I find myself in need of a chiropractor, and my insurance covers only part of the cost for this service. I have a $25 co-pay, and (unlike other covered services) pay 20% of the remainder of the bill. That means the cost chart goes like this:
The point at which I perceive my insurance is bearing a fair share of the cost of treatment is not the lowest number on the chart. It's right around the 50/50 cost split, at $70/office visit. This is clearly not an incentive for me to seek the lowest-cost treatment. I could, if I wished, pay an extra $6-12 in order to stick the insurance company with an additional expense of $24-48. If I thought that this were an iterated prisoner's dilemma situation, where a defector who has been punished might actually change their behavior next round, I would select an expensive chiropractor in order to make the point. Sadly, this isn't, and I don't.
So what will I do? I'll most likely ignore cost and settle on the doctor I feel most comfortable with. And thumb my nose at the bureaucrats.
ETA: Talking with
zeightyfiv, I also realized that if the insurance had decided to pay only a flat 30% of the cost of chiropractic care, I would perceive it as significantly more fair than the chart above, even though it would be financially disadvantageous for me. This probably indicates that if I have to reconstruct a formula to figure out how my benefits work, it's going to smell fishy regardless.
Total cost ($) | I pay ($) | Insurance pays ($) | Ratio (me / ins) |
40 | 28 | 12 | .7/.3 |
50 | 30 | 20 | .6/.4 |
60 | 32 | 28 | .53/.46 |
70 | 34 | 36 | .48/.51 |
80 | 36 | 44 | .45/.55 |
90 | 38 | 52 | .42/.58 |
100 | 40 | 60 | .4/.6 |
The point at which I perceive my insurance is bearing a fair share of the cost of treatment is not the lowest number on the chart. It's right around the 50/50 cost split, at $70/office visit. This is clearly not an incentive for me to seek the lowest-cost treatment. I could, if I wished, pay an extra $6-12 in order to stick the insurance company with an additional expense of $24-48. If I thought that this were an iterated prisoner's dilemma situation, where a defector who has been punished might actually change their behavior next round, I would select an expensive chiropractor in order to make the point. Sadly, this isn't, and I don't.
So what will I do? I'll most likely ignore cost and settle on the doctor I feel most comfortable with. And thumb my nose at the bureaucrats.
ETA: Talking with
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