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Originally Posted by ambient View Post
Please list the nations of the world who have quality, cost-effective healthcare with full population coverage in a purely private market setting.
Quote:
Originally Posted by Hollytree
Australia
Austria
Belgium
Canada
Czech Republic
Denmark
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Japan
Korea, South
Luxembourg
Mexico
Netherlands
New Zealand
Norway
Poland
Portugal
Slovakia
Spain
Sweden
Switzerland
Turkey
United Kingdom
United States (Do you think the Trump family and their ilk don't have good quality private medical care?)
I don't think you read the question: "...full population coverage in a purely private market setting."
Australia
Austria
Belgium
Canada
Czech Republic
Denmark
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Japan
Korea, South
Luxembourg
Mexico
Netherlands
New Zealand
Norway
Poland
Portugal
Slovakia
Spain
Sweden
Switzerland
Turkey
United Kingdom
United States (Do you think the Trump family and their ilk don't have good quality private medical care?)
The fact that a surgery is out-patient has no relevancy to whether it was reasonably possible for the patient to have shopped around for the best bang for the buck in doctors, staff, or clinic--which was the point being made.
Back in 2001, my mother had an automobile accident--the car rolled three times. She was received by the hospital with "no apparent injuries," but kept overnight. She was unresponsive the next morning, but an MRI showed massive hemorrhaging in her brain (ultimately, she never regained consciousness, but was in a coma for eight years before she finally died).
They did brain surgery that day after the accident, and because they had to leave a section of skull out, they fitted her with a leather helmet that looked exactly like the old-school football leather helmets. I noted at the time that the helmet was stamped on the inside, "Made in South Korea."
I saw what they were charging for that helmet on an interim bill. They charged $2,000 for that helmet. Two thousand dollars.
Now, I've been to South Korea. I've bought leather goods in South Korea. I know that helmet could not have cost the hospital more than $200, including shipping.
Since we were in Oklahoma City, I took pictures of the helmet to a local saddle and bridle shop and asked them how much they'd charge to custom make a helmet like that. They quoted $500...custom made.
Now, for most people, $2,000 is significant coin.
The last time I had insurance work done on my car, I was able to direct the sourcing of the parts. But at what point would I have been able to direct the sourcing of that helmet?
Please go look back. The 'charge' was $2000. But who paid, and what amount was actually paid?
Please go look back. The 'charge' was $2000. But who paid, and what amount was actually paid?
So now you're talking about some kind of negotiation after the fact, when an individual will be behind the legal 80-ball, having already taken delivery of goods and services that cannot be returned.
Having already taken a non-returnable delivery for which the patient is legally bound to pay, the patient is in the position of trying to negotiate with Don Corleone.
If he has insurance, the insurance company is a behemoth in the system that has already "negotiated" its power to pay what it deems reasonable.
If he does not have insurance, he can carry his hat in his hands to the hospital business office and attempt to negotiate a lower price, possibly at the cost of his credit standing.
But the fact is that he had no way to negotiate or comparison shop before incurring that legal liability.
So now you're talking about some kind of negotiation after the fact, when an individual will be behind the legal 80-ball, having already taken delivery of goods and services that cannot be returned.
Having already taken a non-returnable delivery for which the patient is legally bound to pay, the patient is in the position of trying to negotiate with Don Corleone.
If he has insurance, the insurance company is a behemoth in the system that has already "negotiated" its power to pay what it deems reasonable.
If he does not have insurance, he can carry his hat in his hands to the hospital business office and attempt to negotiate a lower price, possibly at the cost of his credit standing.
But the fact is that he had no way to negotiate or comparison shop before incurring that legal liability.
I've successfully negotiated medical bills before. I say this fully realizing it is not something the majority would be comfortable doing.
25 years ago I had a bill for $10,000. I didn't have squat at the time. I got like $1100 back from income taxes. (4 kids)
I went to a lawyer and for $100 he sent them a letter basically saying I had $1000. They could accept that or a bankruptcy notice. They took the $1000.
I negotiated bills after that also. Nowhere near that amount though.
So now you're talking about some kind of negotiation after the fact, when an individual will be behind the legal 80-ball, having already taken delivery of goods and services that cannot be returned.
Having already taken a non-returnable delivery for which the patient is legally bound to pay, the patient is in the position of trying to negotiate with Don Corleone.
If he has insurance, the insurance company is a behemoth in the system that has already "negotiated" its power to pay what it deems reasonable.
If he does not have insurance, he can carry his hat in his hands to the hospital business office and attempt to negotiate a lower price, possibly at the cost of his credit standing.
But the fact is that he had no way to negotiate or comparison shop before incurring that legal liability.
In many non-emergent cases you can. Locally we can get about 1/3 off at our hospital if paid in cash. Whether that means a fair price or simply 1/3 off their already inflated price needs to be considered.
Can we drop the "ER" hand-wave? The ER is obliged to stabilize you, not treat you. If you need maintenance medication or chemotherapy or a hip replacement, the ER is no help at all.
Now, tons of doctors do their best to game the system (and may their lives be blessed for what they do) and sneak actual treatment in, but the "OH, they can just go to the ER" is a canard.
That is to say nothing of the fact that it's the least cost-effective way of providing care.
I've successfully negotiated medical bills before. I say this fully realizing it is not something the majority would be comfortable doing.
25 years ago I had a bill for $10,000. I didn't have squat at the time. I got like $1100 back from income taxes. (4 kids)
I went to a lawyer and for $100 he sent them a letter basically saying I had $1000. They could accept that or a bankruptcy notice. They took the $1000.
I negotiated bills after that also. Nowhere near that amount though.
I didn't say negotiation was impossible, and I'll add my own example in a moment.
Neither cognizant shopping nor cognizant negotiation is possible for patients before the fact. Patients are left to attempt negotiation only after incurring a legal responsibility to pay what the hospital has billed.
At that point, it's totally up to the hospital to decide whether and how much it is willing to reduce the bill, and even then whether it will penalize the patient with a credit history black mark.
This is not by any means fair negotiation.
Only a few months ago, my daughter found herself "between insurance" having been laid off one job and looking for the next. During this period, she got a sudden eye infection that progressed so rapidly she was afraid she might lose vision in that eye.
She went to one of the many strip mall "Emergency Clinics" here in Dallas. They did a quick examination, applied a topical antibiotic, prescribed an oral antibiotic...and billed her $11,000 (eleven thousand dollars).
My wife--who is a supreme negotiator (dang, she was a wonder to behold when we were overseas in the Far East)--negotiated that down to $6,000 with no credit remark.
Six thousand dollars is still highway robbery IMO, but the fact that the clinic was willing reduce the bill by 45% merely indicates how overpriced the original bill actually was. This has become "business as normal," which not by any means the way any other business is run--it's a marketplace aberration.
Prior to the ACA, many employers, especially in food services, hospitality and retail who chose to offer health insurance to employees offered junk plans. No shortage of Junk Plans in the Individual Plan Markets too, in states that allowed them. Some of those plans did not include hospitalization, Cancer Treatment or medications. Some of the plans had very low annual caps on claims and no cap on out of pocket expenses. The plan may or may not have included preventative care or Cancer screening.
There was and remains a tendency for consumers to percieve all insurance alike.
I've successfully negotiated medical bills before. I say this fully realizing it is not something the majority would be comfortable doing.
25 years ago I had a bill for $10,000. I didn't have squat at the time. I got like $1100 back from income taxes. (4 kids)
I went to a lawyer and for $100 he sent them a letter basically saying I had $1000. They could accept that or a bankruptcy notice. They took the $1000.
I negotiated bills after that also. Nowhere near that amount though.
That is not usually possible until the bill is in collections or several months late. There is no incentive to reduce the amount of a bill otherwise. There are credit repair agencies that do just what your attorney did but the late pays still impact your credit rating...
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