Name:   copperline - Subject:   Not the case Date:   3/4/2016 8:53:15 AM

No, there has never been a tax write off for the unpaid difference between what is billed and what insurance companies actually pay, and you are specifically prohibited ( in the case of Medicare and Medicaid ) from billing more than the original copay to the patient.  In the case of commercial insurance panels, when you sign up to be a provider, you are legally obligated to accept what they pay and not seek more from the patient (other than their copay & deductible).

Unpaid medical bills simply are written off as bad debt, uncollectable.   This puts upward pressure on pricing and results in these astronomical bills you see from hospitals.   It is a crazy system because it was developed as a response to the commercial insurance industry's presence in the marketplace.   Those bills you see bear little relation to the real cost of delivering the services.

Hosptials & healthcare businesses are unlike any other commercial business I can think of, and can't be managed in the same way.  They can't withhold their services because doing so would endanger lives, so that is illegal.   They can't repossess services once rendered.   And they can't set prices for their services, that is done by insurance companies.   Imagine running a business wherein each of your customers points you to a third party for payment, and that third party gets to set the price that you are paid.

It's complicated.   Maybe that's part of the problem.    Medicare works, and probably should be a model for what the entire health care billing system should be... warts and all.   It's not perfect, but it's lots more rational that what we had before.     Competition between insurance companies isn't keeping medical prices down, it probably is having the opposite effect.

Obamacare has achieved a great deal, there are now 15 million people who have insured healthcare where before they had none.   That number is nothing to scoff at.