Hospital gouging

[Becky2517]

No, the way the medicare system is ran, it would never work...the VA is the same It's just an unrealistic dream I have, that everyone should have the same and equal care

[dijkstra]

Originally Posted by DvlsAdvc8

The total immigrant (legal and illegal) population in Madison Co. is about 18,400 according to MigrationPolicy.org
U.S. Immigrant Population by State and County | migrationpolicy.org
Source: Migration Policy Institute tabulation of data from the U.S. Census Bureau's pooled 2009-2013 American Community Surveys.

That's about 5% of Madison county's ~350,000 total population, and that's ALL immigrants. Of those, about 5,000 are from south of the border (south and central America), or about 1.4% of the total population. I couldn't find a number for Madison county's *illegal* immigrants alone specifically, but the Pew Hispanic Center puts the number under 1.4% of Alabama's population.

So, I think it's safe to say we're looking at somewhere close to 1.4%.

I'm sorry, but I have a hard time believing that this small of a population bears the bulk of the responsibility for Huntsville Hospital et al charging over $10,000 for a scan, blood test and IV bag. It looks more like prejudice-based scapegoat.

Have you been to the emergency room lately? LOL

The illegal immigrants along with the dead beat societal sponges use the emergency room as their doctor for common things that should be handled by a local physician and then there are those trying to get pain meds for their habit. They do so because the emergency room can't turn them away. I don't have any stats but I would be surprised if the emergency room actually gets paid for 30% of their services.

You have to remember that most of us that keep insurance and actually pay our bills, go to a doctor when we have a cold. If we do go to the emergency room, which is rare; it is an actual emergency and they get paid.

[harry chickpea]

The bottom line is -
Somebody mandates you provide a service.
The people who get the service *********.
You do NOT have the moral right to screw others who use your service.
You DO have the right to stop service, either as an entity, or as an individual by quitting and walking away.

PERIOD!

The solution involves hospitals and the boards being willing to go out of business - en masse - to force the idiocy to end. If a million people die or have to seek care elsewhere as a result, multiple millions will survive BECAUSE the bluff has been called.

[Nlambert]

Originally Posted by dijkstra

Have you been to the emergency room lately? LOL

The illegal immigrants along with the dead beat societal sponges use the emergency room as their doctor for common things that should be handled by a local physician and then there are those trying to get pain meds for their habit. They do so because the emergency room can't turn them away. I don't have any stats but I would be surprised if the emergency room actually gets paid for 30% of their services.

You have to remember that most of us that keep insurance and actually pay our bills, go to a doctor when we have a cold. If we do go to the emergency room, which is rare; it is an actual emergency and they get paid.

I agree. When I broke my leg in a rafting accident (and again when I suffered a massive nosebleed due to a botched sinus surgery), I had to sit in the waiting room while I watched a bunch of people come n and out looking for their next fix.

It got so bad after my rafting accident that my wife had to go up to the nurse station and threaten to fight someone just to get me into a room because at that point I had begun to black out in the wheelchair. I watched folks come in, get called by name immediately, and get taken back. Thirty minutes later they were out.

[DvlsAdvc8]

Originally Posted by dijkstra

Have you been to the emergency room lately? LOL

Just a couple months ago actually. I don't recall there being a single hispanic in the room. If there were illegals in the room, they must have been European.

Perhaps it's true about poor people not paying, I have no numbers, but the weight placed on illegals is clearly overblown. Must be an awful lot of non-payers to justify a $10k IV. I mean, that's about half what I was charged for my last child's delivery. And to think, Medicaid covers a lot of poor people. So non-paying people in the gap mean $10k is a reasonable charge for an IV for a patient who passes out from severe dehydration?

Here's what I find hilarious. A few years ago while on vacation in France, I started seeing these big dark floaters in my vision; mostly just inconvenient, but having a family history of retinal problems I knew to take them seriously (it can be a symptom of problems that can lead to permanent blindness), so I went to the hospital. The supposed evil epitome of socialist France. I had BCBS at the time, and when I called them to ask about overseas treatment, hilariously one person told me I'd be covered anywhere, while another person told me I'd only be reimbursed for ER care and only with a detailed statement. Neither really seemed to know what they were talking about. Even more confidence inspiring (sarcasm) was arriving at the hospital: the building looked straight out of 1950. No gleaming fortress with skywalks and trams. Someone at the welcome desk takes about 5 minutes to get my info then sends me to the cashier to pay in advance. Concerned about paying through the nose for something BCBS might not cover, I asked for a detailed statement of charges for insurance. This and my not speaking French caused a lot of confusion. She didn't understand what I was asking for... which made sense once she came out and said the only charge was for 25 euros (it was like $35-40). I was like "oh... okay" and went back to the waiting room. The sign on the wall said to expect a two hour wait, but the accueil lady said it would probably be no more than an hour. The wait was 15 minutes. I was checked out by the doctor, who said I had a retinal tear and would require laser surgery. Another woman told me the emergency surgery, with two doctors working for about an hour, would cost me a whopping... 100 euros (it was like $140). Shortly thereafter, I had what was one of the scariest moments of my life, as she and another doctor proceeded to handle my eye and laser it for 45 minutes. I was told to return next week (a day after I was due to fly home, so I extended my vacation) or immediately at any hour if I had certain symptoms. All said and done after the check-up, I paid less than $200.

Retinal tear requiring laser surgery in France: $200 total and a little over an hour in the ER.
Severe dehydration requiring an IV in the US: over $10,000 (~3,000 out of pocket) and about 3 hours in the ER.

Now, I don't mean to compare these costs as apples and apples, obviously the French pay out the wazoo for their healthcare in taxes... but my goodness what a different experience to not get a follow up bill from everyone who said hello to me plus the janitor. For all the FUD spread about overseas socialized medicine, myself and everyone I know to have required ER care while abroad has had nothing but good things to say.

Maybe I'd feel it was worth it if I'd have gotten to ride the train at Huntsville Hospital.

[NoleFanHSV]

It cost you so little out of pocket because it costs everyone else in taxes. Now in France, I have no idea how their real costs are measured. Then again, I doubt anyone at HH knows what something really costs to have done. I think the consumer price ends up over inflated for various reasons.

[dijkstra]

Another reason for inflated cost in the U.S. is liability insurance and lawsuits. The hospitals and doctors here pay through the nose for insurance and there are two types of doctors.......those that have been sued and those that will be sued, usually for frivolous reasons. That is something that really needs to be addressed within our legal system.

[harry chickpea]

In Florida, my fav. doctor was one who had decided to "go bare." He had some nice signs in his office that he was a doctor to heal people and that he did not have malpractice insurance and would close up shop if forced to do so.

If a person prone to litigation goes to a doctor and there is a choice, he'll choose the doctor with the deepest pockets. In my mind, a doctor without malpractice insurance is MUCH more likely to be careful and prudent, and one that I would trust.

[JuanHunt]

A injured patient would never find a lawyer to sue a doc that had no insurance.
Only 10% of medial injuries make it to court, and of those only about 50% result in a significant award to the plaintiff. Docs mistakenly kill 90,000 people every year.
The cost of malpractice is nothing special in relation to total revenues when compared to other businesses.

[walkies]

This has been a really interesting thread to read through. I am a Physical Therapist, I have practiced for 12 years, 5.5 in the United Kingdom and the remainder here in Huntsville/Madison. There are pros and cons to both systems. As a therapist and as a consumer I have found the level of care I can provide and that which I receive to be on average better in the states than the UK. As the previous comment stated about France, the same is true in the UK that for the most part emergency care is very good. However other chronic or standard conditions it can be very poor (e.g. 18 month wait for a knee replacement even when in sig pain). I will also note that I have much greater disposable income here (taxes are outrageously high in UK to pay for things like socialized medicine) so I also have greater ability to chose to go out of network should I see the need. As a provider in the US I do have frustrations in how the insurance companies dictate care both explicitly (only covering certain treatments) and incidentally (low reimbursement rates lead to a need for high volume of patients which leads to rushed appointments, patient overlap etc.)

For those reasons I have made the decision to open my own PT clinic which is out-of-network (I haven't included a link as wasn't sure if this was against the forum rules, pm me if interested). We opened three months ago. I simply have an hourly rate which I think is reasonable for my skill level and the services I offer, clients can then file an out-of-network claim. I can provide whatever treatment I think is best for the client relative to the research evidence and my professional judgement. There is no insurance company telling me, you cannot do that/we wont pay for that. This rate is the worse case scenario for the client assuming no reimbursement (the other comment mentioned that he could not get a clear answer from HH MedMall regarding a cash pay rate). There is no need for me to negotiate a rate with an insurance company or for a client to negotiate a rate with me. It is set in stone and is simple. Quite honestly I expect more PT clinics to go this way in the long run with high deductible plans, but we will see.