Private Health Insurance Holders at the Risk of Facing Higher Health Costs

Private Health Insurance Holders at the Risk of Facing Higher Health Costs

Patients with private insurance can experience health costs much more than those with Medicare, as shown by the latest report of the Rand Corporation. The study, based on the data collected from over 4,000 hospitals from 49 states and Washington, D. C., from 2020 to 2022, showed that hospitals charged private insurers prices 254% higher than what Medicare would have paid for the same services in 2022.  

These outrageous prices of drugs greatly influence patients with private insurance and ultimately increase premiums for health coverage, which in turn makes access to care more costly. Brian Briscombe, a healthcare cost analyst at Rand Corp., stressed that the products’ high prices result in patients paying more through higher copays, out-of-pocket payments, or indirectly through reduced paychecks.  

Hospital services were the main reason for the high healthcare spending for people with private health insurance in 2022, with the price of hospitals being the primary factor contributing to the overall increase in the average expenditure per person. Besides, the report also showed the massive price difference among states, with some states’ hospitals putting the private insurance prices below 200% of what Medicare would pay. On the other hand, few companies charged prices more than 300% of Medicare rates.  

Besides, the study discovered that hospitals usually charged patients more for medicines the healthcare workers gave than those given in a physician’s office. The necessity for hospitals to be more transparent about their pricing was mentioned, which would, in turn, force insurers to negotiate lower prices and patients to be able to compare prices just like anyone else. 

Though the federal rules, which demand that hospitals give away the prices, are in place, disclosing prices still needs to be complying more. This report is like a window that shows patients’ difficulties with private insurance, thus calling for more transparency and informed choices to fight against the problem of more expensive healthcare at hospitals.

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Nilanjana Basu
Nilanjana is a lawyer with a flair for writing. She has a certification in American Laws from Penn Law (Pennsylvania University). Along with this, she has been known to write legal articles that allow the audience to know about American laws and regulations at ease.

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