Deductibles should be a rolling 12 month bill. If you have something major in December you should be good until next December. This would eliminate all of the issues with deductibles rolling over on Jan 1. It would even bring extra profit to the insurance companies because people might decide to stick with their provider another year since "I already made my deductible until November".
And just because they "billed" your insurance $85k doesn't mean they were actually paid $85. Billable vs allowable and all that mess.
However, if you went into the hospital and asked for the cash cost of a routine procedure they very likely would be able to give you a close approximation to what you would end up paying.
In their case it was a scheduled c-section. In any case they can at the least give you a range: min-max.
Additionally, hospitals keep very accurate track of their c-section rates, so even if they are not able to predict yours in particular, they can definitely tell you what your odds are ahead of time.
And, there are other countries and healthcare systems in which they internally take care of the stats/metrics so that they make a decent amount while you pay a reasonable amount that they tell you before you choose to get the procedure.
The hospital doesn't tell you the estimate of anything because they are afraid of the liability (or maybe just accountability).
It's just lazy or maybe too convenient, to say it can't be done. I mean if already health insurance companies can give you a fixed monthly amount to pay, then they know very well how much it's going to cost them, why not tell us?
That's a difference in the financing system, which hospitals have about as much say in as consumers do.
The insurance companies (including government payers like Medicaid and Medicare) don't just control reimbursement, they control what providers can bill to customers, too. And that includes (by usual and customary charge rules) influencing what they can and need to charge to customers that aren't even being reimbursed by the payer in question.
I did this and it was pretty close.
Of course, they don't make any guarantees that's it accurate. But hell, it's a start.
If they couldn't provide an estimate because unexpected things happen and they can't predict all services that will be required, that'd be one thing. But they can't even provide a list like, "if you need an aspirin, that costs $X. And if you need..."
