So, everyone wants to criticize the Affordable Care act, otherwise known as Obamacare. But, no one wants to take a look at the real issues. These issues are seen every day by those of us representing individuals injured in car wrecks. By way of some examples, I will show you how.
I recently represented a woman who was injured and treated at Trinity Hospital. All of her hospital, therapy and physician bills totaled $57,123.78. BlueCross BlueShield of Alabama paid her bills. How much did they pay? $6,211.42, or 11% of the bill. What happens to the $50,912.36 not paid? Other than co-pays and deductibles, it’s written off. It’s nothing. No one pays it. It’s like funny money, unless . . .
If you have no health insurance, guess how much you owe? $57,123.78. So, if you are lucky enough to have a job and health insurance, your medical bill is $6,211.42. If you don’t have a job or don’t have health insurance, your bill is $57,123.78.
How does this relate to a car wreck? Well, it used to not affect it at all. But, about ten years ago, the Supreme Court of Alabama abolished the collateral source rule which meant that the defendant driver could not introduce into evidence what the health insurer paid until this rule was abolished. Now, the defendant driver’s attorney gets to tell the jury that BCBS paid $6,211.42 and the plaintiff only has to pay that amount back, not the $57,123.78.
So, think about it. If there were two wrecks with the exact same facts and injuries, but one victim had BCBS and one didn’t, their cases would be totally different. The one with health insurance would probably get a verdict or settlement in the range of $15,000-$25,000, depending on what the injury was (shoulder surgery in this case). The one with no health insurance will probably resolve her case in the range of $125,000-$175,000, and after all the bills and fees are paid, the one without health insurance will net a much greater recovery.
Does that make sense? Not to me. Not to most people. But, that is how our law works in Alabama. So, the bottom line take home? Who wins? The defendant? No. The hospital? No. The Plaintiff? No. The Insurance companies? YES YES YES!!
The health insurer collects premiums and pays 11% of the bill. In fact, BlueCross and BlueShield of Alabama has the largest market share in a single state of any insurer in the country – See this article on the conspiracy allegations against various Blue Cross entities. The auto insurers collect premiums and pay out less because they get to introduce what the health insurer paid, not what the bills were, AND the plaintiff can’t tell the jury that the defendant had auto insurance.
As is usual, the citizens allow these laws to go forward because they don’t care until they suffer an injury, and at that point, it’s too late.
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