HealthCare Costs

[Brovane]

I know this is a inflammatory subject. I just thought I would relate my latest experience with the American Health Care System. The wife went into the hospital for 2-nights to have her Thyroid removed because it was very enlarged and going into her trachea and could have started impacting her breathing. After we got the bill. Yes I do have health insurance I was amazed. The Bill was $24k however the negotiated amount with the insurance company was $4k. We ended up paying around $1k for everything which was fine since we have a FSA.

My question is basically if you don't have health insurance you are charged $24k for the same service that they charge $4k for people with health insurance. So the people with the lest ability to pay are charged the most? This to me just sounds crazy. Also how can there be such a great discrepancy in charges for essentially the same service? The entire setup to me just seems crooked. I am just left shaking my head. I know that maybe nationalized health insurance isn't the answers but something is very broken with a system that charges between $4k to $24k for the same service. Just my two cents on the subject.

 

[JS80]

Originally posted by: Brovane
I know this is a inflammatory subject. I just thought I would relate my latest experience with the American Health Care System. The wife went into the hospital for 2-nights to have her Thyroid removed because it was very enlarged and going into her trachea and could have started impacting her breathing. After we got the bill. Yes I do have health insurance I was amazed. The Bill was $24k however the negotiated amount with the insurance company was $4k. We ended up paying around $1k for everything which was fine since we have a FSA.

My question is basically if you don't have health insurance you are charged $24k for the same service that they charge $4k for people with health insurance. So the people with the lest ability to pay are charged the most? This to me just sounds crazy. Also how can there be such a great discrepancy in charges for essentially the same service? The entire setup to me just seems crooked. I am just left shaking my head. I know that maybe nationalized health insurance isn't the answers but something is very broken with a system that charges between $4k to $24k for the same service. Just my two cents on the subject.

Why shouldn't the doctors charge whatever they want to get their $500k salary?

But the right answer is "Medicaid."

 

[sactoking]

Well, there are two answers to your question(s) and I am not advocating either, just stating them:

1) Those w/o insurance are also most likely to not pay their bill at all, meaning that they don't get hit with the $24,000 in costs, your insurance company does. That $4,000 your insurance paid probably should have been $2-3,000 but they had to absorb costs from the hospital spreading the bad debt around.

2) Private citizens are just as able to negotiate their bills are insurance companies are. In some instances, even more so. There's nothing preventing a patient from researching the reasonable charge for a service and negotiating on price.

 

[StageLeft]

Originally posted by: Brovane
I know this is a inflammatory subject. I just thought I would relate my latest experience with the American Health Care System. The wife went into the hospital for 2-nights to have her Thyroid removed because it was very enlarged and going into her trachea and could have started impacting her breathing. After we got the bill. Yes I do have health insurance I was amazed. The Bill was $24k however the negotiated amount with the insurance company was $4k. We ended up paying around $1k for everything which was fine since we have a FSA.

My question is basically if you don't have health insurance you are charged $24k for the same service that they charge $4k for people with health insurance. So the people with the lest ability to pay are charged the most? This to me just sounds crazy. Also how can there be such a great discrepancy in charges for essentially the same service? The entire setup to me just seems crooked. I am just left shaking my head. I know that maybe nationalized health insurance isn't the answers but something is very broken with a system that charges between $4k to $24k for the same service. Just my two cents on the subject.

You are right, insurance pays $4k and people without it will pay $24k (notwithstanding any negotiation, which will be MUCH higher than insurance can get). This is because hospitals know a lot of people will never pay up, so they gouge the fvck out of those who will so that they can break even. Think of it as how when you have really bad credit you get a high interest loan even though ironically that high interest makes your ability to pay it back worse.

There's nothing preventing a patient from researching the reasonable charge for a service and negotiating on price.

But the hospital can say no, you are paying $24k or we see you in court. They try that with the insurance company and the company starts telling people not to see any doctor associated with the hospital, etc., so they at least have a position they can negotiate from. I wonder if there is a group to help negotiate on people's behalf.

 

[sactoking]

Originally posted by: Skoorb
I wonder if there is a group to help negotiate on people's behalf.

The AMA is very interested in cases of improper billing by member doctors.

 

[Atomic Playboy]

Originally posted by: sactoking
2) Private citizens are just as able to negotiate their bills are insurance companies are. In some instances, even more so. There's nothing preventing a patient from researching the reasonable charge for a service and negotiating on price.

In the event of an emergency surgery, you're going to be going around to different hospitals and private practices trying to negotiate the best price? No, because you'd be dead by the time you managed to get an appointment with three of them. It's ludicrous to expect that people would shop around for healthcare the same way they'd shop around for a good auto shop.

 

[sactoking]

Originally posted by: Atomic Playboy
In the event of an emergency surgery, you're going to be going around to different hospitals and private practices trying to negotiate the best price? No, because you'd be dead by the time you managed to get an appointment with three of them. It's ludicrous to expect that people would shop around for healthcare the same way they'd shop around for a good auto shop.

I meant after the fact. Going to a hospital, meeting with the highest up person you can, and saying "You charged me $24,000 for a $4,000 procedure. You can either agree to take $4,000 or I go BK and you get nothing" has been pretty effective in the past.

 

[Slew Foot]

Originally posted by: JS80

Originally posted by: Brovane
I know this is a inflammatory subject. I just thought I would relate my latest experience with the American Health Care System. The wife went into the hospital for 2-nights to have her Thyroid removed because it was very enlarged and going into her trachea and could have started impacting her breathing. After we got the bill. Yes I do have health insurance I was amazed. The Bill was $24k however the negotiated amount with the insurance company was $4k. We ended up paying around $1k for everything which was fine since we have a FSA.

My question is basically if you don't have health insurance you are charged $24k for the same service that they charge $4k for people with health insurance. So the people with the lest ability to pay are charged the most? This to me just sounds crazy. Also how can there be such a great discrepancy in charges for essentially the same service? The entire setup to me just seems crooked. I am just left shaking my head. I know that maybe nationalized health insurance isn't the answers but something is very broken with a system that charges between $4k to $24k for the same service. Just my two cents on the subject.

Why shouldn't the doctors charge whatever they want to get their $500k salary?

But the right answer is "Medicaid."

The 24K was the hospitals bill. That includes the facility, nursing, OR staff, pharmacy, landscaping, community outreach, advertising, etc...
Doctors typically get paid separately, on the bill it will be labeled professional fee. For a surgery like this, its likely 1-2K at the most.

 

[MonkeyK]

Also, by calling it 24K, if the patient doesn't pay, well that's a 24K write-down

Honestly Mr Taxman, we ARE a non-profit

 

[Insomniator]

I don't understand why its just assumed people should have health insurance aka other people paying for their issues. I think an insurance company that only covered people with actual jobs and are not thousands in debt would be very successful.

Insurance can't work when people don't have to pay. Shit happens, nothing is guaranteed in life. Just because you need 25k surgery doesn't mean it should be a given that you can get it regardless of you situation.

 

[mooseracing]

Originally posted by: Insomniator
I don't understand why its just assumed people should have health insurance aka other people paying for their issues.

Just like so many people think healthcare is a right, along with living a decent life, ala welfare.

The cream raises to the top, there isn't someone there taking a spoon digging the bottom and making sure not leave someone/thing behind.

 

[Brovane]

Originally posted by: Insomniator
I don't understand why its just assumed people should have health insurance aka other people paying for their issues. I think an insurance company that only covered people with actual jobs and are not thousands in debt would be very successful.

Insurance can't work when people don't have to pay. Shit happens, nothing is guaranteed in life. Just because you need 25k surgery doesn't mean it should be a given that you can get it regardless of you situation.

Can you imagine the screaming from the public if somebody was allowed to die because they couldn't afford a surgery. Basically the laws are written that the hospital has to treat everyone and stabilize them irregardless of the ability to pay. Basically if you have Health Insurance you are good. If you have no assets our very little you are fine. It is the people in the middle that get hosed that don't have a job with health insurance our lost a job with health insurance but make to much money our to many assets to get medicaid.

 

[Brovane]

Originally posted by: sactoking

Originally posted by: Atomic Playboy
In the event of an emergency surgery, you're going to be going around to different hospitals and private practices trying to negotiate the best price? No, because you'd be dead by the time you managed to get an appointment with three of them. It's ludicrous to expect that people would shop around for healthcare the same way they'd shop around for a good auto shop.

I meant after the fact. Going to a hospital, meeting with the highest up person you can, and saying "You charged me $24,000 for a $4,000 procedure. You can either agree to take $4,000 or I go BK and you get nothing" has been pretty effective in the past.

How would you know it was a $4k procedure. The hospital is not just going to tell you what the negotiated amounts are with various health insurance companies. Also hospitals make it every difficult to find out the cost of service before hand. It isn't like shopping at wal-mart.

 

[Atheus]

Originally posted by: Insomniator
I don't understand why its just assumed people should have health insurance aka other people paying for their issues.

Because it is not a child's fault if their parents don't have any money? Becasue it's not an old person's fault if their pension fund collapses in the recession? Because the hardest jobs pay the least? Because if a dying human being came to your house and asked for help you would help them without asking for money or burn in hell?

*disclaimer; hell does not exist

 

[PokerGuy]

OP, I agree 100% with your post, I've thought the exact same thing. It makes no sense to me that if you have insurance, your insurance gets billed $4k, but if you don't have insurance, you get billed $24k for the same procedure.

 

[alchemize]

It's because unisured people don't/can't pay their bills. It goes to collections, most gets written off. So where an insurance company pays $4K of the $24K bill, on average uninsured probably pay $1K (complete guess) of the $24K bill.

 

[nobodyknows]

Originally posted by: alchemize
It's because unisured people don't/can't pay their bills. It goes to collections, most gets written off. So where an insurance company pays $4K of the $24K bill, on average uninsured probably pay $1K (complete guess) of the $24K bill.

No wonder there are so many medical bankruptcies.


Unhealthy Solutions: Private Insurance, High Costs and the Denial of Care

MM: What are the financial costs to individuals and families, including especially the uninsured?

Woolhandler: We have looked at bankruptcy to see what share of all U.S. bankruptcies are due to medical illness and medical bills. It turns out that at about half of all U.S. bankruptcies are due at least in part to illness. The most surprising thing in our study on bankruptcy was that the overwhelming majority of those American families pushed into bankruptcy by medical bills had insurance, at least at the onset of the illness that bankrupted them. About 76 percent of all people in the U.S. pushed into medical bankruptcy do have health insurance when they first get sick.

There are two ways that they are bankrupted. Sometimes people have insurance through their job, but they become too sick to work, or have to take off work to care for a very sick child, and they lose their health insurance. So they have health insurance and then lose it because of the illness itself.

But another very frequent scenario in our bankruptcy data involved people who held onto their insurance, usually private insurance, throughout the illness that bankrupted them. They were insured the entire time, but were bankrupted anyway by gaps in their coverage ? uncovered services, co-payments and deductibles.

Private health insurance is a defective product. On one hand, you may lose it when you need it most ? when you get sick. On the other hand, even if you are able to hold onto private insurance, the gaps in the coverage mean that you may be bankrupted anyway.

 

[winnar111]

If Zero's health care bonanza is such an 'investment', why is the deficit projected to be $700 billion 10 years from now, despite assuming higher sustained economic growth than this nation has ever seen?

 

[mooseracing]

Originally posted by: Atheus

Originally posted by: Insomniator
I don't understand why its just assumed people should have health insurance aka other people paying for their issues.

Because it is not a child's fault if their parents don't have any money? Becasue it's not an old person's fault if their pension fund collapses in the recession? Because the hardest jobs pay the least? Because if a dying human being came to your house and asked for help you would help them without asking for money or burn in hell?

*disclaimer; hell does not exist

ahh so your beliefs should be pushed on me and I should have to pay for them?

The people that want to be "nice" to society can start their own incurance company that gives out free care and pay for it out of their pocket. I would like to take home at least half my earnings every year, not taxed more for people who aren't going to help recover the costs. Kind of like prisoners, they either work or they die. Not living for free.

 

[alchemize]

Originally posted by: nobodyknows

Originally posted by: alchemize
It's because unisured people don't/can't pay their bills. It goes to collections, most gets written off. So where an insurance company pays $4K of the $24K bill, on average uninsured probably pay $1K (complete guess) of the $24K bill.

No wonder there are so many medical bankruptcies.


Unhealthy Solutions: Private Insurance, High Costs and the Denial of Care

MM: What are the financial costs to individuals and families, including especially the uninsured?

Woolhandler: We have looked at bankruptcy to see what share of all U.S. bankruptcies are due to medical illness and medical bills. It turns out that at about half of all U.S. bankruptcies are due at least in part to illness. The most surprising thing in our study on bankruptcy was that the overwhelming majority of those American families pushed into bankruptcy by medical bills had insurance, at least at the onset of the illness that bankrupted them. About 76 percent of all people in the U.S. pushed into medical bankruptcy do have health insurance when they first get sick.

There are two ways that they are bankrupted. Sometimes people have insurance through their job, but they become too sick to work, or have to take off work to care for a very sick child, and they lose their health insurance. So they have health insurance and then lose it because of the illness itself.

But another very frequent scenario in our bankruptcy data involved people who held onto their insurance, usually private insurance, throughout the illness that bankrupted them. They were insured the entire time, but were bankrupted anyway by gaps in their coverage ? uncovered services, co-payments and deductibles.

Private health insurance is a defective product. On one hand, you may lose it when you need it most ? when you get sick. On the other hand, even if you are able to hold onto private insurance, the gaps in the coverage mean that you may be bankrupted anyway.

Of course physicians hate private insurace, it reduces their income. But as I've said many a time, it is flawed in that the burden of the uninsured is put onto employers and their employees, hospitals, and the taxpayers, and that it is a very large factor in bankruptcies. Nobody should go bankrupt because they got sick. We should figure out a way to offer (at a cost) coverage on a national basis and cut the whole "emergency room" plan that is how unisured get treated now.

 

[bipartisanpwnage]

Originally posted by: mooseracing

Originally posted by: Atheus

Originally posted by: Insomniator
I don't understand why its just assumed people should have health insurance aka other people paying for their issues.

Because it is not a child's fault if their parents don't have any money? Becasue it's not an old person's fault if their pension fund collapses in the recession? Because the hardest jobs pay the least? Because if a dying human being came to your house and asked for help you would help them without asking for money or burn in hell?

*disclaimer; hell does not exist

ahh so your beliefs should be pushed on me and I should have to pay for them?

The people that want to be "nice" to society can start their own incurance company that gives out free care and pay for it out of their pocket. I would like to take home at least half my earnings every year, not taxed more for people who aren't going to help recover the costs. Kind of like prisoners, they either work or they die. Not living for free.

I can only think of one word to say....wow. I don't consider myself the kindest of people, however people like you really take the cake. In case you are unaware, it takes people of all types to make a community, a community of which you are a part. I am personally trying to figure out what it is that makes people like you so heartless and selfish.

Some people face circumstances that simply do not allow for the kind of growth required in an individual to achieve success. Providing health care and education at the expense of those who are more well off is I think very responsible from an investment standpoint for both parties involved. You create a healthier, more educated workforce from the bottom up and, although you spend money now, you create the potential for more productivity in the future. Don't be so quick to judge those that are experiencing problems you have been lucky enough to avoid. Oh and guess what, regardless of your judgment of these people, you STILL have to live with them. I figure, if you don't like it you might as well help lift them from their circumstances so that they may grow.

When I graduate from school and I am making six figures, I am not really going to mind being taxed 50%, or hell even 60%. I would obviously prefer that the money be spent more efficiently and on more effective programs, but we need a more educated voting base and government to do so. And to those making millions of dollars a year, I really doubt they will be unable to obtain the essentials even if they were taxed 80%. I mean come on people. As one of my favorite songs so eloquently states

"Angels on the sideline,
Puzzled and amused.
Why did Father give these humans free will?
Now they're all confused.

Don't these talking monkeys know that
Eden has enough to go around?
Plenty in this holy garden, silly monkeys,
where there's one you're bound to divide it

Right in two

Angels on the sideline,
Baffled and confused.
Father blessed them all with reason.
And this is what they choose.

Silly monkeys give them thumbs,
They forge a blade,
And where there's one they're
bound to divide it,

Right in two.

Monkey killing monkey killing monkey
Over pieces of the ground.
Silly monkeys give them thumbs, they make a club
And beat their brother down.

How they survive so misguided is a mystery.
Repugnant is a creature who would squander the ability
to live tonight in heaven conscious of his fleeting time here.

cut it, divide it all right in two

Angels on the sideline again
Benched along with patience and reason
Angels on the sideline again
Wondering when this tug of war will end"

-Right in two by Tool

 

[nobodyknows]

Originally posted by: alchemize

Originally posted by: nobodyknows

Originally posted by: alchemize
It's because unisured people don't/can't pay their bills. It goes to collections, most gets written off. So where an insurance company pays $4K of the $24K bill, on average uninsured probably pay $1K (complete guess) of the $24K bill.

No wonder there are so many medical bankruptcies.


Unhealthy Solutions: Private Insurance, High Costs and the Denial of Care

MM: What are the financial costs to individuals and families, including especially the uninsured?

Woolhandler: We have looked at bankruptcy to see what share of all U.S. bankruptcies are due to medical illness and medical bills. It turns out that at about half of all U.S. bankruptcies are due at least in part to illness. The most surprising thing in our study on bankruptcy was that the overwhelming majority of those American families pushed into bankruptcy by medical bills had insurance, at least at the onset of the illness that bankrupted them. About 76 percent of all people in the U.S. pushed into medical bankruptcy do have health insurance when they first get sick.

There are two ways that they are bankrupted. Sometimes people have insurance through their job, but they become too sick to work, or have to take off work to care for a very sick child, and they lose their health insurance. So they have health insurance and then lose it because of the illness itself.

But another very frequent scenario in our bankruptcy data involved people who held onto their insurance, usually private insurance, throughout the illness that bankrupted them. They were insured the entire time, but were bankrupted anyway by gaps in their coverage ? uncovered services, co-payments and deductibles.

Private health insurance is a defective product. On one hand, you may lose it when you need it most ? when you get sick. On the other hand, even if you are able to hold onto private insurance, the gaps in the coverage mean that you may be bankrupted anyway.

Of course physicians hate private insurace, it reduces their income. But as I've said many a time, it is flawed in that the burden of the uninsured is put onto employers and their employees, hospitals, and the taxpayers, and that it is a very large factor in bankruptcies. Nobody should go bankrupt because they got sick. We should figure out a way to offer (at a cost) coverage on a national basis and cut the whole "emergency room" plan that is how unisured get treated now.

Then what's taking so long?

 

[nobodyknows]

Originally posted by: nobodyknows

Originally posted by: alchemize

Originally posted by: nobodyknows

Originally posted by: alchemize
It's because unisured people don't/can't pay their bills. It goes to collections, most gets written off. So where an insurance company pays $4K of the $24K bill, on average uninsured probably pay $1K (complete guess) of the $24K bill.

No wonder there are so many medical bankruptcies.


Unhealthy Solutions: Private Insurance, High Costs and the Denial of Care

MM: What are the financial costs to individuals and families, including especially the uninsured?

Woolhandler: We have looked at bankruptcy to see what share of all U.S. bankruptcies are due to medical illness and medical bills. It turns out that at about half of all U.S. bankruptcies are due at least in part to illness. The most surprising thing in our study on bankruptcy was that the overwhelming majority of those American families pushed into bankruptcy by medical bills had insurance, at least at the onset of the illness that bankrupted them. About 76 percent of all people in the U.S. pushed into medical bankruptcy do have health insurance when they first get sick.

There are two ways that they are bankrupted. Sometimes people have insurance through their job, but they become too sick to work, or have to take off work to care for a very sick child, and they lose their health insurance. So they have health insurance and then lose it because of the illness itself.

But another very frequent scenario in our bankruptcy data involved people who held onto their insurance, usually private insurance, throughout the illness that bankrupted them. They were insured the entire time, but were bankrupted anyway by gaps in their coverage ? uncovered services, co-payments and deductibles.

Private health insurance is a defective product. On one hand, you may lose it when you need it most ? when you get sick. On the other hand, even if you are able to hold onto private insurance, the gaps in the coverage mean that you may be bankrupted anyway.

Of course physicians hate private insurace, it reduces their income. But as I've said many a time, it is flawed in that the burden of the uninsured is put onto employers and their employees, hospitals, and the taxpayers, and that it is a very large factor in bankruptcies. Nobody should go bankrupt because they got sick. We should figure out a way to offer (at a cost) coverage on a national basis and cut the whole "emergency room" plan that is how unisured get treated now.

Then what's taking so long?

<crickets>