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Old 08-23-2013, 06:39 AM
 
Location: Earth Wanderer, longing for the stars.
12,411 posts, read 15,949,448 times
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Quote:
Originally Posted by luzianne View Post
That doctor is not the first. I know of a couple in my area who have been doing that for several years (not taking insurance).

But the fee thing is definitely true. My husband cut his finger pretty deeply didn't go to the doctor the first day, but the second day went into the emergency room because he wasn't sure if it might get infected. They put him in an exam room but hadn't taken his insurance information yet. He waited there forever and then the doctor came in, looked at it, said he wouldn't put in stitches (since it was a day old) and that they would get it cleaned up and put a bandage on it. My husband waited a while longer and no one came in, so he left - yes, he absconded from the emergency room! He said he was tired of waiting and he could clean it up himself.

So we get a bill from the ER showing that he was uninsured/self pay. I called them and said hey wait a minute, he does have insurance, they just hadn't taken it yet when he left. So they took the insurance information and sent it through insurance. Insurance didn't pay the claim for some reason so the ER sent us the bill again. THE AMOUNT WAS MUCH MORE THAN IT WAS ON THE ORIGINAL "SELF PAY" BILL. I paid it, but we would have been so much better off if I had just paid the original bill and NOT had them send it through insurance. I thought about calling to protest, but figured it wasn't going to do any good. I had already told them we had insurance.
What a mess.

I believe what you say, but I also have heard that people paying on their own get charged more because the insurance companies strike a deal regarding price.
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Old 08-23-2013, 07:07 AM
 
2,777 posts, read 2,913,662 times
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This is how it used to be. Before third party payers (be it insurance of government-both are to blame for high costs) when people had to pay for care themselves doctors and hospitals had to keep their costs down to compete and you could shop around.
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Old 08-23-2013, 07:35 AM
 
8,313 posts, read 8,593,884 times
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Quote:
This is how it used to be. Before third party payers (be it insurance of government-both are to blame for high costs) when people had to pay for care themselves doctors and hospitals had to keep their costs down to compete and you could shop around.
I've said this before and I will say it again. What this doctor did may be laudable, but to pretend that the health care system would work just "dandy" without insurance and third party payers is ignorance of the most delusional sort.

The average Joe could probably afford to pay family doctors for a visit. That much is probably true.

However, I don't care how low the "cash price" is for treatment, the average Joe would not be able to deal with the many emergencies that strike out of the blue.

1. What happens when your struck by an uninsured driver in a pedestrian lane and you require weeks of hospitalization for your broken legs and damaged torso?

2. What happens when out of the blue you are diagnosed with a cancer that requires extensive surgery and chemotherapy?

3. What happens when your spouse suddenly has a heart attack and the doctors are telling you that he will require bypass surgery and expensive medications to treat him?

I could go on and on. The problem is that health insurance didn't come into existence for no reason at all. It came into existence precisely because the nature of medical care is that much of it is unexpected until a crisis strikes. As bad as it is, the current system of private health insurance was an improvement over what came before it. It is more than a coincidence that the quality of health care has improved dramatically since than too. Once a guaranteed level of reimbursement for these services were present, services could be expanded and improved and more people were interested in making a career in this field.

What is needed is improvement of the system, not some sort of crackpot idea that we could all go back to digging silver dollars out of our wallet to pay the doctor when we get sick.
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Old 08-23-2013, 09:32 AM
 
12,610 posts, read 14,626,937 times
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Quote:
Originally Posted by goldengrain View Post
What a mess.

I believe what you say, but I also have heard that people paying on their own get charged more because the insurance companies strike a deal regarding price.
I think it is true that insurance companies strike a deal with providers, but I think the price is hiked up to begin with and then they "negotiate." But in this case the bill they sent us when they thought we were uninsured was considerably less than they were billing insurance and that we ultimately had to pay.

I also think that Medicare fraud is rampant. In the last seven or eight months that my mom and dad were alive, I took over all their stuff when my dad wasn't able to and then wasn't there anymore. My god - the bills Medicare paid! My mom had Medicare plus supplemental insurance and my dad used VA and no supplemental insurance. But my mom was in a non-VA emergency room at a small community hospital one day for heart problems when I saw that my dad was in severe pain. We didn't know it yet, but he had metastatic prostate cancer. He refused to ever go anywhere besides the VA because he was worried it was going to cost a lot, but that day I convinced him to let them check him in since we were there already and help him with his pain.

Well, they checked him in and put him in a bed and right after that the ER doctor decided that my mom needed to be transferred to a trauma center with a heart center an hour away and they were going to send her by ambulance. I told them we would just take my dad there and asked if there would be a charge for the ER since they checked him in but didn't see him and they said no, absolutely not, they would just cancel his check-in and that would be it. We drove to meet my mom in the ER at the trauma center hospital and had my dad seen in the ER there.

Several months later, after my dad had died, I got a notification from Medicare that they had paid for my dad's ER visit at the community hospital. They had already paid his ER visit for the trauma center that day and this one from the community hospital was paid some time later. I don't know if they didn't send it in right away, or what. But anyway, Medicare paid for two ER visits the same day, and he wasn't even seen at one of the places and I was told would not be billed for that. I would have reported it but at the time I was dealing with my dad's death and suddenly my mom and all my mom and dad's stuff was my responsibility, plus I was trying to work, and I just didn't pursue it.

That same community hospital was where my mom always went when she had exacerbations of her COPD, which was often. Normally they didn't send her to another hospital but kept her there, and I swear they would admit her and keep her the maximum number of days that Medicare would pay, and then they would send her home. The bigger hospital would keep her four or five days and stabilize her and get her out of there to make room for more patients. The community hospital seemed to try to maximize what they could get Medicare to pay and she'd be in the hospital for two or three weeks at a time.

I'm just afraid Obamacare is going to be like Medicare and VA.

Last edited by luzianne; 08-23-2013 at 09:51 AM..
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Old 08-23-2013, 06:36 PM
 
2,777 posts, read 2,913,662 times
Reputation: 2312
Quote:
Originally Posted by markg91359 View Post
I've said this before and I will say it again. What this doctor did may be laudable, but to pretend that the health care system would work just "dandy" without insurance and third party payers is ignorance of the most delusional sort.

The average Joe could probably afford to pay family doctors for a visit. That much is probably true.

However, I don't care how low the "cash price" is for treatment, the average Joe would not be able to deal with the many emergencies that strike out of the blue.

1. What happens when your struck by an uninsured driver in a pedestrian lane and you require weeks of hospitalization for your broken legs and damaged torso?

2. What happens when out of the blue you are diagnosed with a cancer that requires extensive surgery and chemotherapy?

3. What happens when your spouse suddenly has a heart attack and the doctors are telling you that he will require bypass surgery and expensive medications to treat him?

I could go on and on. The problem is that health insurance didn't come into existence for no reason at all. It came into existence precisely because the nature of medical care is that much of it is unexpected until a crisis strikes. As bad as it is, the current system of private health insurance was an improvement over what came before it. It is more than a coincidence that the quality of health care has improved dramatically since than too. Once a guaranteed level of reimbursement for these services were present, services could be expanded and improved and more people were interested in making a career in this field.

What is needed is improvement of the system, not some sort of crackpot idea that we could all go back to digging silver dollars out of our wallet to pay the doctor when we get sick.
No one died for lack of payment prior to Blue Cross.
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Old 08-23-2013, 09:37 PM
 
Location: Foot of the Rockies
85,014 posts, read 98,876,691 times
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Quote:
Originally Posted by mysticaltyger View Post
That's why all health insurance should have deductibles of at least $2500. The more insurance covers, the more unaffordable it gets, and the less people care about the cost of their health care.
The consumer is not the driver of high health care costs.

Quote:
Originally Posted by Kreutz View Post
No one died for lack of payment prior to Blue Cross.
Surely you jest! You believe all this sap about these kindly doctors accepting chickens, or IOUs, or just writing off care?
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Old 08-23-2013, 09:41 PM
 
Location: Texas
42,262 posts, read 49,821,133 times
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Quote:
Originally Posted by jm31828 View Post
Awesome! That is the key- insurance is expensive, and that is mostly because doctors and hospitals seem to think they can charge astronomical prices for even basic services. There is no way it should cost $125 or $150 to see a doctor for 5 minutes to have them look into your throat and verify you have strep, but that's what most doctors are charging these days.
That is what shows up on the bill.
What they walk home with is closer to 28 bucks.
Somewhere in the middle, someone is scamming off the top.
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Old 08-24-2013, 09:08 AM
 
Location: Upstate NY
30,488 posts, read 9,116,959 times
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That's the way it used to be. DH and I are fully prepared to go the concierge route if we ever need to.
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Old 08-24-2013, 08:58 PM
 
Location: Mid-Atlantic
22,740 posts, read 21,795,564 times
Reputation: 27811
Quote:
Originally Posted by Katiana View Post
The consumer is not the driver of high health care costs.



Surely you jest! You believe all this sap about these kindly doctors accepting chickens, or IOUs, or just writing off care?
Some of them did. My mother worked for a doctor like that.
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Old 08-24-2013, 09:10 PM
 
8,313 posts, read 8,593,884 times
Reputation: 25959
Quote:
Some of them did. My mother worked for a doctor like that.
Undoubtedly, some of them did do exactly that. However, to imagine that everyone just got care even when they couldn't pay for it in "the good old days" is to imagine a world that never existed. The state legislature barred malpractice suits against such hospitals because they knew it was extremely common in such a setting.

Some localities provided a "county hospital" where the poor could go. Many of these hospitals were renowned for poor quality of care and high death rates. People who could, avoided them and had doctors visit them at home.

Medical care in those days was primitive and rudimentary and there were several reasons. One was that science and technology had not yet invented treatments and cures for many diseases. Another reason though was that the money in the health care system couldn't support first class care at that time. However, its all part of a circular process. Once health insurance was widely used, physicians and hospitals could pretty much count on reimbursement for their services. This enabled them to expand what they were doing and provide better quality care. Money became available for medical research. People who would not have considered medicine as an occupation previously because of an uncertain income became interested in this field. Medicine became able to attract some of the brightest people in the country.

This idea "that we'd all be better without health insurance" is nonsense of the worst sort.
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