How Medical Billing Works in America

Here’s how medical billing works in America.

Let’s say you’re hungry. You schedule an appointment with your General Chef, who confirms that you are indeed hungry, and that you should indeed eat. The copay is $25. You tell your Chef that you really want a Big Mac, but Burger King is the only restaurant in your network, so they write you a prescription for a Whopper.

Three weeks later, you go to Burger King and order your whopper. They won’t tell you how much the hamburger will cost, but the co-pay $75, payable at the time services are rendered.

A month later, you get separate bills from the grill operator, the bun technician, the lettuce placement specialist, the tomato manager, the condiment dispenser, and the owner of the building the Burger King operates in. None of the paperwork tell you what services are actually covered by the bill. The total is $5,000, and despite the fact that you presented your insurance card before receiving your hamburger, your insurance was neither informed of nor billed for the food.

You submit the meal to your insurance company, but they have forgotten who you are and deny the claim. You fill out form 137-B(i), Appeal for Denied Burger Coverage, and wait. Thirty days pass, and now the bun technician and condiment dispenser have applied late fees to your account.

Your insurance provider remembers who you are, and pays the negotiated $125 for the $5,000 hamburger. This satisfies the bun technician, lettuce placement specialist, tomato manager, condiment dispenser, and landlord, but the grill operator, despite working at a facility that is covered by your insurance is not covered by your insurance himself, and his portion of your meal is again denied by the insurance company. You pay the grill operator $145.

All told, your Whopper cost $245. The various players in the burger-making exercise claim that it cost $5,500, and write you off as a $5,355 loss. The cost of the insurance that sent you to Burger King when you wanted McDonalds was $10,000 for the year.

Democrats claim that medical billing is too complicated and medical procedures are too expensive, but instead of a Single Payer system, they set up a Tiered Hamburger Acquisition system. The Platinum Plan allows you to eat at any restaurant you want, and reimburses 90% of the cost, but can only be afforded by families making more than $100,000 per year. The Gold Plan allows you to select from a variety of well-known chain restaurants, and covers 85% of costs. The Silver Plan allows you to choose between McDonalds, Burger King, and Wendy’s, and covers 80% of costs. The Bronze Plan, which is the only plan feasible for low-income families, forces you to eat at Arby’s, and covers 75% of the cost.

Republicans, on the other hand, want to cut taxes, so they dismantle the Tiered Hamburger Acquisition system and replace it with the American Hamburger Act, which charges a family making $12,000 a year $6,000 for a Catastrophic Meal Replacement Plan. This plan only provides food in case of extreme duress, and states are allowed to opt out of covering patients who became hungry due to lack of eating. If you don’t buy into the plan and become hungry, you aren’t allowed to eat for another six months.

Meanwhile, in Canada anyone can go to a Tim Horton’s whenever they feel hungry, and their taxes have already paid for the meal.