Question about having a baby without maternity insurance. (Atlanta: crime, homes)

[rzzz]

There is no reason the government couldn't force the health care providers to have a list of procedure costs. This is what Japan does. The costs are not "hidden" they are just made up on the spot using algorithms based on where the money is coming from.

[RainyRainyDay]

Originally Posted by FromGA

It would be truly free enterprise if the government (Medicare/Medicaid/...) and employment-based health insurance were not present. With these two involved, it is quasi free market, and all this confusion.

If citizens were responsible for purchasing in the free market, I dont see how costs will be kept hidden for long.

All goods and services are not the same, in the marketplace. If a painter won't provide an exact quote for painting your house, you'll look around for another painter. When it comes to our health, however, most people are not so elastic in our willingness to shop around. I don't see any reason to think that the existence of medicare, medicaid and employment-based health insurance has led to the present impenetrable billing system. What would motivate physicians to move to a more transparent pricing system?

Originally Posted by rzzz

There is no reason the government couldn't force the health care providers to have a list of procedure costs. This is what Japan does. The costs are not "hidden" they are just made up on the spot using algorithms based on where the money is coming from.

I think this is probably true - that the costs are made up on the spot based on where the money is coming from - the problem being that "the spot" is in the various practitioners' billing offices, after the procedure has already taken place.

[Mirabella]

Originally Posted by RainyRainyDay

I have BCBS PPO through my employer. Just received a bill in the mail for $6,312.11 for a D&C last month in the gynecologist's office. That's about a half-hour procedure, under anaesthetic. Gynecologist is in-network and I didn't realize she was using an out-of-network surgical team to assist her. I thought this fairly routine procedure would be no big deal. Apparently I unintentionally agreed to shell out the price of a second-hand car. (By the way, the results were clear. I'm fine. Just out a few thousands of dollars).

I'm from Canada, where if you go to the doctor and they say you need a procedure, you have it and you're done. I know all you conservatives out there LOVE LOVE LOVE your free-enterprise health care insurance system. Any of you care to pay my bill?

If you already paid that bill, I would check back with the doctor's office. My orthopedic surgeon is in-network for my BCBS PPO but with my most recent surgery, his PA was not when she was for the first surgery. So when the EOB came in for a few thousand for her fee, I called the surgeon's office and they said they would reduce the amount to what Blue Cross would cover so I only paid about $150 dollars or so.
There is no way to know if the staff is not categorized as in-network or not and patients aren't expected to know. You choose your physician based on network classification not the staff.

[FromGA]

Originally Posted by RainyRainyDay

All goods and services are not the same, in the marketplace. If a painter won't provide an exact quote for painting your house, you'll look around for another painter. When it comes to our health, however, most people are not so elastic in our willingness to shop around. I don't see any reason to think that the existence of medicare, medicaid and employment-based health insurance has led to the present impenetrable billing system. What would motivate physicians to move to a more transparent pricing system?

Employment-based health insurance hides the cost of healthcare to individuals. The minute you introdue High Deductibles (where individuals take some responsibility), people change their attitude and pay more attention to their health. and how often they rush to the ER. I believe the introduction of high deductibles in the workplace is beginning to work in organizations where it has been introduced.

Other reasons: (a) Defensive medicine due to lawsuits (huge cause, everyone knows this). (b) Someone has to cover the cost of treating uninsured.

[RainyRainyDay]

Originally Posted by FromGA

Employment-based health insurance hides the cost of healthcare to individuals.

I'd love to get some of that kind, because BCBS PPO is not doing a good job of hiding the cost of healthcare to me, at all. Curious to know what insurers do this.

[neil0311]

Originally Posted by FromGA

Employment-based health insurance hides the cost of healthcare to individuals. The minute you introdue High Deductibles (where individuals take some responsibility), people change their attitude and pay more attention to their health. and how often they rush to the ER. I believe the introduction of high deductibles in the workplace is beginning to work in organizations where it has been introduced.

Well, I will let you know in a year or two. My company has been self-insured for years and currently provides coverage for employees and families with zero deductible. They have BCBS provide the network and administer the payout to providers, but the money comes directly from the company and a fund they setup for the purpose.

Due to the changes mandated by Obama-care and the associated tax impacts on "Cadillac plans," starting in 2013 they are doing away with that plan and instituting a "high deductible plan." This to me is a prime example of the blatant lie that is contained in the statement "if you like your plan, you can keep it" that was throw around by our esteemed President a couple of years ago. No I can't, since my company is forcing me to change my plan to comply with your law.

Now I will be forced to have a "health savings account" and the company will fund a certain amount into my HSA each year. The plan will cover certain preventative care at 100% but all other coverage will be subject to a high deductible (not sure what it will be). The money deposited in the HSA is supposed to cover that amount, and the theory is that it will be an offset to me personally.

I don't disagree with the thought process that you care more about the cost when you pay it directly, so maybe that will finally get some sanity back into the cost structure. We'll see.

[GeorgiaLakeSearch]

Originally Posted by neil0311

Well, I will let you know in a year or two. My company has been self-insured for years and currently provides coverage for employees and families with zero deductible. They have BCBS provide the network and administer the payout to providers, but the money comes directly from the company and a fund they setup for the purpose.

Due to the changes mandated by Obama-care and the associated tax impacts on "Cadillac plans," starting in 2013 they are doing away with that plan and instituting a "high deductible plan." This to me is a prime example of the blatant lie that is contained in the statement "if you like your plan, you can keep it" that was throw around by our esteemed President a couple of years ago. No I can't, since my company is forcing me to change my plan to comply with your law.

Now I will be forced to have a "health savings account" and the company will fund a certain amount into my HSA each year. The plan will cover certain preventative care at 100% but all other coverage will be subject to a high deductible (not sure what it will be). The money deposited in the HSA is supposed to cover that amount, and the theory is that it will be an offset to me personally.

I don't disagree with the thought process that you care more about the cost when you pay it directly, so maybe that will finally get some sanity back into the cost structure. We'll see.

Preach! I personally have private because I am technically self employed I could get on one of my companies I own but I rather not. I like having the independence.

[GeorgiaLakeSearch]

Do get the maternity insurance if you want another baby. I have it even though we are not trying because you never know. And if your wife really wants a girl consider adoption so it is gauranteed! Because you might end up with four children.(I know a couple families like this because they wanted a boy or girl). I wish I had a girl(three boys one is mine two are from my wife's previous marriage) I think it would be good for our sons.

[lorilove]

Now I will be forced to have a "health savings account" and the company will fund a certain amount into my HSA each year. The plan will cover certain preventative care at 100% but all other coverage will be subject to a high deductible (not sure what it will be). The money deposited in the HSA is supposed to cover that amount, and the theory is that it will be an offset to me personally.

One nice feature of a HSA is if you don't use the money, it accumulates - you don't lose it. If you never need the money, it basically is treated like an IRA.

[neil0311]

Originally Posted by lorilove

One nice feature of a HSA is if you don't use the money, it accumulates - you don't lose it. If you never need the money, it basically is treated like an IRA.

Agreed, but how many families with children or older adults fall into that category. If you're 20 or 30-something, then it's probably more true.