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Old 09-21-2016, 08:34 AM
 
Location: Foot of the Rockies
86,886 posts, read 102,281,764 times
Reputation: 32946

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Quote:
Originally Posted by BarryK123 View Post
I worked in healthcare for 30+ years. I'd estimate "waste, fraud and abuse" at 50% of what's billed, especially for diagnostic testing. Of course, a significant part of that is practicing "defensive medicine," as a pre-emptive defense against a lawsuit for a poor outcome.
I'd sure not say 50%. DIdn't you work as a dentist, in private practice? When did you see all this stuff? Where do you get your number? Defensive medicine may be waste, but fraud and abuse? I worked in health care for 40+ years.

 
Old 09-21-2016, 02:08 PM
 
1,561 posts, read 2,817,479 times
Reputation: 1994
No, I worked as a physician in private practice for 30 years.

I've seen it in personal, family, and other claims submitted, as well as banter with colleagues about their billing practices.
Upcoding, unnecessary diagnostic tests, etc.

Example - While she was in college, my daughter went to the ER of a well-respected teaching hospital in NYC for an injury. The bill was simply outrageous and full of fraudulent charges (all of which went towards deductible). I contacted their billing dept. and got nowhere. I contacted the NY Atty Genl's office (now the current governor), and got nowhere. Several months later, the feds fined this hospital millions for Medicare and Medicaid fraud. Following that, I again contacted the billing office and asked them if they'd like me to bring some additional items to CMS's attention. They wrote off the entire bill at that point.

Have you wondered why hospitals are buying up physicians' practices? It's because they can bill a facility fee for diagnostic testing that previously was not paid. For example, go to your ophthalmologist and have a visual field test. Insurance pays about $80 for it. Now go for the same test to an ophthalmologist who sold his practice to UC Health. The same $80 is paid for administering and interpreting the test AND an additional $600+ is paid as a facility fee for the test. A physician cannot bill facility fees. A hospital-owned practice can. This opened up a whole new stream of revenue for hospitals and physicians. I don't understand why Medicare and the private insurers haven't addressed this. It would save them a ton of money.
 
Old 09-21-2016, 02:52 PM
 
Location: Foot of the Rockies
86,886 posts, read 102,281,764 times
Reputation: 32946
^^OK, my mistake about your occupation. My apologies.

I've heard about these "facility fees". I heard that Children's Hospital Colorado (formerly Denver Children's Hospital) charges one for its ER/Urgent Care center in Broomfield.

Nevertheless, is there any assurance that this single pay system will do anything about that?
 
Old 09-21-2016, 03:11 PM
 
Location: Arvada, CO
13,227 posts, read 24,316,643 times
Reputation: 12943
Quote:
Originally Posted by Katarina Witt View Post
^^OK, my mistake about your occupation. My apologies.

I've heard about these "facility fees". I heard that Children's Hospital Colorado (formerly Denver Children's Hospital) charges one for its ER/Urgent Care center in Broomfield.

Nevertheless, is there any assurance that this single pay system will do anything about that?
I'm voting no on this thing as I am now an employer who has to pay payroll taxes.

Health insurance companies, providers, and hospitals are bankrupting people when they get injured or sick. That needs to change. If a state (or even county) wants to do single-payer, I'm all for it, as long as they aren't sticking employers or taxpayers with the bill.
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Old 09-21-2016, 03:53 PM
 
1,561 posts, read 2,817,479 times
Reputation: 1994
Quote:
Originally Posted by Katarina Witt View Post
^^OK, my mistake about your occupation. My apologies.

I've heard about these "facility fees". I heard that Children's Hospital Colorado (formerly Denver Children's Hospital) charges one for its ER/Urgent Care center in Broomfield.

Nevertheless, is there any assurance that this single pay system will do anything about that?
No biggie. Apology accepted

Is there an assurance? No. Like any business/lobby, it will depend on pressures from both sides and how much is contributed by each.
 
Old 09-21-2016, 03:58 PM
SQL
 
Location: The State of Delusion - Colorado
1,337 posts, read 842,335 times
Reputation: 1492
I have not heard a single good thing about this. There's even talks that my job, and the jobs of my teammates, may be at risk due to this legislation because it would essentially override our program.

The only person who I know who supports this legislation is my extremely liberal friend. But he's a far left fringe voter who thinks that life should be handed to him on a silver platter even though he's thrown away many great opportunities, so I don't really put much credibility in his stances. I feel like he views this an another handout for him, and less pressure on him to actually have to do something for himself.

That said, I'm in support of a single-payer system throughout the entire US. I just don't think this is the way to go.
 
Old 09-21-2016, 04:34 PM
 
Location: Denver, CO
2,252 posts, read 4,505,239 times
Reputation: 2458
This thing sounds like a giant "Move to Colorado" ad for people with no money and no job. That should really help our economy.
 
Old 09-22-2016, 02:26 PM
 
147 posts, read 187,643 times
Reputation: 291
Quote:
Originally Posted by David Aguilar View Post
.... If a state (or even county) wants to do single-payer, I'm all for it, as long as they aren't sticking employers or taxpayers with the bill.
Well then who is going to pay for it? Oh, wait. Is that what they call "facetious"?
 
Old 09-22-2016, 02:32 PM
 
Location: Foot of the Rockies
86,886 posts, read 102,281,764 times
Reputation: 32946
A lot of us in the NW corridor of the RTD feel that we got burned on FasTracks. Many have expressed that they're concerned the same thing could happen with Colorado Cares. Not that they'd single us out, mind you, but that they'd run out of money and then be up the creek. They'd have to come up with some way to get more money, as with these crazy HOV pay lanes on US 36, cut services, or raise taxes. RTD decided the last option was not politically viable. I fear the same would happen with Colorado Cares.
 
Old 09-22-2016, 03:02 PM
 
Location: Arvada, CO
13,227 posts, read 24,316,643 times
Reputation: 12943
Quote:
Originally Posted by freewest View Post
Well then who is going to pay for it? Oh, wait. Is that what they call "facetious"?
They could do a real estate tax, consumption tax, or otherwise regressive tax for all I care. I wouldn't want it to come from state income, federal income, or employer taxes. I don't know how Irene Aguilar thinks it's fair to balance this on the backs of employers, as if they have something to do with every CO resident's health care.
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