>>and the common practise is that insurance companies are paying double of what private patients are paying.

That isn't me you're quoting there...

>>Hmmm. I read my EOB's very carefully every time I receive medical care. And what I have seen is that the providers bill both the insurance companies and the private patients a horrendous amount of money. However, because the insurance companies have agreements with the participating providers, they (the insurance companies) pay a lot less that the billed amount and the providers write off the difference.

The networks do establish a price. What I see is that the providers need to know who your payor is at bill time- because different payors have slightly different requirements and private payers have different rules again. For outpatient care, bills usually are a variant of the official CMS-1500 form for CPT.HCPCS and E/M codes and for inpatient, consumables usually come via an electronic stock system that records every elastoplast with coders applying ICD-9 for actual care delivery. What I see is that a lot of the huge admin cost relates to efforts to leave nothing out but also not to overcharge because of the penalties.

>>My understanding is that if I did not have insurance, I would be responsible for paying the amount billed since I do not have the same agreement with the providers that the insurance company does. This is my biggest gripe about health insurance in this country.

From what I see for inpatient care, they might not even perform an elective procedure for an uninsured party without surety of payment, or unless there is a charity program against which amounts can be charged.

>>Since you seem to hate the US so much, it is very fortunate for you that you do not live here....

??!! Not sure where you got that... and how do you know I don't have a home there? ;-)