Scorpion sting leaves Arizona woman with $83K bill

[Incorruptible]

This is why we need to end the FDA and need smaller government

 

[Fanatical Meat]

"Edmonds' insurer has paid more than $57,000 and the suburban Phoenix hospital is asking Edmonds for the balance of about $25,000."

Probably shitty insurance though. I had an employer once who offered the worst fucking insurance in history. Really, it barely covered anything. Shopped my own...but I'm healthy.


If the minimum standards impose a maximum annual out of pocket cost, in this case less than $25K, that would help.

What everyone forgets is before Obama Care many insurance policies had life time limits, I used to work for a Fortune 20 Telecom and my life time maximum was $350k. Hence my life was worth 350K. This bite would have take 20% of my benefit (minus my obserdly high emergency care deductables). Like it or not Obama Care is at minimum something different to do.
The real question is why are emergency services so expensive? People going in w/o health care draining the system and completely inefficent hosiptals and insurance companies.
The cost of elective procedures has dropped pretty consistantly because you can shop for them and that weeds out waste.

 

[woolfe9999]

You know, this is one thing I was thinking of a long while back. If the US were to do UHC, would not innovation in the medical field slow down across the board? I've always got the feeling that other countries with UHC/UHC-like systems get to enjoy medical advancements that companies pushed so as to sell them vastly marked up in the US: In effect we're subsidizing the rest of the worlds healthcare innovation cost.

You are by far the most plugged in person on this Forum on HC, what is your opinion on this?

Chuck

We'd have to come to an agreement with other nations that have UHC, that the cost to incentivize innovation would be born by all, or we'll just adopt their model and everyone will suffer from a lack of innovation. Currently we subsidize innovation which benefits them. We pay through the nose for it while they get it cheaply. This simply cannot continue.

 

[werepossum]

We'd have to come to an agreement with other nations that have UHC, that the cost to incentivize innovation would be born by all, or we'll just adopt their model and everyone will suffer from a lack of innovation. Currently we subsidize innovation which benefits them. We pay through the nose for it while they get it cheaply. This simply cannot continue.

Agreed, completely. Once we get UHC, we (and the world) are going to be hard-pressed to keep up with bacterial and viral evolution. We'll have to give up sixteen kinds of pecker pills to stay abreast, so if the government's brand doesn't work for you, well, sucks to be you. Got a very rare disease? Sucks to be you. Allergic to both government-approved medications for your problem? Sucks to be you. Need quick access to a very expensive diagnostic machine? Sucks to be you.

Of course, if you get a non-life threatening medical problem and you don't have health insurance, sucks to be you anyway. Good and bad to both sides, winners and losers to all approaches.

 

[Strk]

Agreed, completely. Once we get UHC, we (and the world) are going to be hard-pressed to keep up with bacterial and viral evolution. We'll have to give up sixteen kinds of pecker pills to stay abreast, so if the government's brand doesn't work for you, well, sucks to be you. Got a very rare disease? Sucks to be you. Allergic to both government-approved medications for your problem? Sucks to be you. Need quick access to a very expensive diagnostic machine? Sucks to be you.

Of course, if you get a non-life threatening medical problem and you don't have health insurance, sucks to be you anyway. Good and bad to both sides, winners and losers to all approaches.

Isn't a good chunk of our research already done by the NIH (either directly or grants to schools) and then patented by companies like pfizer?

 

[Hayabusa Rider]

Agreed, completely. Once we get UHC, we (and the world) are going to be hard-pressed to keep up with bacterial and viral evolution. We'll have to give up sixteen kinds of pecker pills to stay abreast, so if the government's brand doesn't work for you, well, sucks to be you. Got a very rare disease? Sucks to be you. Allergic to both government-approved medications for your problem? Sucks to be you. Need quick access to a very expensive diagnostic machine? Sucks to be you.

Of course, if you get a non-life threatening medical problem and you don't have health insurance, sucks to be you anyway. Good and bad to both sides, winners and losers to all approaches.

A me- too nation bereft of the will to innovate. Sucks to be us.

 

[werepossum]

Isn't a good chunk of our research already done by the NIH (either directly or grants to schools) and then patented by companies like pfizer?

A fair amount is, but the patents belong to the schools who then sell them to the private companies. Sometimes the private company wants to develop it, and sometimes it just wants to kill it to protect an existing lucrative drug. However, the bulk of our R&D costs are borne by the private sector.

I'd also guess that a majority of R&D money isn't to develop a new or more effective drug, but rather to develop a drug that can compete in a lucrative existing market. So removing the incentive for R&D (indeed, removing the means to fund R&D) from the private sector won't be anywhere near a one-for-one loss. For most people, one major drug probably works roughly as well as its competitors. Like everything about UHC it will suck for a minority, but not necessarily for the majority. (Depending on how it is designed and implemented, of course.)

 

[Darwin333]

I have no problem with an estimated cash price up front. Two caveats, sometimes you don't know what might happen during a treatment so a guarantee of a fixed price in that case couldn't apply.

Absolutely agree but a "good faith estimate" would definately be adequate.

Second the patient needs to know this is a cash price, not what they will pay. Often I get "how much will this cost" and I answer "it depends on what your insurance and we can't know that in advance."

With these qualifications, sure.

The problem is that it would be impossible for hospitales to implement under their current billing policies. Do you know of any other industry that is allowed to charge people paying cash upfront 2 to 5 times more for the exact same procedure than people paying with other means? I don't give a damn about "negotions" or any other crap like that. Everyone keeps saying that billing is a huge expense for doctors and hospitals and a lot of the time insurance won't cover a portion leaving the hospital to collect from the patient which often leads to either very slow payback or complete write off. That is all time consuming and costly yet a person that wants to pay cash in advance is charged a much higher price??? That is illegal in probably every other industry except the medical industry, why is that?

That is the reason you don't, and won't, see hospitals posting their prices because they don't have a "standard price". They have one price if your on medicare, another price if you have XYZ insurance, another price if you have no money and another price if you are willing to pay cash upfront. All of this is due to the reality of the system they are forced to work in which forces them to cost shift but at the end of the day its the average joe who has some method of payment that gets the shaft.

And before anyone says what I am suggesting can't be done, I invite you to check out the Surgery Center of Oklahoma. Amazingly they have a price list right there on their website and the procedures that I have been able to compare have been on average 1/5th less than what my, or my friends and families, have been billed for the exact same procedures (granted their insurance paid the bulk of it but thats not my point).

I am sure most of you are asking how in the world can this be, they must have really shitty doctors and fuck up all the time right? Nope, they have an extremely high rating in just about everything. The only difference between them and any other surgery center is they only accept one form of payment and that is cash upfront. They don't accept medicare, medicaid, insurance, nadda, cash on the barrelhead (I assume they take CC, checks, etc..). If you can't pay you don't get treated, period.

Bottom line is they got rid of all of the causes of the cost shifting seen almost everywhere else in the medical industry. You aren't paying for yourself and the last 3 people who didn't have a dollar to their name, you aren't covering the last 5 people whose .gov "insurance" only paid for 80% of their care, etc.... You are only paying for what YOUR procedure costs and they are able to get it done for a fraction of what the rest of the industry charges with equal if not better results.

How bout that.

 

[Darwin333]

What everyone forgets is before Obama Care many insurance policies had life time limits, I used to work for a Fortune 20 Telecom and my life time maximum was $350k. Hence my life was worth 350K. This bite would have take 20% of my benefit (minus my obserdly high emergency care deductables). Like it or not Obama Care is at minimum something different to do.
The real question is why are emergency services so expensive? People going in w/o health care draining the system and completely inefficent hosiptals and insurance companies.
The cost of elective procedures has dropped pretty consistantly because you can shop for them and that weeds out waste.

Cost shifting.

 

[actuarial]

There seems to be a lot of misunderstanding of UHC here, or at least how it could potentially be implemented. Many of the concerns raise are completely dependent on the specific implementation, not on UHC in general.

Drug company incentive: in Canada most drugs are not included under UHC. It is still a private market. UHC does not mean that 100% of healthcare has to be included.

Availability of treatments for rare diseases: up here you are not allowed to charge for treatments on the UHC list, but anything outside of that you are free to pay for. If you have the money you can still pay for crazy rare treatments that the gov won't cover (much like the US and what insurance won't cover).

Incentive to innovate: you are still able to pay just as much as you currently do for any treatment, and private companies will still negotiate on the cost of treatments they design. Also, like above, there should still be a private market for treatments the gov won't pay for.

 

[Hayabusa Rider]

There seems to be a lot of misunderstanding of UHC here, or at least how it could potentially be implemented. Many of the concerns raise are completely dependent on the specific implementation, not on UHC in general.

Drug company incentive: in Canada most drugs are not included under UHC. It is still a private market. UHC does not mean that 100% of healthcare has to be included.

Availability of treatments for rare diseases: up here you are not allowed to charge for treatments on the UHC list, but anything outside of that you are free to pay for. If you have the money you can still pay for crazy rare treatments that the gov won't cover (much like the US and what insurance won't cover).

Incentive to innovate: you are still able to pay just as much as you currently do for any treatment, and private companies will still negotiate on the cost of treatments they design. Also, like above, there should still be a private market for treatments the gov won't pay for.

It's not UHC as it could be that I object to, but putting the control of medicine into the hands of "republicrats" as it were. I'm not inherently against providing universal coverage, but it is not the panacea that many suggest. In it's best possible form it has resource limitations. That's my main issue, that it's a deux ex machina, a thing that government can do oh so well that it doesn't need sufficient due diligence to implement. I define that as looking at the system holistically because it is highly complex and organic. In some ways it's alive in the sense that what happens in one place may strongly affect the other. If the "answer" to real problems is in effect "We have the patient on the table and something is wrong, let's start taking things out and moving them around to see what happens", which the uninformed are saying whether they acknowledge that they are or not, doesn't seem like too great an idea. That's why I want to see a full analysis and active means in place to prevent unwanted consequences before law and regulation start surgery. That is deemed as unwanted and unnecessary because people in other nations with different social and economic systems have it. Never mind that their health care, economy and society evolved naturally over time and that we'd be performing major organ transplants to get where they are, let's just do it and we can revive the patient if it dies.

UHC bad? No, but neither is driving. It's when the ignorant who willfully disregard responsibility get behind the wheel that I object. Oh boy there's a whole lot of that going on.

You might want to look up "false necessity" and "negative capability" and imagine how they apply here.

 

[soulcougher73]

Im no insurance expert, but why do we even have IN and OUT of Network options? Why cant insurance work anywhere at the same rate?

 

[Icepick]

Agreed, completely. Once we get UHC, we (and the world) are going to be hard-pressed to keep up with bacterial and viral evolution. We'll have to give up sixteen kinds of pecker pills to stay abreast, so if the government's brand doesn't work for you, well, sucks to be you. Got a very rare disease? Sucks to be you. Allergic to both government-approved medications for your problem? Sucks to be you. Need quick access to a very expensive diagnostic machine? Sucks to be you.

Of course, if you get a non-life threatening medical problem and you don't have health insurance, sucks to be you anyway. Good and bad to both sides, winners and losers to all approaches.

Let me put you at ease. Most of these things you're worried about in regard to UHC are lies.

 

[Icepick]

Im no insurance expert, but why do we even have IN and OUT of Network options? Why cant insurance work anywhere at the same rate?

I'd like to know this as well. At the surface it appears to be a way for insurance companies to extract more profit from their subscribers. This is one of the first things that must be corrected with our universal health care plan.

 

[actuarial]

Let me put you at ease. Most of these things you're worried about in regard to UHC are lies.

They're not necessarily lies, they're just misunderstandings due to a narrow view of UHC.

 

[werepossum]

It's not UHC as it could be that I object to, but putting the control of medicine into the hands of "republicrats" as it were. I'm not inherently against providing universal coverage, but it is not the panacea that many suggest. In it's best possible form it has resource limitations. That's my main issue, that it's a deux ex machina, a thing that government can do oh so well that it doesn't need sufficient due diligence to implement. I define that as looking at the system holistically because it is highly complex and organic. In some ways it's alive in the sense that what happens in one place may strongly affect the other. If the "answer" to real problems is in effect "We have the patient on the table and something is wrong, let's start taking things out and moving them around to see what happens", which the uninformed are saying whether they acknowledge that they are or not, doesn't seem like too great an idea. That's why I want to see a full analysis and active means in place to prevent unwanted consequences before law and regulation start surgery. That is deemed as unwanted and unnecessary because people in other nations with different social and economic systems have it. Never mind that their health care, economy and society evolved naturally over time and that we'd be performing major organ transplants to get where they are, let's just do it and we can revive the patient if it dies.

UHC bad? No, but neither is driving. It's when the ignorant who willfully disregard responsibility get behind the wheel that I object. Oh boy there's a whole lot of that going on.

You might want to look up "false necessity" and "negative capability" and imagine how they apply here.

Excellent post.

Let me put you at ease. Most of these things you're worried about in regard to UHC are lies.

Wow, now my mind is at ease. All it took was your post and removing my prefrontal cortex, and now I can see that UHC is all good and no bad. We really can have everything for less!

Obama 2012, baby! Simple minds for simple times.