse are totally OUT of POCKET as are his glasses. For Seniors that’s thousands of $$ a year, and not 1 cent is deductable on income taxes. WE paid off the House, cars, and owe no one anything. We are forced to file Short Form. No way we can reach $26 K to file long form. All medical expense should be decuctible. Even Cosmetic that is used to fix a Medical conditon such as a bad Catract Implants, Lasix is the Cosmetic Fix and should be considered a Medical fix for a medical problem.
Medicare just told Knee Orthos to stop doing Partial Knee implants, and do Full ones, even if the Patient doesn’t need a full knee. Which adds up to a much larger bill with Rehab and surgery, office visits. Hubby has 2 partial Knees and they work great, 1 is 9 yrs old, the other 2 yrs old. Rehab was done at home. Driving in 3 days, walking up stairs carefully, never used a cane or walker until the 2nd knee because Medicare demanded it.