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I don't have a lot of time to read tonight - but my understanding of MRI stuff is - even if it's simple technology like you say - the machines cost a lot. Perhaps because there's no financial incentive to produce a cheap MRI machine? Or the cheap manufacturers have been shut out? I don't know. That's a good question - and will tuck it away in the back of my head to look up on a boring cold day in January.
BTW - what do you do for a living? I'm a retired lawyer. Good to meet you . Robyn
my education is in electrical/computer/nuclear engineering, i practice computer security for last 16yrs.
even if the MRI machine was $2mil, if you use it routinely (which means more people) and not just a few times for rare things, the cost per service will drop substantially.
i'm no medical genius here, just looking at basic-101 things. why try to overhaul a big messy system by introducing another big messy unproven system, makes absolutely no sense. but thats what the fed likes to do and it often ends with dismal results and a bunch of wasted taxpayer dollars (just as they did with the bailout, should have let those companies fail into misery saving our taxpayer dollars). marking my calendar days so when we get to that day i get to say "told you so", which isnt too far away.
i dont think you understand how coverages work. the contracted price is a price agreed to for service between servicer and ins company. kinda whacked how that price may vary depending on who the ins co is. but anyways, the ins plan still has things like 80/20 coverages after deductible and/or co-pay, etc, thus the patient is still responsible for a piece of that contracted price.
i know some basic services under HMO are paid 100% by ins after deductible and co-pay, but those are limited # of services.
medical is so confusing, seems that some dont actually understand how this crap works, then throw in the mess of ACA = just gonna get worse before it get better.
Um, yeah, I'm 55, have had employer-provided health insurance for 34 years and I do understand how it works, thanks. I think you are the one who is a bit confused.
The insurance company has a contracted price with the provider. That does NOT mean that the provider can then merrily just charge me any old amount they want to in addition. They can only get the co-pay to which they are entitled. For the biopsy I used in my example, that was ZERO (instead of the usual $5 co-pay I'd pay if for a doctor's visit.) It said right on my explanation of benefits that I owed ZERO. The bill was either a "mistake" or a seedy attempt to gather more money hoping that I didn't have enough sense to know that they weren't entitled to any further money from me.
Now, this was an in-network provider, hence the contracted price. If I had gone out of network, it would have been 80/20. I would have gotten the bill, submitted it to the insurance company, and gotten 80 percent back and paid the provider the 20 percent out of my own pocket. You can't have BOTH, though. It's either in-network or it's not.
my education is in electrical/computer/nuclear engineering, i practice computer security for last 16yrs.
even if the MRI machine was $2mil, if you use it routinely (which means more people) and not just a few times for rare things, the cost per service will drop substantially.
i'm no medical genius here, just looking at basic-101 things. why try to overhaul a big messy system by introducing another big messy unproven system, makes absolutely no sense. but thats what the fed likes to do and it often ends with dismal results and a bunch of wasted taxpayer dollars (just as they did with the bailout, should have let those companies fail into misery saving our taxpayer dollars). marking my calendar days so when we get to that day i get to say "told you so", which isnt too far away.
Agreed about the 101 things. Hence my analogy in other messgaes - health care and airlines. It's better to fill an airline seat than to fly an empty seat. Ditto with MRIs (assuming you can get more than the cost of operating the machine/med techs). It's the same way way with tee times on golf courses too.
The "bailouts" were more complicated IMO - and I'll leave them for another day.
As someone experienced in computer security - have you read the recent stuff about security on the healthcare,gov website - and what do you think? Robyn
Agreed about the 101 things. Hence my analogy in other messgaes - health care and airlines. It's better to fill an airline seat than to fly an empty seat. Ditto with MRIs (assuming you can get more than the cost of operating the machine/med techs). It's the same way way with tee times on golf courses too.
The "bailouts" were more complicated IMO - and I'll leave them for another day.
As someone experienced in computer security - have you read the recent stuff about security on the healthcare,gov website - and what do you think? Robyn
which security topic specifically?
while sifting i came across this, so for those who say "then dont pay the fine", please speak the truth as "the fine" is not some low cost item!!
... and the statement below makes no sense. if its $95/person + $47.50/child, if i have 6 kids, how does that total $285? is there some cap? this data is crap, ACA is crap.
Quote:
The individual shared responsibility payment
If you can afford health insurance but choose not to buy it, you must pay a fee known as the individual shared responsibility payment.
The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5% of income or $695 per person, whichever is higher.
In 2014 the payment for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285.
You make the payment when you file your 2014 taxes, which are due in April 2015.
@Mightyqueen801 - i get the "no more than contracted price". but not all in-network services are covered 100%. do you get what i am saying? also, with ACA in 2014, mark my words, the costs for going out-of-network will baloon dramatically. this leaves us less options.
so does the Fed really think illegal aliens will report themselves, and if they do report is ICE called in immediately? does the below suggest that we have illegal aliens who have SS# and file taxes? or does that last bullet point mean "i am a US citizen but i live in the UK"?
Quote:
Exemptions from the payment
Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”
You may qualify for an exemption if:
You’re uninsured for less than 3 months of the year
The lowest-priced coverage available to you would cost more than 8% of your household income
You don’t have to file a tax return because your income is too low (Learn about the filing limit.)
You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
You’re a member of a recognized health care sharing ministry
You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
You’re incarcerated, and not awaiting the disposition of charges against you
about your security Q. if you are asking about if the site itself or the systems fed runs around ACA are secure. i can almost guarantee you, if the systems are ran by the fed the data in them will be exposed by hackers in no time at all. any ePHI/PII in those systems will be posted on some other publicly available website(s) by hackers.
take my advice now, you (all of you) should put a security freeze on your credit reports (Experian, Equifax, and TransUnion). it's free to do so, but there is a small fee to do temp unlocks when you need access to them. Or go buy LifeLock.
If you don't have insurance then you don't have deductibles and copays. But if you do, the insurance company pays its portion and the remainder is for you to pay. Whatever that amount that you have to pay is, it is considerably less than whatever your total medical bill is. Thats what I meant in not taking into account the insurance payment effect. Whatever is left over and not paid is much less than is possible today.
And if you have a very serious medical problem, the insurance company pays almost all of the total bill. And, as you wrote. there are consequences if you don't pay your portion.
In this regard, ACA simply isn't involved.
True, insurance does cost. And premiums will go up, ACA or not. Most people currently have other forms of insurance (employer offerings, etc) and do not need to go to the ACA exchange. At least, so far.
And, again, the ACA is not healthcare, it is an insurance exchange. Health care is not free with insurance, there are still co-pays/deductibles. Those on a limited budget who not must pay for health insurance or pay the fine, will still need to come up with cash to pay their medical expenses and most of those with lower cost plans will have a lot of out-of-pocket expense. Those hardest hit will be those whose employer is reducing their hours in order to avoid providing health insurance. I see temps being hired to keep under the 50 employee limit. What a great plan!
Quote:
Originally Posted by Mightyqueen801
But you don't pay them, I hope. That happened to me earlier this year. I had biopsies done. Got a bill from the hospital where the biopsies were done saying that it cost $9000, insurance paid $7000, and so I owed $2000 (rounding numbers here.) I thought "oh hell, NO, I know my insurance is better than that" and went onto my health insurance website to check it out. They'd paid the contracted amount, and I owed nothing. The numbers looked nothing like what was in the hospital's bill to me.
I sent them back their bill with a nice little letter saying that according to my health benefits statement, copy attached, I owed nothing and that attempting to bill a patient over the contracted amount with the health insurance could potentially be regarded as insurance fraud. Never heard from them again.
I would be cautious since they could decide to turn it over to a collection agency. I'd have probably followed up on it to make sure I was correct. They can be slow but can catch up with it later.
And, again, the ACA is not healthcare, it is an insurance exchange. Health care is not free with insurance, there are still co-pays/deductibles. Those on a limited budget who not must pay for health insurance or pay the fine, will still need to come up with cash to pay their medical expenses and most of those with lower cost plans will have a lot of out-of-pocket expense. Those hardest hit will be those whose employer is reducing their hours in order to avoid providing health insurance. I see temps being hired to keep under the 50 employee limit. What a great plan!
I would be cautious since they could decide to turn it over to a collection agency. I'd have probably followed up on it to make sure I was correct. They can be slow but can catch up with it later.
ACA is more than that, but agreed, ACA is not a health plan itself.
ACA enforces not paying fine how?
ACA handles lapse in coverage how?
ACA is not well planned, not well thought out, and tested about 0.000001%
if the below was a design guide / ops manual for an IT system, i suspect it would take years to implement and test before being deemed production ready !!
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. Robyn
