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It's not about insurance companies....it's the cost of the care itself. Obamacare didn't address the real problem correctly, it's just going to make it worse.
Recently I had to take my mom to the emergency room when she collapsed. She's 91 years old and had been fighting a cold that she had already seen her doctor about. The emergency room doctor was concerned about her having pneumonia so, they did a blood work up, a chest X-ray and a nasal swab. When everything came back normal, they released her with a prescription for an inhaler. We were there for 4 hours and the bill for the hospital and the doctor is over $5,000. That's the problem...that's ridiculous!
Since my mom is 91, she's on Medicare and how much did Medicare pay?......10%. Obamacare will be paying the same rates as Medicare pays....as bad as $5,000 is, paying only $500 is just as ridiculous. This is why more and more doctors are dropping out of Medicare.
And it creates new costs out of thin air, increasing costs for people trying to run a business, increasing costs to just living your day-to-day life and adding costs to innocuous things like selling your home or filling out your tax returns.
Your scenario shows why a universal health care plan would have been the way to go. IIRC that is what the newly elected president was shooting for but it was shot down.
This country is still one of the richest most powerful countries on the planet and we still have hundreds of thousands of people who can't afford treatment when they are ill. We can afford to bomb anyone we want, but not take care of people who are sick. It's pretty shameful.
As for the costs rising, this was going to happen regardless. People can't afford the ER visits, people can't afford insurance. Therefore people go to ER to get anything done because of the belief that the ER doctors have to take care of everyone who comes in. Then when they can't afford their thousands of dollars bills it goes into collections, now the hospital hasn't been paid a penny. Well they have to make up that money, so the prices rise. Of course once medical costs rise, insurance rises.
I don't believe that the ACA was the best move, but it was better than no move. EVERYONE that sat in the oval office said they were going to come up with something but never did squat. Hopefully people will one day see that medical care for everyone is just as important as public education, police protection & military and will quit the "socialism" nonsense the next time someone brings up the idea of universal health care.
If your mom has Medigap insurance the cost is likely ZERO. You do pay monthly premiums in Medigap plans. If she is in an Advantage plan, the cost is a couple of hundred in co-pays (she might or might not have premiums in this type plan).
If she has neither (and she should) she has to pay the Medicare co-pay (around $1150) Plus 20% of the remainder.
No way did this cost her 90% of the total bill if she is on Medicare.
If your mom has Medigap insurance the cost is likely ZERO. You do pay monthly premiums in Medigap plans. If she is in an Advantage plan, the cost is a couple of hundred in co-pays (she might or might not have premiums in this type plan).
If she has neither (and she should) she has to pay the Medicare co-pay (around $1150) Plus 20% of the remainder.
No way did this cost her 90% of the total bill if she is on Medicare.
I'm an insurance broker...I sell health insurance for a living. Of course she has supplemental coverage....her co-pay is $65. People here are missing my point...the point is $5,000 is a ridiculous amount of money to be billed for the services rendered but, to only be paid $500 is just as ridiculous. If they only get 10% which is what will happen under a single payer system (which is what will eventually happen...sooner if not later), they won't be able to stay in businesses. Right now what private insurance pays makes up for what Medicare doesn't pay. A single payer system will be paying what Medicare pays.
For all those that believe Obamacare is something that's better than nothing...you won't be saying that for long. What we had was something that needed to be fine tune not overhauled. Obamacare will not fixed the problems the system had and only make more so, if what we had was nothing, now we're going to have less than nothing.
BTW, if my mom didn't have a supplement she wouldn't have to pay 20% of the whole bill. The 20% Medicare doesn't pay only applies to the doctor's bill and not the hospital bill (and it 's only 20% of the Medicare approved amount after the deductible has been paid).
I'm an insurance broker...I sell health insurance for a living. Of course she has supplemental coverage....her co-pay is $65. People here are missing my point...the point is $5,000 is a ridiculous amount of money to be billed for the services rendered but, to only be paid $500 is just as ridiculous. If they only get 10% which is what will happen under a single payer system (which is what will eventually happen...sooner if not later), they won't be able to stay in businesses. Right now what private insurance pays makes up for what Medicare doesn't pay. A single payer system will be paying what Medicare pays.
For all those that believe Obamacare is something that's better than nothing...you won't be saying that for long. What we had was something that needed to be fine tune not overhauled. Obamacare will not fixed the problems the system had and only make more so, if what we had was nothing, now we're going to have less than nothing.
BTW, if my mom didn't have a supplement she wouldn't have to pay 20% of the whole bill. The 20% Medicare doesn't pay only applies to the doctor's bill and not the hospital bill (and it 's only 20% of the Medicare approved amount after the deductible has been paid).
Did it ever occur to you that the real cost was probably closer to the $500 that Medicare will pay? Why do you think these hospitals and doctors accept these kind of discounts?
The costs were going crazy anyway, long before Obama was a household word. Did your mother have a supplemental plan?
Incorrect. The Billed rate, and the prices most pay, have absolutely nothing to do with one another. The hospitals are paid by insurance companies, and the government, a UCR rate, which the government controls.
Its those who pay cash dealing with sticker shock at getting a $5K bill, but if these people just call, their bills can often be adjusted downward as well.
Think of it as buying a new car, do you ever pay sticker price?
The bills are so high because the insurance companies often times need to sell their debts as uncollectible.
Did it ever occur to you that the real cost was probably closer to the $500 that Medicare will pay? Why do you think these hospitals and doctors accept these kind of discounts?
The price is probably closer to $1,000 and the $500 "loss" needs to be made up by billing others, which is why the bill was $5K to begin with.
Did it ever occur to you that the real cost was probably closer to the $500 that Medicare will pay? Why do you think these hospitals and doctors accept these kind of discounts?
We accept medicare (for which we currently break even), as we generate enough revenue from private insurance patients to be profitable.
If I was reimbursed at medicare rates for every patient, our practice would go belly up in a few weeks. One tends to forget little issues of overhead. I personally have $850K per year overhead.
Every year we face the "proposed" 30% cuts in medicare reimbursement. If that ever happens, I, as well as all the other 150 docs in our mult-speciality clinic, will drop medicare. We can't go bankrupt for the pleasure of federal officials who dictate prices.
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