God @#%@ I hate our healthcare system

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Ryland

Platinum Member
Aug 9, 2001
2,818
13
81
Im in the same boat. My out of pocket for some tests my wife had done was over $2,000 and I supposedly have decent coverage.
 

Exterous

Super Moderator
Jun 20, 2006
20,431
3,537
126
I'll agree with others that we need more transparent pricing

My OOP is $10K before we get the 80/20 split....shits are not given.

Yes - we get it - you are rich. So rich you cut yourself just so you'd have another reason to spend all that extra money you have
 

TheAdvocate

Platinum Member
Mar 7, 2005
2,561
7
81
Im in the same boat. My out of pocket for some tests my wife had done was over $2,000 and I supposedly have decent coverage.

My employer switched to high deductible plans as our only option. I went from having a $0 deductible to a $6,000 deductible and my premiums only fell $16/mo. On top of that, I am on the hook for 25% of anything I have done, even when I meet my deductible. Basically Im laying out over $1k/mo to self insure. To say I am bitter about it is an understatement. I can actually buy the same coverage through Obamacare, for a little less money.

But insurance isn't the only thing pissing me off. It's the ridiculous "code sheet" that the medical provider community will not disclose and hides behind ("we don't set the code pricing"). It is price fixing, plain and simple, but they put the accountability off on a 3rd party that you cannot contact. Pretty effing convenient, huh?

And it's not even the doctors that are ripping you off, it's the medical facilities and ancillary services/products providers. Case in point - I want to have a minor outpatient surgery that will take about an hour in a generic outpatient office that is basically just another doctor's office that they keep clean. It's a surgery that will improve functionality after an injury I sustained a long time ago (no not my man-bits, or the back door you sickos). Call it a minor knee operation - it's a good example.

Doctor's charge - $4k, but my insurance knocks it down to like $2,800 and I would have to pay $1250 or so.

Facility cost? $23,000. Yes $23,000 for about 1 hr in a suburban strip office center. I think there's a freaking Remax agent in the next office. It's ridiculous. When I asked why the facility is charging almost 6 times what the GD surgeon is charging (you know the guy with the freaking KNIFE cutting me open), they gave me the "codes" BS. I worked my way up to the highest level administrator and point blank asked her to itemize that charge and she flat out refused to do so. So, to use their facility for 45-60 minutes (and they have no special equipment) I am going to have to pay $6,000 + $4,250 ($23k-$6k * 25%) = $10,250, and I won't even have paid the doctor yet. It's insane. Keep in mind I am already shelling out about $13.5k/yr for insurance.

Prior to getting that quote, I had watched a couple of youtube videos about people who had the procedure done, to see if it was worth the hassle of going under the knife. I contacted a couple of those people after I got the quote and asked them how much they paid out of pocket, and the ranges were from $100-$1200, all in. And none of them got a bill for more than $3k (before discounts and insurance) from the facility. They were horrified by my numbers. I'd gladly pay $1K or so for this procedure, but the facility cost is a non-starter.

Problem is - we have two huge health companies who control all medical pricing and procedures in my city - so when I tried to say screw you coke and called pepsi, I got pretty much the same quote.

So I am walking around with diminished physical well being/capacity, despite laying out so much money for insurance, not to mention the huge tax bills I pay.

The fact that I pay in so much money to the system and cannot afford a very minor outpatient procedure shows that this thing is utterly broken. And in my opinion - the biggest problem is on the provider side, not insurance. It's time to scrap the whole system and start over.

Cliffs:

- Insurance deductible way too high ($6k), price barely came down from $0 deductibe plan
- Doctor kinda pricey, but reasonable.
- outpatient surgery center: "bite the pillow, we're going in dry. HAHAHA"
 
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squarecut1

Platinum Member
Nov 1, 2013
2,230
5
46
Fact. The majority of people who have to declare bankruptcy due to medical expenses DO have insurance.
 

Strk

Lifer
Nov 23, 2003
10,198
4
76
I hate my job, but I really am glad for my insurance. $5 preventative, $15 specialist and $75 for an ER visit (waived if admitted) and that's it.
 

gorb

Golden Member
Feb 25, 2011
1,100
90
101
And it's not even the doctors that are ripping you off, it's the medical facilities and ancillary services/products providers. Case in point - I want to have a minor outpatient surgery that will take about an hour in a generic outpatient office that is basically just another doctor's office that they keep clean. It's a surgery that will improve functionality after an injury I sustained a long time ago (no not my man-bits, or the back door you sickos). Call it a minor knee operation - it's a good example.

Doctor's charge - $4k, but my insurance knocks it down to like $2,800 and I would have to pay $1250 or so.

Facility cost? $23,000. Yes $23,000 for about 1 hr in a suburban strip office center. I think there's a freaking Remax agent in the next office. It's ridiculous. When I asked why the facility is charging almost 6 times what the GD surgeon is charging (you know the guy with the freaking KNIFE cutting me open), they gave me the "codes" BS. I worked my way up to the highest level administrator and point blank asked her to itemize that charge and she flat out refused to do so. So, to use their facility for 45-60 minutes (and they have no special equipment) I am going to have to pay $6,000 + $4,250 ($23k-$6k * 25%) = $10,250, and I won't even have paid the doctor yet. It's insane. Keep in mind I am already shelling out about $13.5k/yr for insurance.

Yeah. Things like that are ridiculous. My experiences haven't been as bad as yours but you can see the difference in prices here:
Surgeon billed $464 / Aetna's rate $322.25
Pathology lab billed $207 / Aetna's rate $72.16
Anesthesiologist billed $1,071 / Aetna's rate $712.39
Facility billed $7,149 / Aetna's rate $2,022
 

Jeff7

Lifer
Jan 4, 2001
41,599
19
81
Every other first world country plus some others who are not "first world".

Cuba has a healthcare system vastly superior to American one. Many Middle Eastern countries' citizens have heatlh benefits and facilities that the citizens of the richest nation on earth can barely dream of.

A crying shame...but that is unchecked greed for you
Oh I know that, but as soon as you say something like that, it triggers the built-in communist berserker mode in a lot of people: "Oh, so you want us to be Cuba now? Get out of my country, you damn commie!"
"Terrorist" is a similar trigger word.




Fact. The majority of people who have to declare bankruptcy due to medical expenses DO have insurance.
From the article link I posted:


NerdWallet estimates nearly 10 million adults with year-round health-insurance coverage will still accumulate medical bills that they can't pay off this year.
"With an average American family bringing home $50,000 in income, a high medical bill and a high-deductible insurance plan can quickly become something they are unable to pay," LaMontagne said. "If you have an out-of-pocket maximum of $5,000 or $10,000, that's really tough," he said.
 
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TheAdvocate

Platinum Member
Mar 7, 2005
2,561
7
81
Yeah. Things like that are ridiculous. My experiences haven't been as bad as yours but you can see the difference in prices here:
Surgeon billed $464 / Aetna's rate $322.25
Pathology lab billed $207 / Aetna's rate $72.16
Anesthesiologist billed $1,071 / Aetna's rate $712.39
Facility billed $7,149 / Aetna's rate $2,022

Example #2.

Had tubes put in my toddler son's ears (kept getting infections):

Doctor - $475 - insurance rate
Outpatient facility (We were there for 11 minutes. 11. I know because I called my brother on the phone afterwards and I checked the time of the call) - $7,800.

11 minutes. $7,800.

The local paper ran a story on this (and I was one of the examples they used).

I suspect that the facility is charging what they think you can afford. I am trying not to be that cynical, but a neighbor that makes a lot less than me had his kid's ears done there too and their unadjusted charge was a lot less.
 

Sonikku

Lifer
Jun 23, 2005
15,752
4,562
136
TBH you can ask most surgeons what a prodecure will run and they can give you a pretty accurate cost for what THEY BILL

most of the cost comes from the other hospitial bullshit like charging 500$ for a disposiable gown and other stupid crap like a 300$ dose of asprin. - that shit you cant ask about

if you happen to get an itemized bill its pretty insane what they bill for all that crap. its generally not the Doc who is doing the operation who is charging you an arm and a leg

It's either this or we start choking on Socialism. I will gladly pay $300 for a dose of Asprin because I know that businesses are competing head to head to each other on a free market making everything cheaper and affordable for patients just like me.
 

Scarpozzi

Lifer
Jun 13, 2000
26,389
1,778
126
We're double covered....2 different insurance companies.

I can't tell if it's saved us any money...I just know one deductible out of network is still cheaper than the insurance that's more widely accepted and in-network around here...

I don't know who's more dirty, the insurance companies or the hospitals. I don't blame doctors for getting stuck with the hospitals and insurance companies skimming their profits as they're the only ones actually working....
 

Harabec

Golden Member
Oct 15, 2005
1,371
1
81
It's either this or we start choking on Socialism. I will gladly pay $300 for a dose of Asprin because I know that businesses are competing head to head to each other on a free market making everything cheaper and affordable for patients just like me.

Not an american so I'm sure - are you serious or not? Because that's absurd.
 

squarecut1

Platinum Member
Nov 1, 2013
2,230
5
46
Oh I know that, but as soon as you say something like that, it triggers the built-in communist berserker mode in a lot of people: "Oh, so you want us to be Cuba now? Get out of my country, you damn commie!"
"Terrorist" is a similar trigger word.

Unfortunately that is what they have been programmed to think. Just like the "keep the government off my Medicare!"

There has to be at least a tiny bit of reason that no decent health care system in any country in the world is based completely on free market. Maybe, just a tiny maybe, they realize that free market does not work in a system where the customers are not so much customers but helpless hostages...

Maybe the rest of the world knows something we don't. It is an outrageous thought to many, but maybe it is possible...
 

RadiclDreamer

Diamond Member
Aug 8, 2004
8,622
40
91
TBH you can ask most surgeons what a prodecure will run and they can give you a pretty accurate cost for what THEY BILL

most of the cost comes from the other hospitial bullshit like charging 500$ for a disposiable gown and other stupid crap like a 300$ dose of asprin. - that shit you cant ask about

if you happen to get an itemized bill its pretty insane what they bill for all that crap. its generally not the Doc who is doing the operation who is charging you an arm and a leg

I work for a hospital and all items under $5 are considered part of your daily room fee, this includes tape, needles, bandages, lots of simple meds etc. We also have one of the cheapest bed rates in the state.

Start asking the room rates of your local hospitals, if its high you can bet your behind everything else is as well.

We along with most hospitals bill at midnight, so if you are in the bed at 11:59 and are discharged at 1:05 it counts as a full day. Same goes if you are admitted at 12:01 and stay until 11:59, there is no charge.

Just some FYI tips to help keep your costs down.
 

Jeff7

Lifer
Jan 4, 2001
41,599
19
81
Unfortunately that is what they have been programmed to think. Just like the "keep the government off my Medicare!"

There has to be at least a tiny bit of reason that no decent health care system in any country in the world is based completely on free market. Maybe, just a tiny maybe, they realize that free market does not work in a system where the customers are not so much customers but helpless hostages...

Maybe the rest of the world knows something we don't. It is an outrageous thought to many, but maybe it is possible...
That's probably why I've heard the word "barbaric" used to describe US health care. Medications are advertised like any other product.
The ads for hospitals might as well say, "How much is your life worth? No, seriously, how much are you capable of paying? Remember that if you have kids, they're also going to be willing and able to pay something."



But given the level of corruption in the federal government here, we'd likely end up with more of the same status quo. Those inflated rates would become the new rates, healthcare stocks would go nuts, executives retire early with insane stock bonuses and pensions, and the public gets a rubber-gloved middle finger.
 

bradly1101

Diamond Member
May 5, 2013
4,689
294
126
www.bradlygsmith.org
Just got a bill for $588 and I have good healthcare. I hate how you can go into an office and get a NECESSARY medical procedure completed or evaluated, and you have absolutely no clue what the financial cost will be.

I would have gone to the doctor regardless...but what is the big deal with keeping the cost a secret? Ugggggh


EDIT: I have a $550 deductible and that has already been met. I forgot our company switched from $200 to $550 this year. WHeeee!! My OOP is $1800

I've gotten surprise doc bills too. It cracks me up that they had a sign at the reception desk that said, "All charges are due and payable BEFORE you receive service." That implies that you'll know how much they charge BEFORE your appointment, but that was definitely not the case.
 

gorb

Golden Member
Feb 25, 2011
1,100
90
101
Example #2.

Had tubes put in my toddler son's ears (kept getting infections):

Doctor - $475 - insurance rate
Outpatient facility (We were there for 11 minutes. 11. I know because I called my brother on the phone afterwards and I checked the time of the call) - $7,800.

11 minutes. $7,800.

The local paper ran a story on this (and I was one of the examples they used).

I suspect that the facility is charging what they think you can afford. I am trying not to be that cynical, but a neighbor that makes a lot less than me had his kid's ears done there too and their unadjusted charge was a lot less.


Wow. That's probably the most ridiculous one I've heard of yet
 

SSSnail

Lifer
Nov 29, 2006
17,461
82
86
It's all a scam, designed to be as confusing and obfuscated and full of obstacles as possible, so when you actually have to dispute, it's better just to pay.
 

squarecut1

Platinum Member
Nov 1, 2013
2,230
5
46
It's all a scam, designed to be as confusing and obfuscated and full of obstacles as possible, so when you actually have to dispute, it's better just to pay.

After all this time, it is the same conclusion I have come to. Exact same conclusion
 

Mr. Pedantic

Diamond Member
Feb 14, 2010
5,039
0
76
That's probably why I've heard the word "barbaric" used to describe US health care. Medications are advertised like any other product.
The ads for hospitals might as well say, "How much is your life worth? No, seriously, how much are you capable of paying? Remember that if you have kids, they're also going to be willing and able to pay something."



But given the level of corruption in the federal government here, we'd likely end up with more of the same status quo. Those inflated rates would become the new rates, healthcare stocks would go nuts, executives retire early with insane stock bonuses and pensions, and the public gets a rubber-gloved middle finger.

The fact of the matter is that it's also impossible to have a free market where the customer needs the service more than the provider. That's why you have municipal roads, municipal power, municipal water. These are simply too important to entrust to private entities who have the ability to hold you hostage by threatening to cut your access to necessities of civilisation if you don't comply.
 

ImpulsE69

Lifer
Jan 8, 2010
14,946
1,077
126
Ever since they forced us into HSA from our really good 80/20, I'm scared to even think about going to the doctor. They try to sell it as some wonderful thing, but feels like even more of a scam.
 

sportage

Lifer
Feb 1, 2008
11,493
3,159
136
Well Obamacare was a first step in the right direction i.e. holding insurance co's accountable (kinda), putting in place reforms to benefit the consumer i.e. eliminate caps, eliminate pre-existing, force insurance co's to actually spend more towards insurance and less towards fluff (advertisement). Stuff like that.

But we still live in a greed fed insurance for profit system. Obamacare did not change that nor was Obamacare some goberment takeover.

Next? Universal healthcare.
Why gripe about an $588 bill when all it would take is paying 5% more sales tax, everyone paying an additional 5% sales tax, and that bill would be $-zero- for everyone.

It can be done, don't ya know.
One only needs to mark the correct box on the ballot when they vote.
Don't you get a little sick and tired of hearing millionaires in congress, TV, and talk radio telling you how you don't need or deserve affordable healthcare?
And how wonderful our current unregulated insurance for profit is?
When you hear "for profit", that means one thing.
Someone makes the money, someone spends the money. On their terms, never on yours as the op once again discovered the hard way.
.
.
 
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