They pay less because they "negotiate" a lower price. They have people who know what it actually costs. Plus doctor's know they're going to get paid if they "play by the rules" with the insurance company. The problem is that the average person can't deal because some places only want to take insurance plus you don't know the costs and don't have the time to contact multiple doctors' offices or even have multiple consultations (and their fees) if you feel their opinion is wrong. You could ask about the costs before seeing the doctor, but if you have insurance they may not be willing to negotiate much because they know what they will getting from the insurance company. If you don't have insurance, you have to talk to them and try to work out a deal. Plus you better be prepared to be turned down or offer some cash upfront if you want to be seen.
They pay less because they "negotiate" a lower price. They have people who know what it actually costs. Plus doctor's know they're going to get paid if they "play by the rules" with the insurance company. The problem is that the average person can't deal because some places only want to take insurance plus you don't know the costs and don't have the time to contact multiple doctors' offices or even have multiple consultations (and their fees) if you feel their opinion is wrong. You could ask about the costs before seeing the doctor, but if you have insurance they may not be willing to negotiate much because they know what they will getting from the insurance company. If you don't have insurance, you have to talk to them and try to work out a deal. Plus you better be prepared to be turned down or offer some cash upfront if you want to be seen.
How would they know if they did? They don't get the hospitals' accounting records. However I think it's more why would they give a single customer a discount that is given to someone who provides the bulk of their clients? That includes medicare and medicaid.
0roo0roo
No Lifer
- Sep 21, 2002
- 64,795
- 84
- 91
yea the system is messed up
http://www.thisamericanlife.org/radio-archives/episode/433/fine-print-2011
act 1 of this show shone a light on some bizarre sh*t that goes on.....
http://www.thisamericanlife.org/radio-archives/episode/433/fine-print-2011
act 1 of this show shone a light on some bizarre sh*t that goes on.....
senseamp
Lifer
- Feb 5, 2006
- 35,787
- 6,197
- 126
What's to stop an insurer from sending someone undercover to ask for a discount themselves and see how low of a rate they can get? And if they find out that even a sick guy negotiating under duress is getting a bigger discount than them, they are going to demand an even lower rate.
Are they going to setup some elaborate stunt to pull that off? A hospital isn't going to give a discount on everything. Plus even different insurance companies have different rates per service so it wouldn't be very effective to do it.
alkemyst
No Lifer
- Feb 13, 2001
- 83,769
- 19
- 81
The way it works is someone like an Aetna dictates to the hospital that to be part of their network, this is all they will allow. They caveat that with you cannot charge their participants the difference.
The hospital can take it or leave it.
They then have to take all the trailer trash that washes up on the ER steps due to getting shanked, overdosing, etc and not get a penny.
Then they get the bonus of being sued by some of these types.
They finally have to make up their budget and the only people left are those choosing to 'pay as you go' for their health care.
There is no way to know whether the new health care bill will be a success or not until all parts of the health care bill has kicked in. This won't happen for quite some time yet.
Of course it failed - just like every other scumbag politician Obama sold us out to corporate interests. Hardly surprising considering rational debate among average Americans is nigh impossible, without idiots screaming about Death Panels or how the Other Side (otherwise known as The Enemy) is evil incarnate, but their side can never do any wrong.
- Dec 18, 2001
- 5,641
- 1,909
- 136
Actually from what we where told Urgent Care and doctor's offices cannot give a Toradol shot. So you are stuck with going to the Hospital. My wife has the medication that she takes when she feels the migraine coming on. However for this one it did nothing. Basically when she talked to the doctor's office if she should come in they told her that there wasn't anything they could do and she needed to go the ER to get the Toradol shot. I would think that Urgent Care should be able to give a Toradol shot. However maybe there is some stupid law in CA that prevents this. We eventually went and did see a pain management specialist specializing in headaches and the migraines are back under control. However at the time we where kind of stuck.
the healthcare bill has mostly been gutted already since the repubs took over majority in congress.
the first parts were to go into effect by 2012 I believe with the majority starting in 2014. nothing has even happened yet, and probably wont once congress finishes killing it off.
keep being uneducated and blindly hating obama though. nevermind the rest of our shitty government.
the first parts were to go into effect by 2012 I believe with the majority starting in 2014. nothing has even happened yet, and probably wont once congress finishes killing it off.
keep being uneducated and blindly hating obama though. nevermind the rest of our shitty government.
As far as I'm concerned both sides fucked us over (and are continuing to do so), but I place a lot of the blame on Obama because instead of assuming a leadership role he handed the issue over to Congress. Maybe if he'd had some fucking balls we would have ended up with something better.
No one here is blindly hating Obama. Just because most of the repubs in congress are bad doesn't excuse Obama for the what he has done.
Also this is why we need a Single-Provider healthcare system. Not just a single payer, but a single provider. Time to end all private work in medical care, and time for the government to take over and clean up.
I've had Aetna for the past 8 years.
a handful of trips to the ER, 3 major surgeries, and the usual common stuff... no hassels and no expenses that I considered to be unreasonable.
clearly the broken system is on the brink of collapse.
a handful of trips to the ER, 3 major surgeries, and the usual common stuff... no hassels and no expenses that I considered to be unreasonable.
clearly the broken system is on the brink of collapse.
[FONT="]Aetna thru Ball Aerospace was responsible for having my disability and my insurance health coverage dropped and also was responsible for having me "involuntarily terminated" from my job because of their "over the phone" examination. I was terminated from my position at Ball Aerospace while I was on disability leave and was at the time considered an full time employee. Aetna is the worst insurance that I know of and hides behind Ball Aerospace in its excuses for not providing coverage and also for their involvement in terminating me for getting sick. Because of my health issues I believe Ball Aerospace along with Aetna hope I die before any of this gets resolved which is the same as murder. If you get sick while at Ball Aerospace expect to die if it is serious its what Ball Aerospace and Aetna want.... [/FONT]
alkemyst
No Lifer
- Feb 13, 2001
- 83,769
- 19
- 81
[FONT="]Aetna thru Ball Aerospace was responsible for having my disability and my insurance health coverage dropped and also was responsible for having me "involuntarily terminated" from my job because of their "over the phone" examination. I was terminated from my position at Ball Aerospace while I was on disability leave and was at the time considered an full time employee. Aetna is the worst insurance that I know of and hides behind Ball Aerospace in its excuses for not providing coverage and also for their involvement in terminating me for getting sick. Because of my health issues I believe Ball Aerospace along with Aetna hope I die before any of this gets resolved which is the same as murder. If you get sick while at Ball Aerospace expect to die if it is serious its what Ball Aerospace and Aetna want.... [/FONT]
Chances are Ball Aerospace made that call. Without qualifying your 'disability leave' you fall into the masses looking to be paid to stay at home and drink/game/sleep/eat/etc.
alkemyst
No Lifer
- Feb 13, 2001
- 83,769
- 19
- 81
I always lolz when anecdotal is brought up as crap.
30+ years ago anecdotal usually was favored (providing the person wasn't an idiot).
Stating this you have proven you are on list of the sheep most of the time.
- Oct 30, 2000
- 42,589
- 5
- 0
[FONT="]Aetna thru Ball Aerospace was responsible for having my disability and my insurance health coverage dropped and also was responsible for having me "involuntarily terminated" from my job because of their "over the phone" examination. I was terminated from my position at Ball Aerospace while I was on disability leave and was at the time considered an full time employee. Aetna is the worst insurance that I know of and hides behind Ball Aerospace in its excuses for not providing coverage and also for their involvement in terminating me for getting sick. Because of my health issues I believe Ball Aerospace along with Aetna hope I die before any of this gets resolved which is the same as murder. If you get sick while at Ball Aerospace expect to die if it is serious its what Ball Aerospace and Aetna want.... [/FONT]
Aetena calls you and ask some health related questions.
You give them the incorrect answers.
They contact Ball; Aetna is the one providing your disability insurance.
Ball determines that you should not be on disability leave based on what they were told by Aetna.
Ball pulls the plug on you.
Seems like you need to figure out what you said incorrectly and try to get the determination reversed if legit.
Do not go play a gang of pickup ball ever again.
Now you may feel you have a different story - but without the details; this is what Aetna and Ball see.
Last edited by a moderator:
Brigandier
Diamond Member
- Feb 12, 2008
- 4,394
- 2
- 81
Me too. I take personal experiences of people I know as a counterpoint to statistics, or so called "truths" out there.
Anecdotal evidence isn't the be all end all, but it should be taken, albeit with a grain of salt.
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