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Is there something being proposed that would allow using drugs and treatments not approved by the FDA? Is it being proposed that assisted living arrangements be covered? It's not covered now by Medicare or Medicaid. At least one 'cost cutting' proposal for medicare/medicaid would practically or completely eliminate coverage for in home health care. In home care is much cheaper than nursing home or hospital care and yet it is being cut. How do they think they will save money by leaving only the most expensive options on the table??
Superk, I am so sorry for what you and others are going through. I wish we were still a nation of communities who would rally around our neighbors and friends when they have such needs and help fill in some of the gaps. It's a shame that government seems to be the only answer. However, I'm not willing to sign on to a program that isn't going to address the real needs people have. I don't see these proposals as doing what we really need them to do. Perhaps they will keep working on it and get it right in the end...but it is Washington...what are the odds of that happening?
I'd like to see long term care insurance added on as a sort of rider on regular health insurance policies. Most people don't buy long term care insurance, certainly not at younger ages. There is a much higher chance that a person would suffer a disability or accident leaving them needing long term care than the chance they would die yet more folks have life insurance than disability or long term care insurance.
Oh, Ani, that is huge! Are you very careful to ask for the detailed bills, and scrutinize them? I read a couple of articles about easy it is, due to coding error (most of the time it's not purposely fraud), for you to be charged twice for a service or supply, or for a service to accidentally be "upcoded". The Coding and Billing courses I've been taking come in handy to help me understand how the errors can happen. I'm thinking there's a future in helping citizens decipher their bills and challenge ridiculous charges (?)
Hey, AB!!! Yeah, we have requested detailed statements, but so far we have not been able to wrangle any out of either the hospital or the physicians offices. In fact, even after we paid one bill in total (within 30 days of the insurance paying their part), the physician practice sent our account to a collections firm! I pulled out my cancelled check and then wrote the letter from hell (citing the law re: fair debt collection) to both the collection agency and the physician practice, and sent them both by certified mail. Got a letter back from the collection agency showing the account with a zero balance.
Got a new bill this week, with total amount for hospital stay and have requested a detailed bill . . . but I feel sure it will be the same as earlier this year - no one will send me a thing.
What is so ironic . . . my company does medical record audits and I have taken classes in medical coding, lol. I have found so many coding errors over the years . . . I know how things can get screwed up. But as a consumer, I find it nearly impossible to get things corrected. Pretty crazy, huh?
Also with government run healthcare, something called incentive disappears. Why do better if profit is no objective? (look at the Post Office, public education, government housing)
But that depends how it is run.Our NHS runs on principals that are not dissimilar to a private business. So the primary care health teams (family physicians) have to pay the secondary health care teams(hospitals) for care for their patients. The government gives each primary and secondary health team a budget, which is then divided amongst the departments.
The hospitals have to make money by doing surgery etc,otherwise they will be in the red and if that happens the govt take the amount of overspend from the next years budget.
There is also something called competiton. This means that two or more parties act independently to offer a service to a third party. To gain an advantage, the competitors in the market have an incentive (see above) offer a lower cost, and/or better service. The fact is government run healthcare (single payer, as desired) would eliminate competition, therefore raising cost, and leave no incentive to provide more or better service.
Hospitals here will compete for contracts from primary care providers and we also have something called "patient choice"-so you can choose a hospital for your care.Now all our hospitals are inspected by the helath care comission and recieve star ratings.So poor star ratings and no-one wants to give you their contract or have their care there.
Simple facts.
Ani - I'm going to try to find the link to an article I read that might be useful to you. Will do it right after dinner. That is truly CRAZY that collection would start so fast ... ridiculous. Hmph.
Quote:
Originally Posted by anifani821
Hey, AB!!! Yeah, we have requested detailed statements, but so far we have not been able to wrangle any out of either the hospital or the physicians offices. In fact, even after we paid one bill in total (within 30 days of the insurance paying their part), the physician practice sent our account to a collections firm! I pulled out my cancelled check and then wrote the letter from hell (citing the law re: fair debt collection) to both the collection agency and the physician practice, and sent them both by certified mail. Got a letter back from the collection agency showing the account with a zero balance.
Got a new bill this week, with total amount for hospital stay and have requested a detailed bill . . . but I feel sure it will be the same as earlier this year - no one will send me a thing.
What is so ironic . . . my company does medical record audits and I have taken classes in medical coding, lol. I have found so many coding errors over the years . . . I know how things can get screwed up. But as a consumer, I find it nearly impossible to get things corrected. Pretty crazy, huh?
Ani - I'm going to try to find the link to an article I read that might be useful to you. Will do it right after dinner. That is truly CRAZY that collection would start so fast ... ridiculous. Hmph.
I thought it was ridiculous, too, and was incensed about it. But having worked in the healthcare system for decades, nothing surprises me. So many bills are not paid in a timely fashion - hospitals and physician offices routinely hand their accounts over to collection agencies. They probably tagged our account early in the process b/c we have out of state insurance and they are notoriously difficult to work with. However, it was over 30 days b/n when my check was cashed and when the letter was written, wh/ tells me someone was not paying very close attention to the accounts they turned over.
I thought it was ridiculous, too, and was incensed about it. But having worked in the healthcare system for decades, nothing surprises me. So many bills are not paid in a timely fashion - hospitals and physician offices routinely hand their accounts over to collection agencies. They probably tagged our account early in the process b/c we have out of state insurance and they are notoriously difficult to work with. However, it was over 30 days b/n when my check was cashed and when the letter was written, wh/ tells me someone was not paying very close attention to the accounts they turned over.
ani - The problem is even if you have "good health insurance" you can still end up getting soaked for a goodly amount of money. Remember my "balanced billing thread" from earlier this year? Well, since the amount was only $360, I decided to pay it back...albeit at my rate. I sent them (Carolinas Emergency Group) $40 in May and $80 in June so I figured I'd owe them $240 right? They sent me a statement only crediting me $10 for the $80 payment. I called them up and pointed out the error. The girl I talked to, said to send them a copy of the check and it would be corrected, which I did. Well, next month, I got the bill and it was for $310. Their chances of getting any more money out of me if it is not "corrected" in the next month's bill are slim to none. If they turn it over to a collection agency for non-payment, I won't care. If they can't count... I won't pay!!! If they p*ss me off they might be getting a "package" from the newly-created "Monroe Maniac"!
Hey Ani - here's the link - Rx for saving: A second opinion on medical bills - The Red Tape Chronicles - MSNBC.com (http://redtape.msnbc.com/2009/08/scott-fedyshyn-and-his-wife-recently-brought-home-a-bouncing-baby-boy----and-an-unexpected-600-medical-bill-but-fedyshyn-a.html - broken link) - it's from The Red Tape Chronicles. You probably know all this but it might give you some ideas for another approach to getting those detail billings you really should peruse. And maybe it will help someone else.
I found it very interesting to read the comments ... no matter if people agree or disagree with what the senate and house are tossing around, it seems most understand the system is broken, and as citizens of the greatest country on earth (and I do believe that!) we should have access to health care. IMO (and I'm pretty far to the left) it's a right, and single provider would be the way to go. I don't expect many to agree with me. (I'm also willing to pay much higher taxes.) (Heh, flame suit on.)
Quote:
Originally Posted by anifani821
I thought it was ridiculous, too, and was incensed about it. But having worked in the healthcare system for decades, nothing surprises me. So many bills are not paid in a timely fashion - hospitals and physician offices routinely hand their accounts over to collection agencies. They probably tagged our account early in the process b/c we have out of state insurance and they are notoriously difficult to work with. However, it was over 30 days b/n when my check was cashed and when the letter was written, wh/ tells me someone was not paying very close attention to the accounts they turned over.
Hey Ani - here's the link - Rx for saving: A second opinion on medical bills - The Red Tape Chronicles - MSNBC.com (http://redtape.msnbc.com/2009/08/scott-fedyshyn-and-his-wife-recently-brought-home-a-bouncing-baby-boy----and-an-unexpected-600-medical-bill-but-fedyshyn-a.html - broken link) - it's from The Red Tape Chronicles. You probably know all this but it might give you some ideas for another approach to getting those detail billings you really should peruse. And maybe it will help someone else.
I found it very interesting to read the comments ... no matter if people agree or disagree with what the senate and house are tossing around, it seems most understand the system is broken, and as citizens of the greatest country on earth (and I do believe that!) we should have access to health care. IMO (and I'm pretty far to the left) it's a right, and single provider would be the way to go. I don't expect many to agree with me. (I'm also willing to pay much higher taxes.) (Heh, flame suit on.)
Thank you so much! I was not aware of The Red Tape Chronicles. I watch CNBC (well listen to it halfway in the background) almost every morning, but I don't really watch MSNBC. I am sorry I missed this - and will enjoy reading this series.
Yes, I think everyone who has ever dealt with the healthcare system to any extent would agree that there are things that are simply out of order and need to be fixed, changed, transformed - something! The question is - how do we get there? I don't know that there is an easy answer to this complex question, but I also think that folks (on both sides of the issue) do not really understand how the present system works . . . so there is a lot of confusion out there. And then, with the Kennedy/Dodd bill in the Senate and HR3200 in the other chamber. . . that has added to the confusion. Essentially, the legislation amends the Public Health Services Act - so unless you have a copy of that out in front of you while reading the bills - you are gonna be totally baffled - and I have yet to hear one person (including Congressional Reps) acknowledge that they have even pulled up the health services act. Add to all this that it seems most people have no clue how the legislative process works . . .
The reason you don't hear anyone giving definitive answers is A. they are confused by the legislation themselves B. they have not read but bits and pieces of the legislation C. they don't understand the terms even if they have attempted to read the legislation D. they do not understand healthcare finance (who the heck does? LOL!) etc. etc. Both bills also amend the IRS Tax Code. I don't know that folks mean to be so cryptic about their answers when queried - I think they simply are not experts in the field and so struggle with understanding. What is scary - most of Congress doesn't understand this legislation, yet is voting on it . . . but if the truth were known, most of the legislation Congress votes on hardly anyone (other than staff) has read - or, read thoroughly.
I've had the same insurance from my employer for over 20 years and I don't understand what is going on. I had minor surgery in the late 80s and it did not cost me a single cent. I had this same surgery again in the late 90s and it cost me $1900 and was done out patient. My spouse had a gall bladder taken out a few weeks ago, very similar surgery, was done out patient as well. Wasn't in the hospital more than 5 hours tops. Our portion of the bill is close to $5000 and there are still endless letters coming in. I hate to think what this would have cost if we had to pay all of it.
In addition, I didn't pay for insurance in the 80s, I was paying some in the 90s, and now it's a good bite out of my salary for the two of us.
IMO, there is a lot of money flowing out into the current medical system and nobody seems to know where it is going. I don't have any bills and could survive a layoff except for the medical insurance. It's a nightmare if you don't have it, and you can't afford it, once you are older, if you don't have group insurance through an employer. And we are both relatively healthy. One accident or illness and a lifetime of savings is wiped out, you lose your home, and are on the street. IMO, we need some sort of alternative and I don't mind if the government handles it.
Anyone who claims to let the free market handle it simply has not faced this issue up front. This is how the free market is handling it and it needs to be changed and the only way that is going to happen is for the government to step in.
Also with government run healthcare, something called incentive disappears. Why do better if profit is no objective? (look at the Post Office, public education, government housing)
But that depends how it is run.Our NHS runs on principals that are not dissimilar to a private business. So the primary care health teams (family physicians) have to pay the secondary health care teams(hospitals) for care for their patients. The government gives each primary and secondary health team a budget, which is then divided amongst the departments.
The hospitals have to make money by doing surgery etc,otherwise they will be in the red and if that happens the govt take the amount of overspend from the next years budget.
There is also something called competiton. This means that two or more parties act independently to offer a service to a third party. To gain an advantage, the competitors in the market have an incentive (see above) offer a lower cost, and/or better service. The fact is government run healthcare (single payer, as desired) would eliminate competition, therefore raising cost, and leave no incentive to provide more or better service.
Hospitals here will compete for contracts from primary care providers and we also have something called "patient choice"-so you can choose a hospital for your care.Now all our hospitals are inspected by the helath care comission and recieve star ratings.So poor star ratings and no-one wants to give you their contract or have their care there.
Simple facts.
It helps to make the point (quoted from the article) "...All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do. ..."
It begins to explode the myth that "Cost control stifles innovation".
One of its most important points is "The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage. "
And, it goes on to point out that fragmentation is the biggest reason why we pay the most for our health care and cover and get the least.
None of the points made in the article are strange or new. Much research shows that fragmentation raises our costs, that innovation flourishes around the world, even in countries where cost controls exist.
To me, the big question is, when the heck are we going to evolve to realize access to health care isn't a commodity like buying a laptop or a car or grocery shopping? When are we going to admit that there is NOT a free and open marketplace where competition flourishes amongst healthcare insurers?
Health care need not be "for profit" to be good, to be accessible, to be innovative. It can be, if we take the long view, if we drive out the fragmentation, if we include everyone (thus spreading risk widely), a quality experience available to all citizens.
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Five Myths About Health Care Around the World
