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The insurance companies and the medical providers have figured out a way for both of them to over charge us at the same time knowing we cant do a thing about it. If an insurance company will pay 5 k for treatment of a broken arm The hospital will take that 5k and then say you owe them another 5 k for the bill to be paid. The new xray technician right out of community college making 75 k wants a newer BMW...guess who is going to pay for it...
The insurance companies and the medical providers have figured out a way for both of them to over charge us at the same time knowing we cant do a thing about it. If an insurance company will pay 5 k for treatment of a broken arm The hospital will take that 5k and then say you owe them another 5 k for the bill to be paid. The new xray technician right out of community college making 75 k wants a newer BMW...guess who is going to pay for it...
If you use an in-network provider, they can't charge you above the agreed upon price. If you have a provider that is asking for an extra $5000, report them to the insurance company. Now, that is assuming you are not paying your co-insurance portion of the bill. If you look at your explanation of benefits from your insurance company it will tell you how much you should pay. If the provider is asking above and beyond that, and they are in-network, they are in breach of contract.
Also, if you are on an employer sponsored plan, the coverage is set by your company, not the insurance company. They are almost always self-insured as well--meaning, the premiums collected go to pay claims. If your company as a whole goes above that amount, your rates are going to go up. If they stay within that amount, your rates should stay fairly stable so using your plan wisely will save you money. The insurance company simply handles the paperwork in these cases and a small fee is charged to the company to service the plans. You get the benefit of being in a big network of providers by doing that.
The ONLY entity that needs insurance are the providers.
The doctors and hospitals need to know that their bills will be paid.
But we don't need BC/BS and the others to do that.
Until we eliminate BC/BS and the others we'll continue to be at their mercy.
They and their lobbyists like it this way.
Interesting. In our state BC/BS has the highest premiums...but then again, all health insurance companies here have to be not for profit.
Just curious Golfgal. What state are you in that requires all insurance companies to be not for profit, if you don't mind me asking. I didn't know there were any states like that.
just curious golfgal. What state are you in that requires all insurance companies to be not for profit, if you don't mind me asking. I didn't know there were any states like that.
Just curious Golfgal. What state are you in that requires all insurance companies to be not for profit, if you don't mind me asking. I didn't know there were any states like that.
Being non-profit is a joke!
To become non-profit you pay your administrators a obscene amount of money plus bonus, you purchase other hospitals and/or do building expansions to sop up that extra cash. Folks that don't have insurance you charge them the Charge Master price, then either write that inflated amount off or sell the account for pennies to a collection agency them write off the difference. All charity work is done at Charge Master prices then buy big ads telling who generous they are, all tax deductable of course!
I'm sure there are additional methods to make the profit go away but these are ones that come to mind.
Being non-profit is a joke!
To become non-profit you pay your administrators a obscene amount of money plus bonus, you purchase other hospitals and/or do building expansions to sop up that extra cash. Folks that don't have insurance you charge them the Charge Master price, then either write that inflated amount off or sell the account for pennies to a collection agency them write off the difference. All charity work is done at Charge Master prices then buy big ads telling who generous they are, all tax deductable of course!
I'm sure there are additional methods to make the profit go away but these are ones that come to mind.
Yes, they pay their employees well but they also have to return profits to shareholders/policy holders and that is in the form of reduced premiums...given that MN enjoys the lowest insurance premiums nationally, and a lot of the the health care reform was based on the MN system (along with MA--also not for profit state)..it seems to be working better than other systems....
We have recently added a vast array of new things into Healthcare: Insurance, MRIs, Cat-scans, blood-gas testing, ...
Quote:
Originally Posted by Submariner
I think that every year new procedures are being added into the mix.
We have never seen this level of healthcare, nor this level of expense.
And the most expensive thing that no one ever mentions: the MBA!
Do you have any idea of how many business grads are involved in healthcare? Do you know what the ratio of business administrators to healthcare workers is? Or how it has increased 4000% in just 35 years? Do you know how much money those people are paid? It ain't peanuts.
Walk through a hospital (oh yeah that too...they all look like modern airport terminals [at humongous cost by the way]) and just see how many suits and pantsuits are parading around. Look at how many offices for administrative personnel are present. I remember when the administrative arm of a large community hospital consisted of a single hallway with 6 or 7 doors; and maybe 3 or four additional offices for the laboratory, radiology, and the employment and billing offices. Fast forward to what you'll see today. And by the way, that goes for clinics too.
I also remember when an Infection Control Committee had about 10 or so members (an infection control nurse, an infectious disease specialist, a couple other internists and surgeons, an OR nurse and a pathologist and microbiologist from the lab; a pharmacist and an administrator. In 2007 our infection control committee had (get this) 42 members! I counted 23 administrators. Same infection rates.
Wonder why healthcare has become so expensive? Ever hear the joke about how many ____ it takes to change a lightbulb?
Last edited by TwinbrookNine; 10-26-2013 at 07:48 PM..
And the most expensive thing that no one ever mentions: the MBA!
Do you have any idea of how many business grads are involved in healthcare? Do you know what the ratio of business administrators to healthcare workers is? Or how it has increased 4000% in just 35 years? Do you know how much money those people are paid? It ain't peanuts.
Walk through a hospital (oh yeah that too...they all look like modern airport terminals [at humongous cost by the way]) and just see how many suits and pantsuits are parading around. Look at how many offices for administrative personnel are present. I remember when the administrative arm of a large community hospital consisted of a single hallway with 6 or 7 doors; and maybe 3 or four additional offices for the laboratory, radiology, and the employment and billing offices. Fast forward to what you'll see today. And by the way, that goes for clinics too.
I also remember when an Infection Control Committee had about 10 or so members (an infection control nurse, an infectious disease specialist, a couple other internists and surgeons, an OR nurse and a pathologist and microbiologist from the lab; a pharmacist and an administrator. In 2007 our infection control committee had (get this) 42 members! I counted 23 administrators. Same infection rates.
Wonder why healthcare has become so expensive? Ever hear the joke about how many ____ it takes to change a lightbulb?
Can't disagree with that. Also, how about the marble and granite floors and walls in the new hospitals, with the sculptures and fountains and many boutique shops. Some are operated like a 4 star restaurant with 4 page menus, as opposed to a hospital.
Kind of reminds me of what has happened to the White House staff over the years.
Can't disagree with that. Also, how about the marble and granite floors and walls in the new hospitals, with the sculptures and fountains and many boutique shops. Some are operated like a 4 star restaurant with 4 page menus, as opposed to a hospital.
Kind of reminds me of what has happened to the White House staff over the years.
Most hospitals are build with the funds of donations, at least around here. The boutique shops are run by the auxiliary/volunteer groups and are an income source for the hospital. Having spent a lot of time in hospitals in the last couple years, I appreciate when the food is good....
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