Health insurance-related posts.

Tips on how to keep control over your medical costs.

Quick: You have 10 seconds to answer some crucial questions.

You’ve just been in a bad accident. You have a compound fracture to your right leg.

The neighbors called an ambulance. The paramedics’ first priority is to stabilize you, which involves sedation, given how much pain you’re experiencing.

They’re hooking you up to an IV containing that sedative. In a few seconds, you’re going to be semiconscious and unable to communicate.

Which hospital emergency room do you want to go to?

Which one takes your medical insurance? Are the emergency room physicians also in-network?

How about the orthopedic surgeons?

Above all, what price will the emergency room charge you for your care?

How much will be left over for you to pay after your insurance pays their part?

I’m certain that most of us couldn’t answer those questions quickly, with or without sedation.

And yet thousands of Americans are asked to do exactly this every day … with catastrophic consequences.

Take It or Leave It

Longtime readers will know that I have an interest in the U.S. health care system. They also know that I don’t consider it to be a “free market.”

It’s the opposite. It’s a gargantuan rip-off.

Here’s why.

Economists distinguish between two types of prices for goods and services.

One is “market price.” That’s the price set by the free interaction of supply and demand.

Buyers bid up the price of something until no one else is interested in buying it. If sellers can’t produce the item at a profit for less than that price, it becomes the equilibrium, or market price.

But there’s another type of price that applies to a surprisingly large chunk of the things we buy — “administered prices.”

Administered prices are set by sellers without regard to the market. They just decide what the price will be, and the rest of us have to accept it.

Administrative prices are typically used for public utilities. Because it doesn’t make economic sense to have more than one provider of, say, electricity, prices can’t be set by market competition.

Instead, a public commission sets the price of electricity based on the cost of providing it, an amount to fund expansion of the supply system and a reasonable rate of profit for the provider.

The key factor justifying administrative prices is the absence of competition on the supply side. In the case of public utilities, that’s justified by economic rationality.

But in the case of emergency room services, the rationale is different: Accept treatment at their prices, or face the consequences.

Administered Pricing Gone Wild

Of course, there are other differences betweens public utilities and hospital emergency rooms.

One is that utilities are regulated, and prices are set by public commissions. On the other hand, in much of the country, emergency room pricing is unsupervised. They can charge whatever they want.

But just as important is the way buyers “discover” the price of these two types of goods.

Consider a South African friend of mine. He bought a plot of land abutting the Cape of Good Hope Nature Reserve.

The municipal electricity supply grid ends several miles away. The utility was willing to extend electricity to his plot, but at a price that included the cost of installing miles of poles and wire.

He did his sums, and concluded that it made more financial sense to install solar panels and a battery system instead.

Compare that to Nina Dang. The San Franciscan cyclist fell and broke her arm in April last year.

Her pain was so acute that she was unable to communicate with bystanders, or with the ambulance crew who took her to Zuckerberg San Francisco General Hospital.

There, doctors X-rayed her broken arm and examined the rest of her to make sure she had no other injuries. They put her in a splint, gave her pain medication and sent her home.

A few months later Dang got a bill for $24,074.50.

That was $20,243.71 more than her insurer considered a fair price.

She was therefore responsible for paying the excess. She tried to negotiate, but the hospital threatened to send her to a collections agency.

The problem is obvious. My friend knew what electricity would cost him before he made a decision. Dang didn’t know what her emergency room treatment cost until after it already happened.

My South African friend had a choice; Dang didn’t.

The question of timing — of when the customer gets information about pricing — is what allows hospital emergency rooms to “administer” whatever prices they want.

And that’s exactly what they do.

A fascinating yearlong study by Vox has revealed scandalous practices in our nation’s emergency rooms. They include a $5,571 bill just to sit in a waiting room, $238 for over-the-counter eyedrops and $60 for one 200 milligram ibuprofen.

The cost of identical treatment can range from a few hundred dollars to tens of thousands, depending on the hospital.

What You Can Do

Ultimately, this is a political problem.

Market pricing cannot function in an emergency room setting. The solution has to come from our lawmakers.

The U.S. needs to adopt the practice of most of its peers in the developed world — standardized pricing for everyday health care services.

Until then, there are some things you can do to avoid this kind of scandalous rip-off.

  • If there’s more than one in your area, find out which local emergency rooms take your insurance. Ask them for their price list for common services. They are obligated to make this public, thanks to a law that took effect on January 1. Identify your preferred emergency room, and tell your family, friends and neighbors. Write down a directive stipulating that you be taken there in case of emergency, and put it in your wallet or purse next to your driver’s license or ID.
  • For injuries that don’t appear life-threatening, go first to an urgent care clinic. Such clinics are popping up all over the place to fill the niche between waiting for an appointment from your doctor and going to emergency room. They may be able to treat you on the spot at a much lower price. If they can’t, they’ll help you find the most economical emergency room for you.

You work hard for your money. There’s no reason you should have to hand it over to greedy, unscrupulous hospitals.

But unless you prepare yourself ahead of time, there’s a good chance you will.

Kind regards,

Ted Bauman

Editor, The Bauman Letter

Is dental insurance tax deductible?

Read more: Is dental insurance tax deductible? | Investopedia

A: Dental insurance premiums may be tax deductible. To be deductible as a qualifying medical expense, the dental insurance must be for procedures to prevent or alleviate dental disease, including dental hygiene and preventive exams and treatments. Dental insurance that is for purely cosmetic purposes, such as teeth whitening or cosmetic implants, would not be deductible.

Where Are Dental Insurance Premiums Deductible?

For most taxpayers, the cost of medical and dental insurance premiums paid during the tax year are deductible on form 1040 Schedule A as a medical and dental expense. Only the total of all qualifying medical and dental expenses, including insurance premiums, that when combined exceed 10% of the taxpayer’s adjusted gross income (AGI), will actually be included in the total of all itemized deductions.

For example, if a couple has an AGI of $100,000 and a total of $8,000 of qualifying medical and dental expenses, including dental insurance premiums paid, then none of these expenses would be included as an itemized deduction. Ten percent of the AGI would be $10,000, which is greater than the couple’s total medical and dental expenses.

For a self-employed individual, the cost of dental insurance may be deducted on Form 1040, line 29, without having to itemize deductions on Form 1040 Schedule A with the 10% of AGI limitation described above.

Other Limitations

Dental insurance premiums paid with funds from a Flexible Spending Account (FSA) or Health Savings Account (HSA) are not deductible, as these funds are pretax and the IRS does not allow a double tax benefit.

Top Treats & Foods That Damage Teeth During The Holidays

We all want healthy teeth and healthy gums. But the lure of sweet treats, delicious drinks, and decadent desserts during the holiday season can overwhelm our otherwise sensible choices. Unfortunately, holiday foods that damage teeth are all-too-common this time of year.

Time to switch things up and try a new tradition: Holiday treats that can

strengthen your teeth and your holiday smile.

Avoiding Holiday Foods That Damage Teeth

Even if you’re diligent about brushing and flossing, many foods will make caring for your teeth an uphill battle, or might even damage your teeth outright. In order to help you protect your teeth this holiday season, we’ve put together a list of the holiday treats that damage your teeth the most:

Eggnog. Eggnog is full of sugar, which is always bad for your teeth. But since this drink often has alcohol in it, it can dry out your mouth and prohibits the production of saliva. That means the sugar residue stays in your mouth for longer and does more damage.

Candy Canes. These holiday staples are also loaded with sugar, but what makes them especially bad for your teeth is that they take a long time to finish. Unlike a cookie that you may eat in a minute, candy canes bathe your mouth in sticky sugar for minutes on end.

Holiday Sugar Cookies. That said, cookies can still be an issue. Especially the kind of sugar cookie common around the holiday. C’mon… it has “sugar” in the name! Eating too many of these will only accelerate tooth decay.

Potato Latkes. The pancakes themselves are not the problem, it’s what’s on the side. A common tradition is to dip potato latkes into table sugar, which turns a traditional holiday treat into something that’s damaging your teeth. When possible, eat them with applesauce instead.

Caramel Popcorn. Sugar is once again the culprit in this holiday snack. But it doesn’t help that caramel popcorn is so addictive. It’s easy to munch on it absentmindedly for minutes on end which just exposes more sugar to your teeth for longer.

Of course, this list might be longer if you have braces, Invisalign, or other orthodontics. (Read: “Holiday Eating With Invisalign: Should Candy Canes Be On the Menu?” and “Foods to Eat and Foods to Avoid with Braces.“)

Holiday Treats For Healthy, Happy Teeth

It wouldn’t be much fun to spend the entire holiday season avoiding treats, especially when everyone around you is enjoying them so much. Luckily, you can be merry and be merciful on your teeth at the same time.


Here are some seasonal treats that you can indulge in without feeling guilty:

Peppermint Ho! Peppermint flavors are a staple of the season. Instead of eating candy canes, try peppermint tea (or make your own peppermint tea) and sweeten with low or sugar-free syrup. You can also try these homemade, sugar-free peppermint patties, of this terrific (and easy) dairy and sugar-free peppermint fudge.

Gingerbread. The bold flavor of ginger means that gingerbread tends to have less sugar than other types of cookies and cakes. So try gingerbread cookies over sugar cookies, or try baking actual gingerbread yourself- that way you can control how much sugar goes into it!

Cheese. Love cheese already? A study published in the American Academy of General Dentistry found that eating cheese raises the pH in the subjects’ mouths, lowering the risk of tooth decay. Cheese also contains calcium and protein, both found in foods that strengthen teeth. So go ahead, break out those holiday cheese balls. (We love this Christmas Tree shaped one you can make yourself.) If entertaining, it’s worth learning how to set up a simple cheese platter.

Almonds. Almonds are one of the best-kept secrets of the snack world. They are a good source of calcium and protein (which, again, helps to strengthen teeth) but are also low in sugar. While we don’t usually associate almonds with the holidays, winter has always been a season for roasted nuts. Try these spicy roasted almonds, or these rosemary roasted almonds, to get that nostalgic feel without loading your nuts with sugar. And, if you’re feeling really adventurous, you can make these no-bake almond cranberry Christmas cookies. They’re vegan, low in artificial sugars, and totally tasty.

Keep Your Teeth Happy This Holiday Season

One more thing to consider – during the hustle and bustle of the holiday season, it’s easy to let our guard down and “skip” our usual teeth cleaning habits. Bad idea: This is precisely the time of the year when those habits are most needed!

What is coinsurance? And other health insurance mysteries explained

Why is health care in the U.S. so expensive?

Health insurance. You know you need it, but navigating through the terms and coverage explanations can be ridiculously confusing. But if you don’t understand how your plan works, it could really cost you.

Current law allows younger people to stay on their parent’s plan until they turn 26. And that leaves a lot of them scratching their heads while reviewing their health care options after blowing out their 26 birthday candles.

Many Americans get health insurance through their employer. If not, they can find individual plans via government exchanges, through a broker or directly from an insurance company.

Here’s your cheat sheet to some common terms you might run into when comparing plans during open enrollment:

Claim: This is the bill your doctor submits to your health insurance provider for any care you receive. If you paid for service out-of-pocket, you can also submit your own claim to your insurer directly to try and get reimbursed.

Premium: This is the amount you pay every month to maintain your health insurance plan. Even if you never end up needing health care services, you still have to pay your monthly premium to your health insurance company to stay covered.

Deductible: Your insurance company usually doesn’t start covering your health care bills right away. You’ll probably have to pay a set amount first. That’s called your deductible. It’s how much your plan requires you to shell out for your health care before your insurance starts to cover your bills. Usually, the cheaper the plan, the higher the deductible.

High-deductible health plans: Under these plans, you’re expected to pay more of your health care bills, but your monthly payments for coverage will be cheaper. It can be a good option for a young, healthy person who doesn’t expect to go to the doctor much. These plans allow you to stash away money into a tax-advantaged account called a Health Savings Account (HSA) that can be used to cover deductibles and other medical expenses.

Copayment: A set fee you pay when visiting a doctor after you’ve met your deductible. You might have different copayments for doctor visits, hospital stays and other types of care.

Coinsurance: Some insurance plans expect you to pay a percentage of the bill even after you’ve met your deductible. For example, you could be on the hook for 20% or 30% of the bill while the insurer handles the rest.

In-network provider: A medical professional who is part of your health insurance coverage and has pre-determined agreements with your insurer on what to charge for certain services and visits. Staying in network means your insurance will cover more of the costs and your bills will be much cheaper.

Out-of-network provider: A medical provider who does not have a contract with your health insurer, and will likely be more expensive to receive care from. You can end up being responsible for most, if not all of the bill if you go to an out-of-network doctor.

Out-of-pocket maximum: While deductibles and coinsurance could mean you end up paying a lot of money for health care, the good news is there is a limit to what you’ll be responsible for paying. If you end up with a lot of medical bills one year and reach your plan’s cap, the insurance company will cover 100% of your medical services for the rest of the year.

Explanation of Benefits: While it may look like a bill, it isn’t. An EOB is just an overview of what (and how much) your doctor billed to your insurance company and what the insurer has agreed to cover. It can also include an estimate of how much you might be expected to pay, but the medical provider will send a bill separately.


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