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Robmill0605
08-19-2009, 10:18 PM
I got a first hand look at our health care system today. Guess what? It is not broken.
I worked in my shop today and managed to cut myself deeply with a razor sharp chisel. I knew that I would need some stitches, so my wife drove me to the local hospital emergency room. ( Lee Memorial Hospital) After showing my ID, the administrator asked me if I had insurance.
I said no.
They didn't even ask me how I was going to take care of the bill, they just did triage, sent me right in to wait for the Doc to come. The nurse who treated me asked me if I had insurance?
No, I do not.
"OK, the Doc will be right in."
Not one word about paying.
He comes in, I tell my story of how I cut myself and he stitches me up. He then gives me a script for pain and leaves. A different administrator comes in for me to sign out, and asks me if I have insurance?
No, I do not.
Here comes the amazing part.

" OK, if you can pay even $5.00 ( five bucks) the hospital will drop the bill 40 percent.

Yeah, that's right, 40 percent.
I paid them in full and saved 40 percent of my bill.
So much for there is no health care available. Even if I had paid them only five bucks, the bill would get chopped by 40 percent. So in other words, if the insurance company is paying ,we will screw them for all they are worth.
I know that the concept of actually paying for the services you receive is completely foreign to liberals who believe health care is a right, but this experience really brought home the fact to me that there is no health care crisis.

Milo Christensen
08-19-2009, 10:26 PM
Yes, I had a similar experience many years ago, during the year I was unemployed and uninsured. I needed to have a possible skin cancer removed from my temple and biopsied. The bill for the procedure and lab work was itemized and, because I had said I was unemployed and uninsured, a deduction for cash was also itemized. I paid in cash and saved something on the order of 40%.

Kaa
08-19-2009, 10:27 PM
So in other words, if the insurance company is paying ,we will screw them for all they are worth.

LOL. Someone is pretty clueless.

Here's a first free clue: for the same thing the prices charged to a walk-in patient paying cash are multiples of the prices charged to an insurance company. Not "a bit" higher -- several times as high.

Would you be as happy if I charged you $50 for a burger and offered a 40% discount for paying this price? :D

Kaa

ljb5
08-19-2009, 10:47 PM
According to federal law, hospitals are required to charge all patients the same price for the same procedure.

The loophole is that they are permitted to accept different amounts of payments from different people, depending on whatever factors they like.

So that original bill you saw is just the opening bid. Never accept the opening bid and don't assume everyone else does either.

Robmill0605
08-19-2009, 11:01 PM
I look at it this way. I'm healthy, do not smoke or take drugs. ( does beer count?) If I took my employers health care package to cover just me, the cost would be about $6000 per year. So if I project a 10 year period of no major health care issues, that's $ 60,000 net to me.
I have spent less than $1000 per year total on ALL health care issues for the past ten years .
I'll pay cash.
I'll take the 40 percent .

ljb5
08-19-2009, 11:23 PM
I look at it this way. I'm healthy, do not smoke or take drugs. ( does beer count?) If I took my employers health care package to cover just me, the cost would be about $6000 per year. So if I project a 10 year period of no major health care issues, that's $ 60,000 net to me.
I have spent less than $1000 per year total on ALL health care issues for the past ten years .
I'll pay cash.
I'll take the 40 percent .


Good luck with that.

Hopefully, you recognize the risk you're taking.

Just one minor misstep or surprise medical issue and your financial life is essentially over.

Nanoose
08-19-2009, 11:35 PM
I look at it this way. I'm healthy, do not smoke or take drugs. ( does beer count?) If I took my employers health care package to cover just me, the cost would be about $6000 per year. So if I project a 10 year period of no major health care issues, that's $ 60,000 net to me.
I have spent less than $1000 per year total on ALL health care issues for the past ten years .
I'll pay cash.
I'll take the 40 percent .

Yaa...works really well until you, or one of your loved ones, get(s) cancer or hit by a bus. Good luck.

seanz
08-19-2009, 11:45 PM
Rob;
If you were living in the People's Revolutionary Republic of Australia do you know how much you would have paid for their Heroic Workers Socialist Health Care System (AKA Medicare).....?

And the payments don't go up when you find out you're really sick.

Tom Wilkinson
08-20-2009, 12:16 AM
I look at it this way. I'm healthy, do not smoke or take drugs. ( does beer count?) If I took my employers health care package to cover just me, the cost would be about $6000 per year. So if I project a 10 year period of no major health care issues, that's $ 60,000 net to me.
I have spent less than $1000 per year total on ALL health care issues for the past ten years .
I'll pay cash.
I'll take the 40 percent .

My son broke his arm. Over 10k by the time it was all done. Cost me 5 out of pocket. I can't imagine the bill had it been a more serious injury involving hospitalization, transport etc...

One car wreck could devastate a families finances pretty quickly.

I'll stick with the high deductible plan thanks.

Nanoose
08-20-2009, 12:20 AM
One car wreck could devastate a families finances pretty quickly.



Isn't the stat something like 62-63% of personal bankruptcies in the U.S. are related to medical care costs.

Seems like Rob's got a 1 in 3 chance of his plan working for him.

But chances are he hasn't been banking the $6000/year he's been saving, so his idea to self insure to $60,000 to date, and an additional $6000/year, is merely a pipe dream.

Playing the odds....some people like to gamble.

BrianW
08-20-2009, 12:50 AM
Gotta wave the BS Flag.

Don't believe there's a razor sharp chisel in your shop.



I worked in my shop today and managed to cut myself deeply with a razor sharp chisel.


;)

downthecreek
08-20-2009, 01:32 AM
Isn't the stat something like 62-63% of personal bankruptcies in the U.S. are related to medical care costs.


According to Harvard Medical School (2007) its 62% and, of these, 75% had insurance.

I imagine there are a lot of people in the USA who are happy with their health care but might be a lot less so at some future date.

paladin
08-20-2009, 02:06 AM
My (then) 17 year old son was run down by a drunk driver on his bicycle. I never got a hospital bill. The actual bill paid by the insurance when all was said and done was about 17K...I don't know what it would have been otherwise.

Wayne Jeffers
08-20-2009, 05:06 AM
Health care providers know that a substantial portion of their bill will go uncollected from patients without insurance. Their price includes enough to cover the overhead expense of trying to collect from patients whose ability or willingness to pay is often questionable, plus an allowance for covering the services for the “deadbeats” for whom they know they will never be paid directly.

Health care providers commonly give “discounts” to insurance companies because they are assured of receiving payment from insurance companies for at least a large percentage of the bill. Also, being on the “preferred provider” list with the insurance companies attracts more patients who have insurance, for whom the provider is assured of being paid. (The patient co-pay is much lower if they use providers on the preferred list, with whom the insurance company has reached an agreement for discounts on services.)

I’ve had providers who required that I pay the patient co-pay in advance of non-emergency surgeries. It is pretty common in my experience for doctors to require the co-pay in advance of services at office visits.

Health care providers are not allowed to charge interest on unpaid bills because they are not “banks” as defined in banking laws. Many will agree to give prompt pay discounts if you offer to pay the unpaid portion of your bill in full within 20 or 30 days.

Wayne

Dan McCosh
08-20-2009, 08:18 AM
I got a first hand look at our health care system today. Guess what? It is not broken.
I worked in my shop today and managed to cut myself deeply with a razor sharp chisel. I knew that I would need some stitches, so my wife drove me to the local hospital emergency room. ( Lee Memorial Hospital) After showing my ID, the administrator asked me if I had insurance.
I said no.
They didn't even ask me how I was going to take care of the bill, they just did triage, sent me right in to wait for the Doc to come. The nurse who treated me asked me if I had insurance?
No, I do not.
"OK, the Doc will be right in."
Not one word about paying.
He comes in, I tell my story of how I cut myself and he stitches me up. He then gives me a script for pain and leaves. A different administrator comes in for me to sign out, and asks me if I have insurance?
No, I do not.
Here comes the amazing part.

" OK, if you can pay even $5.00 ( five bucks) the hospital will drop the bill 40 percent.

Yeah, that's right, 40 percent.
I paid them in full and saved 40 percent of my bill.
So much for there is no health care available. Even if I had paid them only five bucks, the bill would get chopped by 40 percent. So in other words, if the insurance company is paying ,we will screw them for all they are worth.
I know that the concept of actually paying for the services you receive is completely foreign to liberals who believe health care is a right, but this experience really brought home the fact to me that there is no health care crisis.

Works fine if you have the cash. The system would probably work even better if they dropped the communal payment system altogether, and no one would be able to pay more than they have. Try running that one by a doctor sometime.

Mrleft8
08-20-2009, 09:03 AM
Carter just number crunched my medical bills for the past year.... August 2008-July 2009 It was over $180,000. If I only paid 60% of that (cash) it would be $108,000 That's a lot of money for an unemployed person....

High C
08-20-2009, 09:53 AM
Well done, Rob. But I think next time you can bargain a lot harder. In the two emergency room bills I've paid in recent years for my kids, the actual amount accepted from insurance was only a bit over 20% of the billed amount...thus a near 80% discount off of "retail".

Considering other hospital charges I've seen and compared to what they actually accept from insurance companies, I'd start any negotiations by asking for a 90% discount and work up from there.

switters
08-20-2009, 09:59 AM
as dull as my chisels are I should be saving even more?

Shang
08-20-2009, 10:33 AM
'...other words, if the insurance company is paying ,we will screw them for all they are worth...'

No, that's not exactly how it works. The insurance companies don't get screwed, their subscribers do... the insurance companies simply pass on the costs for the uninsured by raising the subscribers' rates. The companies' profits continue to grow.
You got careless with a sharp tool,
my health insurance rate went up ten percent this year.

You got off cheap because other people paid the freight.
Please be more careful in the future.
There's more than one meaning to the word "chisel."

LeeG
08-20-2009, 12:08 PM
boy do I feel stupid. When I was taken to the ER to get my head stitched up I said I was self-pay. It never occured to me I could bargain with them AFTER they've performed their services. One ambulance ride and services, a dozen stitches, one CT scan, one hour in ER. $2500. Oh,,and $75 outpatient to have stitches removed.

Peter Malcolm Jardine
08-20-2009, 01:14 PM
I got some stitches a while back. It didn't cost me anything.

A good friend is in intensive care suffer from sarcodosis? (spelling) He is very sick, and we are all hoping he recovers quickly, but he has been in intensive care for about two weeks. He won't have to pay anything either.

Tom Hunter
08-20-2009, 01:18 PM
Do you know what the intitial bill was?

40% off what?

Robmill0605
08-20-2009, 01:24 PM
We often say that teenagers think they're immortal. It's relatively rare to see an adult display such an incredibly juvenile attitude, though.

However, you still haven't answered the most important question:

If you come down with some serious chronic or debilitating medical condition, that requires many hundreds of thousands of dollars, or even a million or more, to treat and possibly cure, what do you plan to do?

a) Give up and die?

b) Expect the government to pay?

Which one is it? There is no third possibility.

There is a third possibility, you just refuse to accept it. I think that I have a window of 10 years before I will need to buy insurance for myself, based on my health and history.. My family has full insurance,
I opted out.

Robmill0605
08-20-2009, 01:26 PM
Do you know what the intitial bill was?

40% off what?


$ 750.00 was the intial bill, I paid $450.00

pcford
08-20-2009, 01:34 PM
Good luck with that.

Hopefully, you recognize the risk you're taking.

Just one minor misstep or surprise medical issue and your financial life is essentially over.

I see the level of acuity which which you view the political environment extends to your take on the cost of medical care.

I recently underwent cataract surgery. Everyone said it was to be a piece of cake...45 minutes, a couple thousand bucks and I am good to go. The operation took two hours was a failure and I had to have another. The total cost was between 15 and 20k. THAT WAS FOR THE LEFT EYE. I still have the right to do.

Cataract surgery is very common for those lucky enough to reach a certain age...it is not to be compared to a trivial slice to your hand. It is amazing how much this stuff costs.

Captain Intrepid
08-20-2009, 01:35 PM
$ 750.00 was the intial bill, I paid $450.00

Thats ridiculous. 10 minutes of work shouldn't cost you $450. The worst part is you think you were getting a deal.

Robmill0605
08-20-2009, 01:37 PM
You didn't answer the question You've avoided answering it, and I've asked several times.

Once again:

If you become sick with a chronic or life threatening illness that outstrips your ability to pay for it, what will you do?

1) Lie down and die, or
2) expect the goevernment to pay

Which one? Your third possibility makes absolutely no sense: you say you 'just refuse to accept it'. Refuse what? Medical care?

I do not accept your choices, but IF that happens I would die.

Just like IF I jumped out of an airplane and my chute didn't open I would die. Or if I sailed out into the ocean I may or may not get recused. However, given the fact that the probability of that happening is minimal, I'll accept that risk. Just as I would by betting my life that my chute would open or any other calculated risk.

Robmill0605
08-20-2009, 01:42 PM
Thats ridiculous. 10 minutes of work shouldn't cost you $450. The worst part is you think you were getting a deal.

Well, we charge $100 at BMW just to tell you what we think is wrong with your car......

This is almost September, so far my total cost year to date is:

$450.00 vs. $6,000. I'm ok with it.

Dan McCosh
08-20-2009, 01:45 PM
So when you get hit by a car, and wake up in a hospital...... (Which is sort of what happened to me.)

Captain Intrepid
08-20-2009, 01:47 PM
Well, we charge $100 at BMW just to tell you what we think is wrong with your car......

This is almost September, so far my total cost year to date is:

$450.00 vs. $6,000. I'm ok with it.

And if I had to go in and get stitches, which I've many times before, I'd be at $0.00. Your point is?

John Smith
08-20-2009, 01:50 PM
Yes, I had a similar experience many years ago, during the year I was unemployed and uninsured. I needed to have a possible skin cancer removed from my temple and biopsied. The bill for the procedure and lab work was itemized and, because I had said I was unemployed and uninsured, a deduction for cash was also itemized. I paid in cash and saved something on the order of 40%.
Have you been paying attention?

I posted these numbers before.

The bill for my wife's stress test was $1100. If you had no insurance, and they took 40% off for cash payment, we'd have paid $660.

I have insurance, and the maximum they allow for this test is $319. Provider has contracted with the insurance carrier to accept and live with $319. Out of that, I pay 15%.

Tom Wilkinson
08-20-2009, 01:53 PM
Have you been paying attention?

I posted these numbers before.

The bill for my wife's stress test was $1100. If you had no insurance, and they took 40% off for cash payment, we'd have paid $660.

I have insurance, and the maximum they allow for this test is $319. Provider has contracted with the insurance carrier to accept and live with $319. Out of that, I pay 15%.

Plus whatever your premium is. A small point, but it is part of the cost.

John Smith
08-20-2009, 01:54 PM
I look at it this way. I'm healthy, do not smoke or take drugs. ( does beer count?) If I took my employers health care package to cover just me, the cost would be about $6000 per year. So if I project a 10 year period of no major health care issues, that's $ 60,000 net to me.
I have spent less than $1000 per year total on ALL health care issues for the past ten years .
I'll pay cash.
I'll take the 40 percent .
Only problem with this theory is; **** happens. You could simply slip and fall down a flight of stairs. Easy to run up a hospital and related bills in the hundreds of thousands. Why do you think so many people file bankruptcy behind medical bills.

Incidently, where to you think the cost of those unpaid bills ends up?

High C
08-20-2009, 01:57 PM
....You got off cheap because other people paid the freight....

This is completely backwards. Rob more than paid the freight. He paid more to that provider than you as an insured patient would have. I recently saw the "allowed" part of a $2400 emergency room bill. It was $477. Insurance paid $477 on a $2400 bill. Rob was paying your freight.

John Smith
08-20-2009, 01:59 PM
There is a third possibility, you just refuse to accept it. I think that I have a window of 10 years before I will need to buy insurance for myself, based on my health and history.. My family has full insurance,
I opted out.
Now, if you have some small problem, let's say a hernia, or you get the flu, your plan may well be sabotaged, as you will now have a pre-existing condition, and you will not be able to get any health insurance.

You risk far more than you think.

John Smith
08-20-2009, 02:00 PM
$ 750.00 was the intial bill, I paid $450.00
That's considrably more than my insurancde allowed our provider to collect for $1100 service.

I guess you still got ripped off.

John Smith
08-20-2009, 02:06 PM
Plus whatever your premium is. A small point, but it is part of the cost.
Absolutely. However, if I didn't pay my part of the premiums, I'd be negotiating on my own over an $1100 bill. My cost for that test was $47. My premiums are $400 a month.

If this was the ONLY test my wife or I had over the year, it would be one thing, but we've both had several tests of varied types and blood work.

In EACH case, the numbers are similar in that the insurance has contracted a very low price compared to the billing price,

When I get my glasses, I go to a participating provider. My insurance pays NOTHING, but they've contracted for a lower price than the uninsured will be asked to pay.

John Smith
08-20-2009, 02:12 PM
A woman was denied coverage by her own health insuror, for breat cancer, simply because she neglected to disclose, on her application, that she was once treated for acne.

But that's OK. Since robmill0605 isn't going to accept any public help if he can't afford to pay for any illness or injury out of pocket, he won't be a burden on the rest of us.

I had suggested to the White House and my reps that they would be wise to divide reform into two bills. I see they are considering that now.

First, they need to get pre-existing conditions or getting ill out of the reasons to deny coverage. They also need to eliminate pre-certification, and insure that everyone who provides service to you in an in-network facility is treated as in-network for billing and payment.

This bill would fix what we have in these regards.

Second bill would concern how to insure the uninsured. I'd suggest simply opening Medicare to all.

My view is it will be more difficult to propagate lies about a simpler piece of legislation.

Maybe this would be a good area to put the punitive awards in civil lawsuits?

John Smith
08-20-2009, 02:15 PM
I'm sure they'll find a way.
Yes, but it won't be as easy.

If they could write a piece of legislation that consumed less than ten pages, everyone could read it.

Captain Intrepid
08-20-2009, 02:20 PM
Ahh... OK, I see. You'd chose to simply die.

Only problem is, he might not have that choice. What if he falls down a flight of stairs, hits his head, and gets knocked out? He could run up a hundred thousand dollars in medical bills while EMTs and hospital staff are acting under implied consent.

John Smith
08-20-2009, 02:44 PM
Only problem is, he might not have that choice. What if he falls down a flight of stairs, hits his head, and gets knocked out? He could run up a hundred thousand dollars in medical bills while EMTs and hospital staff are acting under implied consent.
This is true.

This is also the kind of thing that can lead to an insured person being taken to a non participating hospital, where his insurance is a lot less help.

ljb5
08-20-2009, 02:44 PM
I do not accept your choices, but IF that happens I would die.

I doubt you would see face it so soberly when the time actually comes.

Of course, dying might be the easy way out. What if you develop a condition which is not life-ending, but forces you to live the next forty years with debilitating pain and unable to earn a living?

Would you consider assisted suicide or would you nobly plunge yourself and your family into despair, pain and poverty?

High C
08-20-2009, 02:45 PM
...I'd suggest simply opening Medicare to all....

There would then be no more privately insured people to shift Medicare's costs to. You do realize that Medicare doesn't pay its own way, don't you? And it still is headed off the cliff in an inevitable and spectacular bankruptcy.

Who will pay the bills under your simple plan?

John Smith
08-20-2009, 02:55 PM
There would then be no more privately insured people to shift Medicare's costs to. You do realize that Medicare doesn't pay its own way, don't you? And it still is headed off the cliff in an inevitable and spectacular bankruptcy.

Who will pay the bills under your simple plan?
Let me make this as simple as possible.

Private insurance companies pocket, if they get their way, 35% of the premium dollar. Medicare pockets less than 5% of the premium dollar.

Medicare insures that section of the civilian population that has the most medical needs. If it is extended to people of all ages, the the needs per capita will come down, and its financial status will improve.

Why do we have to give up 35% of our premium dollars to have coverage? How much are my premiums going up in 2010 to cover what my insurance company paid for lobbyists this year?

The good thing about my simple plan is everyone can understand it, and it would be more difficult to distort.

My plan calls for two pieces of legislation. One to fix what we have, and a second on a means to insure everyone.

The problem with our system, is the for profit part is bleeding it dry.

By keeping the "change" simple, we'll be better able to have good debates on how.

Dan McCosh
08-20-2009, 03:19 PM
There would then be no more privately insured people to shift Medicare's costs to. You do realize that Medicare doesn't pay its own way, don't you? And it still is headed off the cliff in an inevitable and spectacular bankruptcy.

Who will pay the bills under your simple plan?


This seems backwards. Medicare is picking up the high-cost patients, that if they were in a strictly private system, would run its costs to the stratosphere. Medicare does pay its own way--it is the future demographics that are troubling.
This thread is interesting, but should point out the obvious--most medical "costs" are not costs, but fees, and the fees are both arbitrary and negotiated constantly, whether by individuals, health insurers, medicare, or associations. Getting the negotiation process out in the open and in a reasonable forum would be a huge step forward.

George Roberts
08-20-2009, 03:32 PM
It is amazing that the people who are in favor of health insurance but not by the health insurance companies ignore risk.

As I recall from a previous thread (I guess I don't recall much) but ..

The health care costs for average person are very small. Easily managed without bankruptcy. Even in old age the costs are small relative to the assets a reasonable life style could have provided.

The risk of incurring health care costs (rather than the loss of income because of a health related incident) that cause bankruptcy are very small.

The cost of insuring against this small risk is very high. The cost is high because those who have a higher than average risk know it and purchase insurance while those who have a lower risk also know it and forgo buying insurance. This pushes the risk up which forces the cost up.

---

Think about this: If bankruptcy was the outcome of health care for common problems, no one could afford either health care or insurance for health care. We are lucky that expensive health care problems are rare.

---

"recently underwent cataract surgery. Everyone said it was to be a piece of cake...45 minutes, a couple thousand bucks and I am good to go. The operation took two hours was a failure and I had to have another. The total cost was between 15 and 20k. THAT WAS FOR THE LEFT EYE. I still have the right to do."

Sorry for the complications. My wife had cataract surgery last month - under $1000/eye. It would be responsible for the surgery center to charge a bit for for "normal" surgery and not charge for the "fix" when things went wrong. But we expect insurance not the surgeon to pay for the blunder.

Mrleft8
08-20-2009, 03:40 PM
It's very clear that we have some bulletproof super studs, some heartless bastads, and some plain and simple morons on this forum.... I will refrain from indicating which members I think fit which category....

High C
08-20-2009, 03:44 PM
...Medicare does pay its own way....

No Medicare doesn't. Medicare pays considerably less than regular insurance for practically every patient and every type of care. Just ask anyone who works in the medical biz collecting or billing for care.

Medicare is heavily subsidized by shifting costs to everybody else.

John, insurance companies "pocket" 35% of the premium dollar? What does that mean? You do realize that you're talking about an industry with an average profit margin of well under 10%, don't you?

Dan McCosh
08-20-2009, 03:52 PM
No Medicare doesn't. Medicare pays considerably less than regular insurance for practically every patient and every type of care. Just ask anyone who works in the medical biz collecting or billing for care.

Medicare is heavily subsidized by shifting costs to everybody else.

John, insurance companies "pocket" 35% of the premium dollar? What does that mean? You do realize that you're talking about an industry with an average profit margin of well under 10%, don't you?


Negotiating a lower fee does not "shift" the cost to someone else. The point is, if Medicare payments were taken out of the system, they would be added to the insurance pool--raising those costs. Private insurance only handles about 40% of the medical costs in the US today--it is a cherry-picked demographic group.

pcford
08-20-2009, 03:52 PM
Sorry for the complications. My wife had cataract surgery last month - under $1000/eye. It would be responsible for the surgery center to charge a bit for for "normal" surgery and not charge for the "fix" when things went wrong. But we expect insurance not the surgeon to pay for the blunder.

I guess they don't do well teaching reading down there in Oklahoma. I never said that the surgeon made a "blunder" to use your words.

The "suspension" that holds the lens...as I understand it, it is called the capsule, is evidently weak in my eyes. When the surgeon tried to take the old lens out and put the new one in, two of the three attachments broke. My father and uncle also had problems with cataract surgery. I presume it was for the same reason.

So it was genetic and not a mistake by the surgeon. I had to have the lens sutured to the inside of the eyeball. This required another specialist...a retinal surgeon...and general anesthetic.

I find your conviction that you will die rather than accept government help amusing.

Mrleft8
08-20-2009, 03:55 PM
I find your conviction that you will die rather than accept government help amusing.

I find it promising.

SamSam
08-20-2009, 03:56 PM
Ahh... OK, I see. You'd chose to simply die.

In that case, your decision to not buy health insurance for yourself is perfectly fine by me... as long as you didn't turn hypocrite and expect the government to pick up the tab.

Of course, one does wonder how your family will feel about that...
If he doesn't have a living will, and is rendered comatose, say in a boating accident, doesn't the hospital have to do all it can to keep him alive and then either the government pays and/or his family still goes bankrupt even though they have their own insurance?

High C
08-20-2009, 03:59 PM
Negotiating a lower fee does not "shift" the cost to someone else....

Oh I profoundly disagree...and the government doesn't negotiate like private insurers. They dictate. Medicare's low reimbursement rates would not be possible were it not for others who pay more. Besides, we hear so much about the uninsured who are subsidized by the rest of us when they get care they can't afford. How is Medicare any different? It is no different. In fact, it's many orders of magnitude worse, a horrific contributor to the high cost of health insurance.

Mrleft8
08-20-2009, 04:02 PM
If we kill all the lawyers, and all the insurance company people..... And I mean kill 'em quick, so they don't need any care, or treatment, will this all go away?

Dan McCosh
08-20-2009, 04:10 PM
Oh I profoundly disagree...and the government doesn't negotiate like private insurers. They dictate. Medicare's low reimbursement rates would not be possible were it not for others who pay more.


This sounds like a good argument for the Canadian system--where the fees are negotiated between the medical associations and the government. A medical bill isn't a "cost" it is a price--and the price may or may not reflect the cost of the service. I think I mentioned earlier that the price of a single surgery amounted to an annual income of $8 million a year for a single doctor. That would seem to leave some room for a lower fee payment. Given the size of the Medicare system it would seem highly unlikely that those being paid by it are, on the average, losing money.

Robmill0605
08-20-2009, 05:10 PM
A woman was denied coverage by her own health insuror, for breat cancer, simply because she neglected to disclose, on her application, that she was once treated for acne.

But that's OK. Since robmill0605 isn't going to accept any public help if he can't afford to pay for any illness or injury out of pocket, he won't be a burden on the rest of us.


A LIBERAL COMPLAINING ABOUT " BEING A BURDEN TO THE "REST OF US"?

The trillions and trillions of our dollars liberals have spent on the " great society" and you are worried I might be a burden on the rest you?

Laughable.

George Roberts
08-20-2009, 05:17 PM
I guess they don't do well teaching reading down there in Oklahoma. I never said that the surgeon made a "blunder" to use your words.

The "suspension" that holds the lens...as I understand it, it is called the capsule, is evidently weak in my eyes. When the surgeon tried to take the old lens out and put the new one in, two of the three attachments broke. My father and uncle also had problems with cataract surgery. I presume it was for the same reason.

So it was genetic and not a mistake by the surgeon. I had to have the lens sutured to the inside of the eyeball. This required another specialist...a retinal surgeon...and general anesthetic.

You properly object to my use of the word blunder. Of course, in the original context one could easily interpret your words to indicate a "blunder" by the surgeon.

Considering that your relatives had "problems," your complication might have been foreseeable. But that is a path I will not wander down.

You seem to object to the $15K cost. I guess you neglected to ask the cost to handle complications. Not your fault no one asks. But it would have been nice if your doctor offered some type of insurance against the risks that complications present.


I find your conviction that you will die rather than accept government help amusing.

You have me confused with someone else. I will gladly take advantage of the health insurance that the government pays me to have.

John Smith
08-20-2009, 06:36 PM
It is amazing that the people who are in favor of health insurance but not by the health insurance companies ignore risk.

As I recall from a previous thread (I guess I don't recall much) but ..

The health care costs for average person are very small. Easily managed without bankruptcy. Even in old age the costs are small relative to the assets a reasonable life style could have provided.

The risk of incurring health care costs (rather than the loss of income because of a health related incident) that cause bankruptcy are very small.

The cost of insuring against this small risk is very high. The cost is high because those who have a higher than average risk know it and purchase insurance while those who have a lower risk also know it and forgo buying insurance. This pushes the risk up which forces the cost up.

---

Think about this: If bankruptcy was the outcome of health care for common problems, no one could afford either health care or insurance for health care. We are lucky that expensive health care problems are rare.

---

"recently underwent cataract surgery. Everyone said it was to be a piece of cake...45 minutes, a couple thousand bucks and I am good to go. The operation took two hours was a failure and I had to have another. The total cost was between 15 and 20k. THAT WAS FOR THE LEFT EYE. I still have the right to do."

Sorry for the complications. My wife had cataract surgery last month - under $1000/eye. It would be responsible for the surgery center to charge a bit for for "normal" surgery and not charge for the "fix" when things went wrong. But we expect insurance not the surgeon to pay for the blunder.

You must get your facts the same place Limbaugh gets his.

FACT is that anyone can develop major illnesses. Last I looked cancer is still quite prevelant. Keep getting older, and you will live into one of those diseases, arthritis, alzheimers, cancer, or any of a bunch of others.

There is very little in the way of health care the average family can pay out of pocket. Even those who have insurance generally have little or no dental coverage.

You must think everyone in this nation is wealthy.

Now I don't know, personally, lots and lots of folks, but out of the friends I have, my neighbor is battling with cancer, my old neighbor is battling with a couple of problems and is about to have her second in patient procedure in as many months, and another friend has problems that they are still trying to diagnose; test after test after test, all very expensive.

My wife and I don't have any severe problems, but our "routine" tests are breaking our budget, and I have insurance. In fact, I have the same Blue Cross my congressman can choose. Everything we have done is subject to one of several separate deductibles, co-pays and co-insurance. We are taking several "maintenance" medications. Our out of pocket for them is a more than noticable "hit" on our monthly income.

Truth of the matter is, the way things are going, I can afford to die. I cannot afford to live much longer under these expenses.

High C
08-20-2009, 06:42 PM
....There is very little in the way of health care the average family can pay out of pocket....

Wow! Another astonishing economic proclamation!

Peter Malcolm Jardine
08-20-2009, 07:37 PM
Oh I profoundly disagree...and the government doesn't negotiate like private insurers. They dictate. Medicare's low reimbursement rates would not be possible were it not for others who pay more. Besides, we hear so much about the uninsured who are subsidized by the rest of us when they get care they can't afford. How is Medicare any different? It is no different. In fact, it's many orders of magnitude worse, a horrific contributor to the high cost of health insurance.

How do you explain the fact that the world's BEST HEALTH CARE SYSTEMS... are public private partnerships if the public part is destined to fail in this manner?

How do you explain the fact that the American health care system is ranked 37th in the world as it is set up now... a private system.

How do you reconcile the fact that 45 million americans are without health care under the present system?

How do you explain the fact that the Canadian system is ranked 30th in the world with NO private component and a much lower % of GDP?

High C
08-20-2009, 08:23 PM
How do you explain the fact that the world's BEST HEALTH CARE SYSTEMS... are public private partnerships if the public part is destined to fail in this manner?

How do you explain the fact that the American health care system is ranked 37th in the world as it is set up now... a private system.

How do you reconcile the fact that 45 million americans are without health care under the present system?

How do you explain the fact that the Canadian system is ranked 30th in the world with NO private component and a much lower % of GDP?

Your post is a complete non sequitur to your quote of my post. There is also a lie in one of your questions. There are not 45 million uninsured Americans.

Shang
08-20-2009, 08:49 PM
Quote:
Originally Posted by Shang, View Post:
....You got off cheap because other people paid the freight....

Originally Posted by High C, View Post:
This is completely backwards. Rob more than paid the freight. He paid more to that provider than you as an insured patient would have. I recently saw the "allowed" part of a $2400 emergency room bill. It was $477. Insurance paid $477 on a $2400 bill. Rob was paying your freight.

On the contrary... I have been paying into the system thousands upon thousands of dollars. I do this because I have a more realistic view than does Rob of the consequences of a catastrophic illness or accident, and I understand that all such events happen unexpectedly. I seriously doubt that even if blessed with ten accident-free years Rob nor anyone else can or will squirrel away enough money to cover the costs that could befall him.
(Rob's offer to die as an economy measure isn't really an option since Rob's family probably needs him, and who knows, they may even like him and want to keep him around.)
If I am exceptionally lucky I will never be faced with a physically devastating and financially ruinous medical situation*. But the money I have poured into the health care system goes not only to provide my own peace of mind, it also goes to subsidize the health expenses of others who are less fortunate than I may have been.

If Rob's dingy gets swamped I'm the one who bails him out either with my health insurance or my tax bucks. There ain't no free lunch.

__________________
* That's for the sake of the discussion, in reality I know first hand.

oldsub86
08-20-2009, 09:23 PM
A friend and his wife have a winter place in Arizona. They went down there at the end of October to set up for their winter time after Xmas. The day after they got there, Bill had chest pains. He has had a heart attack in the past and bypass surgery and his wife is a nurse, so they took no chances. They went to a hospital to have him checked out. He was taken in Friday evening and let go on Saturday after lunch. A number of doctors checked him out and could fine nothing wrong. It has now been almost 10 months and there have been no repeat occurances. All appears to be well.

The bill for his overnight stay and some tests was almost $20,000. Even at 40%, I doubt he would have considered it to be a bargain. He was happy to have pretty good insurance.

Randy

oldsub86
08-20-2009, 09:27 PM
A second scenario. Friends have a son who lives and works in Dallas TX. He would be late 30's or early 40's. His co-workers told him he looked somewhat yellow and suggested he better go and get himself checked out somewhere around Xmas last year. He did and was hospitalized and had surgery. I don't know all of the details but apparently the surgery did not go all that well. The surgeon nicked something he should not have. The fellow almost died. He did ultimatly recover and was so weak that he was in a rehab hospital for about 2 or 3 months to rebuild his strength. The total cost is pretty close to a million dollars. Some or most is covered by his insurance but apparently not all of it. Seems a bit silly to suggest that 40% would be a good deal for cash if one did not have insurance.

Randy

Robmill0605
08-20-2009, 10:44 PM
A friend and his wife have a winter place in Arizona. They went down there at the end of October to set up for their winter time after Xmas. The day after they got there, Bill had chest pains. He has had a heart attack in the past and bypass surgery and his wife is a nurse, so they took no chances. They went to a hospital to have him checked out. He was taken in Friday evening and let go on Saturday after lunch. A number of doctors checked him out and could fine nothing wrong. It has now been almost 10 months and there have been no repeat occurances. All appears to be well.

The bill for his overnight stay and some tests was almost $20,000. Even at 40%, I doubt he would have considered it to be a bargain. He was happy to have pretty good insurance.

Randy
$20,000 for one night?:eek:
Screw them.
I'll tell you what, I'd go see own my Doctor,and then take a limo and check into the Four Seasons Hotel in Miami, and get hookers and room service first. :)

Captain Intrepid
08-20-2009, 10:46 PM
$20,000 for one night?:eek:
Screw them.

They charge extra for that... ;)

High C
08-20-2009, 10:53 PM
....The bill for his overnight stay and some tests was almost $20,000. Even at 40%, I doubt he would have considered it to be a bargain. He was happy to have pretty good insurance.

Randy

The real cost paid by the insurance company was probably discounted far more than 40%. Anyone can negotiate, yes, after the fact, for similar rates. A recent surgical outpatient charge for a family member was $10,500 on the bill...true cost was $1,100. They play a lot of silly games with billing. NO ONE pays those rates.

Robmill0605
08-20-2009, 10:58 PM
A second scenario. Friends have a son who lives and works in Dallas TX. He would be late 30's or early 40's. His co-workers told him he looked somewhat yellow and suggested he better go and get himself checked out somewhere around Xmas last year. He did and was hospitalized and had surgery. I don't know all of the details but apparently the surgery did not go all that well. The surgeon nicked something he should not have. The fellow almost died. He did ultimatly recover and was so weak that he was in a rehab hospital for about 2 or 3 months to rebuild his strength. The total cost is pretty close to a million dollars. Some or most is covered by his insurance but apparently not all of it. Seems a bit silly to suggest that 40% would be a good deal for cash if one did not have insurance.

Randy

Some people take risks by jumping out of airplanes. Or skiing off mountains, or climbing mountains, or driving race cars, or going out to cross oceans.
For what?
They all take a calculated risk. My choice in this matter is nothing more.
a calculated risk for the short term.
What if..... What if.... all you want to.
What if one NEVER takes risks?
Then we would not go out into the unkown in small boats.or risk our lives in deep water or in fog etc. with little chance of help. Or anything else people do.
"What if" all you want to.
Besides if you liberals have your way, you will force me against my will to be covered anyway.
Yeah, that's freedom and change we can believe in, Even if "we" do not want it.

redbopeep
08-21-2009, 12:01 AM
This is completely backwards. Rob more than paid the freight. He paid more to that provider than you as an insured patient would have. I recently saw the "allowed" part of a $2400 emergency room bill. It was $477. Insurance paid $477 on a $2400 bill. Rob was paying your freight.

Yep, insured folks always pay less than the uninsured. I knew this was true because of friends who work in hospital administration but then hubby, while spending a week at a conference in California, ended up in the emergency room (got a bad flue, was dehydrated and ended up passing out in his soup bowl at the hotel restaurant...his co-workers took him to the ER).

Here's among the stupid things that happened:

First, the hospital in San Jose was a preferred provider for our insurance company but logged him in as "uninsured" even though he showed them his ID and the insurance card.

Then, they ran him through a bunch of heart tests--who would know why--he had the flue with all its various symptoms, told them, had a fever, told them...they ignored that info and started running tests related to heart attacks. Hubby is a PhD biomedical engineer--so are the two co-workers who were with him. So, they all three were keenly interested in the equipment being used and procedures as well.

When, after running him through all the routine for "maybe this guy has a heart attack..." which included two specialists :eek: which ended up on the bill! they said "you don't seem to have had a heart attack, it appears that you have the flue" :cool: uh...he knew that.

Well, then the bill came--$4,700! which included charges for procedures which didn't happen and equipment that wasn't functioning (remember hubby and his two co-workers who were by his side the whole time are biomedical engineers who noted a couple key pieces of equipment in the room were non-functioning...)

We didn't know why the hospital didn't direct bill the insurance company, but we went ahead and sent it to the insurance company ourselves. Ah, then we saw why they were treating hubby as "uninsured"...

The preferred provider price for all the stuff they billed was $870! And, that's what they paid. Even though we told them that not all the procedures billed nor the equipment was used, they paid what was billed. Then the hospital started going after us for the "rest" of the $4,700-- that is $3,830! more because supposedly hubby was "uninsured" and the hospital won't accept less than the full bill from an uninsured.

We wrote the hospital several letters and copied the insurance company. The insurance company wrote lettters--no avail, the hospital sent the remaining bill to a collections agency, I sent the agency a copy of the correspondence. That agency sent it on to another agency. More sending copies of correspondence to the "new" collections agency.

Finally, after 2-1/2 years of this, I called the Attorney General's office (in California) to complain about the hospital's actions as well as to complain that the bill was fraudulent (remember the bill included procedures and equipment that had never been used?)

Finally, peace. The calls and letters from collections stopped.

It was an awful process but taught us that hospital and insurance administration are inefficient and most definitely costly. In the 2-1/2 years, I spent 17 hours (yes! 17 HOURS!) on the phone with various hospital, insurance, or collections people. The collections people were most efficient and the others were not.

After this experience, hubby and I both believe that administration of health care and health insurance administration are wasteful and costly parts of our health care system and they are the things that need changing desperately.

Shang
08-21-2009, 11:55 AM
"...Some people take risks by jumping out of airplanes. Or skiing off mountains, or climbing mountains, or driving race cars, or going out to cross oceans.
For what?
They all take a calculated risk. My choice in this matter is nothing more..."


"Calculated risk" means, "I don't know Shinola from applebutter about this, but I think I'll gamble everything I have and hope that nothing bad ever happens."

Good luck. We hope nothing bad ever happens to you either.

Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds
http://www.consumeraffairs.com/news04/2005/bankruptcy_study.html#ixzz0OpuX1cUv
Medical Bankruptcy
http://doctorisin.blogspot.com/2005/02/medical-bankruptcy.html
Declaring Bankruptcy For Medical Expenses
http://marymoore.blog.friendster.com/2009/08/declaring-bankruptcy-for-medical-expenses/
...etc. ...etc. ...etc. ...