More on hospitals and gouging

[astrosfan90]

Link to the story

They do a good job of highlighting how uninsured patients are screwed by the system and charged triple or more than what other patients are charged for procedures. It also notes that HALF of all bankruptcies in the US are as a result of medical expenses such as these.

 

[theeedude]

Federal law does require hospitals to charge every patient the same, whether they have insurance or not. But hospitals can accept different payments from different patients ? and they do.

We need a new federal law to requre that insured and uninsured patients are not only charged the same, but that the insurance company and the uninsured also pay the same.

 

[HombrePequeno]

Originally posted by: senseamp

Federal law does require hospitals to charge every patient the same, whether they have insurance or not. But hospitals can accept different payments from different patients ? and they do.

We need a new federal law to requre that insured and uninsured patients are not only charged the same, but that the insurance company and the uninsured also pay the same.

Essentially people without insurance are paying a risk premium because there is a higher possibilty that they won't be able to pay the entire amount. It's like a credit card company charging a higher interest rate on people who have worse credit because they have a higher chance of declaring bankruptcy.

 

[TraumaRN]

Originally posted by: HombrePequeno

Originally posted by: senseamp

Federal law does require hospitals to charge every patient the same, whether they have insurance or not. But hospitals can accept different payments from different patients ? and they do.

We need a new federal law to requre that insured and uninsured patients are not only charged the same, but that the insurance company and the uninsured also pay the same.

Essentially people without insurance are paying a risk premium because there is a higher possibilty that they won't be able to pay the entire amount. It's like a credit card company charging a higher interest rate on people who have worse credit because they have a higher chance of declaring bankruptcy.

Exactly. It sucks no doubt but people tend to forget hospitals are businesses too and they need money to stay alive. As is many hospitals are struggling to get by because of the expenses involved with taking care of uninsured patients. Alot of hospitals are also unwilling to invoke change to save money, time, efficiency etc, if more hospitals streamlined their services and delivered timely and effective treatment I honestly believe costs for the hospitals would decrease.

EDIT: Post 1000

 

[theeedude]

Originally posted by: HombrePequeno

Originally posted by: senseamp

Federal law does require hospitals to charge every patient the same, whether they have insurance or not. But hospitals can accept different payments from different patients ? and they do.

We need a new federal law to requre that insured and uninsured patients are not only charged the same, but that the insurance company and the uninsured also pay the same.

Essentially people without insurance are paying a risk premium because there is a higher possibilty that they won't be able to pay the entire amount. It's like a credit card company charging a higher interest rate on people who have worse credit because they have a higher chance of declaring bankruptcy.

Well, if you charge someone 4 times as much for healthcare, no big surprise they have a higher chance of declaring bankruptcy.
The thing is that hospitals charge the same thing from insured and uninsured. Yet if insurance company comes back to pay the bill they will accept a quarter of the charge as payment, but if an uninsured person comes back to pay the bill they won't. So even if they are both ready to pay at the same time for the same service, the uninsured has to pay 4 times as much.
If you are self insured motorist, and you have an accident, it's going to cost you same or less to pay for it out of pocket than an insurance company will pay to repair it.
The hospitals are clearly circumventing the intent of the federal law by charging same amounts, but accepting pennies on the dollar from insurance companies, while screwing the uninsured. That's why there needs to be another federal law to fill that loophole.

 

[conjur]

Originally posted by: HombrePequeno

Originally posted by: senseamp

Federal law does require hospitals to charge every patient the same, whether they have insurance or not. But hospitals can accept different payments from different patients ? and they do.

We need a new federal law to requre that insured and uninsured patients are not only charged the same, but that the insurance company and the uninsured also pay the same.

Essentially people without insurance are paying a risk premium because there is a higher possibilty that they won't be able to pay the entire amount. It's like a credit card company charging a higher interest rate on people who have worse credit because they have a higher chance of declaring bankruptcy.

And it feeds the cycle.

Some of the discounts Humana managed (80% at times on the bills I received) on hospital charges are just astounding. The insurance companies are raking in premiums and then cutting deals for massive discounts with the providers. That leaves the uninsured or underinsured (a quickly growing segment of our society) stuck paying the rest. And, since their wages are falling behind inflation, they're mortgaging their homes, selling their homes, working 2-3 jobs, etc. to cover the expenses.

Ownership society? HA!

More like the pwn3d society.

 

[theeedude]

Originally posted by: DeathBUA

Originally posted by: HombrePequeno

Originally posted by: senseamp

Federal law does require hospitals to charge every patient the same, whether they have insurance or not. But hospitals can accept different payments from different patients ? and they do.

We need a new federal law to requre that insured and uninsured patients are not only charged the same, but that the insurance company and the uninsured also pay the same.

Essentially people without insurance are paying a risk premium because there is a higher possibilty that they won't be able to pay the entire amount. It's like a credit card company charging a higher interest rate on people who have worse credit because they have a higher chance of declaring bankruptcy.

Exactly. It sucks no doubt but people tend to forget hospitals are businesses too and they need money to stay alive. As is many hospitals are struggling to get by because of the expenses involved with taking care of uninsured patients. Alot of hospitals are also unwilling to invoke change to save money, time, efficiency etc, if more hospitals streamlined their services and delivered timely and effective treatment I honestly believe costs for the hospitals would decrease.

EDIT: Post 1000

But why should only the other uninsured be subsidizing the deadbeats, and not the insurance comapanies too? Hospital costs are not the problem. Hospital charges are. If hospital charges 4 times what it costs them, and their costs go down, they can keep the charge the same. What are you gonna do about it? You don't know ahead of time what you'll be charged, so it's not like you can shop around. If hospitals can get away with charging whatever they want, they will keep doing it.

 

[borosp1]

Originally posted by: DeathBUA

Originally posted by: HombrePequeno

Originally posted by: senseamp

Federal law does require hospitals to charge every patient the same, whether they have insurance or not. But hospitals can accept different payments from different patients ? and they do.

We need a new federal law to requre that insured and uninsured patients are not only charged the same, but that the insurance company and the uninsured also pay the same.

Exactly. It sucks no doubt but people tend to forget hospitals are businesses too and they need money to stay alive. As is many hospitals are struggling to get by because of the expenses involved with taking care of uninsured patients. Alot of hospitals are also unwilling to invoke change to save money, time, efficiency etc, if more hospitals streamlined their services and delivered timely and effective treatment I honestly believe costs for the hospitals would decrease.

Essentially people without insurance are paying a risk premium because there is a higher possibilty that they won't be able to pay the entire amount. It's like a credit card company charging a higher interest rate on people who have worse credit because they have a higher chance of declaring bankruptcy.

The doctors and Hospital Executives have to make $500k a year from somewhere right? We need universal healthcare in America as healthcare should not be seen as privledge to those who are privledged but a right for all. Thats why poor people sometimes avoid going to the emergency room because they know there gonna have financial hardship in repaying the bill... Thats not how medical treatment and human health should be run.

 

[Thump553]

You have it wrong, HombrePequeno. It's a result of market forces, either real or artificial (ie, legislated). The government (Medicare and Medicaid) and nearly every private insurer mandate that the hospital charge them the lowest available rate.

Since all the big guys demand and get the lowest rate, someone has to be charged a higher rate. And guess who pays it-the uninsured and-more significantly these days-those with large deductibles. As employers dump more and more of health care costs on their employees, the structural unfairness of the current system will become a lot more apparent to more people.

The solution-everyone should be charged the same rate (usual and customary rate) for the same hospital services. The shortfall that inevitably comes from true inability to pay should be paid by a straight government subsidy. This would be the fairest system and would no longer disguise the actual health care costs to society.

 

[TraumaRN]

Originally posted by: senseamp

Originally posted by: DeathBUA

Originally posted by: HombrePequeno

Originally posted by: senseamp

Federal law does require hospitals to charge every patient the same, whether they have insurance or not. But hospitals can accept different payments from different patients ? and they do.

We need a new federal law to requre that insured and uninsured patients are not only charged the same, but that the insurance company and the uninsured also pay the same.

Essentially people without insurance are paying a risk premium because there is a higher possibilty that they won't be able to pay the entire amount. It's like a credit card company charging a higher interest rate on people who have worse credit because they have a higher chance of declaring bankruptcy.

Exactly. It sucks no doubt but people tend to forget hospitals are businesses too and they need money to stay alive. As is many hospitals are struggling to get by because of the expenses involved with taking care of uninsured patients. Alot of hospitals are also unwilling to invoke change to save money, time, efficiency etc, if more hospitals streamlined their services and delivered timely and effective treatment I honestly believe costs for the hospitals would decrease.

EDIT: Post 1000

But why should only the other uninsured be subsidizing the deadbeats, and not the insurance comapanies too? Hospital costs are not the problem. Hospital charges are. If hospital charges 4 times what it costs them, and their costs go down, they can keep the charge the same. What are you gonna do about it? You don't know ahead of time what you'll be charged, so it's not like you can shop around. If hospitals can get away with charging whatever they want, they will keep doing it.

They get away with it because people often feel like there isnt another choice of hospital, and often times(especially in rural areas) there isnt. Or if there is it might be a couple hundred miles away. And hospital costs ARE a problem if the hospital cant cover it's own cost it wont be charging anybody anything because it will be out of business. Hospitals need to focus on getting costs down and then hopefully charges will follow especially considering how hotly contested patients are in urban settings.

And dont be quick to generalize about 'deadbeats' not paying, yes some of them are and some arent. As borosp1 stated health care should be a RIGHT FOR ALL, not just a priviledge for those with insurance.

If you really want to talk about bull$hit rules that hospitals have, how about the one where they'll only stablize an emergency patient then ship them elsewhere when they have the ability to handle and treat that patient and they only ship them elsewhere because the person is uninsured.

 

[jhu]

Originally posted by: Thump553
You have it wrong, HombrePequeno. It's a result of market forces, either real or artificial (ie, legislated). The government (Medicare and Medicaid) and nearly every private insurer mandate that the hospital charge them the lowest available rate.

Since all the big guys demand and get the lowest rate, someone has to be charged a higher rate. And guess who pays it-the uninsured and-more significantly these days-those with large deductibles. As employers dump more and more of health care costs on their employees, the structural unfairness of the current system will become a lot more apparent to more people.

The solution-everyone should be charged the same rate (usual and customary rate) for the same hospital services. The shortfall that inevitably comes from true inability to pay should be paid by a straight government subsidy. This would be the fairest system and would no longer disguise the actual health care costs to society.

that's not quite how it works. everyone does get charged the same. however, what the hospital or doctor charges isn't paid in full. you can charge whatever the hell you want, but medicare has a set fee schedule such that they pay what is on the fee schedule. for example, if a doctor charges $120 for a clinic visit, medicare will only pay maybe $30-$70 depending on the level of service of that visit. insurance companies pay more than medicare but usually less than the services charged. most doctors are only able to take on a limited number of medicare patients because medicare generally doesn't pay enough to cover over-head expenses. so what we have a very convoluted system of charge/fee schedules. and that's only the tip of the iceberg.

 

[Meuge]

Originally posted by: borosp1
The doctors and Hospital Executives have to make $500k a year from somewhere right?

It's the most common and one of the most notorious misconceptions that doctors make a lot of money. An average physician makes under $125k/year in the U.S., and that is continuing to drop. I saw a great poll, which illustrated that this kind of a misunderstanding is little more than anger and jealosy (I wish I had the link for it... it's very relevant to these arguments, but I didn't save it, and now I can't find it).

Two groups were polled, one was asked whether $150k/year was too much to pay to someone who had $500k in education loans, and who had spent 12 years after high school getting his degrees. The other group was asked if it was too much to pay a doctor $150k/year, given the same numbers as the first group. The first group was pretty evenly divided, but the second group overwhelmingly (>90%) voted that the salary was too much. The only difference being that the hypothetical person was identified as a doctor to the second group. If you think that this is not outrageous, then I don't know what is.

You think that paying doctors as much as secretaries will solve america's healthcare problems? You must be joking. There are about 700'000 physicians in the U.S. At $150k/year, that's $105B. With the per-capita health expenditure of around $3000/person/year, doctors salaries account for around 10% of the total cost.


We need universal healthcare in America as healthcare should not be seen as privledge to those who are privledged but a right for all. Thats why poor people sometimes avoid going to the emergency room because they no there gonna have financial hardship in repaying the bill... Thats not how medical treatment and human health should be run.
[/quote]

 

[conjur]

Originally posted by: jhu
that's not quite how it works. everyone does get charged the same. however, what the hospital or doctor charges isn't paid in full. you can charge whatever the hell you want, but medicare has a set fee schedule such that they pay what is on the fee schedule. for example, if a doctor charges $120 for a clinic visit, medicare will only pay maybe $30-$70 depending on the level of service of that visit. insurance companies pay more than medicare but usually less than the services charged. most doctors are only able to take on a limited number of medicare patients because medicare generally doesn't pay enough to cover over-head expenses. so what we have a very convoluted system of charge/fee schedules. and that's only the tip of the iceberg.

Insurance companies are able to negotiate massive discounts due to their sheer size.

This is just a perfect reason why healthcare costs should be removed from corporations and moved to the government. Nationalized healthcare plans with negotiated fees with the providers will result in EVERYONE having access to healthcare, esp. the all-important preventive kind. "An ounce of prevention is worth a pound of cure." Healthier society = more productive society. And, corporations are freed from one financial liability and have another one reduced: healthcare premiums and sick pay.

 

[JEDIYoda]

what you all who think things should be charged equally accross the board don`t know is that alot of health Insurance Companies actually go out seeking better package deals for there clients from hospitals and such so they can give us who do have insurance better rates......

 

[Duckzilla]

Originally posted by: Meuge

Originally posted by: borosp1
The doctors and Hospital Executives have to make $500k a year from somewhere right?

It's the most common and one of the most notorious misconceptions that doctors make a lot of money. An average physician makes under $125k/year in the U.S., and that is continuing to drop. I saw a great poll, which illustrated that this kind of a misunderstanding is little more than anger and jealosy (I wish I had the link for it... it's very relevant to these arguments, but I didn't save it, and now I can't find it).

Two groups were polled, one was asked whether $150k/year was too much to pay to someone who had $500k in education loans, and who had spent 12 years after high school getting his degrees. The other group was asked if it was too much to pay a doctor $150k/year, given the same numbers as the first group. The first group was pretty evenly divided, but the second group overwhelmingly (>90%) voted that the salary was too much. The only difference being that the hypothetical person was identified as a doctor to the second group. If you think that this is not outrageous, then I don't know what is.

You think that paying doctors as much as secretaries will solve america's healthcare problems? You must be joking. There are about 700'000 physicians in the U.S. At $150k/year, that's $105B. With the per-capita health expenditure of around $3000/person/year, doctors salaries account for around 10% of the total cost.


We need universal healthcare in America as healthcare should not be seen as privledge to those who are privledged but a right for all. Thats why poor people sometimes avoid going to the emergency room because they no there gonna have financial hardship in repaying the bill... Thats not how medical treatment and human health should be run.

[/quote]

150k is the lowest and thats for private practice. This is 2002:

Anesthesiology $306,964
Surgery, general $255,438
Obstetrics/Gynecology $233,061
Internal medicine $155,530
Pediatrics/Adolescent medicine $152,690
Psychiatry $163,144
Family Practice $150,267

To imply that all of them make 150k is absurd. Some specialist make over 500k.

 

[jhu]

Originally posted by: conjur
Insurance companies are able to negotiate massive discounts due to their sheer size.

This is just a perfect reason why healthcare costs should be removed from corporations and moved to the government. Nationalized healthcare plans with negotiated fees with the providers will result in EVERYONE having access to healthcare, esp. the all-important preventive kind. "An ounce of prevention is worth a pound of cure." Healthier society = more productive society. And, corporations are freed from one financial liability and have another one reduced: healthcare premiums and sick pay.

healthcare is one area where practically no one pays retail prices, except for the uninsured. even then, if you're uninsured you can generally call the hospital and say that you're not going to pay the full amount. however, not many people know this.

there's really no easy solution to this whole mess since there are so many factors involved. for example, medicare really needs to pay more for services since doctors who only see medicare patients won't be practicing very long. liability issues and tort reofrm is needed so that people in crisis states such as pennsylvania or florida can have affordable ob/gyn or other high-risk services.

 

[Meuge]

Originally posted by: Duckzilla
150k is the lowest and thats for private practice. This is 2002:

Anesthesiology $306,964
Surgery, general $255,438
Obstetrics/Gynecology $233,061
Internal medicine $155,530
Pediatrics/Adolescent medicine $152,690
Psychiatry $163,144
Family Practice $150,267

To imply that all of them make 150k is absurd. Some specialist make over 500k.

And your point being - they studied through high school, college, and medical school... sacrificed years of work during their youth, and came out with a gigantic mountains of loans. By the time a specialist makes those figures you're quoting, he's often 40-45 years old... having spent all the previous years getting there.

Who the f-ck are you to say that he's getting too much money?

 

[jhu]

Originally posted by: Duckzilla


150k is the lowest and thats for private practice. This is 2002:

Anesthesiology $306,964
Surgery, general $255,438
Obstetrics/Gynecology $233,061
Internal medicine $155,530
Pediatrics/Adolescent medicine $152,690
Psychiatry $163,144
Family Practice $150,267

To imply that all of them make 150k is absurd. Some specialist make over 500k.

of course, this depends on what state you practice in. it's a lot less on the coasts and probably a bit more in the midwest states. indeed some specialties do make more than 500k, such as interventional neuroradiology, which requires at least 7-10 years of training. that's also on top of $200k+ of debt coming of medical school.

also, those salaries don't take into account liability. for high-risk specialties such as ob/gyn, they can be astronomical in certain states.

 

[conjur]

Originally posted by: jhu

Originally posted by: conjur
Insurance companies are able to negotiate massive discounts due to their sheer size.

This is just a perfect reason why healthcare costs should be removed from corporations and moved to the government. Nationalized healthcare plans with negotiated fees with the providers will result in EVERYONE having access to healthcare, esp. the all-important preventive kind. "An ounce of prevention is worth a pound of cure." Healthier society = more productive society. And, corporations are freed from one financial liability and have another one reduced: healthcare premiums and sick pay.

healthcare is one area where practically no one pays retail prices, except for the uninsured. even then, if you're uninsured you can generally call the hospital and say that you're not going to pay the full amount. however, not many people know this.

there's really no easy solution to this whole mess since there are so many factors involved. for example, medicare really needs to pay more for services since doctors who only see medicare patients won't be practicing very long. liability issues and tort reofrm is needed so that people in crisis states such as pennsylvania or florida can have affordable ob/gyn or other high-risk services.

Can't Medicaid/Medicare be replaced by a national health plan? That's what I'm envisioning ; with every working citizen contributing to the healthcare fund.

 

[Meuge]

Originally posted by: jhu

Originally posted by: Duckzilla


150k is the lowest and thats for private practice. This is 2002:

Anesthesiology $306,964
Surgery, general $255,438
Obstetrics/Gynecology $233,061
Internal medicine $155,530
Pediatrics/Adolescent medicine $152,690
Psychiatry $163,144
Family Practice $150,267

To imply that all of them make 150k is absurd. Some specialist make over 500k.

of course, this depends on what state you practice in. it's a lot less on the coasts and probably a bit more in the midwest states. indeed some specialties do make more than 500k, such as interventional neuroradiology, who generally has 7-10 years of training.

also, those salaries don't take into account liability. for high-risk specialties such as ob/gyn, they can be astronomical in certain states.

Thank you. Ob/Gyn insurance and litigation laws in Virginia (AFAIK) have almost completely driven out all the specialists from the state.

 

[jhu]

Originally posted by: conjur

Can't Medicaid/Medicare be replaced by a national health plan? That's what I'm envisioning ; with every working citizen contributing to the healthcare fund.


in that case all doctors would need to be government employees who work at government clinics and hospitals since it's unlikely that a hypothetical national plan would be paying any more than medicare/medicaid currently pays.

 

[TraumaRN]

Originally posted by: conjur

Originally posted by: jhu

Originally posted by: conjur
Insurance companies are able to negotiate massive discounts due to their sheer size.

This is just a perfect reason why healthcare costs should be removed from corporations and moved to the government. Nationalized healthcare plans with negotiated fees with the providers will result in EVERYONE having access to healthcare, esp. the all-important preventive kind. "An ounce of prevention is worth a pound of cure." Healthier society = more productive society. And, corporations are freed from one financial liability and have another one reduced: healthcare premiums and sick pay.

healthcare is one area where practically no one pays retail prices, except for the uninsured. even then, if you're uninsured you can generally call the hospital and say that you're not going to pay the full amount. however, not many people know this.

there's really no easy solution to this whole mess since there are so many factors involved. for example, medicare really needs to pay more for services since doctors who only see medicare patients won't be practicing very long. liability issues and tort reofrm is needed so that people in crisis states such as pennsylvania or florida can have affordable ob/gyn or other high-risk services.

Can't Medicaid/Medicare be replaced by a national health plan? That's what I'm envisioning ; with every working citizen contributing to the healthcare fund.

Well in a technical sense medicaid/medicare IS a national health plan....for those disabled, over 65 and under 18(sometimes) And take a peek at your paycheck....everyone with a job contributes to it. Now it's a matter of making it so it spans from growing in mom's womb til death.

And hopefully minus alot of the government BS

 

[Duckzilla]

Originally posted by: Meuge

Originally posted by: Duckzilla
150k is the lowest and thats for private practice. This is 2002:

Anesthesiology $306,964
Surgery, general $255,438
Obstetrics/Gynecology $233,061
Internal medicine $155,530
Pediatrics/Adolescent medicine $152,690
Psychiatry $163,144
Family Practice $150,267

To imply that all of them make 150k is absurd. Some specialist make over 500k.

And your point being - they studied through high school, college, and medical school... sacrificed years of work during their youth, and came out with a gigantic mountains of loans. By the time a specialist makes those figures you're quoting, he's often 40-45 years old... having spent all the previous years getting there.

Who the f-ck are you to say that he's getting too much money?

I didn't imply anything of the sort, I was just stating it for the record.

 

[zendari]

Originally posted by: Meuge

Originally posted by: Duckzilla
150k is the lowest and thats for private practice. This is 2002:

Anesthesiology $306,964
Surgery, general $255,438
Obstetrics/Gynecology $233,061
Internal medicine $155,530
Pediatrics/Adolescent medicine $152,690
Psychiatry $163,144
Family Practice $150,267

To imply that all of them make 150k is absurd. Some specialist make over 500k.

And your point being - they studied through high school, college, and medical school... sacrificed years of work during their youth, and came out with a gigantic mountains of loans. By the time a specialist makes those figures you're quoting, he's often 40-45 years old... having spent all the previous years getting there.

Who the f-ck are you to say that he's getting too much money?

These same people think they dominate the free market because Ken Lay made "too much money".

 

[jhu]

Originally posted by: Duckzilla
I didn't imply anything of the sort, I was just stating it for the record.

in california, the average pediatrician makes $80k-$90k. this includes the specialists.