RE: Hospital and Dr's fees are getting insane! (Full Version)

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variation30 -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 2:46:49 PM)

quote:

ORIGINAL: Arpig

You really are a hard-ass aren't you variation30. I personally am glad I live in Canada where my health care is paid for out of our taxes, otherwise I wouldn't have had the money to see my doctors as often as I have in dealing with my various health issues.


I have no doubt that people who are getting services they normally would not have had access to (at the expense of others) like having these services.

my question is why do you think it is ethical to do this?



windchymes -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 3:09:59 PM)

One thing to remember is to never trust what the doctor or the receptionist says about your insurance coverage.  Legally, the patient is ultimately responsible for knowing his or her own coverage.  When a receptionist says "We ACCEPT your insurance", that can be misleading.   They can "accept" an insurance card from anybody and send a claim to the insurance company.  However, the insurance company won't pay that bill unless your doctor is an in-network "participating provider" with that company.  Otherwise, he is considered "out-of-network" and what the insurance will pay is either reduced or they pay nothing at all. "Participating" is the key word, or "contracted".  Double and triple check your benefits by calling the insurance company directly yourself, there is usually an 800 number on the card, and you can directly ask a customer service rep is that particular doctor is participating or has a contract. Also, they can tell you if specific treatments are covered by them.  Most companies have a website you can access benefits on, too. 

Recently, I had a chiropractor swear that I had great insurance and all the treatments were covered.  Well, he was a participating provider, but one of the treatments he wanted to do on  me was NOT covered by my insurance company, though he and the entire office staff kept insisting it was.  I stuck to my guns, someone called the company directly and they did some quick back-pedalling.   Otherwise, after all their smiling and reassuring me that that treatment was covered, I would have had a big bill to pay out-of-pocket.

You really have to be pro-active and make sure you know your benefits, don't trust office staff to know them for you.  They have dozens of insurances to keep straight, you have only your own.



philosophy -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 3:16:57 PM)

quote:

ORIGINAL: variation30

my question is why do you think it is ethical to do this?



...and my question to you is why you think it ethical to watch a baby born to a poor family die for lack of cash to provide adequate medical care. The child has made no choices, indeed can make no choices. A civilisation is judged by how it treats its most vulnerable members. You clearly believe that society has no claim on you or yours.....an attitude you're not alone in. And yet, here you are, using the internet. On a free site. Participating in a medium that creates societies. Smells of hypocrisy to me.



Maya2001 -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 3:25:49 PM)

variation30 -- could you afford to go thru  all 3 conditions at the same time  as I am .. the one can cost up to $20,000 a year, lifelong for treatment  never mind joint repair and joint replacement surgeries and physio therapy???  I would not  even want to see what all the tests have cost that I have had in the last 6 weeks  I have paid some extensive veterinary costs and can guess some  in those terms  and know the  human  equivalent  5 to 6 times more.. some even more   --a  dozen or more xrays, several ECG, echograms, multiple ultrasounds, ct scans, blood tests galore,  plus all the stuff done when  in ER 3 times .. and I am just at the start of dealing with these issues  just hazarding a guess    I would think  the 3 ER trips are  over  $120 K  already- never mind all the other tests..... for many residents  in the US that is  3 or more years incomes hpw much can the put away for medical costs  are paying basic living costs ??




I do  pay for my care ,,,, it is called taxes,, as well pay a surtax according to my wages, I pay about about $500 in payroll taxes each week plus the health surtax which is $27 a week    ..I am an autoworker so make a lot more than the average factory worker .. and I have no problem with my tax dollars going  benefit  a infant of a single non working teenage mom who needs an open heart surgery or treating the mom for cancer

So my care is not at the expense of others as you like throw out to various canadian members here..I have 35 years of paying taxes  in to cover my bills  .

the majority of Canadians  want  our system  and shouted down efforts to bring in  a tiered system of medical care for fear of  tearing apart the system  we have , the number that would want a system like in the US is likely under 5% , it is not perfect  some some areas there are long wait times which is related mostly to a shortage of doctors entering the medical field here or willing to set up shop in rural areas..the problem is not so much the system  but  our population vs land mass.. to be honest overall we are proud to have the system we have   ..we just want to see it tweaked  and the health surtax came about because polls showed  that the majority of Canadians were willing to pay more in taxes  to better our system    and  even it the past year it has improved dramatically  


I do live in an area that is considered rural so it  has a shortage  of doctors  but i am able and willing  to travel so as to  shorten  my wait times

I will see a surgeon for the lung cancer  and have a biopsy done with in a week and half of DX ...less than 50 miles away   and onocologist I need to see will be in the same area
Right now am under the care of the local hospital cardiologist  until I am referred to one of my own
I will get into the  research auto immune center within  2 to 4 weeks to begin genetic testing and treatment  unless a conflict with surgery timing 100 miles away

for serious life threatening conditions   there is very little wait time ...

there are different pay scales for doctors    depending on their skills  and the location the choose to settle in ..the specialist makes far more than the GP ..and varies by field of expertise



Arpig -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 3:32:45 PM)

quote:

my question is why do you think it is ethical to do this?

Simple really. We all pay our share through our taxes. Not only do we not have to pay at the time of treatment, we pay less for the said treatment than you guys do, so everybody comes out ahead. Remember, my taxes paid for other people's treatment for years when i was in good health.
Also it really is no different than the health insurance  you have in the US. Your monthly rates are calculated to offset the costs the company has to pay out so as to make them a profit. Your treatments are paid out of the premiums other people pay, therefore your high-on-your-horse attitude is based on a fallacy. If you have health insurance then other people are paying for your treatment just as surely as if the bill had been sent to them. What we have in Canada is universal not-for profit health insurance, the premiums for which are paid out of the taxes we pay.



Phoenixpower -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 3:40:05 PM)

Well spoken "Arpig", you found the words i was looking for [:)] I am already frustrated about the health system in UK, which is free, as compared to germany (where I lived 25 of my years) where we paid a little bit more in then here but received a marvellous good service whenever needed and fast (as it was once said on a TV News Programm in UK that waiting times practically don't exist in germany). And yes, we paid every month a little bit which was deducted from our salaries but had never to pay for GP bills additionally (except contributions if dental care was required). Also I could go to ANY GP (it did not have to be one in "my area", I did not have to be registered with one particular GP, no, I was allowed to go to the one i felt comfortable with, the one who was good in my opinion, I was allowed to call the specialist myself to arrange an appointment which suits ME when my GP referred me and also could go without referring to the specialist if I deemed it as being necessary) and did not have to put up with waiting for my GP sending a letter to the specialist and then waiting to receive a letter with an appointment in the next 8 months to receive an appointment time they decide as being good for me, where by then I could be dead. Our service in germany was very fast and on a high standard. Also worries about cancer-medication being refused as it is deemed to be too expensive I never heard in germany whereas here it is often topic on TV, so I am thankful that my granny had great healthcare during her cancer treatment and not to put up with such money issues about treatment costs as some people have to face here. Also MRSA is an issue in quite a few hospitals, where again they said at the british news program (the same as mentioned further up) that MRSA practically doesn't exist in germany. And therefore I did never ever mind to pay my costs as each time I have been in hospital (4 times) I received great care and had not to worry about anything. The american health system is one of the reasons why I declined in the past to consider to meet guys in america as I have no interest to put up with that....even when I do behave well with my finances [;)]



Maya2001 -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 3:40:45 PM)

I also noticed variation30  that you are 23 and a student  are you financially able on "your own" to pay say $300K in medical bills if you ended up in an accident ...or  is it just easy ..to do the talk without the walk  because you personally do not have to worry about because mommy and daddy will foot the bill for you?



TNstepsout -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 4:27:21 PM)

OMG! don't even get me started. I was in the hospital for a couple of days a few weeks ago and I received the summary (which doesn't include the doctors fees or all of the hospital charges yet) and it was 10k!!! They charged 4k for a CAT Scan!! I can't believe it. I was there one and a half days and had some tests run, and IV and some meds. That's it. 



CalifChick -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 4:37:01 PM)

quote:

ORIGINAL: windchymes
You really have to be pro-active and make sure you know your benefits, don't trust office staff to know them for you.  They have dozens of insurances to keep straight, you have only your own.


This is EXACTLY what I preach to doctors' offices in my consulting work.  NEVER, EVER tell the patient what their benefits are, what's covered, etc.  Always tell them it is their responsibility to call their insurance company and understand (*cough*) their coverage.  And I change their financial documents to state that.

I do give them scripts like, "We believe that your insurance will cover this with a $15 copay, but you'll want to call and verify that yourself."

Or, "in our experience, other patients with coverage like this are responsible for 50% of the contracted rate, but it is in your best interest to verify that yourself."


Cali





thornhappy -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 5:03:22 PM)

quote:

ORIGINAL: variation30

quote:

ORIGINAL: thornhappy

That works really well, considering half the bankruptcies nowadays are due to medical bills.



and your point is...?

so people thought it was a good idea to spend all their money on medical bills. what are you trying to say?


It was your statement that people should buy the cure or "find charitous individuals who will help you." If there was a lot of charity going around, do you think folks would have to enter bankruptsy?

Do you pay for your own premiums, or are you still covered by your parents' insurance plan?  If not, do you count on your parents' savings to pay for your medical bills?

Is payout by an insurer a coercive act?

thornhappy




candystripper -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 6:51:06 PM)

quote:

ORIGINAL: housesub4you

So my spouse went into the hospital for some medical tests and the bills are coming in.

We got a bill from a Doctor we did not know. So I looked into it, and it seems (this is the Dr's reason for the bill) he looked at her chart by mistake but since he looked at it he billed us $578.00 for his time

The hospital even put on a charge calling it a Doctors visit and charged us over $600.

No we are not paying it, let them take me to court.

This is getting nuts

Who ever says we don't need medical reform is nuts


The whole medical establishment -- and health insurance industry -- is getting completely out of hand.
 
The hospitals use an accounting method called a Charge Master.  It's a way of shifting costs among patients, procedure by procedure, as the hospital patient load varies through the course of a given day.
 
When well-insured folks are in the hospital, they will be billed at higher rates as the hospital tries to evade the 'burden' of the underinsured and uninsured.  That's why an aspirin sometimes cost $100 on a hospital bill.
 
I applaud you for wading through the bills you've been receiving.  Beware of any line item on your bill which makes no sense.  A bandaid,e.g. iks sometimes billed as 'an infectious disease control device'. 
 
If this is of concern to you, get the bills exchanged between the doctors, the hospitals and the insurance company to compare to yours.  I think you'll be shocked to learn how many 'back room deals' are going on.
 
candystripper  [sm=pole.gif]



pahunkboy -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 7:12:20 PM)

quote:

ORIGINAL: celticlord2112

quote:

We got a bill from a Doctor we did not know. So I looked into it, and it seems (this is the Dr's reason for the bill) he looked at her chart by mistake but since he looked at it he billed us $578.00 for his time

Why not just sue the doctor and the hospital for the invasion of privacy and corresponding HIPAA violation?

(Or just mention the HIPAA violation and see if the charge magically disappears after that)



thats brilliant.  :-)



Joenextdoor -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 7:23:01 PM)

I went in to the ER to get my hand stitched up a year ago.  I paid what the insurance co. said I owed.  Four months later, I get a bill from a billing company in Philly, Monocan Emergency Providers, or something like that.  They were asking for several hundred dollars for what the doctor billed me for the services.  The bill showed they had tried billing Anthem 3 or 4 times and they refused to pay.  I called Anthem to see what that was about.  They told me they had paid a reduced amount and that was all they could ask for.  The date they paid was the first date the bill had listed as well, but the bill showed no payment made, and a balance carried forward.  While I was on hold, the Anthem rep called Monocan and a few minutes later, she said I owed only $30.00.  These billing people intentionally left out the payment from Anthem on my bill, and were trying to get me to send several hundred dollars to them.  I wonder how many people would have just sent the money when they got the bill,and never questioned this?  This is deceitful, and I post this so that anyone who reads it, does not fall for their games. 



came4U -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 7:34:24 PM)

You guys have to pay out of pocket for even a flu shot down there?






monywildcat -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 8:42:44 PM)

Variation30, you must be in incredibly good health to be able to say the things you have.  This is good.  I wouldn't wish poor health on anyone.  And it is also good that you come from a family that didn't have to stress over whether to pay medical bills due to an unforseen accident or illness, or food.  I am fortunate to say the same. 

However, life brings on many challenges and obstacles.  Twins born premature and needed lots of care in the NICU, a motorcycle accident (x was not at fault and we got a settlement, but not nearly enough to cover lost wages, bills, etc).  Then a divorce which has me depending on state health coverage for the little ones, but I don't qualify for myself.  I get sick, I suffer. The kids get sick, we go to the doctor, and I sign in with a 30 dollar pen that says Cymbalta on it, I check the time on the 50 dollar clock that has the Prozac logo emblazoned on the face.  Healthcare costs need reform, badly.  A retired senior shouldn't have to alter their medications to make them last, in order to afford the electric bill.  And these are the ones that were "wise with their property".  I certainly hope that these sorts of hard times do not fall upon you.  But when they do (and they will, trust and believe that) I hope you are able to pay your costs on your own or find those charitible (sp?) resources. 



Joenextdoor -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 9:50:26 PM)

I have private health insurance that I pay out of my own pocket.  Nobody gives me a dime towards the premium, and I do not want anyone to do so.  I have huge problems with national health care, like in Canada, and proposed by some on the left here.  Ok, where do I begin:
1.   There is nothing that government can do more efficiently than the private sector, including health care.  There is no incentive in government to be efficient.  Just look at Medicare.  Its my understanding that 10% of what they spend goes to waste, fraud, and abuse. In the private sector, you must make a profit to continue. 
2.   Health care would be cheaper in this country if we seriously clamped down on the lawyers who are parasites on the system.  There should be a panel that reviews and approves any lawsuit that someone wants to file against a doctor, hospital, or drug company.  When we quit allowing lawyers to run up the costs, the costs to us will come down.
3.   Basically the same argument as the tax issue prior to the election...I do not believe in redistribution of income, which free health care for those who pay no taxes would be.
4.   I have a huge problem with the thought that I will be taxed to provide health care for drug dealers and other criminals, as well as the able bodied young men I see everyday in my hometown, who do nothing but hang around and shoot the breeze all day when they could be working. 


Personally, I think that clamping down on lawyers would have the biggest, and fastest impact on costs.  Everything would be cheaper.  If costs come down, then Insurance rates would fall, and more people would be able to afford insurance, which I am sure, would make insurance cheaper, by there being fewer people for hospitals to have to write -off their bills.  I write this not to get people fired up, or yelling about the huge medical bills they have.  I know its a problem, but if we already have one problem, for God's sake lets not get government involved, or that problem will just get worse.



amelliagrace -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 11:30:45 PM)

quote:

ORIGINAL: Joenextdoor


2.   Health care would be cheaper in this country if we seriously clamped down on the lawyers who are parasites on the system.  There should be a panel that reviews and approves any lawsuit that someone wants to file against a doctor, hospital, or drug company.  When we quit allowing lawyers to run up the costs, the costs to us will come down.



Seriously positive improvement in health care - and its costs - won't materialize if we do not address the nefarious practices of insurance companies....You know, those companies that have bought and paid for Congress, year after year after year?  Those companies who believe they are ENTITLED to a higher profit every year, and twist the arms of state governments for favors when they have a year that they make less PROFIT that the year before.  Those companies who are aided and abbetted by the government when they lie, cheat, and generally fuck-over most people with a claim - be it health, home, or auto.  Those companies.
 
Tort reform has its place - and it is a signifigant one - but so does regulating the insurance industry (all flavors, not just medical), which has become quite the Evil Empire.  It is amazing how many people know at least one individual who used to work for an insurance company, and quite, because they couldn't look at themselves in the mirror if they followed comany policy - or got fired for having the audacity to be honest with a client.
 
Then there is the issue of hospitals and physicians who will charge $50 (that includes what the insurance pays, plus the out of pocket co-pay from the patient)for a test if you are with insurance company A, $100 if you have the misfortune of being with comany B,  and then fucks your sidways with a freight train if you are uninsured - to the tune of $500.  And no, I'm not exaggerating.
 
Saying that things would be soooooo much better if only we cracked down on all the evil lawyers sounds nice and neat, easy and tidy.  It is also a simplistic view that doesn't take into consideration the other major players.
 
Grace



amelliagrace -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 11:41:41 PM)

Variation30 -
 
It must be nice and comfortable in that little bubble of ignorant oblivion.  Reality can be a real bitch.  Let's see what you think in twenty years or so, when you are a bit drier behind the ears, when your parents and grandparents are older and into serious chronic health issues, and perhaps one of your children has developed an incurable disease, or had a crippling accident.
 
Then again, you may prefer to simply pull the plug on them, rather than bother with the expense of fixing them up, or improving their quality of life.  Because if you do, unless you are among the VERY wealthy, why, it might seriously impact your savings, your home ownership, your credit rating, your insurability, and your ability to blithely go through life unencumbered by such unsavory facets of life.
 
Grace



GoddessDustyGold -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 11:43:57 PM)

quote:

ORIGINAL: philosophy

quote:

ORIGINAL: variation30

my question is why do you think it is ethical to do this?



...and my question to you is why you think it ethical to watch a baby born to a poor family die for lack of cash to provide adequate medical care. The child has made no choices, indeed can make no choices. A civilisation is judged by how it treats its most vulnerable members. You clearly believe that society has no claim on you or yours.....an attitude you're not alone in. And yet, here you are, using the internet. On a free site. Participating in a medium that creates societies. Smells of hypocrisy to me.


A brief hijack here:
 
I admit I am continually confused by the challenge that if one does not feel that society as a whole has an obligation to take care of each other in every way possible, then why does that immediately preclude one from participating in any form of society?
I have often seen that one should not be using the free internet when they object to paying certain taxes or is not in support of something like a universal health plan run by government.  I pay a private company each  month so that I have a modem and access to the internet.  My internet is not free!  This site is free, and I am happy to be here for free.  But the owners are private owners and should they choose to begin charging for use of this site, or certain services on this site, that is well within their rights.
Just because anyone feels that something like health care is the basic responsibility of the individual, rather than the collective, does not mean they should be expelled from society.  At least I don't think so.  Long before we had this global and collective mentality, people were living in society and making their way according to their means. 
/end hijack
By the same token, in the USA, people who do not pay taxes and/.or cannot afford private health care of insurance are not denied health care.  County hospitals are available, and for profit hospitals are required to offer emergency care.  If a poor family has a premature baby, the baby will be cared for, regardless of the personal financial situation of the family.  They will not be thrown out onto the street.   
In our modern society and shrinking world it is easy to point fingers and say that so and so is callous or unfeeling if they do not want to put their money into the collective pot so that everyone everywhere has the exact same standard of living and/or healthcare.  People do not want in this country.  Or I should say, they do not need to be in want.  They may not be able to have steak every week, or live in a fancy house or have two cars, but there are many resources available, both state and private.  Much of the problem lies in the fact that people do not check to see what is available.  They would rather be able to just go anyhere and know that they are covered automatically. That includes all the illegal aliens and the 40% of the legal and taxable population who does not pay any taxes.   
I agree that the healthcare system needs a major overhaul.  I spent about 6 hours in an emergency room a few months ago.  I had a CT with contrast, I think they took blood, I did not have to pee in a cup and I refused the morphine.  The bill was almost $5,000 ($4,941 and change to be exact).  Fortunately My healthcare plan paid the whole thing and I paid $50. 
I disagree that allowing the federal government to take over is the answer.  I think it is the worst of all possible solutions and only invites more waste and corruption. 
And guess what?  I have the right to that opinion without taking the consequence of being expelled from society as a whole.  Most of us are already paying a sufficient elegancy to keep the infrastructure intact.  Please don't throw Me to the wolves because I don't feel like upping My bill to take care of yet another social program that is already being handled in a different way. 
No hypocrisy about it. 
 
Edited - typos and to mention that I am more than dry behind the ears.



Joenextdoor -> RE: Hospital and Dr's fees are getting insane! (11/12/2008 11:55:12 PM)

I have no problem with some regulation of insurance companies.  Remember though, insurance companies are "for profit companies", and publically traded companies are always under pressure to grow profits.  Companies that do not, see their stock prices tumble.  With regard to claims, disputes over claims should be handled by a review panel, and not litigated.  The part about what the hospital charges....my experience with the stitches I talked about earlier showed me the huge difference there.  Its not that the hospital charges one rate to the insured, and another to the uninsured.  Its that the hospital charges the same rate to all, and if a person is insured, the hospital must accept what they will pay for a given service, if they are to be a qualified provider.  It sucks to be uninsured and not get the lower price, but its not some conspiracy.  My bill was for over $1,500.  The charges were done in line item form, with what the hospital charged, and what Anthem agreed to pay.  In the end, that $1,500 bill cost me only $340.  That was plenty, but alot better than the entire amount.  If I was uninsured and had to pay the full amount, it would not be the fault of a hospital or insurance company. 
Again, I know something has to be done about insurance companies.  I am not letting them off the hook, but I do not think you realize the extent to which the trial lawyers affect health care.  I do not have figures on the health industry, but let me give you this one example.  When you go to buy a step ladder, a full 30% of the price you pay is due to lawyers.  That $100 ladder should have only cost you $70, but thanks to trial lawyers, it doesn't.  Now, if lawyers can have that impact on the ladder industry, can you imagine the depth that they have their claws into the health industry?  When  doctor's malpractice insurance premiums run in excess of $100,000 a year, something is seriously wrong.  They would not be that excessive if not for lawyers.  I can only imagine what a hospital pays a year.  If not for all these parasitic lawyers, those premiums would come way down, and those costs would not be passed along to you.  I think so many people just think "hey they have deep pockets, let them pay".  None of these people or entities have money machines.  Doctors do not work for free, and hospitals and insurance companies don't either.  They will make a profit, or they will cease to exist.  Call it what you want, but thats just a fact.  Better regulation should stop some of the tactics used to control costs, but still, the name of the game IS controlling costs.  If you tell an insurance carrier that you can only charge this amount for a premium, and you must pay this and that no questions asked, then you will no longer have these entities. 

Lastly, I was not offering a simplistic anything.  To pick out just one of four points I offered is disengenuous.  My original post was not soley about why health care is pricey, but it was 4 reasons that I absolutely do not wish to see national health care in this country.  I still feel, as stated in the previous post, that the quickest way to reduce health care costs in this country is clamping down on lawyers.  At no time did I say it was the only way, just the quickest.



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