[Kappy]

All I know is that when you or your insurance company pays for a hospital visit you are not paying for just yourself. Every single item & service used gets charged to you at a higher cost due to others that can not pay their hospital expenses. Did you ever get an itimized cost after a hospital stay? Ask for one and you will be amazed at the individual charges. About 10 years ago I did this after surgery & found I was charged $50 per suture (stitch) to sew me back up. I can't imagine what the cost is now

[daniellefort]

Originally Posted by Kappy

All I know is that when you or your insurance company pays for a hospital visit you are not paying for just yourself. Every single item & service used gets charged to you at a higher cost due to others that can not pay their hospital expenses. Did you ever get an itimized cost after a hospital stay? Ask for one and you will be amazed at the individual charges. About 10 years ago I did this after surgery & found I was charged $50 per suture (stitch) to sew me back up. I can't imagine what the cost is now

Yeah but just keep in mind that just because they charge $50 each doesn't mean they get paid $50 each. Medical billing has a very complicated payment system which many of those procedures are covered under 1 payment as a group. I worked in the medical billing office for many years and though it's not right, doctors will charge more to the insurance only to be compensated for a much lesser amount charged. Example $70 office visit you see charged, doctor only gets maybe $30, add your copay of $10 he gets $40 on a $70 charge. Now the offices i worked for would only charge the $40 (or whatever rate he would get from an insurance) to those who didn't have insurance but i'm sure many doctors don't do that and just charge the full $70. Lab testing is the worst. Blood testing for $400 my daughter recently had was only paid $50 for all of them. yup, $50 for a $400 charge and the rest was insurance write off that nobody paid. Someone with no insurance would have to pay that full $400. She was in the ER also not long ago. Insurance was charged $4950, they were paid just over $2000, i paid $100 copay. Again, that's where the $50 suture charges come into play. Need to mark up the bill to the insurance as high as they can just to break even.

[Wild Style]

Originally Posted by macguy

My wife's sister lives in Germany and the health care is marginal at best. You can wait forever for a treatment. Her nephew broke his leg badly and it didn't heal correctly. Forget followup therapy or anything. Their health care motto is, "Your better so thats good enough". The kid is half a cripple now because of the terrible care he got in Germany.

its like a lose, lose situation. Free health care but long waits or health care you have to pay for but cant afford.

[Kappy]

Originally Posted by daniellefort

Yeah but just keep in mind that just because they charge $50 each doesn't mean they get paid $50 each. Medical billing has a very complicated payment system which many of those procedures are covered under 1 payment as a group. I worked in the medical billing office for many years and though it's not right, doctors will charge more to the insurance only to be compensated for a much lesser amount charged. Example $70 office visit you see charged, doctor only gets maybe $30, add your copay of $10 he gets $40 on a $70 charge. Now the offices i worked for would only charge the $40 (or whatever rate he would get from an insurance) to those who didn't have insurance but i'm sure many doctors don't do that and just charge the full $70. Lab testing is the worst. Blood testing for $400 my daughter recently had was only paid $50 for all of them. yup, $50 for a $400 charge and the rest was insurance write off that nobody paid. Someone with no insurance would have to pay that full $400. She was in the ER also not long ago. Insurance was charged $4950, they were paid just over $2000, i paid $100 copay. Again, that's where the $50 suture charges come into play. Need to mark up the bill to the insurance as high as they can just to break even.

Get the point. You're right, the Drs. & hospitals do have a contract with the insurance companies & they don't get paid according to what they ask for, unless you don't have insurance. So how much of the medical cost problems are because of the insurance companies? They get hefty premiums , & if you are not on a group plan Let's face it, health care is all about making money & is a business like any other. It's unfortunate we don't have other options & can't shop anyplace else for less.

[macguy]

Originally Posted by Wild Style

its like a lose, lose situation. Free health care but long waits or health care you have to pay for but cant afford.

This is the honest of god truth. My wife went over there when her sister was having a baby to help out. After the baby was born they were sent home the next day from the hospital. That night the baby stopped breathing and my wife saved it's life and they got it back to the hospital. My wife said it was one of the worst experiences in her life. The baby could have died in the waiting room just trying to get them on the case.

[bale002]

Originally Posted by Wild Style

it's like a lose, lose situation. Free health care but long waits or health care you have to pay for but cant afford.

There is no free health care in Europe.

Health care in Europe is financed through the tax system: in most countries, the more you earn, the more you pay, in others there may be a flat rate, like an insurance premium, paid to the government. Either way, individuals pay premiums (taxes) to the government, and the government pays health care providers for their services, whether or not the health care providers are government employees. There are also private clinics alongside the government system and in some countries doctors can carry on a private practice, alongside their public practice, even using government-owned facilities.

This fixation on horror stories of long waits and other problems in single-payer systems is mostly propaganda for consumption among US residents to justify the country's own complicated health care payments system - witness some of the above posts, so complicated that I could not stomach to read through them.

I am sorry for any individual horror stories of long waits in single-payer systems, but, again, there are horror stories in multiple-payer systems as well, as well as success stories, even in so-called third world countries where, if you find the right doctor, the care is highly personal and can be excellent, especially on the preventive side.

In short, quality varies on a case-by-case basis whether in a single-payer system or a multiple-payer system or some other system, the question here is how the system is financed and who has access to it: this is the debate in the US right now, and most of the proposals I've seen so far seem to me to be aimed at pumping more money into the system, most of which will probably go to the insurance companies anyway.

Perhaps the best solution from the individual perspective is to throw in the towel, try to save as much as possible, and invest in health insurance company stock, assuming that their respective boards and executives don't try to rip off shareholders too.

So the lose-lose situation is not the question of quality - which runs the gamut in all systems - it's getting ripped off in the myriad folds of a multiple-payer or getting ripped-off, usually by government employees, in a single-payer system, choose your poison.

My personal choice would be a full-fledged market-based system with government-mandated transparency on pricing and billing, but what we have in this country is a complicated hodgepodge and current proposals only add to that hodgepodge, actually quite scary.

[daniellefort]

I brought my daughter to a specialist in Gainesville just for a consult. I couldn't imagine the office visit charge $750 for literally sitting there for 15 minutes just talking about the problem. Nothing else done, no RX given. Insurance only paid them $250 but if i was uninsured i probably would have been billed for that. It's crazy. Even now if you have a group plan your still paying a high premium. BCBS for me is $650 a month for family plan with a $2000 deductible but with my daughters medical problems and my open heart surgery when i was a kid, we couldn't afford or take the risk to go without it.

[Kappy]

Originally Posted by daniellefort

I brought my daughter to a specialist in Gainesville just for a consult. I couldn't imagine the office visit charge $750 for literally sitting there for 15 minutes just talking about the problem. Nothing else done, no RX given. Insurance only paid them $250 but if i was uninsured i probably would have been billed for that. It's crazy. Even now if you have a group plan your still paying a high premium. BCBS for me is $650 a month for family plan with a $2000 deductible but with my daughters medical problems and my open heart surgery when i was a kid, we couldn't afford or take the risk to go without it.

That Dr. visit was over the top. My HMO was increased by $900 this year & that is only for two people. This is a group plan through employment. I was so shocked that I called the company & asked if this was correct or a mistake. They said that we should expect a cost increase like this every year. After enough years of this, with deductions taken directly from the paycheck, we could end up owing the employer for the privilege of working

[daniellefort]

Originally Posted by Kappy

That Dr. visit was over the top. My HMO was increased by $900 this year & that is only for two people. This is a group plan through employment. I was so shocked that I called the company & asked if this was correct or a mistake. They said that we should expect a cost increase like this every year. After enough years of this, with deductions taken directly from the paycheck, we could end up owing the employer for the privilege of working

Yes it was incredible to charge that much. He was an infection specialist but again, all he did was tell me what we already knew and continue doing what we were already doing and that was it. each year our insurance has gone up $1000 a year too. they looked into changing to HMO but with all my daughters special needs, i really didn't want to have the hassle of going through approvals and all for her office visits and tests and it really wasn't much cheaper than what we already were paying anyways. I just wonder how much more can it possibly continue to go up in cost.