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Old 02-03-2018, 06:08 PM
 
18,744 posts, read 8,368,965 times
Reputation: 4118

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Quote:
Originally Posted by RogueMom View Post
Yeah, what in the **** was provided that costs, or is any way in the realm of reality, worth that kind of money?

Our healthcare system is a disgrace.

When I had my first child 20 something years ago, they had the "24 hours and out" policy. Meaning, if there were no complications with mother or baby, you left the hospital in 24 hours. I had an easy delivery, they kept the baby in the room with me the whole time for ME to change and feed, then released us the next day, and the bill was some hugely inflated cost even back then. Fortunately, I had a job that had halfway decent insurance coverage. Really, all the doctor did was give me some good drugs and cut the umbilical cord.

I could have stayed at the nicest, ritziest hotel in town, had room service delivered to my door, hired a nanny to take care of the baby, and just used a midwife, and some good drugs, for the three hour delivery, and come out WAY cheaper than what the insurance company was charged for the crappy hospital room.

The problem is NOT that people lack insurance. It is the obscene cost of care and profiteering that has been, and is still going on!
The medical bill is not the cost, and is not what the hospital will accept as full payment. The itemized medical bill is directly inflated to get the most from payers. And in most cases the amount accepted will be substantially less.

For instance a $12K ER bill might be paid off by Anthem for $2K. And if you don't have insurance you can take the time and effort to probe their low end and have them reduce the total charge.

lol

 
Old 02-03-2018, 06:10 PM
 
18,744 posts, read 8,368,965 times
Reputation: 4118
Quote:
Originally Posted by YourWakeUpCall View Post
Bills are inflated for reasons other than to cover unpaid bills. Malpractice insurance for example. Again, there simply isn't enough empirical data to proclaim the bill outrageous.
It may or may not be outrageous, but most likely will be settled for a lower number.

For instance my wife's total trauma and related bills for our 1/1/17 crash was over $1.2M. Her Obamacare paid about $300K in total, and the bills are settled.

I'm a doc and I think her care and all they did was worth WAY more than $300K.
 
Old 02-03-2018, 06:12 PM
 
3,614 posts, read 3,863,605 times
Reputation: 2288
Quote:
Originally Posted by Hoonose View Post
I think we let the accepting ER docs decide. If the patient came in with abdominal pain and the doc ordered a CT scan right then and there, that should be considered emergent. Here's a bentyl call your doc in the morning is probably not.

Anthem can save money by training their patients to use their urgent care more often. But it won't happen overnight, maybe a year to get the word out. The urgent care facility can always refer up to the ER if deemed necessary.
Letting the ER docs decide results in too many ER visits and too many admissions. After all, they're revenue. That said, Anthem needs to do this more precisely if they are going to do it at all. If nothing else they should be excluding the first ER visit in a year from review under this policy as a stopgap while they fix their clearly broken algorithm. Would be easy for them to implement, reduce the rate of false positives like this one, and concentrate review on the cases most likely to be problematic (frequent fliers).
 
Old 02-03-2018, 06:14 PM
 
8,480 posts, read 3,289,010 times
Reputation: 6834
Quote:
Originally Posted by YourWakeUpCall View Post
Read my earlier post. Unless you are a hospital administrator, you have no idea what sort of overhead costs (including covering for people who don't pay their bills, malpractice insurance, etc.) are rolled into the bill. As such, you've drawn a conclusion based on insufficient data.
This is a good argument for some sort of national health care or subsidized health system.

It's one thing for the prices of consumer goods to reflect overhead costs that include theft or "people who don't pay their bills," financial costs and the like. I'd even accept that it's reasonable for housing prices to reflect costs of say sewer systems or flood control measures that might not even impact a particular dwelling but be spread among an entire community.

These are items and costs that a consumer can weigh when making a purchase decision. Or when choosing where to live - in assessing insurance costs and local taxes for "communal" cost structures

Health care? Not so much, with this thread the perfect example of a consumer caught between assessing a life-and-death situation and being assessed "overhead costs" for others who don't pay their bills.

Not a surprise that almost every other nation handles this differently. And I'd say better.
 
Old 02-03-2018, 06:14 PM
 
18,744 posts, read 8,368,965 times
Reputation: 4118
Quote:
Originally Posted by ALackOfCreativity View Post
Letting the ER docs decide results in too many ER visits and too many admissions. After all, they're revenue. That said, Anthem needs to do this more precisely if they are going to do it at all. If nothing else they should be excluding the first ER visit in a year from review under this policy as a stopgap while they fix their clearly broken algorithm. Would be easy for them to implement, reduce the rate of false positives like this one, and concentrate review on the cases most likely to be problematic (frequent fliers).
Work it out between Anthem and the hospital/docs. I agree at least a year.
 
Old 02-03-2018, 06:41 PM
 
3,614 posts, read 3,863,605 times
Reputation: 2288
Quote:
Originally Posted by Hoonose View Post
Work it out between Anthem and the hospital/docs. I agree at least a year.
Ideally they would. I don't expect either the hospital or insurer wants to go after the patient for the money in the first place. The insurer wants people who shouldn't be at the ER in the first place sent out to urgent care instead or home if they don't even need that because it's much cheaper. The hospital wants to maximize revenue and minimize malpractice risk, which means treating anyone who shows up to the ER in the ER and then sending the insurer a claim.

Outside of a shared ownership or financial responsibility deal like Kaiser, the only way for the insurer to try to force the hospital to turn away cases they should be turning away is to deny the claims, which opens up the patient to being directly billed, which the hospital then does because in turn that's the only way to pressure the insurer to back down from the policy. So you get the patient stuck in the middle which neither want if they could avoid it while still getting the desired behavior out of the other side.
 
Old 02-03-2018, 07:09 PM
 
25,777 posts, read 16,394,630 times
Reputation: 15959
Quote:
Originally Posted by momonkey View Post
Agreed.

It's a fantasy in your head because it's a stupid idea that no one with common sense will agree to.

My employer provides me with fantastic insurance and I don't have to pay for it.

Why would I want ****ty insurance that I have to pay for and the waiting lists that come with a single-payer system?

Why are leftists so hell-bent on forcing the working poor to cover the expense of heath insurance for fat cat employers?


Hey man, I didn’t say free healthcare. Just cut out the investors and stock traders. Make the medical industry back into the medical arts. You and I have great coverage, but at the same time Phizer is making billions per year in clear profits that are going to investors and a lot of people are being left out.
 
Old 02-03-2018, 07:09 PM
 
Location: Ohio
24,623 posts, read 19,066,222 times
Reputation: 21733
Quote:
Originally Posted by floridarebel View Post
But universal healthcare is too expensive they said.
In total, federal spending would increase by about $2.5 trillion (257.6 percent) in 2017. Federal expenditures would increase by about $32.0 trillion (232.7 percent) between 2017 and 2026.

https://www.urban.org/sites/default/...-Care-Plan.pdf
 
Old 02-03-2018, 11:36 PM
 
31,889 posts, read 14,877,064 times
Reputation: 13548
Quote:
Originally Posted by nmnita View Post
of course not and I realize too fully what you are saying, but for us, who do pay or for our insurance companies who have to foot the bill for those who think they do not have to anti up, the costs are unfair. Why should I pay for Joe who decides not to pay to couldn't pay? Wouldn't you agree the women's bill was over the top? So tell us, what is your answer to the problem?? I have a granddaughter who is a nurse practitioner. She see patients all the time who have no intentions of paying their bill. When she was an ER nurse, several years ago, she even say more of this. We also have a few nurses and doctors in our family.
Medicare for all which most countries have. Why is it that I pay a co pay of $10 dollars for surgery when you have to pay....how much for surgery.
 
Old 02-04-2018, 01:36 AM
 
Location: Sunshine Coast, QLD
3,674 posts, read 3,021,085 times
Reputation: 5466
Quote:
Originally Posted by Northman83 View Post
I got electricity going through my heart, from my left arm and out the right arm, 3 years back.

Called my doctor, 10 min later I took an EKG at his office, 30 min later I was at the ER for a full check up and spent the night in the heart ward.

Was checked in the morning, everything was OK. Walked down the stairs and said bye to the personal at the entrance and walked out.


Never seen a bill.


Thats healthcare in Norway.


But but .......socialism is evil, bootstraps, Personal Responsibility..... Ummm I'm not paying for your poor lifestyle choices....hmmmm you may have not seen a bill, but I bet you can't own tons of guns and walk around with them!! Ummmmm 80% income tax rate..... We beat Hillary,, MAGA MAGA MAGA!!!!! How do you expect us to MAGA if healthcare is free or affordable? I mean only us MAGAers should have health-care so we can Lord it over those non privileged people. Why should those lesser people have what WE have?? Those poor people should go without since they don't deserve it! Now THAT is how you MAGA!!!
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