Health care: Which System?

[Trumplestiltskin 5,791]

This is all very fascinating. It seems to me that many in this thread think we should pay doctors what we "feel" they and what they do is worth. This of course pays no attention to the fact they are the only people who could do what they do and we need them.

I also find it interesting that so many want to get paid in full (and presumably what they feel they are worth) while they don't wish to give the same consideration to others.

If you buy a defective product in a store you can return it. If the doctor you pay to fix a problem (like a persistent nosebleed) by cauterising a blood vessel - and doesn't resolve the problem, then you're obligated to pay the same amount again.

If we're looking at it from a consumer value for money point of view - how is it you can charge an apparently arbitrary figure for it?

When I had surgery the out of pocket costs were around $2500. I don't know what they were for - or how that breaks down from what the doctor charges the insurance company, to what I pay at the end.

How do I (or anyone) know that the charges incurred during a hospital visit, or a doctors visit are:

(i) legitimate

(ii) within the acceptable market price for that service

If you're looking at it from a customer point-of-view, then it's your responsibility to "shop around." If one doctor charges above what you're willing to pay, then go to another one. If you accept the doctor (and thereby his procedures) you need to deal with it.

Of course you do - because you have no choice in the matter.

But how exactly does a person shop around? If you have to go in for any sort of procedure, its next to impossible to get an accurate estimate of the final out of pocket costs - because they're dependent on how much (or even if) the insurance company pays out, besides which the average person doesn't have the first idea about the market rate for different procedures.

Ask the physician first. Other than that, check to see what your health insurance provider covers and what percentage of any given procedure's cost.

I've done it. They won't commit to even a ballpark figure (unless you consider "Well it could be in the hundreds or the thousands" to be a useful indicator).

[Trumplestiltskin 5,791]

the prices being charged are not transparent, and that is part of the problem. it would be easier to stomach the costs of some procedures if you knew in advance. try calling a radiologist and asking in advance how much an ultrasound would cost? or how much a blood test for your iron count would cost? what if you need an MRI and you don't have insurance, but you actually have the cash to pay for it? it's really hard to get a straight answer. and oftentimes, the answer you get on the phone is not what you get charged, and therein lies the frustration.

a procedure that has been the same for years should have a transparent cost. an estimated cost w/ insurance, if need be, because they all apparently bargain differently. but if you don't have insurance, the cost should be fixed and exact and available before the appointment occurs.

That's the problem - charges are tacked on, and there are so many you have no idea what they're for.

I was getting bills up to a year after I had my surgery - and the list of charges insurance website was crazy and what insurance claimed to have been billed for often didn't match up with the providers bills.

When you suddenly have a half dozen to people to pay - you're looking at a huge investment of time going back and forth on the phone between the provider and the insurance company (talking to a different agent each time). Its a circus!

As I say, I'm not surprised that people only visit the Dr or the hospital as an absolute last resort. Health "care" it ain't!

Edited May 14, 2009 by Private Pike

[mawilson 2,133]

Well I've just been lumbered with a $250 bill for a bit of dentistry the wife had done a few months ago. I'm got an outstanding bill for another $300 for a ENT "procedure" I had done. And we're expecting another one for a biopsy the wife had to get last month.

We're probably looking at (at least) the best part of $1000 for little more than diagnostic stuff!

Wow... diagnostic stuff costs money. Shocking!

Its not that it costs money - its how much money it costs.

I don't feel that $1000 out of pocket (excluding the initial co-pays) is reasonable for what was done; and as I've said before the general attitude it inspires (and I've seen the effect this has on people) is to put their own health in danger rather than get things checked out because they're afraid of being bankrupted by the system.

Sitting in a doctors office for 45 minutes for a 5 minute appointment where a guy shoves a stick up your nose and bills you $300 for the privilege is a rip-off.

Perhaps, even though $250 for "a bit of dentistry" sounds reasonable and isn't going to bankrupt anyone.

[Trumplestiltskin 5,791]

Well I've just been lumbered with a $250 bill for a bit of dentistry the wife had done a few months ago. I'm got an outstanding bill for another $300 for a ENT "procedure" I had done. And we're expecting another one for a biopsy the wife had to get last month.

We're probably looking at (at least) the best part of $1000 for little more than diagnostic stuff!

Wow... diagnostic stuff costs money. Shocking!

Its not that it costs money - its how much money it costs.

I don't feel that $1000 out of pocket (excluding the initial co-pays) is reasonable for what was done; and as I've said before the general attitude it inspires (and I've seen the effect this has on people) is to put their own health in danger rather than get things checked out because they're afraid of being bankrupted by the system.

Sitting in a doctors office for 45 minutes for a 5 minute appointment where a guy shoves a stick up your nose and bills you $300 for the privilege is a rip-off.

Perhaps, even though $250 for "a bit of dentistry" sounds reasonable and isn't going to bankrupt anyone.

By itself no, but I'm thinking about what happens down the road if you wind up with a chronic condition or something that requires major long-term treatment.

[mawilson 2,133]

So TRUE!

Suckin' on barry's muthafuckin TEAT! So funny to WATCH! theyll all be screamin and cryin when their pocket books are EMPTY an they cant get their fuckin' CAFFAY LATAYS!

You've got the idiot down to a T.

It's awesome.

[AlHayatZween 2]

Yeah, $250 at the dentist sounds plausible.

We just maxed out our dental insurance for $2k, and honestly, i don't even know what they spent it on? i have a mind to ask for an itemized list of what costs what... let's see how far i get w/ that...

[DEDixon 39]

This is all very fascinating. It seems to me that many in this thread think we should pay doctors what we "feel" they and what they do is worth. This of course pays no attention to the fact they are the only people who could do what they do and we need them.

I also find it interesting that so many want to get paid in full (and presumably what they feel they are worth) while they don't wish to give the same consideration to others.

If you buy a defective product in a store you can return it. If the doctor you pay to fix a problem (like a persistent nosebleed) by cauterising a blood vessel - and the procedure doesn't resolve the problem (or makes it worse), then you're obligated to pay the same amount again for a roll of the dice.

If we're looking at it from a consumer value for money point of view - how is it that someone can charge an apparently arbitrary figure for it?

When I had surgery the out of pocket costs were around $2500. I don't know what they were for - or how that breaks down from what the doctor charges the insurance company, to what I pay at the end.

How do I (or anyone) know that the charges incurred during a hospital visit, or a doctors visit are:

(i) legitimate

(ii) within the acceptable market price for that service

I guess doctors and mechanics are the same. When I take my car to get fixed, they tell me it is fixed, I'm good to go, but it isn't fixed so I go back the next day to complain, they want to try again, but they aren't offering to take yesterday's parts off the car and refund the labor.

[Peikko 1,575]

You can always get a new car - no new bodies available.

[Trumplestiltskin 5,791]

Yeah, $250 at the dentist sounds plausible.

We just maxed out our dental insurance for $2k, and honestly, i don't even know what they spent it on? i have a mind to ask for an itemized list of what costs what... let's see how far i get w/ that...

I wonder if there is some sort of insurance loophole - that you're allowed to request that and delay sending any payment.

Of course - they'll probably bill you for the list as well...

[one...two...tree 2,762]

(My Mom sent me this email today...)

"Just for the record, your Dad's and my "supplemental" insurance costs us an additional $800 per month. The two tests (endoscopic procedure and colonoscopy) I had last month cost over one-fourth what the _entire_ hip replacement surgery your Dad had done in Ireland. I could have elected not to have those done, but since both showed pre-cancerous problems which will need to be monitored, I am thankful I could do it.

Also, most people who object to national health coverage do not seem to understand that those of us who do have insurance are already paying for those who do not have insurance by way of higher health costs and insurance premiums.

I am sure we could discuss this to infinity but with the millions of baby boomers beginning to retire, this issue must be not only discussed, but we must find a solution for all of us."

(from AARP)

If you’re still looking for a reason we need to fix health care now, here’s one:

People on Medicare spend an average of 30% of their income on out-of-pocket health costs.

Thirty percent! It’s astounding. And, as you can imagine, it’s unsustainable in this economy.

That’s why we’re in this fight – to make sure Congress passes reform that strengthens Medicare and ensures that everyone can afford the care they need.

Click here to let Congress know that we need health reform that keeps Medicare affordable.

...

To me, this campaign is about fighting for the most vulnerable in our health care system. It’s about fighting for the people who are dependent on costly medications or frequent hospitalizations. The people who are watching costs skyrocket while their retirement incomes shrink. The people for whom 30 percent isn’t a statistic, but a very real burden.

It’s about fighting for the thousands of older Americans that can’t afford their prescription drugs due to a gap in Medicare coverage. We’re committed to closing the coverage “donut hole” that forces them to pay premiums without getting insurance coverage on prescription drug costs.

Join the campaign and show Congress we’re in this together. If you are one of the first 10,000 to act before midnight Tuesday, we’ll send you the campaign bumper sticker.

After you’ve taken action, pass this message along to your friends and family who will join us in taking advantage of what may be our best opportunity to pass meaningful health reform.

Thanks for all you do.

Sincerely,

Barry Jackson

AARP Online Advocacy Manager

[AlHayatZween 2]

Also, most people who object to national health coverage do not seem to understand that those of us who do have insurance are already paying for those who do not have insurance by way of higher health costs and insurance premiums.

very true!

health costs are also much higher because of the unhealthy lifestyles a lot of us lead, which means preventative care & education should be priorities as well (if possible).

i hate to be a bummer, but i wonder if we can pull this off...

[one...two...tree 2,762]

Also, most people who object to national health coverage do not seem to understand that those of us who do have insurance are already paying for those who do not have insurance by way of higher health costs and insurance premiums.

very true!

health costs are also much higher because of the unhealthy lifestyles a lot of us lead, which means preventative care & education should be priorities as well (if possible).

i hate to be a bummer, but i wonder if we can pull this off...

I hope so... the Obama Administration is talking about a single payer system, but more like expanding Medicare to those who cannot afford their own private insurance. It's a step in the right direction.

Edited May 14, 2009 by Col. 'Bat' Guano

[mawilson 2,133]

People on Medicare spend an average of 30% of their income on out-of-pocket health costs.

Thirty percent! It’s astounding. And, as you can imagine, it’s unsustainable in this economy.

Why is it astounding? What else are old people going to spend their income on?

[Ban Hammer 13,364]

People on Medicare spend an average of 30% of their income on out-of-pocket health costs.

Thirty percent! It’s astounding. And, as you can imagine, it’s unsustainable in this economy.

Why is it astounding? What else are old people going to spend their income on?

yeah, it keeps them off the road