quote:

ORIGINAL: DaddySatyr

Greed and lack of adherence to the Hippocratic Oath.

[/thread]



Peace and comfort,



Michael

quote:

ORIGINAL: servantforuse

You get what you pay for. If you don't like it go to Cuba, like Chaves just did..

quote:

ORIGINAL: SoftBonds
The second major reason has to do with the insurance people do have. Disclosure, I used to work in medical billing.
Medical billing is one of the top growing jobs, and if you can do the work well, you can get a job anywhere, and get paid quite well (compared to other no-degree-required fields). Why is that?
Well, Aetna (to pick an insurance company at random) pays out 81% of the money they collect as premiums to doctors and hospitals or otherwise for care. In other words, their administrative cost is 19% (compared to Medicare's rate of 2% of payments to medical providers). Now a part of that is sales, and clearly they take a profit, and there are a lot of paperwork fees, but a big portion of their costs is the claim denial department. These are the folks who either disagree with the doctor about what care is needed, or who deny a claim because the patient's middle name is spelled wrong.
As a medical billing clerk, when this happens you shrug, note the reason the claim was denied, and work to fix it. Of course, they do anything they can to keep you from realizing what was wrong (e.g. wrong spelling of middle name=no patient in our records with that name), but you get a feel for the problem after a while. If it is a question about medical necesity, you chase down a doctor and get him to write a note on the chart so you can send that note to the insurance company-needless to say, that costs the doctor time, which costs the hospital money.
In any case, there is a small army of medical billing clerks, often 1/doctor or provider, to deal with the insurance companies.
Now ask yourself, does the extra administrative costs to the insurance companies plus the extra costs to the hospital for billing clerks come from thin air? Or does it come from the patients?
I'd estimate that about $2500 of the extra $4000 per person the US spends on health care compared to Europe and Canada is from this cause, vs. about $1500 from the uninsured, but I haven't run the numbers...

quote:

ORIGINAL: SoftBonds

Well, Aetna (to pick an insurance company at random) pays out 81% of the money they collect as premiums to doctors and hospitals or otherwise for care. In other words, their administrative cost is 19% (compared to Medicare's rate of 2% of payments to medical providers).

quote:

ORIGINAL: DesideriScuri

quote:

ORIGINAL: SoftBonds
The second major reason has to do with the insurance people do have. Disclosure, I used to work in medical billing.
Medical billing is one of the top growing jobs, and if you can do the work well, you can get a job anywhere, and get paid quite well (compared to other no-degree-required fields). Why is that?
Well, Aetna (to pick an insurance company at random) pays out 81% of the money they collect as premiums to doctors and hospitals or otherwise for care. In other words, their administrative cost is 19% (compared to Medicare's rate of 2% of payments to medical providers). Now a part of that is sales, and clearly they take a profit, and there are a lot of paperwork fees, but a big portion of their costs is the claim denial department. These are the folks who either disagree with the doctor about what care is needed, or who deny a claim because the patient's middle name is spelled wrong.
As a medical billing clerk, when this happens you shrug, note the reason the claim was denied, and work to fix it. Of course, they do anything they can to keep you from realizing what was wrong (e.g. wrong spelling of middle name=no patient in our records with that name), but you get a feel for the problem after a while. If it is a question about medical necesity, you chase down a doctor and get him to write a note on the chart so you can send that note to the insurance company-needless to say, that costs the doctor time, which costs the hospital money.
In any case, there is a small army of medical billing clerks, often 1/doctor or provider, to deal with the insurance companies.
Now ask yourself, does the extra administrative costs to the insurance companies plus the extra costs to the hospital for billing clerks come from thin air? Or does it come from the patients?
I'd estimate that about $2500 of the extra $4000 per person the US spends on health care compared to Europe and Canada is from this cause, vs. about $1500 from the uninsured, but I haven't run the numbers...

Why are doctors so expensive?

I once heard (though I can't find any definitive evidence to prove or refute the allegation) that the rise of the insurance company has essentially created the rise in care costs. I'm not arguing on it's validity or invalidity, but if it is the cause, what would adding yet another insurance do to roll back costs? Absolutely nothing. If insurance companies are the cause, then perhaps there is something in there that we need to look at more. I'm not for or against insurance companies, to be honest. I understand their reason for being.

Look at auto insurance. I have to have it, whether I need it or not. If I never get into an accident, what has my premiums gotten me, other than poorer? Pretty much nothing.

What happened prior to the rise of the insurance company?

quote:

ORIGINAL: erieangel

When I first started my current job 3 1/2 years ago, I opted for a health plan that had higher premiums but no deductible. I few months later, I had to have some X-rays done. The insurance company sent me a statement after they paid for the X-rays. The lab's charge was somewhere in the vicinity of $250 and the insurance company paid only $56. Cost to me=nothing.

I have sense been forced to save money on a monthly basis by changing my policy and taking the deductible. Next time I need X-rays, I will have to pay the full amount the lab charges.

quote:

Basically, Doctors are paying for a lot of medical billing clerks to fight petty battles against health insurance companies to get paid for their services. Meanwhile, the insurance companies have to pay for the folks that deny claims. That is a lot of people being paid to fight over whether or not you really needed that appendectomy...